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The current systematic review and meta-analysis was conducted to evaluate the effects of kiwifruit intake on anthropometric indices and key cardiometabolic parameters. Related articles were found by searching PubMed, ISI Web of Science, and Scopus to detect relevant Randomized Clinical Trials (RCTs) and novel systematic reviews relating to kiwi consumption in adults, up to August 2023. The weighted mean difference (WMD) and 95% confidence intervals (CIs) were calculated using a random-effects model. Heterogeneity, sensitivity analysis, and publication bias were assessed and reported using standard methods. Six RCTs were included in the meta-analysis. Analyzing overall effect sizes demonstrated a significant reduction in low-density lipoprotein cholesterol (LDL) levels (WMD: -9.30 mg/dL; 95% CI: -17.56 to -1.04, p  = .027), whereas no significant alterations of triglycerides (TG) (WMD: -12.91 mg/dL; 95% CI: -28.17 to 2.34, p  = .097), total cholesterol (TC) (WMD: -7.66 mg/dL; 95% CI: -17.85 to 2.52, p  = .141), high-density lipoprotein cholesterol (HDL) (WMD: 2.87 mg/dL; 95% CI: -0.36 to 6.11, p  = .141), fasting blood glucose (FBG) (WMD: 1.06 mg/dL; 95% CI: -1.43 to 3.56, p  = .404), C-reactive protein (CRP) (WMD: 0.15 mg/dL; 95% CI: -0.40, 0.70, p  = .0598), body weight (BW) (WMD: 0.85 kg; 95% CI: -1.34 to 3.04, p  = .448), body mass index (BMI) (WMD: 0.04 kg/m 2 ; 95% CI: -0.75 to 0.83, p  = .920), and waist circumference (WC) (WMD: 0.18 cm; 95% CI: -1.81 to 2.19, p  = .855) were found. Our findings suggest that consuming kiwifruit does not have a significant impact on anthropometric indices and cardiometabolic factors, except for LDL-C levels., Competing Interests: Not applicable., (© 2024 The Author(s). Food Science & Nutrition published by Wiley Periodicals LLC.)

Metabolic acidosis (MA) may play a key role in the pathogenesis of protein-energy wasting (PEW) in patients with chronic kidney disease (CKD). To present a comprehensive synthesis of the effect of oral sodium bicarbonate (SB) supplementation on anthropometric measures in patients with CKD, a systematic review was undertaken in PubMed/MEDLINE, Web of Science, Cochrane CENTRAL, and Google Scholar, of relevant articles published prior to September 2022. The summary statistics of effect size, nonstandardized weighted mean difference (WMD), and 95% confidence interval (CI) were used to compare the effects of SB supplementation on anthropometric parameters vs. control group. To detect probable sources of heterogeneity, a series of predefined subgroup analyses were conducted. In total, 17 studies with 21 treatment arms, including 2203 participants (1149 cases, 1054 controls), met our inclusion criteria and were included in the meta-analysis. SB supplementation had no significant effect on body weight (BW), midarm muscle circumference (MAMC), or lean body mass (LBM) in patients with CKD. There was a significant increase in body mass index (BMI) (MD: 0.59 kg/m 2 , 95% CI: 0.25 to 0.93, p  = 0.001) after SB supplementation in the overall analysis. In subgroup analysis, LBM was increased in studies that were ≥ 24-week duration (MD: 1.81 kg, 95% CI: 0.81 to 2.81) and in participants with BMI lower than 27 kg/m 2 (MD: 1.81 mg/L, 95% CI: 0.81 to 2.81). SB supplementation may yield increases in BMI in predialysis CKD patients. However, our findings did not support the beneficial effects of SB supplementation on other anthropometric outcomes. There is an evident need for long-term high-quality interventions to confirm these findings., Competing Interests: None., (© 2023 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)

We aimed to evaluate the effect of spirulina sauce on glycemic indices, lipid profile, oxidative stress markers, and anthropometric measurement in type 2 diabetic patients. Forty patients were randomly assigned to receive 20 g/day spirulina sauce (containing 2 g of spirulina) or placebo for 2 months. Anthropometric and biochemical indices were measured at the beginning and end of the intervention. Fasting blood glucose (mean difference (MD): -15.3 mg/dL, 95% confidence (CI): -44.2 to 13.60, p  = .26), HbA1c (MD: 0.13%, 95% CI: -0.83 to 0.57, p  = .75), insulin (MD: -1.46 μIU/mL, 95% CI: -4.0 to 1.09, p  = .28), and HOMA-IR (MD: -0.35, 95% CI: -2.0 to 1.32, p  = .68) did not change significantly between groups. QUICKI increased significantly (MD: 0.025, 95% CI: 0.006 to 0.045, p  = .03). Among the lipid profile, triglyceride (TG) (MD: -68.6 mg/dL, 95% CI: -107.21 to -29.98, p  < .001), total cholesterol (MD: -29.55 mg/dL, 95% CI: -55.28 to -3.81, p  = .02), and LDL (MD: -17.7 mg/dL, 95% CI: -33.24 to -2.15, p  = .01) were significantly decreased in the spirulina group compared to the control; whereas, the change in HDL was non-significant. No significant change was observed in body composition and anthropometric measurements, except waist circumference, which was reduced (MD: -2.65 cm, 95% CI: -3.91 to -1.38, p  = .001). Hunger index significantly decreased and fullness increased marginally significantly. Although malondialdehyde was significantly reduced, no change was observed in total antioxidant capacity (TAC). Spirulina sauce was not effective for glycemic control in type 2 diabetes; however, could be useful for controlling appetite and ameliorating lipid profile., Competing Interests: No conflicts of interest., (© 2023 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)

Diet can affect the inflammatory state of the body. Accordingly, the dietary inflammatory index (DII) has been developed to quantify the inflammatory properties of food items. This study sought to investigate the association between dietary inflammation index (DII) and the odds ratio of elevated CRP (E-CRP) through a systematic review and meta-analysis study. The International electronic databases of PubMed, Web of Science (ISI), and Scopus were searched until May 2023 to find related articles. From 719 studies found in the initial search, 14 studies, with a total sample size of 59,941 individuals, were included in the meta-analysis. The calculated pooled odds ratio (OR) of E-CRP in the highest DII category was 1.39 (95% CI: 1.06, 1.14, test for heterogeneity: p  = .63, and I 2  = .0%) in comparison with the lowest DII category. Also, the results of this study showed that each unit increase in DII as a continuous variable generally elicited a 10% increase in the odds of E-CRP (OR 1.10, 95% CI 1.06, 1.14, test for heterogeneity: p  = .63, and I 2  = .0%). Subgroup meta-analyses showed that there is a higher E-CRP odds ratio for the articles that reported energy-adjusted DII (E-DII) instead of DII, the studies that measured CRP instead of hs-CRP, and the studies that used 24-h recall instead of FFQ as the instrument of dietary intake data collection. Individuals with a higher DII were estimated to have higher chances of developing elevated serum CRP. This value was influenced by factors such as the participants' nationality, instruments of data collection, methods used to measure inflammatory biomarkers, study design, and data adjustments. However, future well-designed studies can help provide a more comprehensive understanding of the inflammatory properties of diet and inflammatory serum biomarkers., Competing Interests: The authors declare that they have no conflict of interest., (© 2023 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)

Uncontrolled diabetes can lead to diabetic nephropathy (DN). The aim of the study was to investigate the relationship between different dietary micronutrient patterns and risk of DN in women. This was a case-control study. One hundred and five patients had DN (defined as urinary mg of albumin per gram of creatinine ≥30 mg/g) were chosen as the case and 105 women without DN were chosen as control. Dietary intakes were assessed by a semi-quantitative food frequency questionnaire. Principal component analysis with varimax rotation was used to derive the micronutrient patterns. Patterns were divided into two groups of lower and higher than median. Logistic regression was used to discern and find the odds ratio (ORs) of DN, and its 95% confidence interval (CI) based on the micronutrient patterns in crude and adjusted model. Three patterns which were included, (1) mineral patterns such as chromium, manganese, biotin, vitamin B6, phosphorus, magnesium, selenium, copper, zinc, potassium, and iron, (2) water-soluble vitamin patterns such as vitamin B5, B2, folate, B1, B3, B12, sodium and C, and (3) fat-soluble vitamin patterns such as calcium, vitamin K, beta carotene, alpha tocopherol, alpha carotene, vitamin E, and vitamin A, were extracted. An inverse relationship was found between risk of DN and following mineral patterns and fat-soluble vitamin patterns in adjusted model (ORs = 0.51 [95% CI 0.28-0.95], p  = .03) and (ORs = 0.53 [95% CI 0.29-0.98], p  = .04), respectively. No relationship was seen between water-soluble vitamin patterns and risk of DN in crude and adjusted model but the significance was decreased in adjusted model. The risk of DN was 47% decreased after high adherence of fat-soluble vitamin patterns. In addition, we saw a 49% decrease of risk of DN in high adherence group of mineral patterns. The findings confirm that renal-protective dietary patterns can reduce risk of DN., Competing Interests: The authors declare that there is no competing interest., (© 2023 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)

There have been numerous clinical trials that have investigated the effect of sodium intake on blood pressure in diabetic patients. The purpose of this systematic review and meta-analysis was to evaluate the clinical trial studies performed on the effect of low sodium diet (LSD) versus high sodium diet (HSD) on blood pressure in diabetic patients. PubMed, Scopus, and Web of Science were systematically searched from database inception to July 10, 2021. Both type 1 and 2 diabetes was considered. Overall, there were 15 studies included in this meta-analysis. The weighted (WMD) mean difference with 95% confidence interval (CI) was calculated using a random-effects model. Risk of bias in the studies was assessed based on the Cochrane collaboration tool and the quality of all the studies was considered as good. Overall, LSD significantly reduced SBP (systolic blood pressure) (WMD: -3.79 mmHg, 95% CI: -6.02, -1.56) and DBP (diastolic blood pressure) (WMD: -1.62 mmHg, 95% CI: -2.84, -0.40), in comparison with HSD, in diabetics. However, LSD had no significant effect on MAP (mean arterial pressure) in comparison with HSD (WMD: -1.81, 95%CI: -5.49, 1.87). Although subgroup analysis could not attenuate heterogeneity in SBP, subgroup analysis in DBP based on duration (≤1 week: WMD: -2.35, 95%CI: -3.69, -1.00, I 2  = 48.9%, p  = 0.081, >1 week: WMD: -1.04, 95% CI: -2.83, 0.76, I 2  = 74.7%, p  = 0.003) and study design (cross-over: WMD: -1.94, 95% CI: -2.71, -1.17, I 2  = 32.1%, p  = 0.183, parallel: WMD: -2.17, 95% CI: -6.48, 2.13, I 2  = 82.4%, p  = 0.001) successfully detected sources of heterogeneity. LSD significantly reduced SBP and DBP, however, had no effect on MAP, in comparison with HSD., Competing Interests: Authors had no conflict of interests., (© 2023 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)

Acorn is a nutritious fruit with the reported potential of ameliorating diseases, including diabetes. This research aimed to assess the effects of acorn muffin consumption on glycemic, lipid indices, and appetite in patients with type 2 diabetes. Sixty-six subjects were dichotomized to receive either one muffin containing 10 grams of acorn flour or a placebo muffin containing white wheat flour (no bran), per day, for 8 weeks. Acorn muffin consumption improved glycated hemoglobin ( p  = .06, mean difference [MD] = -0.65), triglyceride ( p  = .06, MD = -36.38), and high-density lipoprotein ( p  = .05, MD = 1.30), albeit only marginally significantly. Among appetite parameters, hunger, desire to eat, and prospective to eat were significantly lower, and satiety and fullness were significantly higher, in the acorn muffin group. In conclusion, acorn muffins could be utilized as an adjuvant therapy to control appetite and ameliorate glycated hemoglobin in patients with type 2 diabetes. However, further investigations are required for a more comprehensive conclusion., Competing Interests: None., (© 2022 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)

Iron deficiency anemia is the most common type of micronutrient deficiency in the world. Adolescence represents a period of increased risk of iron deficiency. Therefore, we aimed to determine the impact of nutrition education by a digital game on markers of iron-deficient anemia in adolescent girls. In this study, 176 adolescent girls were randomly dichotomized into the intervention and control groups. At the beginning and the end of the intervention, knowledge, attitude, and practice of both groups were assessed by a questionnaire. Girls in the intervention group received the necessary education through a digital game during a 14-week period, while those in the control group received basic nutritional education through PowerPoint and pamphlets. Additionally, serum transferrin, serum iron, transferrin saturation, ferritin, CBC difference, and total iron binding capacity (TIBC) tests were checked. In this study, nutrition education significantly increased the level of knowledge, attitude, and practice of adolescent girls regarding their diet ( p  ˂ .05). Hemoglobin level was also significantly raised ( p  ˂ .05). However, no significant effect was observed on other markers of iron-deficient anemia, such as serum iron, TIBC, and hematocrit, in the intervention group compared with the control group ( p  ˃ .05). The results of this study indicated the positive impact of nutrition education based on digital game on knowledge, attitude, and practice scores, as well as a significant difference in hemoglobin. It is recommended that educational games be designed for students in the future to promote health and nutrition information., (© 2022 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)

Pain is a globally prevalent problem, and a comprehension of its pathophysiology is important with respect to patient's health. Musculoskeletal pain conditions (MPs) may be associated with physical, lifestyle, and nutrition status, while dietary acid load (DAL) may be inversely associated with musculoskeletal health in adults. This cross-sectional study consisted of 175 adults experiencing pain. Anthropometric measurements, physical activity (PA), and pain intensity were assessed via specific questionnaires. Dietary data were collected using a 7-day 24-h recall. Foods and beverages were analyzed with Nutritionist IV software for extracting the total energy and nutrients. Net endogenous acid production (NEAP) and potential renal acid load (PRAL) were evaluated for assessing the DAL. Linear regression and Spearman correlation were used to investigate the association of exposure and input variables. Linear regression showed a positive relationship between PRAL and NEAP and pain intensity in the crude model. This significant positive relationship remained after adjusting for all confounders. A lower consumption of potassium, magnesium, vitamin B9 and C, and fiber was seen in the following quartiles of PRAL and NEAP. In addition, MPs intensity and PRAL and NEAP had a weak, positive correlation. This study suggests that a higher DAL may be associated with MPs. However, further research is needed., Competing Interests: The author declares that there is no competing interest., (© 2022 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)

Objective: This study sought to investigate the effect of Spirulina on cardiometabolic risk factors, oxidative stress biomarkers, glycemic profile, and liver enzymes in nonalcoholic fatty liver disease (NAFLD) patients., Methods: This randomized, double-blind clinical trial was performed on 46 NAFLD patients. Subjects were allocated to consume either Spirulina sauce or placebo, each 20 g/day for 8 weeks. Fatty liver grade, liver enzymes, anthropometric parameters, blood pressure, and serum lipids, glucose, insulin, malondialdehyde, and antioxidant capacity were assessed pre- and postintervention., Results: Fatty liver grade was significantly different between the two groups. A significant change for ALT (alanine aminotransferase) and AST (aspartate aminotransferase) was seen between the two groups ( p  = .03 and .02, respectively), while ALP (alkaline phosphatase) serum levels were not significantly different within or between groups. Pertaining to glycemic profile, all variables, except HOMA-IR, were not significantly different within or between groups. Finally, statistically significant changes were seen in both MDA (malondialdehyde) and TAC (total antioxidant capacity) among the groups ( p  = .04 and <.001, respectively)., Conclusions: Spirulina may improve fatty liver grade by modifying liver enzymes, oxidative stress, and some lipid profiles; however, there was effect of Spirulina on anthropometric characteristics and blood pressure., Competing Interests: All authors declare that they have no conflict of interest., (© 2021 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)

Children with hemophilia are an enhanced risk of modifiable cardiovascular and metabolic abnormalities. There is currently no nutritional guideline to prevent or manage cardiometabolic risk factors in these patients. Therefore, the present study sought to investigate the effect of the Dietary Approaches to Stop Hypertension (DASH) diet on cardiovascular and metabolic risk factors among children with hemophilia. In this parallel randomized clinical trial, 40 children (all male) with hemophilia were randomly allocated to the DASH group ( n  = 20) or control group ( n  = 20) for 10 weeks. The intervention group received the DASH diet (50%-55% of energy from carbohydrate, 27%-30% of energy from fat and 16%-18% energy from protein), and the control group received nutritional recommendations based on healthy eating practices. Systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood sugar (FBS), triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were measured at the beginning and end of the study. Serum vitamin C was measured as a biomarker of compliance with the DASH diet. Study was registered at IRCT.ir (IRCT20130903014551N6). A significant increase in serum vitamin C in the DASH diet group was observed compared to the control group ( p  = .001), indicating good compliance with the DASH diet. There was a significant reduction in SBP (-0.48 mmHg), DBP (-0.48 mmHg), FBS (-5.86 mg/dl), TC (-16.07 mg/dl), TG (-17.21 mg/dl), and LDL-C (-9.79 mg/dl), and a significant increase in HDL-C (3.39 mg/dl), in the DASH diet group compared with the control group. Adherence to the DASH diet in children with hemophilia yielded beneficial effects in blood pressure, lipid profiles, and FBS., (© 2020 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)