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Abstract. Background: The aim of this study was to assess the effects of supplementation with flaxseed on anthropometric measurements, lipid profile, insulin resistance, and inflammatory biomarkers in overweight and obese adults. Methods: Fifty overweight and obese adults with body mass index (BMI) of 30.72 ± 3.31 kg/m2 participated in this study. Participants were randomly assigned to take lifestyle advice or lifestyle advice plus 30 g/day milled flaxseed for 12 weeks. The primary outcome was body weight; secondary outcomes included other anthropometric parameters, lipid profile and inflammatory biomarkers. Results: At the end of the study, the following significant mean differences were seen in flaxseed and control groups, respectively: weight [−9.36 vs. −3.09 kg; P 2; P Conclusion: These results suggest that flaxseed supplementation in addition to lifestyle modification is significantly superior to lifestyle modification alone for weight loss. More studies with different dosages of flaxseed are needed to find the optimal dosage. This trial was registered at clinicaltrials.gov as NCT02410668.

Summary Aim The aim of this randomized trial was to find whether resveratrol could improve menstrual dysfunction, clinical signs (i.e., acne and hair loss), and the biochemical evidence of hyperandrogenism in the women with PCOS. Methods Women, in the age range of 18–40 years, diagnosed with PCOS, as defined by the Rotterdam criteria, and no other known cause of abnormal menstruation, were recruited. Participants were randomized based on a 1:1 ratio, to either 1000 mg resveratrol or 1000 mg placebo daily groups, for a period of 3 months. Results Seventy-eight patients were randomized: 39 to the resveratrol group and 39 to placebo. Results were analyzed according to the intention-to-treat principle. At the end of study, it was found that women who received resveratrol had a statistically higher regular menstruation rate, as compared to those who got placebo (76.47% vs. 51.61%; p = 0.03), and lower hair loss (32.10% vs. 68.00%; p = 0.009). We also found no significant differences between the two groups in terms of ovarian and adrenal androgens, sex hormone binding globulin (SHBG) levels, free androgen index (FAI), glycoinsulinemic metabolism and lipid profile. Moreover, the resveratrol treatment did not interfere with the thyroid, liver and kidney functions. The negative effect of resveratrol on the body composition was also observed, though not influencing changes in the weight, relative to the placebo group. Conclusion Resveratrol improved menstrual cyclicity and hair loss, even though levels of androgens, insulin and lipids remained unchanged.

To assess serum vitamin D trend from baseline to 12 months after one anastomosis gastric bypass (OAGB).In this observational cohort analysis of longitudinal data, we assessed the trend of serum vitamin D, and its associations with anthropometric, and biochemical measurements in 98 patients undergoing OAGB in a bariatric surgery center. All participants were on800 IU/day vitamin D supplementation.Vitamin D, lipid profile, creatinine, and albumin levels significantly improved at 12 months post-surgery. Vitamin D concentrations significantly increased from 26.52 ± 12.32 to 54.52 ± 27.90 ng/mL at 12 months. The correlations between vitamin D concentrations and weight, body mass index, lipid profile, ferritin, glycemic indices, and albumin were not significant. In addition, the correlations between vitamin D and parathormone, vitamin D receptor, calcium, phosphorus, body composition, and basal metabolic rate (BMR) did not reach the threshold of statistical significance at 12 months following bariatric surgery. Although there was a significant correlation between body weight and body composition (P 0.001) and basal metabolic rate (BMR) (r = 0.762, P 0.001) at 12 months, there were no significant correlations between weight change percent and body composition (P 0.05), BMR (r = -0.101, P = 0.350), and vitamin D (r = 0.120, P = 0.271) at 12 months.Our results showed that supplementation of vitamin D with dosage of800 IU/day is sufficient for prevention of vitamin D deficiency within 12 months after OAGB surgery. Note: This data is mandatory.

Introduction It has been shown that a high acid load in the human body can affect inflammatory factors and the nitric oxide pathway. These factors are also thought to play an important role in the initiation of migraine attacks. We have therefore explored the association between dietary acid load and odds of migraine in a case–control study. Methods The migraine group (n = 514, diagnosed according to the International Classification of Headache Disorders 3rd edition [ICHDIII] criteria) was recruited from a tertiary headache clinic. The controls consisted of 582 sex-matched healthy volunteers who were randomly selected from the general population. A validated 168-item semiquantitative food frequency questionnaire was used for dietary intake assessments. Estimation of the dietary acid load was performed using three different measures: potential renal acid load (PRAL) score, net endogenous acid production (NEAP) score, and protein/potassium ratio. Results Multivariable logistic regression analysis showed that, in comparison with the lowest tertile, the highest tertile of dietary acid load measures, including PRAL (odds ratio [OR] 7.208, 95% confidence intervals [CI] 3.33–15.55), and NEAP (OR 4.108, 95% CI 1.924–8.774) scores and the protein/potassium ratio (OR 4.127, 95% CI 1.933–8.814), significantly increased the odds of migraine (P value for trend ≤ 0.001). Conclusion In this study, high dietary acid load was associated with higher odds of migraine. It is therefore possible that restricting dietary acid load could reduce the odds of migraine in susceptible subjects. However, due to the preliminary nature of the current evidence, caution is advised in drawing a definitive conclusion. More well-designed studies are required for a better understanding of this important issue. Supplementary Information The online version contains supplementary material available at 10.1007/s40120-021-00247-2.

Miscarriage is a pregnancy condition in which the fetus or embryo naturally dies before being able to survive independently. According to studies, diet and dietary factors are associated with the risk of miscarriage (pregnancies20 weeks). A 168-item semi-quantitative feed frequency questionnaire was used to estimate the Dietary Antioxidant Index (DAI) and the Index of Nutritional Quality (INQ). We aimed to assess the relationship between INQ and DAI with odds of miscarriage.In summary, 135 Iranian women with a history of three or more miscarriages were included. We calculated the INQ using the following formula: INQ = consumed amount of a nutrient per 1,000 kcal/Recommended Dietary Allowance of that nutrient per 1,000 kcal. We standardized each dietary vitamins/minerals by subtracting the global mean and dividing the result by the universal standard deviation to compute DAI. We computed the DAI by summing up the standardized intakes of these vitamins and minerals and equal weight.Regression models were used to extract the odds ratios (ORs) and 95% confidence intervals (CIs) in crude and multivariate adjustments. Controls significantly had higher INQ of vitamin B12, niacin, vitamin D, vitamin E, vitamin C, and zinc. Modeling INQs of vitamin D (OR: 0.004, 95% CI, 0.00-0.025) and B12 (OR: 0.04, 95% CI, 0.005-0.41) as a continuous variable showed a significant and protective effect in multivariate adjustment. Modeling DAI as a categorical variable showed a significant protective effect (ORRecommending a diet rich in antioxidants such as vitamin E, C, zinc, and selenium and a quality diet containing vitamins B12 and D can be considered an effective strategy to reduce the odds of miscarriage in women with a history of recurrent miscarriage.

Summary Objectives Few epidemiological data are available regarding the associations of dietary intakes of polyphenols with non-alcoholic fatty liver disease (NAFLD). We sought to examine the associations of dietary intake of polyphenols with the prevalence of NAFLD. Methods We analyzed data from a case-control study of 225 patients with NAFLD cases and 450 controls. All participants completed a validated 168-item food frequency questionnaire, the results of which were subsequently used to calculate dietary polyphenol. Results Based on multivariate logistic regression analysis, after adjustment for age and sex, it was shown that participants who were in the highest tertile of total flavonoids (OR = 0.65, 95% CI = 0.44–0.98) and total phenolic acids (OR = 0.63, 95% CI = 0.42–0.94) were associated with a lower odds of NAFLD compared with the lowest tertile. Although the association of total flavonoids and the odds of NAFLD disappeared after additional adjustment for BMI, physical activity, smoking, SES, dietary fat, and energy intake (OR = 0.67, 95% CI = 0.38–1.19). The odds of NAFLD was 66% lower (OR = 0.44, CI = 0.24–0.78, p for trend = 0.006) among participants who were in the highest tertile of lignans intake compared with the lowest tertile. Conclusion Our study showed that a high intake of lignans lowers the odds of NAFLD. We strongly recommend that the concepts proposed in this study must be tested in future longitudinal researches, to determine the association of total and subgroup of polyphenol intake with different stages of fatty liver diseases.

Evidence suggests an increasing global trend in non-alcoholic fatty liver disease (NAFLD) prevalence. Researchers have noted the importance of the role of dietary antioxidants in reducing the incidence of NAFLD. The dietary antioxidant index (DAI) is a valid indicator that considers the -diet's total antioxidant properties. The present study was designed and conducted to investigate the relationship between DAI and NAFLD. We hypothesized that there is a link between the DAI and the NAFLD.This case-control study included 295 patients with NAFLD and 704 controls. The patients' dietary intake was assessed through a valid and reliable semi-quantitative food frequency questionnaire. We standardized each of vitamin A, C, E, and selenium, manganese, and zinc by subtracting the global mean and dividing by the global SD to calculate the DAI.Subjects with DAI score -0.46 were at higher odds of having NAFLD compared to subjects with DAI -0.46 ≥ (ORThe role of antioxidants in reducing the odds of NAFLD is fundamental. Taking antioxidants such as vitamins A, E, C, zinc, selenium, and manganese through food can effectively reduce NAFLD odds. On the other hand, studies should examine DAI's sensitivity and specificity in various settings and outcomes to use it in clinical work.

Vitamin D deficiency can be regarded as one of the overgrowing health problem in all of the world. Evidence from a clinical trial suggested a role for probiotic bacteria in increasing vitamin D. However, probiotic's effect is strain specific and this effect should be confirmed about different strains. The objective was to determine if yogurt fortification with probiotic bacteria, Lactobillus acidophilus La‐B5, Bifidobacterium lactis Bb‐12 either alone or in combination with vitamin D can be a complementary treatment for vitamin D deficiency. The end‐points were vitamin D, cardio metabolic lipid profile, anthropometric indices (weight, height, waist, hip, fat mass, lean body mass) and dietary intake. A 10‐week parallel‐group, double‐blind, randomized and controlled trial was conducted on 140 obese men and women. The participants were randomly allocated to receive 100 grams either 1) plain low‐fat yogurt or 2) probiotic yogurt or 3) vitamin D‐fortified yogurt or 4) probiotic and vitamin D cofortified yogurt. All groups received low‐calorie diet. Vitamin D increased significantly in group 4 (p = .008), group 3 (p = .001) and group 1 (p = .012 with no difference between groups. Vitamin D‐fortified yogurt had the most effect size and showed a significant difference versus plain (p = .018) and probiotic yogurt (p = .002). Regarding lipid profile, there were no significant differences between groups. Data from this study does not support the hypothesis that yogurt fortified with probiotic bacteria, Lactobillus acidophilus La‐5 and Bifidobacterium lactis Bb‐12 either alone or in combination with vitamin D might impose any increasing effect on serum level of vitamin D in comparison with vitamin D‐fortified yogurt., A 10‐week parallel‐group, double‐blind, randomized and controlled trial was conducted on 140 obese men and women. The participants were randomly allocated to receive either 1) plain low‐fat yogurt or 2) probiotic yogurt or 3) vitamin D‐fortified yogurt or 4) probiotic and vitamin D co‐fortified yogurt. All groups received low‐calorie diet. vitamin D increased significantly in group 4 (p = 0.008), group 3 (p = 0.001) and group 1 (p = .012 with no difference between groups. Vitamin D‐fortified yogurt had the most effect size and showed a significant difference vs. plain (p = 0.018) and probiotic yogurt (p = 0.002).

Cardiovascular diseases (CVDs) are considered as a major cause of health loss for all regions of the world. Atherosclerosis is one of the most important underlying causes of CVDs. Vascular dysfunction is the primary marker of atherosclerosis. Various studies have investigated the effect of egg intake on CVDs. This study aimed to determine the effect of egg and its derivatives consumption on vascular function.Using a comprehensive search strategy, the searching was conducted on PubMed, Scopus and Google Scholar search engines resources (from inception up to Feb 2020). Intended exposure and outcome were egg or its derivatives intake, and vascular function measuring methods, respectively.A total of 35 papers were found through search databases. Finally, seven trials were included, which were published between 2005 and 2018. Results showed that acute and chronic consumption of whole eggs did not have a significant adverse effect on flow-mediated dilatation (FMD). Also, lutein-enriched egg yolk and egg ovalbumin-derived protein hydrolysate did not have significant positive effects on FMD and pulse wave velocity (PWV), respectively. However, one month egg-yolk-derived phospholipid (PL) preparation intervention increased FMD by 3.4% (p 0.05), and replacing a portion of a glucose challenge with whole eggs or egg whites improved postprandial FMD (p 0.05).We concluded that consumption of whole egg, despite being rich in cholesterol, has no adverse effect on vascular function, and even some of egg derivatives may improve vascular function. Further research is needed to justify the potential effects of egg or its derivatives on vascular function.

Summary Background The aim of this study was to evaluate the effects of supplementation with 109 spores of Bacillus coagulans (GBI-30) plus inulin in patients with non-alcoholic fatty liver disease (NAFLD). Methods In a randomized, double-blind, placebo-controlled clinical trial, fifty three patients with NAFLD were randomly assigned to receive either a synbiotic or a placebo capsule for 12 weeks. The primary outcome was reduction in steatosis score in Fibroscan exam. Results At the end of study, serum alanine aminotransferase and γ glutamine transaminase decreased significantly more in synbiotic group compared to placebo group (p = 0.001, and p = 0.004, respectively). Synbiotic supplementation significantly reduced serum tumor necrosis factor-α (p = 0.03) and nuclear factor-κB activity (p = 0.04). Moreover, hepatic steatosis reduced significantly more in synbiotic group compared to placebo group (p Conclusion Our results indicate that 12 weeks supplementation with B. coagulans plus inulin is beneficial for treatment of NAFLD and its related inflammation without any significant effects on related cardiovascular risk factors. Clinical trials This trial was registered at irct.ir with number of IRCT20100524004010N23.

Background and aim Type 2 diabetes is one of the global epidemic disorders, which causes many side effects on the body. Fructose is a lipogenic monosaccharide. Recent studies have reported the adverse effects of this carbohydrate on diabetes. This study aimed to evaluate the clinical efficacy of a low-fructose diet on the metabolic alterations in patients with type 2 diabetes. Methods This study was a randomized, single-blind clinical trial on 50 patients with type 2 diabetes. Participants randomly allocated to two groups, to receive either diabetic-diet or diabetic-diet with low-fructose for 8-weeks. Anthropometric measurements, systolic blood pressure (SBP), Diastolic blood pressure (DBP) and metabolic factors were assessed at baseline and the end of the trial. Results At the end of trial, reduction in body weight, waist circumference, and blood pressure were not significant except for DBP (P = 0.013). Statistical analysis showed that low-fructose diet compared to control group significantly declined fasting blood glucose (FBG), Hemoglobin A1c (HbA1c), Triglyceride (TG), high-density lipoprotein-cholesterol (HDL-C) and high-sensitivity C-reactive protein (hs-CRP) (P = 0.015, P = 0.001, P= Conclusion Our results showed that eight weeks of low-fructose diet results in a significant improvement in FBG, HbA1c, TG, HDL-C and hs-CRP in patients with type 2 diabetes.

BACKGROUND It is unknown which compounds in spermatozoa or seminal plasma may be involved in the regulation of sperm motility. OBJECTIVES The aim of this study was to investigate the effects of DHA (22:6n-3), vitamin E, and their probable interactions in men with asthenozoospermia. METHODS A factorial, randomized, double-blind, placebo-controlled trial was conducted in infertility clinics in Tehran, Iran. The participants were idiopathic asthenozoospermic men aged 20-45 y, with normal endocrine function. Their concentration of spermatozoa and percentage of morphologically normal spermatozoa were equal to or above the lower reference limits, according to the fifth edition of the WHO guideline. Out of 717 men referred to the infertility clinics, 180 asthenozoospermic men were randomly assigned to 1 of 4 groups according to stratified blocked randomization by age and sperm concentration. Participants took daily 465 mg DHA plus 600 IU vitamin E (DE), 465 mg DHA plus placebo (DP), 600 IU vitamin E plus placebo (EP), or both placebo capsules (PP) for 12 wk. Sperm characteristics, oxidative stress of seminal plasma, serum and sperm membrane fatty acids, dietary intakes, anthropometric measurements, and physical activity were measured at baseline and after 12 wk. RESULTS After the intervention, mean ± SD sperm progressive motility was greater in the DE group (27.9 ± 2.8) than in the DP (25.7 ± 3.4), EP (26.1 ± 2.8), and PP (25.8 ± 2.6) groups (P

BACKGROUND & OBJECTIVE(S): The current evidence base regarding the impact of propolis consumption on lipid profile in humans is equivocal. Thus, we sought to investigate the impact of propolis consumption on anthropometric indices and lipid profile in this meta-analysis. METHODS: Cochrane Library, Scopus, PubMed, and Web of Science electronic databases were searched up to December 2019. A random-effects model used to pool effect size. The leave-one-out method used to conduct sensitivity analysis. RESULTS: Five RCTs were included in this study. Our findings indicated a significant decrease in triglyceride (TG) (WMD: −3.91 mg/dl, 95% CI: −4.22, −3.60), and a significant increase in high-density lipoprotein (HDL) (WMD: 3.41 mg/dl, 95% CI: 0.05, 6.76), however, for body mass index, weight, cholesterol (CL), and low-density lipoprotein (LDL), no significant alterations were evident. CONCLUSION: This study revealed that consumption of propolis is associated with a reduction in TG levels, in addition to an increase in HDL levels. Nevertheless, additional research is required to further delineate the relationship between propolis consumption and lipid profile. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40200-020-00604-2) contains supplementary material, which is available to authorized users.

PurposeThis study aims to investigate the association of vitamin D intake and the risk of depression, anxiety and stress among Tehranian female adolescents.Design/methodology/approachThis cross-sectional analysis included 263 participants. A valid and reliable food frequency questionnaire was used to determine dietary intake of vitamin D. Depression, anxiety and stress scores were characterized by Depression Anxiety Stress Score-21 questionnaire. Multivariable logistic regression was used to estimate the odds ratio (OR) for the occurrence of depression, anxiety and stress according to the tertiles of vitamin D intake.FindingsThe mean ± standard deviation age and body mass index (BMI) of participants were 16.2 ± 1.0 years and 22.2 ± 4.1 kg/m2, respectively. Mean score of depression, anxiety and stress of participants were 9.8 (low-grade depression), 8.4 (low-grade anxiety) and 14.0 (borderline for stress), respectively. In the final model, after adjustment for age, BMI, physical activity, mother/father’s education level, dietary fiber and total energy intake, the OR for depression in the highest compared to the lowest tertile of vitamin D intake was 0.53 (95% confidence interval [CI], 0.24–0.98) (pfor trend: 0.040). Moreover, based on the fully adjusted model, participants in the highest tertile of vitamin D intake had lower odds of stress (OR: 0.49; 95% CI: 0.23–0.93), in comparison to those in the lowest one (pfor trend: 0.021).Originality/valueTo the best of the authors’ knowledge, this is the first study to assess the association of vitamin D intake and risk of psychological disorders, including depression, stress and anxiety in Middle East and North Africa region’s female adolescents.

Purpose Data on relationship between dietary intake of sodium and non-alcoholic fatty liver disease (NAFLD) risk are scarce. This paper aims to find the possible association between sodium intake and NAFLD. Design/methodology/approach This is a case-control study on NAFLD patients proven by a gastroenterologist using Fibroscan, and age-matched controls. Dietary intakes were assessed using a valid and reliable food frequency questionnaire. Findings In the multivariable-adjusted model, after adjustment for potential confounding variables, participants in the highest tertile of sodium intake had a greater risk of developing NAFLD (OR= 2.42; 95% CI: 1.13–5.15) compared to those in the lowest tertile of sodium intake (p-value = 0.023). In sub-analysis, subjects with BMI ≥ 25 in the third tertile of sodium intake had higher risk of NAFLD compared to those in the lowest tertile of sodium intake [(OR: 3.95; 95% CI: 1.75–8.90), (p-value = 0.001)]. However, no significant association was found between tertiles of energy-adjusted daily sodium intake and NAFLD prevalence risk in participants with BMI < 25. Originality/value The findings revealed that higher sodium intake is related with a higher prevalence of NAFLD, an association that can be partly mediated through obesity.

Food insecurity is a major and multidimensional global problem, particularly in rural and vulnerable areas. In this cross-sectional study, we aimed to identify the relationship between social support and food insecurity in 404 Iranian rural households. We selected the sample by cluster random sampling and collected data using three questionnaires [demographic, Multidimensional Perceived Social Support Scale (MSPSS), and United States Department of Agriculture food security questionnaires] and analyzed data using chi-square tests and logistic regression (using SPSS version 19.0). Of the 404 Iranian households, 168 (41.6%) were classified as food secure. The logistic regression analysis revealed that education and job status of the household heads and household income were significantly associated with food security status. Additionally, perceived social support was protective against food insecurity after adjusting for confounding factors [compared with the first quartile, second quartile odds ratio (OR)=1.76, 95% confidence interval (CI): 0.94∼3.3 and fourth quartile OR=2.21, 95% CI: 1.13∼4.33]. This study indicated that social support contributes to a reduced chance of food insecurity in rural households. These results suggest that policy makers should focus on strengthening social support in vulnerable communities to help protect against hunger and poverty.

Limited studies have conducted on the association between carbohydrate intake, glycemic index (GI), glycemic load (GL), and BC risk among Middle Eastern women. Our objective was to examine whether intake of carbohydrates, GI and GL would lead to more risk of BC among Iranian women. In this case-control study, 136 women with histologically confirmed BC and 272 control women were recruited. Dietary intake was assessed using a validated 168-item food frequency questionnaire (FFQ) from which GI and GL were estimated. We calculated Odds ratios (OR) using logistic regression. The multivariate OR for the highest vs. the lowest quartile was 2.49 (95% CI 1.28-4.82; P trend = 0.005) for GI with a significant trend. OR for GI and GL among postmenopausal women were 4.45 (95% CI 1.59-12.47; P trend = 0.002) and 4.15 (95% CI 0.87-19.67; P trend = 0.03), respectively. OR for GI among women with reduced vegetable intake was 13.55 (95% CI 3.90-46.99; P trend

Objective Colorectal cancer is one of the most common cancers in the world, whereas dietary factors are its most modifiable risk factors. The index of nutritional quality is considered as a general overview of the nutrient content of diet. The aim of this study is to determine the relationship between the index of nutritional quality and the risk of colorectal cancer and adenomas. Methods Overall, 129 colorectal cancer and 130 colorectal adenoma cases and 240 healthy controls were studied in three major general hospitals in Tehran province, Iran. Index of nutritional quality scores were calculated based on information on the usual diet that was assessed by a valid and reliable Food Frequency Questionnaire. Multivariate logistic regression was used to estimate the relationship between the index of nutritional quality scores and the risk of colorectal cancer and adenoma. Results After controlling for several confounding factors, the index of nutritional quality of calcium, vitamin C, riboflavin, folate and fiber were associated with decreased risk of colorectal cancer [ORcalcium: 0.21 (0.08-0.52), ORvitC: 0.16 (0.09-0.28), ORvitB2: 0.35 (0.18-0.65), ORfolate: 0.33 (0.16-0.65), ORfiber: 0.35 (0.21-0.58)]. Also, the inverse association were observed between risk of CRA and the index of nutritional quality of calcium, vitamin C, riboflavin, folate and fiber [OR calcium: 0.32 (0.14-0.74), ORvitC: 0.51 (0.34-0.73), ORvitB2: 0.48 (0.28-0.82), OR folate: 0.44 (0.23-0.81), OR fiber: 0.62 (0.42-0.92)]. Conclusion This study showed that individuals who have a healthier diet, high in calcium, vitamin C, riboflavin, folate and fiber and food groups like fruits, vegetables and whole-grain and less in sweets and red or process meats are at a lower risk of colorectal cancer and CRA than those with unhealthy and poor diet.

Purpose The purpose of this paper is to evaluate the possible relationship of dietary glycemic index (GI) and glycemic load (GL) with ulcerative colitis (UC) risks because there is insufficient evidence on the association of GI and GL with UC incidences. Design/methodology/approach In this case–control study, dietary GI and GL of 62 patients with histology-confirmed UC and 124 controls were assessed using a validated semi-quantitative food frequency questionnaire. The primary outcome measure was the association between dietary GI and GL and UC risk. Findings In age-adjusted and unadjusted models, there was no statistically significant association between dietary GI and GL and UC risk. However, after adjusting for all known covariates, the odds ratio of UC in third tertile of GI was 2.86 folds higher than first tertile (95% CI: 1.02–8.00, p for trend = 0.04). In the case of GL, when the confounders were adjusted, although subjects in the third tertile were at 2.70 times higher risk of having UC than those in the first tertile (95% CI: 0.72–10.15, p for trend = 0.15), the association was not statistically significant. Originality/value In conclusion, the findings indicate a positive relationship between dietary GI and risk of UC. Further prospective studies are needed to elucidate if the findings are consistent, in addition to experimental studies to explore the potential mechanisms of this association.

Colorectal cancer (CRC) is the third most common and the third most deadly cancer worldwide. In Iran, CRC is the third and fifth most common cancer in females and males, respectively. Chronic oxidative stress has been implicated in the development of CRC and its precursor, colorectal adenomatous polyps (CAP). While there were a few studies that suggested a favorable role of individuals antioxidants on the CRC risk, the total antioxidant capacity (TAC) of diet has been less investigated. Consequently, the aim of this study is to investigate the association of TAC with the odds of CRC and CAP. This is a case-control study. The participants were 130 cases with incident, histologically confirmed CRC, 134 cases with incident of CAP and 243 hospital-based controls. TAC has been assessed with dietary ferric-reducing antioxidant potential and oxygen radical absorbance capacity method based on collected dietary intake data through a reproducible and valid food frequency questionnaire. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the association between the TAC and CRC and CAP odds were estimated by multiple logistic regression. After controlling for potential confounders, TAC was significantly associated with CRC and CAP odds. (ORQ3-Q1 for CRC = 0.25, 95% CI: 0.13-0.46, Ptrend = 0.001. ORQ3-Q1 for CAP = 0.48, 95% CI: 0.27-0.85, Ptrend = 0.01). The findings of this study suggested an inverse association between TAC and CRC and CAP risk.

PurposeNon-alcoholic fatty liver disease (NAFLD) is the most common cause of liver disease worldwide. The purpose of this study is to assess the possible association between habitual intake of allium vegetables and NAFLD risk.Design/methodology/approachIn this study, 196 cases of NAFLD and 803 age-matched controls were enrolled from the same clinic. Dietary intakes were assessed using a validated food frequency questionnaire. Consumption of allium vegetables, including raw garlic and onions, were calculated and considered as grams/day in all participants.FindingsParticipants in the highest tertile of allium vegetable intake had 64% lower risk of NAFLD compared with those in the lowest tertile of the allium vegetables intake (odds ratio [OR]: 0.35; 95% confidence interval [CI]: 0.23-0.51;p< 0.001). After controlling for potential confounders, there was no significant change in this inverse association (OR: 0.36; 95% CI: 0.22-0.56;p< 0.001).Originality/valueThis study for the first time showed that higher consumption of allium vegetables was associated with lower risk of NAFLD. The results did not change when the authors adjusted the analysis for the known risk factors of the disease, which indicate the independency of the association.

Background As pancreatic cancer (PC) is a malignancy with poor prognosis, finding strategies for its prevention became a notable priority. Among all the factors influencing the risk of PC, dietary items especially fats are considered as the most modifiable risk factors.This study is designed to assess the associations of dietary intake of fatty acids with the risk of PC incidence. Methods A total of 50,045 adults between 40 and 75 years old participated in this cohort study in 2004–2008 and were followed up to the present. Intakes of fatty acids was evaluated by validated food-frequency questionnaire (FFQ). Cox proportional hazards regression model was used to estimate hazard ratio (HR) with 95 % confidence interval of differing levels of dietary intakes of fatty acids for incidence of PC. Results At the end of follow-up period, 76 cases of PC were identified and 46,904 participants without history of cancer, acute kidney disorders, fibrosis and cirrhosis were included in the study. Dietary total saturated fatty acids (SFAS) was associated with PC risk (HR = 1.05 (1.01–1.09), Ptrend=0.01), whereas dietary total monounsaturated fatty acids (MUFAS) was inversely associated with the risk of PC (HR = 0.92 (0.86–0.99), Ptrend=0.04). Dietary total polyunsaturated fatty acids (PUFAS) did show a protective but not significant association with the risk of PC (HR = 0.91(0.84-1.00), Ptrend=0.05). Conclusions The amount of total fat intake is not a risk factor for PC in our study and focusing on the intake of specific fatty acids becomes more striking. Unsaturated fatty acids including PUFAS and especially MUFAS are considered as protective dietary factors in PC prevention. In contrast, total SFAS is positively associated with the increased risk of PC. However, very long chain and odd-chain saturated fatty acids intake may be protective against PC.

Objective There is compelling clinical evidence implicating certain dietary components in the development and clinical course of progression in ulcerative colitis (UC). This study aimed to assess whether any association exists between ulcerative colitis and scores on a healthy eating index. Methods In this case-control study patients with UC were recruited and assessed together with healthy controls. The participants completed a validated 168-item food frequency questionnaire, the results of which were subsequently used to generate individual healthy eating index (HEI-2015) scores. Results Altogether 58 patients with UC and 123 healthy controls were recruited. After controlling for confounding factors, participants who were in the highest quartile of the HEI-2015 had a 66% lower odds ratio (OR) of UC than the lowest quartile (OR = 0.34, 95% confidence interval 0.12-0.96). Conclusion HEI-2015 was associated with UC in this cohort. Further elucidation of the role of key dietary elements is now warranted.

PurposeNeuromyelitis Optica Spectrum Disorder (NMOSD) is a rare disease with unknown risk factors. The role of oxidative stress and nutritional factors is imprecise in NMOSD development. Therefore, this paper aims to evaluate the effects of dietary total antioxidant capacity (TAC) on the odds of NMOSD.Design/methodology/approachDietary TAC was determined in 70 definite NMOSD cases and 164 healthy controls in term of Ferric Reducing Antioxidant Power (FRAP) method. A validated 168-item semi-quantitative food frequency questionnaire (FFQ) was used for dietary assessment. Three multivariate regression models were applied to analyze the odds of NMOSD across the TAC quartiles.FindingsA significant inverse association was found between dietary TAC and odds of being assigned to the NMOSD group in all three regression models. In the fully adjusted model ORs (95% CI) in the second, third and fourth quartiles of TAC vs the first quartile were as follows: 0.11 (0.04-0.29), 0.05 (0.01-0.16) and 0.01 (0.00-0.05), respectively. Odds of NMOSD also indicated a significant decreasing trend across the quartiles of dietary TAC (p-trend: p p p p p p Originality/valueIn the present study, a new hypothesis was proposed concerning the influence of dietary TAC on the odds of NMOSD. A diet rich in foods with high TAC can be effective in the modification of the NMOSD odds.

The present study aimed to evaluate the possible effect of grounded flaxseed and flaxseed oil on serum levels of inflammatory markers, metabolic parameters, and the severity of disease in patients with UC.In this open-labeled randomized controlled trial, 90 UC patients were randomly assigned to one of the 3 groups for 12 weeks: grounded flaxseed (GF; 30 g/day), flaxseed oil (FO; 10 g/day) and control group. The weight, waist circumference, systolic and diastolic blood pressure, serum inflammatory markers (interleukin-6 (IL-6), interferon gamma (INF-γ), transforming growth factor beta (TGF-β), and Erythrocyte Sedimentation Rate (ESR)), and fecal calprotectin were measured at the baseline and end of the study.Totally, 75 patients (43 men and 32 women) with a mean age of 31.54 ± 9.84 years participated in the present study. Comparing the change of the variables indicated a significant decrease in fecal calprotectin (P 0.001), Mayo score (P 0.001), ESR (P 0.001), INF-γ (P 0.001), IL-6 (P 0.001), waist circumference (P = 0.02), Diastolic Blood Pressure (DBP) (P 0.001), and Systolic Blood Pressure (SBP) (P 0.001) and a significant increase in TGF-β (P 0.001) and Inflammatory Bowel Disease Questionnaire-Short form (IBDQ-9) score (P 0.001) in the GF and FO groups compared to the control. No difference was obvious between the FO and GF groups except for TGF-β.The present study showed that both flaxseed and flaxseed oil, attenuate inflammatory markers, disease severity, blood pressure, and WC. However, the effect of flaxseed on weight and BMI was not evident.

Purpose The results of human studies evaluating the efficacy of plant Phytosterols on liver function were inconsistent. Therefore, the purpose of this paper is to eliminate these controversies about the Phytosterols consumption on liver serum biochemistry in adult subjects. Design/methodology/approach The literatures systematically searched throughout PubMed and Scopus databases up to June 2018; it was conducted by using related keywords. Estimates of effect sizes were expressed based on weighted mean difference (WMD) and 95% CI from the random-effects model (erSimonian and Laird method). Heterogeneity across studies was assessed by using I2 index. Eighteen studies reported the effects of Phytosterols (PS) supplementation on liver serum biochemistry. Findings The current meta-analysis did not show a significant effect on ALT (MD: 0.165 U/L, 95% CI: −1.25, 1.58, p = 0.820), AST (MD: −0.375 IU/Liter, 95% CI: −1.362, 0.612, p = 0.457), ALP (MD: 0.804 cm, 95% CI: −1.757, 3.366, p = 0.538), GGT (MD: 0.431 U/L, 95% CI: −1.803, 2.665, p = 0.706) and LDH (MD: 0.619 U/L, 95% CI: −4.040, 5.277, p = 0.795) following PS consumption. Originality/value The authors found that no protective or toxic effects occur after the consumption of Phytosterols on liver enzymes including ALT, AST, ALP, LDH and GGT.

PurposePolyphenols are plant-derived bioactive compounds with some known hepato-protective effects. The purpose of this study is to evaluate the association between polyphenol consumption and risk of nonalcoholic fatty liver disease (NAFLD) and its related conditions such as impaired lipid profile and elevated hepatic enzymes.Design/methodology/approachA total of 196 NAFLD patients and 803 controls were enrolled in this case-control study. Biochemical and anthropometric measurements as well as polyphenol consumption during the previous year were assessed.FindingsIn unadjusted model, participants who consumed the third and fourth quartiles of polyphenols intake were less likely to have NAFLD in comparison to those who consumed the first quartile [odds ratio, OR: 0.48; 95 per cent confidence interval, CI: (0.30-0.77) and OR: 0.62; 95 per cent CI: (0.40-0.96), respectively]. In separate analysis of genders, this effect was seen only in male participants [OR: 0.29; 95 per cent CI: (0.14-0.58) and OR: 0.21; 95 per cent CI (0.10-0.42), respectively], and the association remained significant after adjustment for energy, body mass index, age and smoking.Originality/valueHigher total polyphenol intake is associated with a decreased risk of NAFLD. Prospective studies are needed to confirm these results.

Background Numerous studies have revealed that diet has been considered as an important pathogenic factor for nonalcoholic fatty liver disease (NAFLD). The Index of Nutritional Quality (INQ) is a method of quantitative and qualitative evaluation of single foods and diets, which has special significance in recognizing clinical nutritional problems. Materials and Methods This study included 295 patients with NAFLD and 704 controls. The dietary intake was assessed through a valid and reliable food frequency questionnaire. INQ was calculated from the questionnaire data and was compared between the 2 groups. Results The controls had higher INQ of vitamin D, vitamin E, thiamin, riboflavin, niacin, vitamin B12; biotin, pantothenic acid, magnesium and zinc compared to the patients with NAFLD. After controlling for several covariates, positive associations were observed between NAFLD risk and INQs of riboflavin (ORriboflavin = 0.49, 95% confidence interval [CI]: 0.28-0.78; ORbiotin = 0.35, 95% CI: 0.18-0.76; ORpantothenic = 0.28, 95% CI: 0.12-0.64; ORmagnesium = 0.28, 95% CI: 0.11-0.75; ORzinc = 0.15 95% CI: 0.05-0.42). Conclusions Findings of the present study suggest that subjects who follow a more healthy and nutrient-rich diet, especially in terms of vitamins D, B1, B2, B12, B3 and zinc, are at a lower risk of NAFLD compared to those who consume unhealthy and nutrient-poor diet.

The aim of this study is to examine the relationship between dietary polyphenols' classes and individual polyphenol subclasses and also the risk of Colorectal cancer (CRC) and colorectal adenomas (CRA).A hospital-based case-control study on the association between CRC and CRA and dietary polyphenols was conducted.Overall, 129 colorectal cancers, 130 colorectal adenoma cases and 240 healthy controls were studied in three major general hospitals in Tehran province, Iran.In a multivariate-adjusted model for potential confounders, higher consumption of stilbenes (OR 0.49 for the highest vs. the lowest quartile; 95% CI = 0.24-0.99; p for trend = 0.013) was associated with the decreased risk of CRA. Moreover, an inverse association between the risk of CRC and the intake of total polyphenols (OR 0.05 for the highest vs. the lowest quartile; 95% CI = 0.01-0.19; p for trend=0.001), total flavonoids (OR 0.36 for the highest vs. the lowest quartile; 95% CI = 0.16-0.79; p for trend = 0.005), total phenolic acids (OR 0.24 for the highest vs. the lowest quartile; 95% CI = 0.10-0.56; p for trend = 0.002), anthocyanin (OR 0.21 for the highest vs. the lowest quartile; 95% CI = 0.08-0.55; p for trend = 0.001) and flavanols (OR 0.38 for the highest vs. the lowest quartile; 95% CI = 0.17-0.85; p for trend = 0.001) was observed.The present study showed that a higher intake of total polyphenols, total flavonoids, total phenolic acids anthocyanin and flavanols was related to the decreased risk of CRC. The higher consumption of stilbenes was also inversely associated with the risk of CRA.

The aim of this study was to assess the superiority of low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) diet plus Bacillus coagulans supplementation to low FODMAP diet alone in the reduction of irritable bowel syndrome (IBS) symptoms. In this randomized clinical trial, fifty IBS patients who met Rome IV criteria for IBS were randomly assigned to receive a low FODMAP diet plus either a probiotic or a placebo capsule for 8 weeks. Probiotic capsules contained 109B. coagulans spores and 400 mg inulin, while placebo capsules consisted of 500 mg rice starch. Significant improvements were observed in abdominal pain intensity and frequency, abdominal distension, satisfaction with bowel habits, quality of life, defecation consistency, and patient-reported severity score in both groups; however, only improvement in severity score was significantly higher in probiotic group compared with placebo group (P = 0.001). Moreover, the frequency of patients with clinical improvement in IBS-symptom severity scale (IBS-SSS) was significantly more in probiotic group compared to placebo group (P = 0.038). Our results indicate that the addition of probiotic supplement containing B. coagulans to the low FODMAP diet might be superior to low FODMAP diet in alleviating IBS symptoms.

Migraineurs have been identified to have chronically decreased serotonin levels while its concentrations markedly increase during ictal periods. Regarding the importance of adequate tryptophan intake in regulating serotonin homeostasis and subsequent effect on migraine attacks, we designed the current study. The migraine group (n = 514, diagnosed according to the ICHDIII criteria) was recruited from a tertiary headache clinic. The controls consisted of 582 sex-matched healthy volunteers who were randomly selected from general population. After collecting demographic and anthropometric data, a validated 168-item semi-quantitative food frequency questionnaire (FFQ) was used for dietary intake assessments. Multiple regression models were applied to explore the relationship between migraine and tryptophan intake. The mean (SD) of the age of participants in the controls and migraine group was 44.85 (13.84) and 36.20 (9.78) years, respectively. The multiple regression models were adjusted for age (year), sex, body mass index (BMI) (kg/m2), total daily energy intake (kcal/day), dietary intakes of total carbohydrates (g/day), animal-based protein (g/day), plant-based protein (g/day), total fat (g/day), saturated fat (g/day), and cholesterol (mg/day). It was shown that there is a negative association between tryptophan intake and migraine risk ((OR in the 3rd quartile = 0.46; 95% CI = 0.25–0.85) (OR in the 4th quartile = 0.40; 95% CI = 0.16–0.98) compared with the first quartile; P for trend = 0.045). Therefore, our results showed that subjects who had a median intake of 0.84–1.06 g of tryptophan per day had reduced odds of developing migraine by approximately 54–60%, relative to those consumed ≤ 0.56 g/day.

The aim of this study was to assess the effects of Nigella sativa consumption on inflammatory biomarkers in patients with Non-alcoholic fatty liver disease (NAFLD).This is a randomized, double-blind, placebo-controlled clinical trial. Fifty NAFLD patients were assigned to receive either two gram/day Nigella sativa seed as Nigella sativa group (NSG), or two gram/day starch as placebo group (PG) for 12 weeks.At the end of the study, the serum levels of tumor necrosis factor-α (TNF-α) decreased significantly compared with the beginning of the study in both groups, while the levels of high sensitive C reactive protein (hs-CRP) and nuclear factor kappa-B (NF-κB) only decreased significantly in the NSG (P 0 0.05). Only reduction in the serum levels of TNF-α was significantly more in NSG compared to the PG (P = 0.001). After adjusting the effects of confounding factors, the results remained unchanged. According to Fibroscan exam, hepatic steatosis and its percentage decreased significantly only in the NSG (P 0 0.005); however, the changes were not significantly different between two groups. After adjusting for confounding factors, only steatosis percentage reduction was significantly more in the NSG compared to PG (P = 0.005).Our results have shown that two gram/day consumption of Nigella sativa can reduce inflammatory biomarkers in patients with NAFLD. Further studies with different doses are highly recommended to find the optimal dosage.

Purpose The purpose of this paper is to assess the association between galactose intake and risk of nonalcoholic fatty liver disease (NAFLD). Design/methodology/approach In total, 196 newly diagnosed patients with NAFLD and 803 controls were recruited from a referral hepatology clinic. Dietary intakes were assessed using a validated and reliable food frequency questionnaire. Dietary intakes of galactose were compared between cases and controls. Findings Median (interquartile range) of dietary galactose intake was 2.24 (1.36-3.53) g/day for all subjects. In age and sex adjusted-model, subjects in the highest tertile of galactose intake had more than three times higher risk of NAFLD compared with those in the lowest tertile (odds ratio [OR]: 3.05; 95 per cent confidence interval [CI]: 2.02-4.54), (p-value < 0.001). Additionally controlling for body mass index (BMI), physical activity, energy intake and dietary lactose intake, the direct association between galactose intake and NAFLD remained significant (OR: 2.77; 95 per cent CI: 1.55-4.95), (p-value < 0.001). Originality/value This study was the first one to assess the association between galactose intake and risk of NAFLD.

Background The associations between dietary indices and mortality have not been evaluated in populations from the Middle East, which have different dietary patterns compared to the US and Europe. In this study, we evaluated the association between six dietary indices and mortality in the Golestan Cohort Study (GCS) in Iran, which is the largest prospective study in the Middle East with 50,045 participants. Methods The six dietary indices, namely the Healthy Eating Index (HEI-2015), Alternative Healthy Eating Index (AHEI-2010), Alternative Mediterranean Diet (AMED), Dietary Approach to Stop Hypertension created by Fung (DASH-Fung) and Mellen (DASH-Mellen), and the World Cancer Research Fund (WCRF/AICR) index, were applied to data from a food frequency questionnaire, computed and divided into quintiles. Adjusted Cox models were used to estimate hazards ratio (HR) and 95% confidence intervals (CI) for overall and cause-specific mortality, using the lowest quintile as a reference group. Results Among 42,373 participants included in the current analyses, 4424 subjects died during 10.6years of follow-up. Participants with the highest quintile dietary scores, compared with the lowest quintile dietary scores, had significantly decreased overall mortality in the AHEI-2010, AMED, DASH-Fung, and WCRF/AICR indices (HR 0.88, 95% CI = 0.80–0.97; 0.80, 0.70–0.91; 0.77, 0.70–0.86; and 0.79, 0.70–0.90, respectively). A reduced cardiovascular mortality was found for high AHEI-2010 and DASH-Fung scores (17% and 23%, respectively), and a reduced cancer mortality for high HEI-2015, AMED, and DASH-Fung scores (21, 37 and 25%, respectively). Conclusion Various indices of dietary quality are inversely associated with overall mortality, and selectively with cancer and cardiovascular mortality in the GCS, which contribute to the generalizability and validity of dietary guidelines.

Diabetes mellitus is one of the most common and important metabolic diseases in human. Curcumin, which is a natural polyphenol found in turmeric, can be used in treatment of diabetes complications for its antidiabetic, anti-inflammatory, and antioxidant properties. In this double-blind randomized clinical trial, 44 patients with Type 2 diabetes randomly assigned to curcumin or placebo group. Patients consumed either 1,500-mg curcumin or placebo daily for 10 weeks. Anthropometric measurements were measured at baseline and at the end of the study. Serum concentrations of triglyceride (TG), total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, high-sensitivity C-reactive protein, and adiponectin were determined after 12-hr fasting at the beginning and end of study. The mean serum level of TG decreased in curcumin group compared with baseline (109 ± 36 vs. 124 ± 36; p < 0.05). At the end of study, the mean concentration of high-sensitivity C-reactive protein decreased in the curcumin group compared to the control (2.9 ± 2.9 vs. 3.4 ± 4.2; p < 0.05). The mean serum concentration of adiponectin increased (64 ± 3 vs. 63 ± 4; p < 0.05) in the treatment group compared with the placebo at the end of the study. The results of the current study indicate that curcumin consumption may reduce diabetes complications through decreasing TG level as well as indicators of inflammation.

Background The optimum dosage for vitamin D supplementation has not yet been elucidated in patients with Ulcerative colitis (UC). The aim of this study was to investigate the effects of two vitamin D regimens in UC patients with vitamin D deficiency. Methods In this double blind randomized clinical trial, 50 patients with mild to moderate UC, who met inclusion criteria, received either 1000 or 2000 IU/day of vitamin D (as low dose or high dose group, respectively) for 12 weeks. Serum 25-hydroxy vitamin D (25-OHD) level, total antioxidant capacity (TAC), and Total Oxidant Status (TOS), the inflammatory bowel disease questionnaire − 9 (IBDQ-9) score and the Simple Clinical Colitis Activity Index Questionnaire (SCCAI) score were assessed before and after intervention. Results At the end of study, serum 25-OHD levels significantly increased in the high dose group (P

It is known that diet plays a pivotal role in the pathogenesis and management of nonalcoholic fatty liver disease (NAFLD); however, the knowledge on the role of different food groups such as legumes is not enough. We designed this study to assess the relationship between legume intake and risk of NAFLD in framework of a case-control study among Tehrani adults. One hundred and ninety-six newly diagnosed patients with NAFLD and 803 controls were studied, and their dietary intake was assessed using a valid and reliable food frequency questionnaire. Conditional logistic regression was used to determine the odds ratio (OR) of NAFLD per increase of one serving/week dietary legumes, lentil, and beans adjusting for potential confounders. In energy-adjusted model, greater intake of legumes, lentils, and beans was associated with a lower risk of NAFLD. These risk associations remained significant after adjusting for all known risk factors of NAFLD. OR of NAFLD in adjusted models for higher dietary intake of legumes, lentils, and beans were 0.73 (0.64–0.84), 0.61 (0.46–0.78), and 0.35 (0.17–0.74), respectively. Our findings suggest that higher intake of total legumes (beans, lentils, and peas) was associated with lower risk of NAFLD.

Objectives The aim of this study was to investigate the effects of citrulline (Cit) supplementation on inflammatory markers and liver histopathology in patients with non-alcoholic fatty liver disease (NAFLD). In this clinical trial, fifty NAFLD patients were assigned to receive 2 g/day Cit or placebo for 3 months. Results At the end of study, serum high sensitive C-reactive protein (hs-CRP) and activity of nuclear factor kappa B (NF-κB) were reduced in Cit group significantly more than placebo group (P-value = 0.02 and Trial registration IRCT201703194010N18 on 2017-10-13

Background Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide. Adoption of sedentary life style and westernized diet are shown to be associated with development of NAFLD. Since previous studies suggested that calcium (Ca) to magnesium (Mg) ratio intake is associated with some chronic diseases including dyslipidemia and insulin resistance, we designed this study to find any possible association between this ratio and NAFLD development. Methods The NAFLD was diagnosed using Fibroscan according to a CAP cut-off value of 263 dB/m. Dietary intakes of one hundred and ninety-six patients with incident NAFLD diagnosis, and eight hundred and three controls without NAFLD were assessed using a valid food frequency questionnaire (FFQ). Dietary nutrients were calculated using Nutritionist IV software. Results Age of the study population (57 % female) was 43.2 ± 14.1 years. In addition, energy-adjusted daily calcium to magnesium intake ratio was 2.34 ± 0.57 and 2.73 ± 0.69 for control and case groups, respectively. In the multivariable-adjusted model, after adjustment for potential confounding variables; including, age, gender, BMI, alcohol consumption, smoking, diabetes, physical activity, energy, dietary fiber, carbohydrate, fat, and protein intakes, participants in the third (Q3) and fourth (Q4) quartile of Ca/Mg ratio intake had a greater development of incidental NAFLD compared to the lowest quartile (Q1) [(OR = 2.86; 95 % CI: 1.20–6.81), (P-value = 0.017) and (OR = 5.97; 95 % CI: 2.54–14.01), (P-value r = 0.18; P = 0.01); contrarily, it had no correlation with plasma levels of AST. Conclusions The current study revealed that higher dietary Ca to Mg intake ratio is associated with a greater development of NAFLD. Further interventional studies are needed to confirm the causal relationship of the Ca/Mg ratio intake and development of NAFLD.

Background & aims: Fasting and energy-restricted diets have been evaluated in several studies as a means of improving cardiometabolic biomarkers related to body fat loss. However, further investigation is required to understand potential alterations of leptin and adiponectin concentrations. Thus, we performed a systematic review and meta-analysis to derive a more precise estimate of the influence of fasting and energy-restricted diets on leptin and adiponectin levels in humans, as well as to detect potential sources of heterogeneity in the available literature. Methods: A comprehensive systematic search was performed in Web of Science, PubMed/MEDLINE, Cochrane, SCOPUS and Embase from inception until June 2019. All clinical trials investigating the effects of fasting and energy-restricted diets on leptin and adiponectin in adults were included. Results: Twelve studies containing 17 arms and a total of 495 individuals (intervention = 249, control = 246) reported changes in serum leptin concentrations, and 10 studies containing 12 arms with a total of 438 individuals (intervention = 222, control = 216) reported changes in serum adiponectin concentrations. The combined effect sizes suggested a significant effect of fasting and energy-restricted diets on leptin concentrations (WMD: ?3.690 ng/ml, 95% CI: ?5.190, ?2.190, p ? 0.001; I2 = 84.9%). However, no significant effect of fasting and energy-restricted diets on adiponectin concentrations was found (WMD: ?159.520 ng/ml, 95% CI: ?689.491, 370.451, p = 0.555; I2 = 74.2%). Stratified analyses showed that energy-restricted regimens significantly increased adiponectin (WMD: 554.129 ng/ml, 95% CI: 150.295, 957.964; I2 = 0.0%). In addition, subsequent subgroup analyses revealed that energy restriction, to ?50% normal required daily energy intake, resulted in significantly reduced concentrations of leptin (WMD: ?4.199 ng/ml, 95% CI: ?7.279, ?1.118; I2 = 83.9%) and significantly increased concentrations of adiponectin (WMD: 524.04 ng/ml, 95% CI: 115.618, 932.469: I2 = 0.0%). Conclusion: Fasting and energy-restricted diets elicit significant reductions in serum leptin concentrations. Increases in adiponectin may also be observed when energy intake is ?50% of normal requirements, although limited data preclude definitive conclusions on this point. 2020 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism This work was supported financially by the National Nutrition and Food Technology Research Institute , Shahid Beheshti University of Medical Sciences , Tehran, Iran (Grant Number: 1000328 ). Scopus

Background and objectives Flavonoids are the most important group of polyphenols with well-known beneficial effects on health. However; the association of intake of total flavonoid or their subclasses with all-cause or cause-specific mortality is not fully understood. The present study aims to evaluate the association between intake of total flavonoid, flavonoid subclasses, and total and cause-specific mortality in a developing country. Methods A total number of 49,173 participants from the Golestan cohort study, who completed a validated food frequency questionnaire at recruitment, were followed from 2004 till 2018. Phenol-Explorer database was applied to estimate dietary intakes of total flavonoid and different flavonoid subclasses. Associations were examined using adjusted Cox proportional hazards models. Results During a mean follow-up of 10.63 years, 5104 deaths were reported. After adjusting for several potential confounders, the hazard ratios (HRs) of all-cause mortality for the highest versus the lowest quintile of dietary flavanones, flavones, isoflavonoids, and dihydrochalcones were 0.81 (95% confidence interval = 0.73–0.89), 0.83(0.76–0.92), 0.88(0.80–0.96) and 0.83(0.77–0.90), respectively. However, there was no association between total flavonoid intake or other flavonoid subclasses with all-cause mortality. In cause-specific mortality analyses, flavanones and flavones intakes were inversely associated with CVD mortality [HRs: 0.86(0.73–1.00) and 0.85(0.72–1.00)] and isoflavonoids and dihydrochalcones were the only flavonoid subclasses that showed a protective association against cancer mortality [HR: 0.82(0.68–0.98)]. Conclusion The results of our study suggest that certain subclasses of flavonoids can reduce all-cause mortality and mortality rate from CVD and cancer.

Background Regarding the increasing prevalence of cardiometabolic abnormalities, and its association with non-communicable chronic diseases, providing preventive and therapeutic strategies is a priority. A randomized placebo-controlled study was conducted to assess the effects of combination therapy of milled brown flaxseed and hesperidin during lifestyle intervention on controlling cardiovascular risk in prediabetes. Methods A total of forty-eight subjects were randomly assigned to receive lifestyle intervention plus combination therapy of brown flaxseed (30 g milled) and hesperidin (two 500 mg capsules) or lifestyle modification alone for 12 weeks. Changes from baseline in anthropometric measures, lipid profile and atherogenic indices, glucose homeostasis parameters, and inflammatory biomarkers was assessed as a primary end point. Results Anthropometric data comparison between the two groups showed a significant reduction in weight (p = 0.048). Waist circumference reduction was about twice that of the control group (− 6.75 cm vs − 3.57 cm), but this difference was not statistically significant. Comparison of blood pressure changes throughout the study indicated a greater reduction in blood pressure in the intervention group rather than control group (− 5.66 vs. − 1.56 mmHg, P = 0.049). Improvements of lipid profile and atherogenic indices, glucose homeostasis parameters, and inflammatory biomarkers in flaxseed-hesperidin group was significantly more than the control group after 12 weeks of intervention (p Conclusion Our results indicate that co-administration of flaxseed and hesperidin as an adjunct to lifestyle modification program is more effective than lifestyle modification alone in the metabolic abnormalities remission of prediabetic patients. Trial registration: The trial was registered with ClinicalTrials.gov, number NCT03737422. Registered 11 November 2018. Retrospectively registered, https://clinicaltrials.gov/ct2/results?cond=&term=NCT03737422&cntry=&state=&city=&dist=.

Abstract. Introduction: Neuromyelitis optica spectrum disorder (NMOSD) is a demyelinating inflammatory disease of The Central nervous system. We aimed to investigate the association between low carbohydrate diet (LCD) and NMOSD odds. Method: Seventy NMOSD patients with definite diagnosis and 164 hospital-based controls were enrolled in this case-control study. Dietary data was obtained using a validated 168-item food frequency questionnaire. To determine the LCD score, participants were stratified into 11 groups according to carbohydrate, protein, fat, animal fat, animal protein, vegetable fat and vegetable protein intakes. Higher intake of protein and fat, and lower intake of carbohydrate received a higher score between 0-10. Macronutrients scores were summed together and LCD scores calculated. The association between LCD scores and likelihood of being assigned to NMOSD group was investigated using multiple regression models. Results: Total LCD scores increased from the median of 21.00 in the first decile to 53.00 in the tenth decile of LCD score. After adjustment for confounding factors including age, gender, BMI, energy intake, cigarette smoking and alcohol consumption, an inverse association was detected between LCD scores and odds of NMOSD. The odds of suffering from NMOSD declined significantly about 78% (OR: 0.22; 95% CI: 0.05–0.87) and 76% (OR: 0.24; 95% CI: 0.06–0.93) in the fifth and sixth deciles of LCD score compared to the first decile. Conclusion: From the obtained results it can be speculated that higher carbohydrate and lower protein and fat intakes may be associate with the increased odds of NMOSD. However, further studies are needed to confirm these results.

Resumo Fundamento Os glicocorticóides (GCs) são amplamente prescritos para o tratamento de numerosos distúrbios clínicos devido às suas propriedades anti-inflamatórias e imunomoduladoras, e um dos efeitos indesejáveis mais comuns desses medicamentos é a dislipidemia. Objetivo Avaliar o efeito da quercetina, um flavonoide derivado de plantas, no perfil lipídico de ratos tratados com glicocorticóides em altas doses. Métodos Um total de 32 ratos Sprague-Dawley foram distribuídos aleatoriamente entre quatro grupos (8 ratos por grupo) e tratados por 6 semanas com uma das seguintes opções : (i) solução salina normal; (ii) 40 mg/kg de succinato sódico de metilprednisolona (MP); (iii) MP + 50 mg/kg de quercetina; (iv) MP + 150 mg/kg de quercetina. O MP foi injetado por via subcutânea e a quercetina foi administrada por gavagem oral 3 dias por semana. No final do estudo, o perfil lipídico dos animais foi medido através de kits enzimáticos. Os dados foram analisados e a significância estatística foi estabelecida em p

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease. Nuts are nutrient- and calorie-dense foods with several health-promoting compounds. In this case-control study, we investigated the association between nut intake and NAFLD risk. Hundred ninety-six subjects with NAFLD and eight hundred three controls were recruited. The participants' dietary intakes were assessed by a valid and reliable semi-quantitative food frequency questionnaire (FFQ). Participants were categorized according to deciles of daily nuts intake. Multivariable logistic regression models were used with NAFLD as the dependent and deciles of daily nuts intake as an independent variables. Range of age was 18 to 75 years. Forty three percent of participants were male. Range of nuts intake was between 0 to 90.90 g/day. In model 3, after adjusting for potential confounding variables including, age, sex, BMI, alcohol consumption, smoking, diabetes and physical activity, the relation between daily nuts intake and risk of NAFLD was positive and significant in the deciles 9 and 10 compared to the lowest decile (odds ratio [OR], 3.22; 95% confidence interval [CI], 1.04-7.49; p = 0.039 and OR, 3.03; 95% CI, 1.03-8.90; p = 0.046, respectively). However, in the final model after additional adjusting for energy intake, no significant association was found. According to the findings, there is not any significant relationship between nuts intake and NAFLD risk; while higher intake of nuts is related to the higher risk of NAFLD mediated by energy intake.

Objective The purpose of the present study was to determine the association between energy-dense nutrient-poor snacks intake and the risk of non-alcoholic fatty liver disease (NAFLD) in Iranian adults. For this purpose, a total of 143 cases with a newly confirmed diagnosis of NAFLD and 471 controls free of the disease were studied. Dietary intake was assessed using a food frequency questionnaire. Results The percentage of calories from total energy-dense nutrient-poor snacks was 6.08% and 5.04%, in patients and controls, respectively (P = 0.036). Compared with subjects in the lowest quartile of total energy-dense nutrient-poor snacks intake, the risk of NAFLD for those in the top quartile of consumption increased by about two times, in both crude (OR: 1.94; 95% CIs 1.16–3.26; P for trend = 0.015) and adjusted (OR: 2.27; 95%CIs 1.19–4.31; P for trend = 0.001) models. The relative odds of NAFLD increased significantly in the fourth quartile of dietary cake and biscuit (OR: 1.21, P for trend = 0.037) and soft drinks (OR: 1.64, P for trend = 0.005) intake compared with the lowest corresponding quartiles, after adjustment for age, sex, body mass index, physical activity, alcohol, energy intake. Our results indicate that there might be a moderate positive association between energy-dense nutrient-poor snacks intake and risk of NAFLD.

The relation of some antioxidant nutrients with psychological disorders has been studied previously. The aim of this study was to examine the association between antioxidant vitamin intakes and the risk of depression, anxiety, and stress.This cross-sectional study was conducted on 263 Tehranian female adolescents. Dietary intakes of vitamin E, C, and β-Carotene were determined using a valid and reliable food-frequency questionnaire. Depression, anxiety, and stress scores were characterized by DASS-21 (Depression Anxiety Stress Score-21 items) questionnaire. The multivariable logistic regression models were used to determine the odds ratios (ORs) and 95% confidence intervals (95%CIs) of depression, anxiety, and stress across tertiles of antioxidant vitamin intakes.The mean ± SD age of participants was 16.20 ± 0.97 years. Also, the mean ± SD depression, anxiety and stress scores of participants were 9.89 ± 4.15, 8.43 ± 4.39 and 14.00 ± 6.45, respectively. In the fully adjusted model, subjects in the highest tertile of β-Carotene had a lower prevalence of depression (OR:0.46, 95%CI:0.23-0.95), anxiety (OR:0.40, 95%CI:0.20-0.81), and stress (OR:0.35, 95%CI:0.17-0.73) compared to the lowest tertile (P for trend0.05). Moreover, individuals in the top tertile of vitamin E had a lower prevalence of stress, in comparison to the bottom tertile (OR:0.34, 95% CI:0.13-0.89), (P for trend0.05). However, no significant associations were found between the intakes of vitamin E and C and other psychological disorders.In this study, higher intake of β-Carotene was associated with lower prevalence of depression, anxiety and stress. Also, we found an inverse relationship between vitamin E intake and the risk of stress.

Non-alcoholic fatty liver disease (NAFLD) is growing in prevalence globally and no definitive evidence for any approved pharmacological approaches for patients with NAFLD has been found yet. This study was aimed to assess the clinical effects of flaxseed and hesperidin in patients with NAFLD. In this randomized, controlled, clinical trial, one hundred eligible patients with NAFLD were enrolled and randomly assigned to four dietary intervention groups including lifestyle modification program (control), lifestyle modification program with 30 g whole flaxseed powder, lifestyle modification program with 1 g hesperidin supplementation, and lifestyle modification program with combination of 30 g flaxseed and 1 g hesperidin (flax-hes) for 12 weeks. The changes in anthropometric parameters, metabolic profiles of glucose and lipids, inflammatory biomarkers and hepatic steatosis and fibrosis were evaluated. After the 12-week dietary interventions, significant reductions in body mass index, glucose hemostasis parameters and hepatic steatosis were observed in all groups. Repeated measures analysis of variance revealed a significant effect for time relative to almost all paraclinical parameters. Post hoc analysis with Bonferroni correction revealed that the three intervention groups experienced significant decreases in plasma levels of alanine aminotransferase, indices of insulin resistance and insulin sensitivity, fasting glucose and fatty liver index compared to control (p

Objective Diet quality is known to influence cancer risk. The Healthy Eating Index (HEI) is one of the most frequently used measures of diet quality. However, the association between HEI-2015 and breast cancer risk is not known. The present study was undertaken to evaluate the association between HEI-2015 and breast cancer risk. Methods A case-control study comprising 134 breast cancer patients and 265 cancer-free controls were conducted. Dietary intakes were assessed using a validated food frequency questionnaire (FFQ), from which the HEI-2015 score was calculated. Logistic regression was used to derive the odds ratios (ORs) for measuring the association between HEI-2015 scores and breast cancer risk. Results Subjects in the top quartile of HEI-2015 had a 46% lower chance of breast cancer compared with subjects in the bottom quartile (OR 0.54; 95% CI 0.30, 0.98). After adjustment for potential confounders such as age, age at menarche, oral contraceptive drug use, menopausal status, marital status, body mass index, smoking and education level, the association between HEI-2015 score and a lower risk of breast cancer was enhanced (OR 0.32; 95% CI 0.16, 0.65). Conclusion We successfully demonstrated that a higher HEI-2015 score was associated with a reduced breast cancer risk.

Chronic inflammation is implicated in breast cancer (BrCa) development; however, studies on the association of the inflammatory potential of diet and breast cancer have produced conflicting results. With this as background, we investigated the association between dietary inflammatory index (DII