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This systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted to determine the effects of grapes and grape products on inflammation and oxidative stress among adults. PubMed, Scopus, ISI Web of Science, and Cochrane Library databases were searched up to July 2020 to identify RCTs investigating the effects of grape and grape products on inflammatory and oxidative stress markers. Weighted mean differences (WMD) were pooled using a random-effects model. Of the 8,962 identified studies, 24 RCTs (27 arms) were included in the statistical analysis. Grape products significantly reduced serum C-reactive protein (CRP) levels (WMD: -0.35 mg/L; 95% CI: -0.62, -0.09, p = .008), but they had no significant effect on serum tumor necrosis factor-alpha (TNF-α) (WMD = -1.08 pg/ml; 95% CI: -2.29, 0.11, p = .07), interleukin-6 (IL-6) (WMD = 0.13 pg/ml; 95% CI: -0.35, 0.60, p = .60), total antioxidant capacity (TAC) (WMD = 0.15; 95% CI: -0.35, 0.65, p = .54), or malondialdehyde (MDA) (WMD = 0.14; 95% CI: -0.64, 0.92, p = .72). The analysis indicated possible decreasing effects of grapes and grape products on CRP, but they might not be able to change IL-6, TNF-α, TAC, and MDA concentrations. Nonetheless, further studies are warranted before definitive conclusions may be reached.

Previous studies have suggested that grape and its products may possess blood pressure (BP)-lowering properties. Due to inconsistencies in results, we aimed to systematically examine the effect of grape products on BP by conducting a meta-analysis of randomized controlled trials (RCTs). PubMed, Scopus, Web of Science (ISI), and Cochrane Library databases were comprehensively searched until March 2020. Human clinical trials which reported the effect of grape products supplementation on systolic BP (SBP) and diastolic BP (DBP) were included. Data were pooled using a random-effects model and expressed as a weighted mean difference (WMD) with a 95% confidence interval (CI). Twenty-eight studies comprising a total of 1344 subjects were included in our meta-analysis. The overall outcome of the meta-analysis indicates that grape products consumption can significantly reduce SBP (WMD: −3.40 mmHg, 95% CI: −6.55, −0.24, p = .03, I2 = 93.4%) and DBP (WMD: −1.69 mmHg, 95% CI: −3.12, −0.27, p = .01, I2 = 80.4%). This meta-analysis found a moderate and statistically significant reduction for either SBP or DBP with grape products compared with controls. Additional high-quality studies are needed to further evaluate the causal conclusions.

Inconsistencies exist with regard to influence of fasting and energy-restricting diets on markers of glucose and insulin controls. To address these controversial, this study was conducted to determine the impact of fasting diets on fasting blood sugars (FBSs), insulin, homeostatic model assessment insulin resistance (HOMA-IR) and hemoglobin A1c (HbA1c) levels. A comprehensive systematic search was carried out in electronic databases, i.e., Scopus, PubMed, and Web of Science through June 2019 for RCTs that investigated the impact of fasting and energy-restricting diets on circulating FBS, insulin, HOMA-IR and HbA1c levels from. Weighted mean difference (WMD) with the 95% CI were used for estimating combined effect size. The subgroup analysis was applied to specify the source of heterogeneity among articles. Pooled results from 30 eligible articles with 35 arms demonstrated a significant decrease in FBS (WMD): -3.376 mg/dl, 95% CI: -5.159, -1.594

This systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to summarize the effect of almond intake on anthropometric indices in adult subjects. We searched PubMed, Scopus, ISI Web of Science, Cochrane Library, and Google Scholar databases until January 2020 to identify relevant RCTs. Data were reported as weighted mean differences (WMDs) and standard deviations (SDs) to show the magnitude of effects of almond on body weight (BW), body mass index (BMI), waist circumference (WC), fat mass (FM), and fat-free mass (FFM). Out of 2983 reports, 28 RCTs (37 arms) were eligible for including in our meta-analysis. The pooled results, obtained using a random-effects model, showed that almond intake significantly decreased BW (WMD: −0.38 kg, 95% CI: −0.65, −0.10, p = 0.007, I2 = 30.5%) and FM (WMD: −0.58 kg, 95% CI: −0.87, −0.28, p < 0.001, I2 = 4.9%). However, we found no significant effect of almond administration on BMI (WMD: −0.30 kg m−2, 95% CI: −0.67, 0.06, p = 0.101, I2 = 62.6%), WC (WMD: −0.60 cm, 95% CI: −1.28, 0.06, p = 0.078, I2 = 0.0%), and FFM (WMD: 0.23 kg, 95% CI: −0.04, 0.50, p = 0.097, I2 = 49.5%). Overall, the current meta-analysis demonstrated that resveratrol almond intake significantly reduced weight and FM, but did not affect BMI, WC, and FFM. Further studies are still required to confirm our results.

Number trials have evaluated the effect of almond intake on glycemic control in adults; however, the results remain equivocal. Therefore, the present meta-analysis aims to examine the effectiveness of almond intake on glycemic parameters. Online databases including PubMed, Scopus, ISI web of science, Embase, and Cochrane Library were searched up to August 2021 for trials that examined the effect of almond intake on glycemic control parameters including fasting blood sugar (FBS), insulin, HOMA-IR, and HbA1C. Treatment effects were expressed as mean difference (MD) and the standard deviation (SD) of outcomes. To estimate the overall effect of almond intake, we used the random-effects model. In total, 24 studies with 31 arms were included in our analysis. The meta-analysis revealed that almond intake did not significantly change the concentrations of FBS, HbA1c, insulin levels, and HOMA-IR. In conclusion, there is currently no convincing evidence that almonds have a clear beneficial effect on glycemic control. Future studies are needed before any confirmed conclusion could be drowned.

Objectives: This study aimed to compare the analgesic effect of single-dose spinal versus epidural analgesia for labor pain to verify if applying a single dose spinal analgesia is an efficient technique for labor pain management as an alternative for epidural analgesia. Methods: A total of 128 women in the active phase of labor were randomly allocated into two groups of spinal analgesia (n = 64) and epidural analgesia (n = 64). The latter received a bolus dose of 16 mL of 0.125% bupivacaine and 50 μg fentanyl and repeated 5 - 10 mL of bolus dose. The former received 2.5 mg hyperbaric bupivacaine plus 50μg fentanyl. Pain intensity was measured using the visual analog scale (VAS). The duration of analgesia, mode of delivery, the duration of labor, side effects, and maternal satisfaction were also compared. Results: There were no significant differences in the rate of cesarean section, duration of labor, postpartum hemorrhage, and the frequency of the fetal heart deceleration until 30 min after analgesia between the two groups. Measured pain after 30 (P = 0.0001) and 90 min (P = 0.01) was significantly lower in the spinal group than the epidural group. However, there was no significant difference between the spinal and epidural groups concerning the VAS scores at 150, 210, and 270 minutes. Maternal satisfaction was higher in the spinal group (P = 0.002). The mean duration of analgesia was longer in the spinal group than the epidural group (P = 0.0001). Conclusions: According to the findings, single-dose spinal analgesia, compared to epidural analgesia, is a safe, fast, and efficient technique for labor analgesia, which can be easily performed. In addition, it provides a high satisfaction level in the parturient.

The aim of this study was to perform a systematic review and meta-analysis of randomized clinical trials (RCTs) to examine the effect of grapes/grape products supplementation on glycemic indices in adults. Our systematic search to find relevant RCTs was performed up to February 2020 using PubMed, Scopus, ISI Web of Science, Cochrane Library, and Google Scholar. Based on the heterogeneity between included studies, a random effects or a fixed model was applied in the meta-analysis, and results were expressed as weighted mean differences (WMD) with 95% confidence intervals (CI). Twenty-nine clinical trials (1,297 participants) fulfilled the eligibility criteria of the present meta-analysis. Overall, the grapes/grape products supplementation significantly reduced homeostatic model assessment of insulin resistance (HOMA-IR) (WMD: -0.54, 95% CI: -0.91, -0.17, p = . 004) but did not affect fasting insulin levels (WMD: -0.90 μIU/ml, 95% CI: -1.04, 2.84, p = .362) and hemoglobin A1C (Hb1Ac) percentage (WMD: 0.00%, 95% CI: -0.10, 0.11, p = . 916) in the main analyses. In addition, changes to fasting blood glucose (FBG) levels were in favor of the control group (WMD: 1.19 mg/dl, 95% CI: 0.05, 2.34, p = .041). We found that giving grapes/grape products to adults might have beneficial effects on the HOMA-IR. Further, large-scale RCTs with longer duration are required to confirm these results.

A number of clinical trials have examined the effect of almond intake on lipid profile in recent years; however, the results remain equivocal. Therefore, the present study aims to summarize and quantitatively examine the available evidence on the effectiveness of almond intake on lipid parameters by employing a systematic review and meta-analytic approach. Online databases including PubMed, Scopus, Embase, and Cochrane Library were searched up to September 2020 for randomized controlled trials that examined the effect of almond intake on lipid profile in adults. Treatment effects were expressed as weighted mean difference (WMD) and the corresponding standard error (SE) in the concentrations of serum lipids. To estimate the overall effect of almond intake, we employed the random-effect model. In total, 27 studies with 36 effect sizes were included in our analysis (1154 cases and 904 control subjects). The meta-analysis revealed that almond intake significantly changed the concentrations of triglycerides (WMD = -6.68 mg dL-1; 95% CI: -11.62, -1.75, p = 0.008), total cholesterol (WMD = -4.92 mg dL-1; 95% CI: -7.81, -2.03, p = 0.001), and low-density lipoproteins (WMD = -5.65 mg dL-1; 95% CI: -8.75, -2.55, p < 0.001); however it did not have a significant effect on high-density lipoprotein (WMD = -0.21 mg dL-1; 95% CI: -1.26, 0.84, p = 0.697) levels. Meta-regression analysis indicated a linear relationship between the dose of almond and change in TG (P = 0.021). This meta-analysis concludes that almond intake can significantly reduce lipid parameters. To draw straightforward conclusions regarding generalized recommendations for almond intake for improving lipid profile, there is a need for more well-controlled trials exclusively targeting patients with dyslipidaemia.

BACKGROUND Hyperinsulinaemia is considered as a major risk factor for the development of a myriad of chronic diseases. We examined the association between the dietary insulinaemic potential and the odds of non-alcoholic fatty liver disease (NAFLD) among Iranian adults. METHODS After being subjected to a liver ultrasound, 166 patients with NAFLD and 200 controls were included in the study. The dietary intakes and the physical activity levels of the participants were evaluated using a validated semi-quantitative food frequency questionnaire and the International Physical Activity Questionnaire (short IPAQ), respectively. The insulinaemic potential of the diet was assessed by computing the scores of the Empirical Dietary Index for Hyperinsulinemia (EDIH) and the Empirical Dietary Index for Insulin Resistance (EDIR). RESULTS Compared with the control subjects, patients with NAFLD were significantly older; had higher values for body mass index, fasting blood sugar, triglycerides, low-density lipoprotein cholesterol, total cholesterol and alanine transaminase; and were more likely to smoke. Moreover, NAFLD patients had significant lower levels of high-density lipoprotein cholesterol and were less likely to perform physical activity. The risk of NAFLD was higher in the individuals in the highest tertile of the EDIH (odds ratio [OR] = 2.79; 95% confidence interval [CI] = 1.32-5.90; p value for trend

Background: The most important psychological problems of dialysis patients are anxiety, depression, and stress. These psychological problems cause different consequences for the patients. ‎Therefore, it seems necessary to use strategies to reduce the psychological problems in hemodialysis ‎patients. Objectives: This study was conducted to evaluate the effectiveness of spiritual therapy on depression, anxiety, and stress in hemodialysis patients referred to the dialysis ward of special diseases center of Birjand in 2019 - 2020. Methods: In this semi-experimental study, 70 patients with chronic kidney disease (CKD) under hemodialysis referred to the dialysis ward of special diseases center of Birjand in 2019 - 2020 were selected by available sampling method and randomized into two experimental groups (35 patients) and control (35 patients). The patients in the experimental group received eight sessions of 60-minute (one session per week) of spiritual intervention therapy, and the control group received no spiritual intervention. Data collection tools were a form of demographic profile and Lovibond SH and Lovibond PF (1995) questionnaire. Data were analyzed using SPSS 26 statistical software, and Fisher’s exact test, chi-square test, independent t-test, repeated measures ANOVA, Bonferroni post hoc test at a significance level of P < 0.05. Results: In this study, 68 patients were ‎examined in two experimental (33 patients) and control (35 patients) groups.‎ The mean score of depression, anxiety, and stress before the intervention in patients in the ‎experimental and control groups was not significantly different ‎(‎P‎ =‎ 0.61‎)‎, but immediately and three ‎months after the intervention in patients in the experiment group was significantly lower than the ‎control group (P < 0.001).‎ Conclusions: Based on the results of the present study, it can be said that spiritual therapy is considered an effective solution for reducing depression, anxiety, and stress in hemodialysis patients.

This meta-analysis was designed to determine the effect of quinoa seed on cardiovascular disease (CVD) risk factors in adults. PubMed, Scopus, ISI Web of Science, and Cochrane library were searched electronically from their inception to February 2020 to identify eligible RCTs. We calculated the pooled estimates of weighted mean differences (WMDs) and their 95% confidence intervals (CIs) by using random-effects models. Five eligible RCTs representing 206 subjects were enrolled. The pooled result showed that quinoa seed supplementation significantly lowered the body weight (WMD: -1.26 kg, 95% CI: -2.35, -0.18, p = .02), waist circumference (WC) (WMD: -1.15 cm, 95% CI: -2.08, -0.21, p = .01), fat mass (FM) (WMD: -0.59%, 95% CI: -1.14, -0.03, p = .03), insulin serum level (WMD: -0.86 pmol/L, 95% CI: -13.38, -1.59, p = .01), triglyceride (TG) (WMD: -7.20 mg/dl, 95% CI: -9.52, -4.87, p .001), total cholesterol (TC) (WMD: -6.86 mg/dl, 95% CI: -10.64, -3.08, p .001), and low density lipoprotein (LDL) (WMD: -3.08 mg/dl, 95% CI: -5.13, -1.03, p = .003) levels. However, no significant changes were seen in other markers (p .05). The current evidence suggests that quinoa seed might be utilized as a possible new effective and safe supplementary option to better prevent and control CVD in humans.

Objective This study was conducted to systematically review the efficacy of panax ginseng supplementation on anthropometric indices in adults. Methods PubMed Scopus ISI Web of Science Google Scholar and the Cochrane library were searched up to February 2018. Randomized controlled trials (RCTs) investigating the effects of ginseng supplementation on anthropometric indices including weight body mass index (BMI) waist circumference (WC) and body fat percentage were included. Pooled effect size measured using random effect model (DerSimmonon method). Results Eleven eligible RCTs were considered. Meta-analysis showed that ginseng did not have any significant effect on weight (MD: -0.038 kg 95 % CI: -0.665 0.589 p = 0.905) BMI (MD: 0.103 kg/m2 95 % CI: -0.080 0.286 p = 0.268) WC (MD: 0.117 cm 95 % CI: -4.385 4.620 p = 0.959) and body fat percentage (MD: -1.137 % 95 % CI: -4.006 1.732 p = 0.437). Moreover no significant effect was observed in subgroup analysis. Conclusion It seems that ginseng supplementation does not affect anthropometric and body composition indices in adults. Further large-scale well-designed studies are warranted.