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The worldwide growing trend of obesity across all ages has increased the number of researches on the obesity management and prevention. Boron is a potential essential trace element and there are some promising results on its weight lowering effect. Therefore, the present meta-analysis was aimed to assess the effect of boron on body weight.Databases including PubMed, Scopus, Cochrane Library, Embase, and Google Scholar were searched from 1995 until November 2021 using the definitive keywords. Searching was limited to articles with English language. Human studies were excluded in our analyses regarding their limited number and the heterogeneity of study designs. All of the relevant animal studies on rodents with weight changes as a primary outcome were included. The assessments of risk of bias and heterogeneity were conducted using the Cochrane Risk of Bias tool and I-square (I2) statistic respectively.According to our findings the overall effect of boron administration orally was significant decrease of body weight (WMD = -18.12 g 95% CI -23.28, -12.96; P 0.001). The boron compound administration was more effective in the borax form and also when the intervention duration was ≤ 4 weeks. Moreover, the effect size was greater in the male gender rather than female animals.Most of the experimental studies supported the weight lowering effect of boron although, there are a few inconsistent evidences. It seems that the weight lowering effect of boron may be through increasing the energy metabolism, thermogenesis, lipolysis and inhibition of adiposeness. However, future clinical trials can better clarify the effects of boron on obesity management.

Smoking is a common public problem leading to increases in oxidative stress and decreases in the levels of some micronutrients, finally affecting adipokine levels. The aim of this study was to compare the serum levels of omentin (intelectin-1), chemerin, TNF-α, and some micronutrient intakes in male smokers and non-smokers.40 male smokers and 40 male non-smokers with a mean age of 38.6±14.1 years were included in this study. Serum levels of omentin, chemerin, and TNF-α were measured. To calculate the daily intake of energy, carbohydrate, protein, fat, and some of the micronutrients, the 24-h recall and semi-quantitative food frequency questionnaire (FFQ) was used.Omentin, chemerin, and TNF-α levels in male smokers were lower than non-smokers, but these differences were not statistically significant. However, after adjustment for total and saturated fat intakes and age, omentin (β=138.4, p=0.027) and TNF-α (β=144.5, p=0.015) revealed significant differences.The serum levels of omentin, chemerin, TNF-α, and some micronutrient intakes were not significantly different between smokers and non-smokers. Further population studies are needed to clarify this subject.

Background: Malnutrition is an acute or a chronic condition resulting from an imbalance in the intake, both in the form of undernutrition and over nutrition, leading to changes in the composition or reduced function of the body. Bio-social conditions and acute or chronic diseases are the most important factors affecting nutrition. It has been suggested that awareness of the prevalence and severity of malnutrition in hospitalized patients can be used by managers to understand the causes, health care system requirements, and health plans. Methods: Medical records of 483 patients from 11 different wards of Shariati general hospital were assessed to evaluate the quality of nutritional assessment and the rate of referral to nutrition experts by physicians. This study consisted of two phases: evaluation of initial nutritional assessment and assessing the accuracy of malnutrition screening forms completion. Results: Our study showed no initial nutritional assessment for 34% of the patients. Assessment of the accuracy of malnutrition screening showed that there was a considerable error in the reporting of BMI (66%), weight loss (51%), appetite loss (50%), and severity of the patient’s situation (39%). Also, the rate of referral to a nutritionist was 0% and 1% in the first and second phases of the study, respectively. Conclusion: The present study showed that the quality of nutritional screening and subsequent referral to nutrition experts for professional nutritional assessment is negligible in Shariati hospital, Tehran, Iran.

Cardiovascular disease (CVD) is the leading cause of death in children with chronic kidney disease (CKD) and accounts for 40% of all deaths among pediatric patients with stage 5 chronic kidney disease (CKD 5). Dyslipidemia is common in children with CKD and is considered one of the major causes of CVD in these patients. As carnitine plays a key role in lipid metabolism and because plasma levels are reduced in hemodialysis patients, the aim of this study was to determine the effects of L-carnitine supplementation on serum lipid profiles, apolipoproteins, and free carnitine (FC) levels. A total of 30 children on hemodialysis (6–18 years) were enrolled and 24 completed the study. Twelve patients received 50 mg/kg/day L-carnitine, while the other 12 patients received placebo for 10 weeks. Serum FC, total cholesterol (TC), LDL-C, HDL-C, TG, Apolipoprotein B (ApoB), and Apolipoprotein A1 (ApoA1) were determined at the baseline and after the intervention. One-way repeated measures analysis was used to evaluate the effects of L-carnitine supplementation. Oral L-carnitine supplementation led to decreased ApoB levels and ApoB/ApoA1 ratio, but these changes were not significant compared to placebo. Meanwhile, L-carnitine supplementation significantly reduced serum LDL-C and TC and increased serum FC compared to placebo. No significant changes were observed in serum TG and HDL-C levels. Given the significant reduction in LDL-C and TC levels, L-carnitine supplementation had positive effects on improving hyperlipidemia in children receiving hemodialysis. For more decisive results, studies with longer duration of L-carnitine therapy on children receiving hemodialysis with significant dyslipidemia are recommended. We registered the present trial in the Iranian Registry of Clinical Trials website (available at: http://www.irct.ir , identifier: IRCT20170202032367N2).

Background Most studies have shown beneficial effect of bariatric surgery (BS) on serum levels of sex hormones. Objective A systematic review and meta-analysis was conducted to examine the magnitude of possible changes in levels of sex hormones following BS. Settings Electronic databases were searched, including PubMed, Scopus, Web of Science, and Embase, for relevant studies. Methods The heterogeneity of the studies was examined by χ2 tests and the degree of heterogeneity was estimated using I2 statistic. Results The results of pooled analyses revealed that BS caused a significant increase in luteinizing hormone (LH), follicular stimulating hormone (FSH), total testosterone (TT), and sex hormone binding globulin (SHBG) levels and conversely, decreased dehydroepiandrosterone (DHEA) and estradiol (E2) levels in males. For females, BS significantly increased LH, FSH, and SHBG levels and conversely, decreased androstenedione (AE), E2 and TT levels. Additionally, the level of progesterone (P), prolactin (PRL), free testosterone (FT) and dehydroepiandrosterone sulfate (DHEA-S) showed no significant changes in patients who had undergone BS. Conclusion BS changed most sex hormones levels including LH, FSH, TT, SHBG, AE, DHEA, and E2. It seems that BS is able to exert substantial impacts on sex hormones levels and as well as sexual function, however, larger, and more precise trials are required to specifically focus on these claims.

Summary Background Several mechanisms have been proposed for the effect of vitamin E on weight loss. Yet various interventional studies with wide ranges of doses and durations have reported contradictory results. Methods Cochrane Library, PubMed, Scopus, and Embase databases were searched up to December 2020. Meta-analysis was performed using random-effect method. Effect size was presented as weighted mean difference (WMD) and 95% confidence interval (CI). Heterogeneity was evaluated using the I2 index. In order to identification of potential sources of heterogeneity, predefined subgroup and meta regression analyses was conducted. Results A total of 24 studies with 33 data sets were included. There was no significant effect of vitamin E on weight (WMD: 0.15, 95% CI: −1.35 to 1.65, P = 0.847), body mass index (BMI) (WMD = 0.04, 95% CI: −0.29 to 0.37, P = 0.815), and waist circumference (WC) (WMD = −0.19 kg, 95% CI: −2.06 to 1.68, P = 0.842), respectively. However, subgroup analysis revealed that vitamin E supplementation in studies conducted on participants with normal BMI (18.5–24.9) had increasing impact on BMI (P = 0.047). Conclusion There was no significant effect of vitamin E supplementation on weight, BMI and WC. However, vitamin E supplementation might be associated with increasing BMI in people with normal BMI (18.5–24.9).

Obesity and overweight are associated with the burden of chronic diseases. The aim of the present meta-analysis is to determine the efficacy of spirulina in reducing of obesity indices. PubMed, Web of Science, Scopus, EMBASE and Cochrane library databases were searched up to November 2019. Randomized controlled trials comparing spirulina supplementation with a placebo or no treatment for anthropometric indices were included. Meta-analysis was performed using random-effects model. Subgroup analysis and meta-regression were carried out. Publication bias was evaluated using standard methods. Spirulina had ameliorative effects on weight (WMD = −1.85 Kg; 95% CI: −2.44, −1.26; p < .001; I2 = 82.4%, p < .001), and waist circumference (WMD = −1.09 cm; 95% CI: −2.16, −0.01; p = .046; I2 = 0.0%, p = .757) while no significant effect was shown on body mass index, even after sensitivity analysis (SMD = −0.53 Kg/m2; 95% CI: −1.25, 0.19; p = .149; I2 = 92.9%, p < .001); however, spirulina was effective in studies lasted for at least 12 weeks (SMD = −1.25 Kg/m2; 95% CI: −2.21, −0.28; p = .011; I2 = 90.8%, p < .001). Spirulina supplementation exerts beneficial effects on weight and waist circumference. The ameliorative effect of spirulina on body mass index was revealed in longer duration of supplementation.

PurposeStudies investigating the association between dietary inflammatory index (DII) and body mass index (BMI) have led to inconsistent findings. Therefore, to decisively conclude, this paper aims to clarify the relationship between DII and obesity by performing meta-analysis.Design/methodology/approachPubMed, Scopus and Google Scholar were searched up to July 2017 using key words selected from Medical Subject Headings and other related keywords to identify all relevant articles. In total, 22 articles were entered into the meta-analysis; 22 studies compared the mean of BMI among subjects with highest versus the lowest DII and 4 studies had data on the hazard risk (HR) or odds ratio (OR) for obesity.FindingsA meta-analysis on included studies indicated a significant association on either mean differences (MD) in BMI (MD = 0.811; 95 per cent CI: 0.365-1.256;p: 0.0001) or obesity OR (OR: 1.310; 95 per cent CI: 1.144-1.500;p= 0.000) by comparing the highest and lowest DII categories. Between-study heterogeneity was high (Cochrane Q test,p< 0.001, I2= 98.1 per cent, df = 21, τ2= 0.9273), and only dietary assessment methods could explain the source of heterogeneity in which 24-h dietary recalls were homogeny (I2= 8.4 per cent, df = 2,p= 0.335).Originality/valueThe results of the present meta-analysis suggest that adherence to high DII score increased BMI and obesity. More prospective studies in different populations are needed to better clarify this relation.

Background & objective(s) No meta-analysis is available on the effect of Nigella sativa (NS) on obesity indices. This systematic review and meta-analysis was conducted to systematically review the available Randomized Clinical Trials (RCTs) that examined the effects of NS on Body Weight (BW), Body Mass index (BMI), and Waist Circumference (WC) in adults. Methods Relevant articles published up to January 2018 were searched through PubMed/Medline, SCOPUS, Cochrane Library, and Google Scholar databases, using relevant keywords. All RCTs that examined the effect of NS supplementation on BW, BMI, or WC were included. Results Overall, thirteen RCTs, including 875 subjects (64% males) were included in this study. Combining effect sizes from ten studies, NS supplementation significantly reduced BW (Weighted Mean Differences (WMD): −1.76 kg, 95% CI: −3.34 to −0.17, I2 = 87.4%), as compared to placebo. Subgroup analysis by the intervention type (I2 = 0.0%), participants’ gender (I2 = 0.0%), and age (I2 = 5.5%) removed between-study heterogeneity. A significant reduction was seen in BMI (WMD: −0.85 kg/m2, 95% CI: −1.23, −0.46, I2 = 70.6%) after NS supplementation than placebo among eleven trials. Subgroup analysis based on study duration (I2 = 0.0%), participants’ gender (females: I2 = 0.0% & both genders: I2 = 20.9%), an age (I2 = 35.9%) disappeared the heterogeneity. However, no significant reduction was found in WC comparing NS supplementation to placebo (WMD: −4.04 cm, 95% CI: 11.37, 3.27, I2 = 97.8%) in five studies. Conclusions We find a significant effect of NS supplementation on BW and BMI in adults. However, the effect of NS supplementation on WC was not significant in this meta-analysis.

Since, the main cause of death in Rheumatoid arthritis (RA) patients is the presence of type 2 diabetes, abnormal increase in blood lipids, blood pressure and obesity, the aim of this study was to assess the effects of Barberry on the anthropometric indices and metabolic profile in patients with RA.present study was a double-blinded, placebo-controlled randomized clinical trial.70 active RA patients were randomly allocated into intervention or placebo group INTERVENTION: Participants received 6 capsules of 500 mg barberry extract or placebo for 3 months.Serum levels of fasting blood sugar (FBS), triglyceride (TG), LDL cholesterol (LDL-C) and HDL cholesterol (HDL-C), systolic and diastolic blood pressure and anthropometric factors were assessed at baseline and at the end of the trial.The results of intervention on 62 patients showed that weight, BMI, and conicity index increased in both groups, but this was significant only in the placebo group (p0.001). Waist and hip circumference were decreased in the intervention group and increased significantly in the placebo group (p0.001). Body fat percent (p = 0.04), LDL-C (p = 0.05) and SBP (p = 0.02) significantly were decreased in the intervention group. The results showed a significant decrease in body fat percent (p = 0.05), hip circumference (p0.001), FBS (p = 0.03) and HDL-C (p = 0.03) in the intervention group compared to the placebo.Overall, the results of this study demonstrated that the extract of Berberis Integerrima had beneficial effects on metabolic profile and anthropometric indices in RA patients.

Background A meta-analysis is needed to comprehensively consolidate findings from the influence of metformin on IGF-1 levels. The present study was conducted with the objective to accurately evaluate the influence of metformin intake on IGF-1 levels via a meta-analysis of randomized controlled trials. Methods A comprehensive systematic search was carried out in PubMed/MEDLINE, Web of Science, SCOPUS and Embase from inception until June 2019. Weighted mean difference (WMD) with the 95 % CI were applied for estimating the effects of metformin on serum IGF-1 levels. Results 11 studies involving a total of 569 individuals reported changes in IGF-1 plasma concentrations as an outcome measure. Pooled results demonstrated an overall non-significant decline in IGF-1 following metformin intake (WMD: -8.292 ng/ml, 95 % CI: -20.248, 3.664, p = 0.174) with heterogeneity among (p = 0.000,I2 = 87.1 %). The subgroup analyses displayed that intervention duration Conclusion We found in children, intervention duration 18 years old, metformin intake significantly increased IGF-1. We suggest that caution be taken when interpreting the findings of this review, particularly given the discordant supplementation practices between children and adults.

Recently, obesity has become a common worldwide concern. Leptin, as an adipocytokine, plays a major role in the etiology of obesity. Prior studies have demonstrated that zinc potentially affects serum leptin levels. However, clinical trials carried out in this regard are not consistent. Therefore, current meta-analysis was conducted to ascertain the actual effect of zinc supplementation on serum leptin levels in adults. Databases of PubMed, SCOPUS, and Google Scholar were methodically searched to identify relevant articles up to April 2018. Clinical trials that examined the effect of zinc supplementation on serum leptin concentrations as outcome variables in human adults were included. The mean difference (SD) of leptin changes in the intervention and placebo groups were used to calculate the overall effect size. Totally, 663 articles were identified, of which 6 studies were eligible randomized controlled trials (RCTs) with 7 treatment arms. The analysis suggested that zinc supplementation exerts no significant effect on overall serum leptin (WMD: 0.74 ng/ml; 95% CI: −1.39 to 2.87, p=0.49). Nevertheless, sex and duration of intervention seemed to impact the extent of zinc’s influence. In trials with female subjects, zinc consumption led to a significant decrease in serum leptin level (WMD: −1.93 ng/ml; 95% CI: −3.72 to −0.14, p=0.03) as well as trials that lasted for more than 6 weeks (WMD: −1.71 ng/ml; 95% CI: −3.07 to −0.35, p=0.01), in comparison to the control group. Zinc supplementation did not significantly improve leptin concentrations, but it may result in a decreased circulating leptin level in studies with a duration of more than 6 weeks especially among females.

Background: Studies have shown that evening primrose oil (EPO) supplementation might be effective in improving lipid profile, however, the results are inconsistent. This study was performed to determine the direction and magnitude of the EPO effect on the lipid profile. Methods: PubMed, Scopus, Cochrane Library, Embase and Web of Science databases and Google Scholar were searched up to September-2019. Meta-analysis was performed using the random-effects model. Lipid profile including high-density lipoprotein (HDL), total cholesterol (TC), triglyceride (TG), and low-density lipoprotein (LDL) was considered as the primary outcome. Results: A total of 926 articles were identified through database searching, of which, six RCTs were included in the meta-analysis. There were six studies on HDL, TC, and TG and four studies on LDL. EPO supplementation had no significant effect on TC, TG, LDL, and HDL. However, in subgroup analysis, a significant reduction in TG at a dose of �4 g/day (weighted mean difference WMD = �37.28 mg/dl; 95% CI: �73.53 to �1.03, p =.044) and a significant increase in HDL in hyperlipidemic subjects (WMD = 5.468 mg/dl; 95% CI: 1.323 to 9.614, p =.010) was found. Conclusion: Oral intake of EPO at a dose of �4 g/day significantly reduces serum TG levels and significantly increases HDL levels in hyperlipidemic subjects. © 2020 John Wiley & Sons, Ltd.

Background N-acetyl cystatin (NAC) potentially can contribute to weight changes due to its antioxidant activities. Aim of the review we carried out a systematic review and meta-analysis of randomized clinical trials in order to examine whether NAC consumption can result in any changes in anthropometric indices. Methods Using appropriate keywords, we searched online databases of PubMed-Medline, SCOPUS, Web of Science, Embase databases and Google Scholar, published for relevant articles up to Nov 2019. Random-effect model was employed to report weighted mean differences. Sensitivity and subgroup analyses were carried out. Results A number of 7 eligible studies were identified. The results indicated no significant effect of NAC on BMI, weight and WC [(SMD=-0.08 Kg/m2 ; CI: -0.25, 0.08; P = 0.335, I2 = 0.0 %, P = 0.967), (SMD= -0.38 Kg; 95 % CI: -2.11, 2.87; P = 0.766, I2 = 0.0 %, P = 0.691) and (SMD= -0.22 Cm; 95 % CI: 0.52, 0.08; p = 0.153, I2 = 0.0 %, P = 0.826), respectively. No effect of sensitivity and subgroup analyses were observed. Conclusion There was no significant effect of NAC supplementation on obesity indices. As far as we assessed anthropometric factors mainly as the secondary outcome in these studies rather than the main outcome, more specific trials are suggested to assess this relationship precisely.

Prolonged inflammation could be considered as the leading cause of chronic diseases such as cardiovascular disorders, type two diabetes, and obesity. N-acetylcysteine (NAC) is considered an antioxidant. The present meta-analysis aims to determine the efficacy of NAC in alleviating inflammation and oxidative stress. PubMed-Medline, SCOPUS, Web of Science and Embase databases and Google Scholar were searched up to Nov 2019. Random effect analysis was used to perform meta-analysis. Subgroup analyses were carried out to find heterogeneity sources. Meta-regression analysis was used to explore linear relationship between effect size and variables. Trim and fill analysis were performed in case of the presence of publication bias. Quality assessment was performed using Cochrane Collaboration's tool. A total of 28 studies were included in meta-analysis. NAC significantly decreased malondialdehyde (MDA) (SMD = -1.44 μmol/L; 95% CI: -2.05, -0.84; P 0.001), IL-8 (WMD = -2.56 pg/ml; 95% CI: -3.89, -1.23; P 0.001) and homocysteine (WMD = -1.45 pg/ml; 95% CI: -2.74, -0.17; P = 0.027) levels. There were no significant effects of NAC supplementation on CRP (SMD = -0.1 g/L; 95% CI: -0.52, 0.32; P = 0.647), TNF- α (WMD = -0.2 pg/ml; 95% CI: -0.65, 0.25; P = 0.378) and IL-6 (WMD = -0.41 pg/ml; 95% CI: -1.15, 0.32; P = 0.270) levels. However, NAC effects were significant in ameliorating TNF-α and IL-6 using sensitivity analysis. NAC significantly decreased MDA, IL-8, and homocysteine levels. The effects of NAC on amending TNF-α and IL-6 levels were significant after sensitivity analysis. No significant change was observed on CRP levels.

Background and purpose: Clinical studies investigating the effects of berberine supplementation on anthropometric indices in humans have generated inconsistent results. Thus, the objective of this systematic review and meta-analysis was to clarify the effects of berberine supplementation on obesity indices in human subjects. Methods Several online medical databases were systematically searched up to February 2019. All clinical trials exploring the effects of berberine supplementation on indices of obesity were included. The combined weighted mean difference (WMD) of eligible studies was assessed using a random-effects model. We evaluated publication bias by using the Egger's test. Results Overall, 10 studies were included. The combined outcomes suggested a significant influence of berberine administration on body mass index (BMI) (WMD: −0.29 kg/m2, 95% CI: −0.51 to −0.08, p = 0.006) and waist circumference (WC) (WMD: −2.75 cm, 95% CI: −4.88 to −0.62, p = 0.01). However, berberine supplementation yielded no significant decline in body weight (BW) (WMD: −0.11 kg, 95% CI: −0.99 to 0.76, p = 0.79). Following the dose-response evaluation, berberine intake was found to significantly reduce BMI (r = −0.02) and WC (r = −0.72) based on treatment duration. Conclusion The results of the current study support the use of berberine supplementation for the improvement of obesity indices.

Objective: The purpose of this study was to evaluate the effects of ATRA (all trans retinoic acid), vitamin D3, and their combination on circulating levels of miR (MicroRNA) -125a-5p, miR-126, and miR-34ain diabetic rats.Materials and Methods: Total miRNA was extracted from plasma samples. miRNA expression profiles of 30 rats in five groups were analyzed after 4-week intervention. The expression levels of miRNAs were measured using qRT-PCR.Results: We analyzed the expression of miR-126, miR-125a-5p, and miR-34a in serum among all five groups (p=0.268). The levels of miRNA-126 (p=0.004) and miR-125a-5p (p=0.014) showed a significant difference among our experimental groups. The circulating levels of miR-126 decreased in DC (Diabetic control) group compared to the HC (Healthy control) group (p=0.009). In addition, vitamin D3+ATRA supplementation increased miR-126 expression (p=0.014). Moreover, the levels of miR-125a-5p decreased in the DC group compared to the HC group (p=0.019).Conclusion: The expression of miR-126 and miR-125a-5p decreased in diabetic rats. Also, vitamin D3+ATRA can be considered a new therapeutic agent that can elevate miR-126 expression and prevent diabetes-related cardiovascular complications.

Aims Patients with type 2 diabetes mellitus (T2DM) are prone to cardiovascular disease (CVD) due to inflammation process and oxidative stress. ADMA (Asymmetric dimethylarginine) and ICAM-1 (inter-cellular adhesion molecule-1) play an important role in CVD pathogenesis. Ginger as an anti-oxidant and anti-inflammation can effect on these biomarkers. The aim of present study was to characterize the effect of ginger supplementation on ADMA and ICAM-1 serum levels in patients with T2DM. Methods The present study is a randomized double-blind clinical trial which is conducted among 45 diabetic patients (nginger=23, nplacebo=22). The participants were randomly divided into two intervention and placebo groups which were received 2 g ginger powder and 2 g wheat flour for 10 weeks, respectively. ADMA and ICAM-1 concentration were measured by ELISA method. Results Ginger supplementation decreased ADMA serum levels significantly (P=0.002) and sICAM-1 serum levels marginally (P=0.097) in supplementation group after intervention. No significant difference was observed between placebo and supplementation groups. Conclusions Present study was conducted among patients with type 2 diabetes mellitus to investigate the effect of ginger supplementation on ADMA and sICAM-1 levels. There was a significant decrement in ADMA serum concentration and slight reduction in sICAM-1 levels in intervention group. The amount of reduction in both biomarkers was not statistically significant in between-groups comparison.

Diabetes mellitus is considered a metabolic disorder characterized by high blood sugar. Active disease is associated with low grade chronic inflammation resulting from the enhanced release of inflammatory mediators such as interleukin (IL)-1 β, IL-6, induced nitric oxide synthase, and cyclooxygenase-2 enzymes that lead to insulin resistance and disease progression. Nuclear factor kappa-B (NF-κB) is a key mediator involved in the inflammatory process which plays an important role in the inflammatory pathogenesis of diabetes. Based on recent evidence, ginger—which contains many phytochemicals—is believed to exert anti-inflammatory properties through multiple mechanisms, such as probably inhibiting the activation of NF-κB signaling pathway. It can thus be a target agent in the treatment and control of diabetes. It appears that ginger may be a complementary agent in diabetes treatment by targeting the NF-κB cascade pathway and exerting antioxidant or anti-inflammatory actions. In this context, this review aims to present the recent evidence regarding the mechanisms of action of ginger in NF-κB signaling pathways in diabetes mellitus.