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

There is no dietary strategy that has yet been specifically advocated for haemophilia. Therefore, we sought to assess the effect of the Dietary Approaches to Stop Hypertension (DASH) diet in adolescents with haemophilia. In this parallel trial, forty male adolescents with haemophilia were dichotomised into the DASH group or control group for 10 weeks. The serum high sensitivity C-reactive protein, IL-6, complete blood count (CBC), serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase, partial thromboplastin time (PTT), waist circumference (WC), percentage of body fat, fat-free mass and liver steatosis were measured at the beginning and end of the study. Serum vitamin C was measured as a biomarker of compliance with the DASH diet. The DASH diet was designed to include high amounts of whole grains, fruits, vegetables and low-fat dairy products, as well as low amounts of saturated fats, cholesterol, refined grains, sweets and red meat. Serum vitamin C in the DASH group was significantly increased compared with the control ( P = 0·001). There was a significant reduction in WC ( P = 0·005), fat mass ( P = 0·006), hepatic fibrosis ( P = 0·02) and PTT ( P = 0·008) in the DASH group, compared with the control. However, there were no significant differences regarding other selected outcomes between groups. Patients in the DASH group had significantly greater increase in the levels of erythrocyte, Hb and haematocrit, as compared with the control. Adherence to the DASH diet in children with haemophilia yielded significant beneficial effects on body composition, CBC, inflammation and liver function.

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

Background: Sparse data are available regarding the efficacy and safety of single anastomosis sleeve ileal (SASI) bypass surgery, where most available studies utilized short-term follow-ups. Therefore, this study was conducted to evaluate the safety and outcomes of this procedure in three consecutive years after the surgery., Materials and Methods: This retrospective study was carried out with 116 patients who underwent SASI from October 2016 to September 2021. Anthropometric, clinical, and biochemical data were recorded before, 1, 2, and 3 years after surgery., Results: The 1, 2, and 3-year percentage of excess weight loss (%EWL) were 87.37%, 90.7%, and 80.6%, respectively. Remission or improvement was recorded for diabetes mellitus in 90.9%, hypertension in 80.0%, hyperlipidemia in 100%, sleep apnea in 100%, and irregular menstruation in 58.06 at 3 years after surgery. No mortality and 5.1% early major postoperative complications were recorded. Eight patients (6.8%) had reversal surgery due to EWL > 100%., Conclusions: The SASI bypass is an effective bariatric surgery that achieved sequential weight loss and improvement in medical comorbidities three years after the surgery; however, standardization of SASI procedure technique is needed to ameliorate nutritional deficiencies., (© 2022. The Author(s) under exclusive licence to Société Internationale de Chirurgie.)

Background: The aim of this systematic review and meta-analysis was to determine the effect of olive leaf extract (OLE) supplementation on cardiovascular-related variables, including lipid, glycemic, inflammatory, liver and renal-related factors, as well as blood pressure., Methods: PubMed, ISI Web of Science, Scopus, and Cochrane library were searched, up to October 2021, for relevant controlled trials. Mean differences and standard deviations were pooled for all outcomes, using a random-effects model. The methodological quality, as well as quality of evidence were assessed using standard tools., Results: Twelve studies (n = 819 participants) were included in our analyses. Overall analyses showed that OLE supplementation significantly decreased triglyceride (TG) levels (WMD = - 9.51 mg/dl, 95% CI - 17.83, - 1.18; P = 0.025; I 2  = 68.7%; P-heterogeneity = 0.004), and systolic blood pressure (SBP) (WMD = - 3.86 mmHg, 95% CI - 6.44, - 1.28 mmHg; P = 0.003; I 2  = 19.9%; P-heterogeneity = 0.28). Subgroup analyses also revealed a significant improvement in SBP (- 4.81 mmHg) and diastolic blood pressure (- 2.45 mmHg), TG (- 14.42 mg/dl), total cholesterol (TC) (- 9.14 mg/dl), and low-density lipoprotein-C (LDL-C) (- 4.6 mg/dl) measurements, in patients with hypertension. Significant reductions were also observed in TC (- 6.69 mg/dl), TG (- 9.21 mg/dl), and SBP (- 7.05 mmHg) in normal-weight individuals. However, no meaningful changes were seen in glucose hemostasis, liver and kidney, or inflammatory markers., Conclusion: The present study revealed that supplementation with OLE yielded beneficial effects for blood pressure and lipid profile in adults, especially in patients with hypertension. As the quality of evidence for glucose hemostasis variables, liver, kidney, and inflammatory markers, were low-to-very low, higher quality RCTs may impact the overarching results. This study was registered at PROSPERO with the code CRD42022302395., (© 2022. The Author(s).)

Background: Current evidence suggests that adherence to the Mediterranean diet (MeD) can reduce inflammation in chronic diseases; however, studies pertaining to relapsing-remitting multiple sclerosis (RRMS) are limited. Therefore, the aim of this study was to investigate the potential of the modified MeD (mMeD) in improving Dietary Inflammatory Index (DII) scores, disability and fatigue severity, compared with traditional Iranian diet (TID), in RRMS patients., Results: Of the 180 patients enrolled, 147 participants were included in the final analysis (n of mMeD = 68; n of TID = 79). Self-reported adherence was good (˜81 %). Dietary intakes of forty-five food parameters were assessed through the FFQ. The mMeD significantly reduced DII scores after 6 months (2·38 ± 0·21 to -1·87 ± 0·86, P < 0·001), but TID did not elicit any changes (2·21 ± 0·44 to 2·14 ± 1·01, P = 0·771). Additionally, Modified Fatigue Impact Scale (MFIS) total score decreased significantly (72·4 ± 17·2 to 63·9 ± 14·2, P < 0·001), whereas there was no considerable improvement for Expanded Disability Status Scale (EDSS) in the mMeD group., Methods: After initial screening ( n 261), 180 RRMS patients were randomised to receive mMeD or TID (as control) for 6 months. DII score, EDSS and twenty-one-item MFIS were evaluated at baseline and trial cessation. Multivariate ANCOVA was conducted and adjusted for age, gender, body weight, BMI, education level, supplement use, family history and duration of MS., Conclusion: Adherence to mMeD, for 6 months, improved dietary inflammatory status and fatigue severity in RRMS patients; however, the TID did not positively impact dietary inflammation and MFIS score.

Context Research has shown IL-1 α might play a role in the associations between the MH group and DII and DIL. Objective . We evaluated the association of inflammatory markers, IL-1 α and TGF- β , with dietary insulin load and index in women with healthy and unhealthy obesity phenotypes. Materials and Methods . 228 obese/overweight women aged 18-48 years were included in this study. Biochemical factors were obtained from blood samples. Body composition, anthropometric measures, and physical activity assessments were performed. Dietary intakes, DII, and DIL were assessed. Results . Significant associations were observed between the MH group and the DII group (OR = 2.142, 95% CI = 1.421, 2.850, and p  = 0.040), in which IL-1 α may play a role. Discussion and Conclusion . Significant associations were observed between the MH group and DII. IL-1 α might play a role in these associations., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Sahar Noori et al.)

The resting metabolic rate (RMR) represents the largest component of total daily energy expenditure. The sale of ultra-processed foods (UPF) is increasing globally; however, UPF can have many adverse effects, including increasing inflammatory markers and altering RMRs. This cross-sectional study included 285 healthy overweight and obese women. Anthropometric measurements were evaluated using a bioelectrical impedance analyzer InBody 770 scanner. High-sensitivity C-reactive protein (hs-CRP), plasminogen activator-1 (PAI-1), monocyte chemoattractant protein (MCP-1), and interleukin-1 beta (IL-1β) blood levels were measured after a 12-h fasting. Indirect calorimetry was used to evaluate the RMR by using the Weir equation, and RMR deviation (RMR estimated - RMR actual), RMR per body mass index (BMI), and free fat mass (FFM) were estimated. A validated food frequency questionnaire (FFQ) was used, and seven groups of UPFs were extracted based on the NOVA method. A negative association between the RMR [β = -0.159, 95% confidence interval (CI): -0.471, -0.052, P = 0.044], RMR per BMI (β = -0.014, 95% CI: -0.025, -0.006, P = 0.036), and RMR per FFM (β = -0.241, 95% CI: -0.006, -0.000, P = 0.041) using the NOVA score was observed after adjusting for confounders. This association disappeared after inclusion of each inflammatory marker. All the markers may inversely mediate the relationship between the mentioned variables and the NOVA score. hs-CRP and MCP-1 also had a negative effect on the relationship between the NOVA score and RMR deviation. Finally, UPF intake is likely related with the RMR, mediated through changes in the production of hs-CRP, PAI-1, MCP-1, and IL-1β., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Bahrampour, Shiraseb, Noori, Clark and Mirzaei.)

The novel Coronavirus (COVID-19) has spread rapidly across the globe and has involved more than 215 countries and territories. Due to a lack of effective therapy or vaccine, urgent and concerted efforts are needed to identify therapeutic targets and medications. COVID-19 main protease represents a major target for drug treatment to inhibit viral function. The present study sought to evaluate medicinal plant compounds as potential inhibitors of the COVID-19 main protease using molecular docking and molecular dynamic analysis. The PDB files of COVID-19 main protease and some medicinal plant compounds were retrieved from the Protein Data Bank (http://www.rcsb.org) and Pubchem server, respectively. The Gromacs software was used for simulation studies, and molecular docking analysis was done using Autodock 4.2. The COVID-19 main protease simulation, compared with some phytochemicals docked to the COVID-19 main protease, were analyzed. Glabridin, catechin, and fisetin had the greatest tendency to interact with the COVID-19 main protease by hydrogen and hydrophobic interactions. Docking of these phytochemicals to COVID-19 main protease led to an increase in the radius of gyration (Rg), decrease in the Root mean square fluctuation (RMSF), and induced variation in COVID-19 main protease secondary structure. The high tendency interaction of glabridin, catechin, and fisetin to COVID-19 main protease induced conformational changes on this enzyme. These interactions can lead to enzyme inhibition. This simulated study indicates that these phytochemicals may be considered as potent inhibitors of the viral protease; however, more investigations are required to explore their potential medicinal use.Communicated by Ramaswamy H. Sarma.

Objective: Rheumatoid arthritis (RA) is a chronic disease associated and oxidative stress. The critical role of a dietary antioxidant in increasing the antioxidant defense system is undeniable and makes the assessment of the potential link between dietary antioxidants and diseases informative. Given the limited available data on dietary antioxidants, this study aimed to evaluate the association between DTAC and the risk of RA., Methods: This case-control study was carried out on 100 patients with RA and 197 healthy individuals aged 19-69 years. Data on dietary intake were collected using a validated 168-items quantitative food frequency questionnaire. DTAC was calculated based on the ferric reducing ability of plasma (FRAP), the ability of dietary antioxidants to reduce ferric to ferrous ions, presented in mmol per 100 g of foods (mmol/100 g). To find the association between DTAC and risk of RA, binary logistic regression adjusted for potential confounders was used., Results: The mean age of the study participants was 49.26 and 40.88 years in the case and control groups, respectively. Participants in the top tertile of DTAC were less likely to have RA in the crude model (OR, 0.34; 95% CI, 0.18-0.64; P-trend: 0.001). Such that, when multiple potential confounders were controlled, the association remained significant in the full adjustment model (OR, 0.28; 95% CI, 0.10-0.76; P-trend: 0.001)., Conclusions: The finding indicates a significant inverse association between DTAC and the risk of RA, suggesting that promoting a naturally elevated antioxidant capacity might help prevent the development of RA. Further prospective studies are required to confirm these findings., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest., (Copyright © 2022 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Background : The association between dietary patterns and cardiorespiratory fitness (CRF) is not well established. Objective : We sought to investigate association between a posteriori dietary pattern and CRF in middle-aged adults. Design : Adults (n = 276), aged 20-74 years, who were residents of Tehran, Iran were recruited. Diet was assessed by using a validated 168-item semi-quantitative food frequency questionnaire. Principal component analysis was used to derive dietary patterns. Socio-economic status, anthropometric measures, body composition, and blood pressure were recorded. CRF was assessed by using a graded exercise treadmill test. Analysis of variance and linear regression models were used to discern the association between dietary patterns and CRF. Results : Higher scores of the healthy dietary pattern had no association with VO 2max (p = 0.13 ). After controlling for potential confounders, VO 2max was positively associated across tertiles of healthy dietary patterns (p < 0.001). Higher adherence to the "mixed" dietary pattern was inversely related to VO 2max (p < 0.01). After adjusting for confounders, the significant association disappeared (p = 0.14). Higher scores of the "Western" dietary pattern was not associated with VO 2max (p = 0.06). However, after controlling for potential confounders, VO 2max was positively associated with the "Western" dietary pattern (p = 0.01). A positive linear association between the "healthy" dietary pattern and CRF for the total sample (R 2  = 0.02; p < 0.01) were presented. Conclusions : Overall, our findings suggest that higher adherence to a "healthy" and "Western" dietary pattern was positively associated with CRF. However, further studies are required to examine and clarify the causal relationship between dietary patterns and CRF.

This study aimed to compare for the first time the immediate and retention effects of theory-based and atheoretical motor competence (MC) interventions, by conducting a systematic review to determine which intervention approach resulted in the most improvements for motor outcomes. In accordance with PRISMA guidelines, studies were identified from searches across seven databases, for articles relating to theory-based (Achievement Goal Theory, Dynamic Systems Theory, and Social-Cognitive Theory) and atheoretically-derived MC interventions in typically developing children and adolescents. Publication bias was assessed using an adapted form of Consolidated Standards of Reporting Trials statement. Of the thirty two included studies, seventeen utilized theory-based intervention approaches. The majority of studies were grounded in Achievement Goal Theory. Also, the majority of MC interventions elicited immediate (short) and/or long-term effects for children and adolescents. Studies varied with regards to intervention components and MC assessment. Many studies scored poorly for risk of bias items. Overall, the levels of success for theoretical and atheoretical intervention programmes were not distinguishable. Findings open up new horizons for motor skills instruction to be taught using developmentally appropriate pedagogy, a research field which has gained significant traction among stakeholders in recent years.

Objective: Obesity is related to increasing leptin and some inflammatory factors that are associated with low-grade inflammation. Moreover, several studies have shown Caveolin-1 (CAV1) genetic variations may be associated with dietary intake. The current study aimed to evaluate the interaction of CAV1 rs3807992 with types of the energy-adjusted dietary inflammatory index (EDII) in leptin, leptin resistance, and Galectin 3, as inflammatory factors., Methods: This cross-sectional study was carried out on 363 overweight and obese females. Dietary intake and DII were obtained from a 147-item food frequency questionnaire (FFQ). The CAV-1 genotype was measured using the PCR-RFLP method. Anthropometric values and serum levels of leptin and Galectin 3 were measured by standard methods., Results: Increased adherence to EDII in the interaction with CAV1 genotypes led to an increase in leptin level 79.15 (mg/l) (β = 79.15, CI = - 1.23,163.94, P = 0.04) in model 3, after controlling for further potential confounders. By contrast, adherence to EDII in the interaction with the genotype including risk alleles showed no significant interaction, even after adjustment in model 3 (β = 0.55, CI = - 0.99, 2.09, P = 0.48). Although, a marginal positive significant interaction was found between EDII and CAV1 genotypes on Galectin 3, after adjustment in model 3 (β = 31.35, CI = 0.13, 77.13, P = 0.05)., Conclusions: The present study indicates that a high adherence of EDII and CAV1 genotypes containing risk alleles may be a prognostic factor and increase both leptin and Galectin3. However, it seems that the presence of interaction was not on leptin resistance. Further functional studies are necessary to elucidate the exact mechanism., (© 2022. The Author(s).)

Background: This study investigated the acute effects of two physical activity (PA) bouts on children's cognitive and affective responses., Methods: Twenty-nine participants (16 boys and 13 girls; M age = 9.34 years, SD = 0.48), using a within-subjects crossover design, performed three 15-min conditions: (a) TDM-The Daily Mile™; (b) 12 repeated 30-45-s shuttle runs at ≥ 85% HR MAX ; and (c) a sedentary control condition. Cognitive performance (i.e., Stroop, Digit Span, and Corsi blocks) was measured before PA and 1 and 30 min post-PA. Felt Arousal and Feeling Scale self-report scales were administered before, during, and after PA., Results: The results show no changes following the TDM condition relative to the sedentary control condition in cognitive responses. However, when comparing the shuttle runs condition to the sedentary control condition, participants showed higher arousal, an improved reaction time, and lower self-reported pleasure at 1 min post-PA. Nevertheless, at 30 min post-PA, participants' pleasure values were higher in the shuttle runs condition than they were before PA., Conclusions: When comparing PA conditions, shuttle runs enhanced reaction time and might thus be seen as an option to implement or modify PA opportunities in school settings.

Purpose: Diet is one of the most important factors influencing cardiovascular disease (CVD). The negative relationship between carbohydrate intake with lipid profiles and body weight has been previously investigated. However, this is the first study seeking to assess the association of carbohydrate quality index (CQI) with CVD risk factors., Methods: This cross-sectional study was conducted on 291 Iranian overweight and obese women, with a body mass index (BMI) ranging between 25 and 40 kg/m 2 , and aged 18-48 years. CQI scores were calculated by using a validated 168-item semi-quantitative food frequency questionnaire (FFQ). Biochemical and anthropometric measures were assessed using standard methods, and bioelectrical impedance was used to measure body composition., Results: We observed that fruits ( P < 0.001), vegetables ( P < 0.001), and protein ( P = 0.002) intake were higher in participants with a higher score of the CQI. When we adjusted for potential confounders, we observed that the CQI was negatively related to systolic blood pressure (SBP) (β = -6.10; 95% CI = -10.11, -2.10; P = 0.003) and DBP (β = -3.11; 95% CI = -6.15, -0.08; P = 0.04). Also, greater adherence to a high CQI dietary pattern, compared to the reference group, was negatively related to HOMA-IR (β = -0.53; 95% CI = -0.94, -0.12) (P for trend = 0.01), WC (β = -3.18; 95% CI = -6.26, -0.10) ( P for trend = 0.04), BMI (β = -1.21; 95% CI = -2.50, 0.07) ( P for trend = 0.06), and BF (β = -2.06; 95% CI = -3.82, -0.30) ( P for trend = 0.02)., Conclusion: In line with previous studies, the CQI was inversely associated with blood pressure, WC, BMI, and BF. Further prospective and clinical trial studies are suggested to confirm these data., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Khosravinia, Shiraseb, Mirzababaei, Daneshzad, Jamili, Clark and Mirzaei.)

Aim: Evidence demonstrates the negative impact of excessive screen-based sedentary time (screen-based sedentary behavior; SSB) on mental health in adolescents. However, little is known regarding the associations between different types of SSBs and anxiety symptoms in adolescents. Thus, this study sought to explore the associations between different types of SSBs and anxiety symptoms in a sample of Chinese adolescents., Methods: A web-based questionnaire survey was used to collect data. In total, 1,998 study participants conveniently recruited in Guangdong Province completed the questionnaire. Of them, 1,331 study participants provided valid data for variables of interest. SSB was categorized into television/movie time, video game time, and internet-surfing time. Anxiety symptoms were assessed using Zung Self-Rating Anxiety Scale, a validated assessment in Chinese youth populations. Generalized linear models were used to explore the associations between different types of SSBs and anxiety symptoms., Results: In adolescents, video game time of 6 or more h was positively and significantly associated with anxiety symptoms (odds ratio = 5.25, 95% CI: 1.86-14.84, p < 0.01). This association was also observed specifically in boys (odds ratio = 5.12, 95% CI: 1.56-17.44, p < 0.05); however, in girls, there were no associations between different types of SSBs and anxiety symptoms., Conclusion: Interventions aiming at reducing video games in adolescents, especially in boys, should be designed to prevent anxiety symptoms. This kind of intervention should also take sex differences into consideration. Future studies are encouraged to confirm the veracity of the findings in this study., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Chen, Clark and Ren.)

Aims: Direct and indirect evidence were combined in this systematic-review and network meta-analysis (NMA) to assess and compare the effect of nutritional supplements on glycemic control, and rank the supplements accordingly., Methods: PubMed, Scopus, and Web of Science were searched up to April 2021. We included randomized controlled trials that investigated the effect of vitamins D, C, and E, magnesium, zinc, calcium, selenium, and omega-3 on at least one glycemic marker, including glycated hemoglobin (HbA1c), fasting blood sugar (FBS), homeostasis model assessment-estimated insulin resistance (HOMA-IR), HOMA-B, and insulin, in adults with type 2 diabetes. To estimate effectiveness of supplements, a random-effects NMA in the Bayesian framework was applied. To assess risk of bias, Cochrane Collaboration Tool was used., Results: Analysis of 178 studies indicated that zinc, vitamin D, omega-3, vitamin C, and vitamin E were effective in reducing HbA1c with low certainty. For reduction of FBS, zinc, vitamin D, and vitamin C, and for HOMA-IR, vitamin D were effective with low certainty. None of the supplements were effective in the reduction of insulin and HOMA-B with low certainty. After excluding poor-quality studies, only vitamin D was significantly effective in reducing all of the markers. Consistently, when the analysis was restricted to studies with a duration of ≥12-weeks, vitamin D reduced HbA1c, FBS, and HOMA-IR., Conclusions: Vitamin D supplementation was more effective compared to other supplements in improving HbA1c, FBS, and HOMA-IR, albeit with low certainty of evidence. This result was confirmed by low-risk of bias studies., Registration: CRD42021240691., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022. Published by Elsevier B.V.)

Background: Cardiovascular disease (CVD) is the leading cause of death in women globally. Recent studies have reported that the minor allele (C allele) for melanocortin 4 receptor (MC4R) rs17782313 may be related to the incidence of obesity and the risk of CVD. Therefore, the present study aimed to investigate the interactions between the modified Nordic-style diet score (MND) and MC4R gene variant on markers of CVD., Methods: The current cross-sectional study was conducted on 282 Iranian women, aged 18-48 years, with a body mass index (BMI) ≥ 25. MND score was assessed using a 147 items food frequency questionnaire (FFQ). Genotyping of the MC4R (rs17782313) was conducted by the PCR method. The anthropometric measurements and serum profiles were assessed by standard protocols., Results: The means and standard deviation (SD) of age, weight, and BMI of individuals were 36.67 ± 9.10 years, 81.29 ± 12.43 kg, and 31.26 ± 4.29 kg/m 2 , respectively. The overall prevalence of rs17782313 genotypes was 30.1%, 24.8%, and 45.1% for TT, TC, and CC, respectively. Our results showed significant negative interactions between high MND score and rs17782313 SNP in terms of visceral fat level (VFL) (β: -10.84, 95% CI: -20.64 to -1.04, P = 0.03) and total cholesterol (β: -24.24, 95% CI: -49.87 to 1.38, P = 0.06) in the crude model. After adjusting confounders, the interaction between high MND scores and VFL remained significant., Conclusion: In conclusion, the results of the present study suggest that diet, gene variants, and their interaction should be considered in metabolic disease risk assessment. Further studies are needed to confirm these data and better elucidate the interaction., (© 2022. The Author(s).)

The effect of a 40-min nap opportunity was investigated during the day following a late evening simulated soccer match. Twelve male amateur soccer players (23 ± 3 years; 77.3 ± 5.3 kg; 1.76 ± 0.04 m) performed the Loughborough-intermittent-shuttle test at 21h00 and the following day they completed the sleepiness scale after either a nonap (N0) or 40-min nap (N40) opportunity that began at 14h00. At 17h00, participants performed the 5-m shuttle run test (5mSRT) (6 × 30-s with 35-s in-between; best distance (BD) and total distance (TD) were calculated). After performing the 5mSRT, they provided their rating of the perceived exertion (RPE) and rated their muscle soreness. Sleepiness scores were significantly lower in N40 in comparison with N0 (P < 0.05). A significant increase of TD (+64.5 m) and BD (+9.6 m) after N40 compared to N0 was observed (P < 0.05). The improved performance was associated with reduced levels of muscle soreness and lower RPE. In conclusion, a daytime 40-min nap opportunity after a late evening simulated soccer match improves short-term repetitive maximal performance in soccer players, and has positive effects on perception of sleepiness, muscle soreness, and RPE.

Despite the apparent beneficial effects of probiotics/synbiotics on glucose haemostasis, lipid profile and inflammatory responses, it is not clear whether these beneficial effects also impact renal and hepatic function in diabetes. Therefore, we sought to assess the effect of probiotics/synbiotics supplementation on renal and liver biomarkers in adults with type 2 diabetes mellitus (T2DM) using a systematic review and meta-analysis of randomised controlled trials (RCT). PubMed, Scopus, Web of Science and Cochrane Library were systematically searched, up to February 2021. The pooled weighted mean difference (WMD) was estimated using a random-effects model. The methodological quality of studies, as well as certainty of evidence, was assessed using standard scales. Fifteen related trials were identified. Meta-analysis of six trials, involving 426 participants, indicated that probiotics/synbiotics supplementation reduced serum levels of creatinine (WMD = -0·10 mg/dl, 95 % CI -0·20, -0·00; P = 0·01; I 2 = 87·7 %; P -heterogeneity < 0·001), without any significant effect on blood urea nitrogen (BUN), glomerular filtration rate or microalbuminuria. No significant improvement was found on liver biomarkers following probiotics/synbiotics supplementation. The subgroup analysis showed a significant improvement in BUN when follow-up duration lasted for 12 weeks or more (WMD = -1·215 mg/dl, 95 % CI -1·933, -0·496; P = 0·001) and in creatinine levels in patients with renal dysfunction (WMD = -0·209 mg/dl, 95 % CI -0·322, -0·096; P < 0·001). Our results are insufficient to advocate the use of probiotics/synbiotics for improving renal or liver function in patients with T2DM. Indeed, due to the low certainty of evidence, these findings need to be affirmed in further high-quality RCT.

Objective: Despite numerous experimental studies in the literature, there are few clinical trials regarding the effect of date palm pollen (DPP) supplementation on sexual function improvement. In the present study, we sought to evaluate the impact of DPP on female sexual function in Iranian non-menopausal women., Methods: Between October 2019 and December 2019, health centers in the city of Khalkhal, volunteers meeting the inclusion criteria were recruited in randomized clinical trials. Sixty-eight women were randomly stratified and assigned to one of the two study groups: placebo group ( n  = 35) and palm pollen group ( n  = 35), and received a starch or palm pollen capsule (300 mg per day), respectively, for 35 d. The Female Sexual Function Index (FSFI) instrument was used to assess female sexual function., Results: After DPP supplementation, the increase in desire, lubrication, and the overall score, was statistically significant compared to the placebo group ( P  = 0.002, P  = 0.000, and P  = 0.042; respectively); Whilst there was no significant differences in the remaining domains (arousal: P  = 0.763; orgasm: P  = 0.370; satisfaction: P  = 0.474; pain: P  = 0.259). There was a statistically significant positive correlation between the coitus and preintervention levels of desire ( r  = 0.298, P  = 0.038), arousal ( r  = 0.328, P  = 0.021), lubrication ( r  = 0.361, P  = 0.011), orgasm ( r  = 0.320, P  = 0.025), satisfaction ( r  = 0.327, P  = 0.022), and overall scores ( r  = 0.338, P  = 0.018)., Conclusion: This study suggests that DPP (300 mg supplementation for 35 d), given to non-menopausal women, could improve the lubrication and desire domains of FSFI., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 Tianjin Press of Chinese Herbal Medicines. Published by ELSEVIER B.V.)

This study aimed to examine the effects of two high-intensity interval training programs (HIIT) on maximal aerobic velocity (MAV), hematological variations and muscle damage markers in young healthy adults. Twenty-nine male physical education students, aged 20.3 ± 3.3 years, volunteered to participate in this study, and were randomly assigned to a control group (CG, n = 9) or two intervention groups (group 1 or 2). Intervention group 1 (n = 10) exercised at 100% of their MAV (EG 100 ) while group 2 (n = 10) exercised at 110% MAV (EG 110 ). Before and after the eight week training program, blood samples were drawn at rest, before, and after an intermittent exercise. Aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT), C reactive protein (CRP), creatine kinase (CK) concentrations and hematological parameters (white blood cells [WBC], monocytes [MO], lymphocytes [LY], neutrophil [NE]) and lactate dehydrogenase (LDH) were measured. Post-hoc tests showed that MAV was significantly higher in EG 110 compared to EG 100 after HIIT (p < 0.01, η p 2  = 0.05), whilst ALAT, ASAT, and CPR were significantly lower (p < 0.01; 0.02 < η p 2  < 0.11) in EG 110 compared to EG 100 . Moreover, post-hoc tests indicated that LY decreased significantly (p < 0.001, η p 2  = 0.21) only for EG 110 . Furthermore, there were significant positive correlations for both EG 100 and EG 110 between MAV and ALAT (r = 0.66, p = 0.044 and r = 0.64, p = 0.041 respectively), CK (r = 0.67, p = 0.031 and r = 0.86, p = 0.030, respectively), LDH (r = 0.74, p = 0.014, and r = 0.071, p = 0.021, respectively). In addition, there was a significant positive correlation for both, EG 100 and EG 110 between MAV and LY (r = 0.79, p < 0.01; r = 0.72, p < 0.05, respectively). Concerning the relationship between MAV and NE, there was a significant positive correlation (r = 0.66; p < 0.05) only for EG 110 . Findings from this study revealed that HIIT at 110% MAV was more efficient to improve MAV and reduce muscle damage. In addition, we observed significant associations between performance improvements (MAV) and markers of muscle damage., (© 2022. The Author(s).)

Background: Abnormal uterine bleeding (AUB), alopecia, low quality of life, and acne are considered as complications of polycystic ovary syndrome (PCOS). We hypothesized that magnesium supplementation would yield beneficial effects on PCOS related complications., Objective: To examine the effects of magnesium supplementation on AUB, alopecia, quality of life, and acne., Methods: In this parallel randomized clinical trial, we randomly assigned 64 women with PCOS to the magnesium group (n = 32) or placebo group (n = 32) for 10 weeks. AUB, alopecia, quality of life, and acne were assessed by the International Federation of Gynecology and Obstetrics criterion, the Sinclair Scale, the Health Survey Quality of Life Questionnaire, and the Global Acne Grading System, respectively. This randomized clinical trial was registered at IRCT.ir (IRCT20130903014551N9)., Results: Magnesium supplementation significantly improved the components of quality of life including physical functioning (p = 0.011), role limitations due to physical health (p = 0.012), role limitations due to emotional problems (p < 0.001), energy/fatigue (p = 0.005), emotional wellbeing (p < 0.001), social functioning (p = 0.002), general health (p = 0.013), and total quality of life (p < 0.001), compared with placebo. No significant effect was observed on acne, alopecia, and AUB., Conclusion: Magnesium supplementation in women with PCOS had a significant positive effect on improving total quality of life., Trial Registration: This randomized clinical trial was registered at IRCT.ir on 2020-10-18 (Registration Code: IRCT20130903014551N9 )., (© 2022. The Author(s).)

Objective: To investigate the effects of whole body vibration on chronic ankle instability-associated sensorimotor deficits in balance, strength, joint position sense and muscle activity., Data Sources: Electronic databases including Cochrane Library, PubMed, Embase, Web of Science, EBSCO, China National Knowledge Infrastructure and WanFang were searched from database inception up to 31 March 2022., Methods: The risk of bias and methodological quality of included studies were assessed using the Cochrane tool and Physiotherapy Evidence Database (PEDro) scale respectively. Standardized mean difference (SMD) and mean differences (MD) with 95% confidence interval (CI) were calculated using the RevMan 5.3 software. Meta-regression was conducted with Stata 16., Results: Eight studies, with 315 subjects were eventually included in this review with an average PEDro score of 6.1/10. Significant effects of whole body vibration on balance (SMD = 0.61, 95% CI: 0.12 to 1.09, P  = 0.01), and on the posterolateral direction (MD = 5.52, 95% CI: 1.02 to 10.01, P  = 0.02) and medial direction (MD = 3.90, 95% CI: 0.87 to 6.94, P  = 0.01) of the star excursion balance test were found. Whole body vibration significantly improved the peak torque (SMD = 0.36, 95% CI: 0.04 to 0.69, P  = 0.03), joint position sense (SMD = 0.60, 95% CI: 0.10 to 1.11, P  = 0.02), and muscle activity in tibialis anterior (SMD = 0.46, 95% CI: 0.04 to 0.88, P  = 0.03) and gastrocnemius (SMD = 0.68, 95% CI: 0.14 to 1.23, P  = 0.01)., Conclusions: The current evidence supports the use of whole body vibration to improve sensorimotor deficits involving balance, strength, joint position sense, and muscle activity in people with chronic ankle instability.

Background: Rheumatoid arthritis (RA) is a chronic, systemic inflammatory, and debilitating autoimmune illness. The objective of the present study was to evaluate the relationship between animal flesh foods consumption and rheumatoid arthritis., Methods: Meat consumption was assessed by using a semi-quantitative Food Frequency Questionnaire (168 items) in a case-control study of 297 subjects (100 newly diagnosed cases and 197 healthy controls). An expert rheumatologist diagnosed patients based on the American College of Rheumatology definitions, 2010. Multivariate logistic regression, adjusted for lifestyle and nutritional confounders, was used to evaluate the relationship between dairy consumption and rheumatoid arthritis., Results: Participants with greater consumption of fish and seafood were less likely to have RA (OR 0.52; 95% CI 0.27-0.98). Conversely, a higher processed meat intake was associated with increased odds of RA (OR 3.45; 95% CI 1.78-6.68). However, no significant association was found between red meats and poultry consumption and the risk of RA in the fully adjusted model., Conclusions: The present study suggests an inverse association between fish and seafood consumption and the risk of RA. On the contrary, a higher amount of processed meat intake was associated with increased odds of RA. However, further studies are warranted to confirm the veracity of our findings., (© 2022. The Author(s).)

The current study aimed to evaluate the efficacy of sitagliptin vs. placebo in treating non-alcoholic fatty liver disease (NAFLD). In a triple-blind randomized clinical trial, we assigned 120 eligible subjects with NAFLD to receive daily dosing of 50 mg sitagliptin ( n = 60) or the placebo ( n = 60) for 56 weeks and lifestyle modification in both groups. Laboratory and anthropometric outcomes were measured, and liver stiffness was assessed using a fibroscan. The primary outcome measures were changes from baseline in fibrosis scores and liver transferases. Out of 120 patients randomized into sitagliptin and placebo groups, 76 patients completed the trial, of whom 44 were in the sitagliptin and 32 in the placebo groups. Patients receiving sitagliptin showed a significant decrease in the fibrosis scores ( P = 0.001). The reductions in the alanine aminotransferase (AST) ( P = 0.036) and aspartate AST ( P < 0.001) levels were also statistically significant. The effect of sitagliptin in reducing fibrosis scores was significantly greater in normal-weight and overweight individuals than in obese individuals ( p = 0.036, and p = 0.018, respectively), whereas the effects of sitagliptin on AST levels were greater among overweight/obese patients ( p = 0.028, and p = 0.016, respectively). Sitagliptin reduced fibrosis scores and liver enzymes in NAFLD patients after 56 weeks of therapy. The changes in fibrosis scores were more prominent in patients with normal weight and overweight than obese patients, whereas the effects on AST levels were greater among overweight/obese patients. Other randomized trials with larger sample sizes and longer treatment durations may be required before precise results can be reached., Clinical Trial Registration: [https://www.irct.ir/trial/46140], identifier [IRCT20140430017505N2]., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Doustmohammadian, Nezhadisalami, Safarnezhad Tameshke, Motamed, Maadi, Farahmand, Sohrabi, Clark, Ajdarkosh, Faraji, Nikkhah, Sobhrakhshankhah, Ebrahimi and Zamani.)

Background: Unhealthy dietary patterns are the most important modifiable risk factors for obesity and overweight. This study aimed to examine the relationship between Dietary Phytochemical Index (DPI) and resting metabolic rate (RMR), mediated by inflammatory factors, in overweight and obese women., Methods: A total of 404 women, aged 18-48 years, were included in the cross-sectional study. DPI was calculated using the 147-item food frequency questionnaire (FFQ). Anthropometric measurements, RMR, and blood biomarkers were assessed using standard protocols., Results: There was marginally significant association between adherence to DPI and RMR status in the crude model (OR = 1.41, 95% CI 0.94-2.11, P = 0.09). After adjusting for potential confounders, a significant association was seen between the DPI and increase RMR.per.kg (OR = 2.77, 95% CI 0.98-7.82, P = 0.05). Our results indicated that plasminogen activator inhibitor-1 (PAI-1), transforming growth factor (TGF-β), and monocyte chemoattractant protein-1 (MCP-1) had a mediatory effect on the association between RMR and DPI (P > 0.05). Indeed, it was shown that, PAI-1, TGF-β, and MCP-1 destroyed the significance of this association and could be considered as mediating markers. However, no mediating effect was observed for high-sensitivity C reactive protein (hs-CRP)., Conclusions: Adherence to DPI can improve the RMR by reducing levels of inflammatory markers, and may be considered as a treatment for obesity. However, more long-term studies are recommended., (© 2022. The Author(s).)

Background and Aims: The Healthy Beverage Index (HBI) is a valuable technique to estimate the synergistic effects of overall beverage consumption. Several studies have evaluated the associations between HBI and beneficial changes in the health status. however, there is no study on the association between patterns of beverage consumption and mental health status. Therefore, this study sought to examine the association between HBI and psychological disorders among overweight and obese women., Methods: 199 overweight and obese women, between the ages of 18 and 55 y, were enrolled in this cross-sectional study in Tehran, Iran. To collect beverage dietary data, a validated semi-quantitative food-frequency questionnaire (FFQ) was used. Furthermore, the DASS-21 questionnaire was used to assess psychological profile states., Results: The association of total depression anxiety stress (DASS) score with healthy beverage index (HBI) tertiles in models was marginally significant (OR =: 0.78; 95% CI 0.30-2.02; P-value = 0.074; (OR = 0.77; 95% CI 0.28-2.16; P-value = 0.062), respectively. In terms of stress, anxiety, and depression, after adjusting for confounders, participants with higher HBI in the third tertile had lower odds of depression vs. the first tertile (OR = 0.99; 95% CI 0.35-2.81; P-trend = 0.040)., Conclusion: We demonstrate that the total DASS score was associated with HBI tertiles. We also found that participants with higher HBI had lower odds of depression. However, additional well-designed studies are needed to confirm the veracity of these findings., (© 2022. The Author(s).)

For an optimal performance, soccer players and referees need to consume a high-quality diet. The Healthy Eating Index (HEI) is a tool that can estimate diet quality and has been shown to be associated with body composition. The aims of the present study were first to determine the HEI-2015 score of the diets consumed by athletes and second its association with different body composition parameters of athletes. We conducted a cross-sectional study on 198 soccer players and referees. Dietary intakes were recorded using a validated food frequency questionnaire (FFQ), and HEI scores were calculated. Body composition parameters were measured using the bioelectrical impedance analysis. The mean score for the HEI-2015 was 65⋅04. A multiple linear regression model showed significant associations of the HEI-2015 score with percent body fat (PBF), percent muscle mass (PMM), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) in male soccer players aged <18 years, body mass index (BMI) in male soccer players aged ≥18 years and BMI and waist-to-height ratio (WHtR) in male soccer referees after adjustment for covariates ( P < 0⋅05). The mean overall score for the HEI-2015 shows that Iranian soccer players and referees have an acceptable quality of diet. We also found significant associations between the HEI-2015 score and different body composition parameters in male soccer players and referees but we did not find any significant association in female athletes ( P > 0⋅05)., (© The Author(s) 2022.)

The study aimed to investigate the association of adults adhering to Dietary Approaches to Stop Hypertension (DASH) and Mediterranean diet (MeD) with nonalcoholic fatty liver disease (NAFLD) using structural equation modeling (SEM) in Iran. In this population-based cross-sectional study, 3,220 adults (44.65% female) aged ≥18 years were selected from the Amol Cohort Study (AmolCS). The dietary intakes were assessed by a validated 168-item semi-quantitative food-frequency questionnaire (FFQ). Residual method energy adjustment of MeD and DASH scores were calculated. Demographic characteristics and anthropometric and laboratory measurements were collected. NAFLD was diagnosed by an expert radiologist via ultrasound sonography. Based on the primary hypothesis, DASH, MeD, and NAFLD were fitted into models. Metabolic syndrome (MeS) as a potential risk factor directly affected NAFLD risk in all these models. In both genders, the higher adherence to DASH negatively affected NAFLD risk indirectly through the two following paths. (1) Dietary acid load (DAL) and metabolic syndrome (2) DAL and hemoglobin A1c (HbA1c). In addition, the higher DAL positively affected NAFLD risk among male participants indirectly via increasing HbA1c level and MeS (from DAL to HbA1c: β = 0.07, P < 0.001; from HbA1c to MeS: β = 0.10, P < 0.001). Similarly, in both genders, the relationship between MeD and NAFLD was mediated through (1) DAL, HbA1c, and MeS and (2) DAL and MeS. Further, among male participants, the MeD and NAFLD risk were also associated via the mediators of HbA1c and MeS. In female participants, the higher MeD score was directly associated with a reduction of NAFLD risk (β = -0.07, P = 0.008). The present study found three important mediators, including DAL, HbA1c, and MeS, in the association of DASH and MeD scores with NAFLD risk. Preventive and therapeutic interventions should target the mediators, including DAL, HbA1c, MeS, and its components, to reduce NAFLD incidence in the general population., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Doustmohammadian, Nouri Saeidlou, Esfandyari, Gholizadeh, Maadi, Motamed, Ajdarkosh, Khoonsari, Clark and Zamani.)

To quantify the effects of curcumin supplementation on exercise-induced muscle damage, muscle soreness, inflammatory biomarkers, muscle strength, and joint flexibility via assessment of creatine kinase (CK), visual analogue scale (VAS) score, maximal voluntary contraction (MVC), and range of motion (ROM), respectively. Online databases, including PubMed, Google Scholar, and Scopus, were searched up to February 2021. RevMan® software (version 5.3) was used for assessing the risk of bias to assess the quality of studies. The mean differences (MD) and confidence intervals (95% CI) of CK activity (IU/L), VAS score, tumor necrosis factor (TNF-α) (pg/ml), interleukin-6 (IL-6) (pg/ml), IL-8 (pg/ml), MVC (nm) and ROM (degree) were pooled using a random- or fixed-effect model. Between-study heterogeneity was assessed using χ-square or I 2 statistic. Ten trials met the eligibility criteria and were included in the pooled analysis. Meta-analysis showed that curcumin supplementation significantly reduced serum CK activity [WMD = -65.98 IU/L, 95% CI (-99.53 to -32.44)], muscle soreness [WMD = -0.56, 95% CI (-0.84 to -0.27)], and TNF-α concentration [WMD = -0.22 pg/ml, 95% CI (-0.33 to -0.10)]. Also, curcumin supplementation elicited significant improvements in MVC [WMD = 3.10 nm, 95% CI (1.45-4.75)] and ROM [WMD = 6.49°, 95% CI (3.91-9.07)], although no significant changes in IL-6 and IL-8 levels were found. Dose-response analysis indicated that there is a significant non-linear association between the daily dose and the final effect size regarding TNF-α. Curcumin supplementation may improve some aspects of DOMS, including muscle damage, muscle soreness, inflammation, muscle strength, and joint flexibility. Further, well-designed and high-quality studies with larger sample sizes are needed to ascertain the long-term effects and safety of curcumin supplementation., (© 2022 John Wiley & Sons Ltd.)

Objective: Myocardial infarction is the irreversible cell death of cardiac muscle that takes place after the blood flow is cut off to a specific region of the heart muscle. The molecular angiogenesis process that may follow after the incidence, due to any activity or its intensity, is unknown. The purpose of this research was to examine some of the matrix metalloproteinase (MMP) responses to an acute course of endurance exercise and electrical stimulation in induced myocardial infarcted Wistar rats., Materials and Methods: In this experimental case-control study, 40 induced myocardial infarcted Wistar rats (8-week-old, mean weight 130±30 g) were randomly assigned into 4 conditions: endurance exercise, exercise + electrical stimulation, only electrical stimulation, and control group. The infarction was induced 24 hours after the subcutaneous injection of 150 mg/kg of Isoproterenol. The exercise and exercise plus electrical stimulation groups performed a session of endurance exercise on an animal treadmill, at 20 m/min for one hour. The electrical stimulation was delivered by foot shock, set with the intensities of 0.5 mA for 20 minutes. Immediately after the cessation of the treatment protocol, MMP1, MMP2, and MMP9 were measured by the ELISA method. Data analysis was performed by using Two-way ANOVA and significance was set at α = 0.05., Results: One session of endurance exercise or electric stimulation, or their combination, had no significant effect on the level of MMPs., Conclusions: One session of acute endurance exercise, stimulation, or their combination, elicited no significant effect on the level of MMPs of artificially induced myocardial infarcted Wistar rats.

Background: Women with GDM have a higher risk of future cardiovascular diseases (CVD). Meanwhile, synbiotics have been demonstrated to have favorable impacts on atherogenic indices, and inflammatory and oxidative stress indicators, all of which are known to be CVD-predictive factors. The aim of this randomized controlled trial was to evaluate the effects of synbiotic supplementation on the atherogenic indices of plasma, high-sensitivity C-reactive protein (hs-CRP), and plasma malondialdehyde (MDA) in women with GDM., Methods: Eligible pregnant women with GDM were randomized into two groups to receive a daily synbiotic capsule [500 mg of L.acidophilus(5 × 10 10  CFU/g), L.plantarum(1.5 × 10 10  CFU/g), L.fermentum(7 × 10 9  CFU/g), L.Gasseri(2 × 10 10  CFU/g) and 38.5 mg of fructo-oligo-saccharides], or placebo, for 6 weeks. The ratios of TC/HDL-C, LDL/HDL-C, and logTG/HDL-C were calculated as the atherogenic indices. Serum hs-CRP and MDA concentrations were quantified before and after the intervention. Cohen's d(d) was used to calculate the magnitude of the effect., Results: Ninety participants completed the study. There was no significant difference in dietary antioxidant and mineral intakes between the two groups. Compared with placebo, synbiotic supplementation resulted in a significant decrease in logTG/HDL-C ratio with a medium-low effect size (mean difference = -0.11; 95% CI -0.21, 0; P values for the placebo and the intervention groups were 0.02, and 0.042, respectively; P between groups = 0.003; d = 0.25). No significant changes were observed in other parameters., Conclusions: Overall, 6 weeks of synbiotic supplementation in women with GDM resulted in a significant improvement in logTG/HDL-C, suggesting that synbiotics may have a beneficial role in reducing the risk of future CVDs associated with GDM. Nevertheless, more studies are needed to confirm the veracity of these results. Trial Registration IRCT201511183140N16 (December 29th, 2015)., (© 2022. The Author(s).)

Anthropometric variables (AV) are shown to be essential in assessing health status and to serve as markers for evaluating health-related risks in different populations. Studying the impact of physical activity (PA) on AV and its relationship with smoking is a non-trivial task from a public health perspective. In this study, a total of 107 healthy male smokers (37 ± 9.42 years) were recruited from different states in Malaysia. Standard procedures of measurement of several anthropometric indexes were carried out, and the International Physical Activity Questionnaire (IPPQ) was used to ascertain the PA levels of the participants. A principal component analysis was employed to examine the AV associated with physical activity, k-means clustering was used to group the participants with respect to the PA levels, and discriminant analysis models were utilized to determine the differential variables between the groups. A logistic regression (LR) model was further employed to ascertain the efficacy of the discriminant models in classifying the two smoking groups. Six AV out of twelve were associated with smoking behaviour. Two groups were obtained from the k-means analysis, based on the IPPQ and termed partially physically active smokers (PPAS) or physically nonactive smokers (PNAS). The PNAS were found to be at high risk of contracting cardiovascular problems, as compared with the PPAS. The PPAS cluster was characterized by a desirable AV, as well as a lower level of nicotine compared with the PNAS cluster. The LR model revealed that certain AV are vital for maintaining good health, and a partially active lifestyle could be effective in mitigating the effect of tobacco on health in healthy male smokers.

Background: The impact of carotenoid intake on the risk of mental disorders and poor sleep quality is unclear. Thus, we sought to examine the association between carotenoid intake, mental health, and sleep quality among university students., Methods: A total of 368 healthy university students (181 men, 49%), aged 18 to 43 years, volunteered for this study. Dietary intake, physical activity, sleep quality, mental health, and body mass index (BMI) were evaluated. A multivariable logistic regression analysis test was used to estimate the odds ratio (OR) and 95% confidence interval (CI)., Results: The mean age of the participants was 22.9 ± 3.9 years and mean BMI was 23.1 ± 3.8 kg/m 2 . The students in the highest quartile of carotenoid intake had a significantly lower risk of poor sleep quality (OR = 0.19, 95% CI: 0.09 to 0.40; P  < 0.001) and depression (OR = 0.27, 95% CI: 0.12 to 0.59; P = 0.001). In the sex-stratified subgroup analysis, the depression risk was significant for men (OR = 0.28, 95% CI: 0.07 to 0.59; P = 0.007), but not for women. Furthermore, we did not observe any specific relationship between carotenoid intake and the risk of anxiety or stress., Conclusion: It appears that the students with higher carotenoid intake may have a better quality of sleep and lower risk of depression. More longitudinal and in-depth qualitative and quantitative research, with a longer-term follow-up, is needed to support the veracity of our findings., (© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Objective: Previous studies have shown an association between diet quality and sleep quality. The objective of this study was to investigate the association between modified Nordic diet with sleep quality and circadian rhythm in overweight and obese woman., Methods: We enrolled 399 overweight and obese women (body mass index (BMI): 25-40 kg/m 2 ), aged 18-48 years, in this cross-sectional study. For each participant, anthropometric measurements, biochemical tests, and food intake were evaluated. Sleep quality and circadian rhythm was measured by Pittsburgh Sleep Quality Index (PSQI) and morning-evening questionnaire (MEQ) questionnaire. Modified Nordic diet score was measured using a validated 147-item food frequency questionnaire (FFQ)., Results: Overall, 51.7% of the subjects were good sleepers (the Pittsburgh Sleep Quality Index (PSQI) < 5) while 48.3% were poor sleepers (PSQI ≥ 5). Moreover, participants were divided into five groups of MEQ, namely, completely morning 8 (2.4%), rarely morning 82 (24.8%), normal 196 (59.2%), rarely evening 43 (13%), and completely evening 2 (0.6%). After controlling for confounders, there was a significant association between poor sleep quality and the modified Nordic diet (OR = 0.80, %95 CI = 0.66-0.98, P = 0.01). Moreover, a significant positive association was observed between the completely morning and modified Nordic diet (OR = 1.80, %95 CI = 0.54-6.00, P = 0.03), in addition to a significant inverse association between the completely evening type and modified Nordic diet (OR = 0.16, %95 CI = 0.002-5.41, P = 0.02)., Conclusions: The present study indicated that higher adherence to a modified Nordic diet reduces poor sleep quality. Also, the completely morning type was associated with higher adherence to a modified Nordic diet, and completely evening type was associated with lower adherence to a modified Nordic diet., Levels of Evidence: Level IV, evidence obtained from multiple time series analysis., (© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

The purpose of this systematic review and meta-analysis is to provide an accurate description of the effect of Ramadan observance on sleep duration, sleep quality, daily nap duration, and daytime sleepiness in athletes and physically active individuals. Five electronic databases (PubMed, Web of Science, Scopus, Wiley, and Taylor and Francis) were used to search for relevant studies conducted with athletes or physically active individuals during Ramadan, published in any language, and available before May 23, 2021. Studies that included assessments of sleep quantity and/or quality, and/or daytime sleepiness, and/or daily naps in athletes and physically active individuals were included. The methodological quality of the studies was assessed using "QualSyst". Of the 18 papers included in this study (298 participants in total), 14 were of strong quality, two were moderate, and the remaining two were rated as weak. Individuals who continued to train during Ramadan experienced a decrease in sleep duration (number of studies, K = 17, number of participants, N = 289, g = -0.766, 95% confidence interval [CI] -1.199 to -0.333, p = 0.001). Additionally, the global score of the Pittsburgh Sleep Quality Index increased from 4.053 (K = 5, N = 65, 95% CI 3.071-5.034) pre-Ramadan, to 5.346 (95% CI 4.362-6.333) during Ramadan, indicating a decrease in sleep quality. The duration of daytime naps increased during compared to pre-Ramadan (K = 2, N = 31, g = 1.020, 95% CI 0.595-1.445, p = 0.000), whereas Epworth Sleepiness Scale scores remained unchanged during versus pre-Ramadan (K = 3, N = 31, g = 0.190, 95% CI -0.139-0.519, p = 0.257). In conclusion, individuals who continued to train during Ramadan experienced a decrease in sleep duration, impairment of sleep quality, and increase in daytime nap duration, with no change in daytime sleepiness levels., (© 2021 The Authors. Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society.)

A series of recent studies have indicated that the Caveolin-1 (CAV-1) gene variant may be associated with metabolic and inflammatory markers and anthropometric measures. Furthermore, it has been shown that a plant-based dietary index (PDI) can elicit a positive impact on these metabolic markers. Therefore, we sought to examine whether PDI intakes may affect the relationship between CAV-1 (rs3807992) and metabolic factors, as well as serum inflammatory markers and anthropometric measures, in women with obesity. This current study consisted of 400 women with overweight and obesity, with a mean (SD) age of 36.67 ± 9.10 years. PDI was calculated by a food frequency questionnaire (FFQ). The anthropometric measurements and serum profiles were measured by standard protocols. Genotyping of the CAV-1(rs3807992) was conducted by the PCR-RFLP method. The following genotypic frequencies were found among the participants: GG (47.8%), AG (22.3%), and AA (2.3%). In comparison to GG homozygotes, risk-allele carriers (AA + AG) with higher PDI intake had lower ALT (P: 0.03), hs-CRP (P: 0.008), insulin (P: 0.01) and MCP-1 (P: 0.04). Furthermore, A-allele carriers were characterized by lower serum ALT (P: 0.04), AST (P: 0.02), insulin (P: 0.03), and TGF-β (P: 0.001) when had the higher following a healthful PDI compared to GG homozygote. Besides, risk-allele carriers who consumed higher unhealthful PDI had higher WC (P: 0.04), TC/HDL (P: 0.04), MCP-1 (P: 0.03), and galactin-3 (P: 0.04). Our study revealed that A-allele carriers might be more sensitive to PDI composition compared to GG homozygotes. Following a healthful PDI in A-allele carriers may be associated with improvements in metabolic and inflammatory markers and anthropometric measures., (© 2022. The Author(s).)

We aimed to assess the dietary composition of lunch meal using a posteriori-derived dietary patterns and to determine the association of lunch composition with obesity in a sample of Iranian adults. This cross-sectional study was conducted on 850 men and women in Tehran (aged 20-59 years). Dietary intakes were assessed using three 24-h dietary recalls, and dietary patterns were identified via principal component factor analysis. For each identified pattern, scores were calculated for each participant and then classified into tertiles. Central obesity was defined WHO criteria. General obesity was defined as a BMI of more than 30 kg/m2. Three major dietary patterns were identified at lunch meal using twelve food groups: 'Bread, grains and fat', 'Western' and 'Potato and eggs'. After adjustment for potential confounders, participants at the top tertile of the 'Bread, grains and fat' dietary pattern had greater odds for a higher waist-to-hip ratio (WHR), compared with those in the lowest tertile (OR: 1·44, 95 % CI 1·01, 2·07). However, we found no association between 'Western' or 'potato and eggs' patterns and WHR (OR: 0·89, 95 % CI 0·62, 1·28 and OR: 1·16, 95 % CI 0·69, 1·42, respectively). None of the identified dietary patterns was associated when defining obesity with waist circumference or BMI. In conclusion, participants had a greater chance of central obesity defined based on WHR following a lunchtime pattern with a higher and positive loading factor for 'Bread, grains and fat'.

Background: The main purpose of this study was to investigate the relationships between minutes played (MP) with maturity status, fitness, and hormonal levels, and to quantify their influence on minutes played., Methods: Twenty-four elite youth soccer players under-16 years participated in this study, over a full-season period. Anthropometric measures, maturity status, hormonal and physical fitness levels were collected. Participants were monitored during the season. After the end-season, players were assessed in 6 different tests over a four-day period., Results: The maximum oxygen consumption (V̇O 2max ) was strongly correlated with MP (r = 0.75), maturity offset (r = 0.52), and countermovement jump (r = 0.53). Multiple linear regression explained 76% of MP (F (8, 15) = 6.05, p = 0.001), with an R2 of 0.76. Moreover, Growth hormone (GH) and V̇O 2max . were the most influential factors in MP (F (2, 21) = 17.92, p ≤ 0.001), with an R2 of 0.63., Conclusion: High levels of GH and V̇O 2max have a preponderant role in MP by elite youth soccer players, it appears to be more pragmatic to consider other contextual dimensions, as they can impact selection for competition and minutes of participation in a match., (© 2022. The Author(s).)

Background: Accruing adequate daily amounts of time spent on movement behaviors (physical activity (PA), sedentary behavior (SB), and sleep) in childhood has been associated with positive short and long-term health outcomes. Nonetheless, how waking time is distributed across PA and SB among preschoolers who are short and adequate sleepers at night is unknown., Aim: This study investigated: (1) if there are differences in a movement behaviors composition among adequate and short nocturnal sleepers; and (2) the association between preschoolers' time spent in PA, SB, and sleep among adequate and short nocturnal sleepers., Methods: A total of 270 preschoolers (132 boys; 3.97 ± 0.81 years old; 15.48 ± 1.62 kg/m 2 ) participated in this study. PA and SB were assessed using accelerometry (model wGT3X). Sleep duration was assessed through a parental-proxy interview, and preschoolers were stratified as short and adequate sleepers, according to attendance to international sleep duration guidelines. Compositional data analysis was used to explore the time-use patterns of behaviors among adequate and short sleepers., Results: Short sleepers spent 64 min less time asleep, accumulated 32 min in more sedentary time (p = .005, Cohen's d = 0.36, Bayes Factor: 6.17), and 24 min more in light PA (p = .0005, Cohen's d = 0.44, Bayes Factor: 46.37) compared to adequate sleepers., Conclusions: Being a short sleeper was associated with greater time spent in SB and light PA during their waking hours. The health implications of movement behaviors composition among short sleep preschoolers should be further investigated., (© 2021 Wiley Periodicals LLC.)

Objective: Low resting metabolic rate (RMR), as a risk factor for weight gain and obesity, can be influenced by many factors. Empirical research has confirmed the role of appetite and related hormones in obesity and energy intake. This study aimed to investigate the relationship between appetite and related hormones in overweight or obese Iranian women with normal and hypo RMR., Methods: This case-control study was conducted on 42 Iranian adult women (21 cases, and 21 controls), aged 18-48 years. An impedance body analyzer was used to obtain the body composition and an indirect calorimeter was used to assess the RMR. The Flint questionnaire was used to assess appetite, dietary intake, and physical activity were assessed by FFQ and IPAQ questionnaires respectively, and ELISA kits were used to assess leptin, ghrelin, and insulin hormones., Results: The results of the study demonstrated a negative association between ghrelin hormone level (β = -0.34, 95%CI = -61.70,-3.86, P-value = 0.027) and RMR, and a positive association between insulin hormone level (β = 0.48, 95%CI = 9.38-34.35, P-value = 0.001) and RMR. Also, results of the appetite questionnaire showed that, in general, both appetite (β = 0.32, 95%CI = -0.10-2.99 P-value = 0.044) and hunger variable (β = 0.30, 95%CI = 0.04-5.87, P-value = 0.047) have a positive association with RMR. There was no significant association between leptin levels and RMR., Conclusion: It is evident that appetite and related hormones have a potential role in promoting a normal RMR., (© 2022. The Author(s).)

Musculoskeletal pains (MPs), defined as persistent or recurrent pain, is a complex health problem. High overall calorie and fat intake have been related to obesity and MPs. Dietary energy density (DED), defined as energy content of food and beverages (in kcal) per unit total weight, has been associated with chronic muscle, cartilage, bone damage and pain. Thus, the purpose of this study is to investigate the association between DED and MPs in adult men and women. A total of 175 men and women (> 18 years) with MP participated in the study. A validated short form physical activity (PA) questionnaire, demographic, and McGill Pain Questionnaire were used. Anthropometric measurements were evaluated via standard protocols. Furthermore, a seven-day 24-hour recall of diet was used to determine the dietary intake. Total DED was calculated and divided into quartiles. Linear regression was used to discern the association between DED and MPs in adults. Participants assigned in the highest category of DED were characterized by lower intake of potassium, magnesium, vitamin C, folate, and fiber. However, results showed displayed higher intake of sodium, vitamin E, vitamin B3, fat, protein, cholesterol, saturated fatty acids, monounsaturated fatty acids, and polyunsaturated fatty acids (p < 0.001). Finally, after adjustment for confounders such as age, gender, PA, body mass index, waist circumference, education, job, marital status, history of some chronic diseases and vitamin C supplementation, a significant positive association was detected between DED and pain intensity. There was no significant association between DED and pain frequency in all models., Competing Interests: Conflict of Interest: The authors declare that they have no competing interests., (Copyright © 2022. The Korean Society of Clinical Nutrition.)

The purpose of this study was to examine the test-retest reliability, and convergent and discriminative validity of a new taekwondo-specific change-of-direction (COD) speed test with striking techniques (TST) in elite taekwondo athletes. Twenty (10 males and 10 females) elite (athletes who compete at national level) and top-elite (athletes who compete at national and international level) taekwondo athletes with an average training background of 8.9 ± 1.3 years of systematic taekwondo training participated in this study. During the two-week test-retest period, various generic performance tests measuring COD speed, balance, speed, and jump performance were carried out during the first week and as a retest during the second week. Three TST trials were conducted with each athlete and the best trial was used for further analyses. The relevant performance measure derived from the TST was the time with striking penalty (TST-TSP). TST-TSP performances amounted to 10.57 ± 1.08 s for males and 11.74 ± 1.34 s for females. The reliability analysis of the TST performance was conducted after logarithmic transformation, in order to address the problem of heteroscedasticity. In both groups, the TST demonstrated a high relative test-retest reliability (intraclass correlation coefficients and 90% compatibility limits were 0.80 and 0.47 to 0.93, respectively). For absolute reliability, the TST's typical error of measurement (TEM), 90% compatibility limits, and magnitudes were 4.6%, 3.4 to 7.7, for males, and 5.4%, 3.9 to 9.0, for females. The homogeneous sample of taekwondo athletes meant that the TST's TEM exceeded the usual smallest important change (SIC) with 0.2 effect size in the two groups. The new test showed mostly very large correlations with linear sprint speed ( r = 0.71 to 0.85) and dynamic balance ( r = -0.71 and -0.74), large correlations with COD speed ( r = 0.57 to 0.60) and vertical jump performance ( r = -0.50 to -0.65), and moderate correlations with horizontal jump performance ( r = -0.34 to -0.45) and static balance ( r = -0.39 to -0.44). Top-elite athletes showed better TST performances than elite counterparts. Receiver operating characteristic analysis indicated that the TST effectively discriminated between top-elite and elite taekwondo athletes. In conclusion, the TST is a valid, and sensitive test to evaluate the COD speed with taekwondo specific skills, and reliable when considering ICC and TEM. Although the usefulness of the TST is questioned to detect small performance changes in the present population, the TST can detect moderate changes in taekwondo-specific COD speed., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Aloui, Tayech, Mejri, Makhlouf, Clark, Granacher, Zouhal and Ben Abderrahman.)

Numerous clinical trials have examined the beneficial effects of Juglans regia leaf extract (JRLE) in patients with type 2 diabetes mellitus (T2DM); however, the results of these studies are inconsistent. Therefore, we conducted the current systematic review and meta-analysis to evaluate the effect of JRLE on glycemic control and lipid profile in T2DM patients. We searched online databases including PubMed, Scopus, EMBASE, and Web of Science for randomized controlled clinical trials that examined the effect of JRLE on glycemic and lipid indices in T2DM patients. Data were pooled using both fixed and random-effect models and weighted mean difference (WMD) was considered as the overall effect size. Of the total records, 4 eligible studies, with a total sample size of 195 subjects, were included. The meta-analysis revealed that JRLE supplementation significantly reduces fasting blood glucose (WMD, -18.04; 95% confidence interval [CI], -32.88 mg/dL, -3.21 mg/dL; p = 0.017) and significantly increases fasting insulin level (WMD, 1.93; 95% CI, 0.40 U/L, 3.45 U/L; p = 0.014). Although the overall effect of JRLE supplementation on hemoglobin A1c was not significant, a significant reduction was seen in studies with an intervention duration of > 8 weeks (WMD, -0.64; 95% CI, -1.16%, -0.11%; p = 0.018). Moreover, we also found no significant change in lipid parameters. Our findings revealed a beneficial effect of JRLE supplementation on glycemic indices in T2DM patients, but no significant improvement was found for lipid profile parameters., Competing Interests: Conflict of Interest: The authors declare that they have no competing interests., (Copyright © 2022. The Korean Society of Clinical Nutrition.)

Objective: Obesity is a highly prevalent, non-communicable, disease associated with numerous comorbid complications, such as cardiovascular disease. Following a healthy diet is known to help reduce the risk of both obesity and cardiovascular disease. This study was conducted to evaluate the association of recommended food score (RFS) and none recommended food score (NRFS) with cardiovascular risk factors in overweight and obese women., Methods: This cross-sectional study was performed on 379 overweight and obese (BMI ≥25 kg/m 2 ) women aged 18-48 years. Anthropometric measurements and body composition analysis were assessed in all participants. Dietary intake was assessed by a valid and reliable food frequency questionnaire (FFQ) containing 147 items, and RFS and NRFS was calculated. Biochemical assessments including TC, HDL, LDL, TG, FBS, insulin, HOMA-IR, and hs-CRP were quantified by ELISA., Results: The mean age and BMI of participants were 36.73 ± 9.21 (y) and 31.17 ± 4.22 (kg/m 2 ), respectively. Binary logistic regression showed that participants in the highest tertile of the RFS compared to the lowest tertile had 57% lower odds for hypertriglyceridemia [OR = 0.43, 95%CI = 0.20-0.92, P = 0.03]. Subjects with high adherence to the NRFS had lower HDL [OR = 2.11, 95%CI = 1.08-4.12, P = 0.02] and higher odds for hypertriglyceridemia [OR = 2.95, 95%CI = 1.47-5.94, P = 0.002] compared to low adherence., Conclusions: There was an inverse significant association between adherence to RFS and odds of hypertriglyceridemia. There was a significant association between NRFS and hypertriglyceridemia, in addition to an inverse association between NRFS and HDL. We recommend that people increase their consumption of fruits, vegetables, whole grains, lean meats or meat alternates, and low-fat dairy and avoid red meat, processed meat, chips, high-fat dairy, solid oil, refined grains, and variety of sweetened foods to prevent cardiovascular disease., (© 2022. The Author(s).)

Background: It has been posited that both metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUHO) could be emergent from diet and inflammatory markers. Thus, we sought to investigate the influence of plant-based diet on MHO and MUHO phenotypes mediated by inflammatory markers in overweight and obese women., Methods: This cross-sectional study was conducted on 289 women aged ≥18 years, with a body mass index (BMI) ≥25 kg/m 2 . Dietary intake was measured using 147 item food frequency questionnaire, as well as anthropometrics and biochemistry panel, in all participants. Metabolic health phenotypes were considered using Karelis score, while plant-based diet indices (PDI) were evaluated based on 18 food groups, where healthy and unhealthy PDI were identified., Results: Accordingly, 26.9% of women had MHO and 73.1% had MUHO phenotypes. After adjusting for potential confounders, TGF- β 1 had a significant inverse association with hPDI ( β : -0.28; 95% CI: 452.99, -85.25; P : 0.004). Moreover, we found that women with higher hPDI had lower odds of MUHO (OR: 0.95; 95% CI: 0.39, 2.30; P : 0.03). Regarding the mediatory effect of the inflammatory markers, TGF- β 1 ( P : 0.73), IL- β 1 ( P : 0.14), and MCP1 ( P : 0.51) played a role in decreasing the odds of MUHO among hPDI tertiles., Conclusion: There was a significant inverse relationship between adherence to hPDI and MUHO phenotype in overweight and obese Iranian women. This association appeared to be mediated by TGF- β 1, IL- β 1, and MCP1., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Azam Mohamadi et al.)

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

Lycopene has been posited to regulate insulin-like growth factor-1 (IGF-1). We aimed to conduct a systematic review of the effects of lycopene on circulating IGF-1 and insulin-like growth factor binding proteins (IGFBPs) in adults. A systematic search was carried out in PubMed, Scopus, ISI Web of Science, and the Cochrane Library databases for randomized controlled trials (RCTs), published from inception until March 2020. A total of 11 studies fulfilled the selection criteria. Eleven studies examined the effect of lycopene supplementation on IGF-1, one of which reported a significant reduction. Moreover, three, four, and ten studies were found for IGFBP-1, IGFBP-2, and IGFBP-3, respectively; where one study found a significant increase in these proteins. In conclusion, no consistent modifying effect of lycopene supplementation on IGF-1 and IGFBPs levels are evident in the literature. More research is needed to explore the effect of lycopene on IGF-1 system., (© 2022 John Wiley & Sons, Ltd.)

Dietary modifications remain the mainstay in managing nonalcoholic fatty liver disease (NAFLD). Published data on the effect of overall dietary patterns on NAFLD is scarce. The present study aims to extract the dietary patterns and investigate their association to NAFLD by gender, using structural equation modeling, among adult participants in Amol, northern Iran. In this cross-sectional study, data from 3,149 participants in the Amol cohort study (55.3% men, n = 1,741) were analyzed. Usual dietary intake was assessed by a validated 168-items semiquantitative food frequency questionnaire. We classified major dietary patterns by explanatory factor analysis (EFA) and confirmatory factor analysis (CFA). NAFLD diagnosis was based on ultrasound scanning, including increased hepatic echogenicity, abnormal appearance of hepatic arteries, and diaphragm in the absence of excessive alcohol consumption. Multivariable logistic regression and structural equation modeling (SEM) were used to explore the relationship between dietary patterns and NAFLD. Three distinct dietary patterns, including western, healthy, and traditional/mixed dietary patterns, were identified. Adult male who adhere to the western dietary pattern were more affected with NAFLD risk [Q1, Q2, Q3, Q4, odds ratio (OR) = 1, 1.16, 1.34, 1.39; 95% confidence interval (CI) = 0.83-1.61, 0.96-1.85, 0.98-1.96, p trend = 0.04, respectively]. A full mediating effect of healthy dietary pattern, western dietary pattern, and traditional dietary pattern via dietary acid load (DAL) proxy (of dietary patterns to DAL: βstd = -0.35, p < 0.006, β std = 0.15, p = 0.009, and β std = 0.08, p = 0.001, respectively), on NAFLD was found through mediation analysis using SEM. A western dietary pattern comprising frequent intake of salty and sweet snacks, soft drinks, refined grains, processed meats, cooked and fried potatoes, eggs, and coffee was associated with a higher odds of NAFLD in an Iranian male population. Additionally, our findings might provide a mechanistic explanation for the association between dietary patterns and NAFLD via DAL proxy. However, further prospective studies, including assessing acid-base biomarkers, are needed., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Doustmohammadian, Pishgar, Clark, Sobhrakhshankhah, Nikkhah, Faraji, Motamed, Mansourian, Amirkalali, Maadi, Kasaii, Ebrahimi and Zamani.)