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Objective 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. Methods 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. Results 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. Conclusion 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.

The present study aimed to investigate the effects of propolis and melatonin supplementation on inflammation, clinical outcomes, and oxidative stress markers in patients with primary pneumosepsis.This pilot randomized controlled trial was conducted on 55 patients with primary pneumosepsis who were randomly assigned to the intervention and control groups. In the three intervention groups, the patients received propolis alone (1,000 mg/day), propolis (1,000 mg/day) plus melatonin (20 mg/day), and melatonin alone (20 mg/day). The control group received placebo. The inflammatory and oxidative stress markers as well as clinical outcomes were evaluated before and after the intervention, and the 28-day survival rate was also recorded.After the intervention, the combination of propolis and melatonin significantly reduced interleukin-6 (-55.282 pg/mL) and C-reactive protein (-21.656 mg/L) levels, while increasing gavage intake (326.680 mL/day) and improving some clinical outcomes (APACHE II, SOFA, and NUTRIC scores) compared to the control group. However, no significant difference was observed between the groups in terms of oxidative stress and hematological indices. In addition, there was no significant difference in the 28-day survival rate between the groups (p = 0.07).Supplementation with propolis and melatonin may improve clinical outcomes by reducing inflammation. Further investigations are required to confirm these findings.Hintergrund und Zielsetzung: Mit der vorliegenden Studie sollten die Auswirkungen einer Supplementierung mit Propolis und Melatonin auf das Entzündungsgeschehen, die klinischen Ergebnisse und die Marker für oxidativen Stress bei Patienten mit primärer Pneumosepsis untersucht werden. Material und Methoden: An dieser randomisierten kontrollierten Pilotstudie nahmen 55 Patienten mit primärer Pneumosepsis teil, die randomi­siert den Interventionsgruppen bzw. der Kontrollgruppe zugewiesen wurden. In den drei Interventionsgruppen erhielten die Patienten Propolis als Monotherapie (1’000 mg/Tag), Propolis (1’000 mg/Tag) plus Melatonin (20 mg/Tag) und Melatonin als Monotherapie (20 mg/Tag). Die Kontrollgruppe erhielt ein Placebo. Vor und nach der Intervention wurden die Entzündungsmarker sowie die Marker für oxidativen Stress und die klinischen Ergebnisse beurteilt, und es erfolgte eine Erfassung der 28-Tage-Überlebensrate. Ergebnisse: Nach der Intervention war unter der Kombination von Propolis und Melatonin ein signifikanter Rückgang der Konzentration von Interleukin-6 (–55,282 pg/mL) und C-reaktivem Protein (–21,656 mg/L) gegenüber der Kontrollgruppe zu beobachten, wohingegen die Aufnahme von Sondennahrung (326,680 mL/Tag) zunahm und einige klinische Ergebnisse (APACHE-II-, SOFA- und NUTRIC-Scores) eine Verbesse­rung zeigten. In Hinblick auf den oxidativen Stress und die hämatologischen Indizes bestand jedoch kein signifikan­ter Unterschied zwischen den Gruppen, und auch bei der 28-Tage-Überlebensrate fand sich kein signifikanter Unterschied zwischen den Gruppen (p = 0,07). Schlussfolgerung: Eine Supplementierung mit Propolis und Melatonin kann die klinischen Ergebnisse durch eine Verringe­rung des Entzündungsgeschehens verbessern. Zur Bestätigung dieser Ergebnisse sind weitere Untersuchungen erforderlich.

Inflammation plays an important role in the pathophysiology of traumatic brain injury (TBI). Based on the anti-inflammatory properties of French maritime pine bark extract and the neuroprotective effects, we aimed to evaluate the effects of its supplementation on TBI. Sixty-seven TBI patients admitted to the intensive care units (ICUs) were enrolled. After stabilizing the hemodynamic status, the intervention group received 150 mg of French maritime pine bark extract supplementation (Oligopin) with enteral nutrition for 10 days. The control group received a placebo. Inflammatory status and oxidative stress markers were measured three times. Also, clinical and nutritional statuses were assessed. Supplementation, significantly decreased IL-6 (β = -53.43 pg/ml, 95% confidence interval [CI] = -91.74, -15.13, p = .006), IL-1β (β = -111.66 pg/ml, 95% CI = -183.79, -39.5402, p = .002) and C-reactive protein (β = -19.99 mg/L, 95% CI = -27.23, -12.76, p ˃ .001) in the intervention group compared to control group after 10 days. Clinical scores including acute physiology and chronic health evaluation II and sequential organ failure assessment were reduced (β = -3.72, 95% CI = -5.96, -1.49, p = .001and β = -2.07, 95% CI = -3.23, -0.90, p < .001, respectively), and Nutric score was reduced compared to control group (β = -.60, 95% CI = -1.08, -0.12, p = .01). The survival rate was higher by 15% in the intervention group compared to control group. Oligopin supplementation in TBI patients in ICU reduced inflammation and improved the clinical status and malnutrition score and thereby reducing the mortality rate.

There are few studies about the relationship between dietary patterns and aggression. The aim of this study was to assess the relationship between the main dietary patterns and aggression scores among adolescent girls in Iran.This cross-sectional study was conducted on 670 adolescent girls. The 168-item self-administered Semi-quantitative Food Frequency Questionnaire was used to evaluate dietary intake and to identify major dietary patterns, while factor analysis was applied. Aggression was evaluated by the validated Persian version of the Buss-Perry questionnaire. Statistical analysis was performed by crude and adjusted models.Three main dietary patterns including healthy, fast food, and Western were identified. A significant positive association was found between more adherence to Western dietary pattern and the presence of a high aggression score (OR: 2.00; 95% CI: 1.32-3.05, p-Although Western dietary patterns were associated with increased aggression risk, there was no significant relationship between healthy and fast food dietary patterns and the prevalence of a high aggression score. Further studies, particularly longitudinal intervention studies, are required to clarify this relationship.

Cardiovascular disease (CVD) is the leading cause of mortality, morbidity, and financial losses and has a high prevalence across the world. Several studies have investigated the association between various CVD types with zinc and copper status as the essential minerals for the human body, proposing contradictory and similar results. This narrative review aimed to survey the correlations between zinc and copper status in the human body and some risk factors of CVD, as well as the assessment methods of zinc and copper status in the human body. According to the reviewed articles, zinc and copper deficiency may increase the risk of coronary heart disease, valvular regurgitation, and myocardial lesions, cardiac hypertrophy. Furthermore, it could lead to the expanded mitochondrial compartments of the heart, acute and chronic heart failure, and elevation of inflammation markers, such as interleukin-1 (IL-1) and IL-6. Two methods are primarily used for the assessment of zinc and copper in the human body, including the direct method (measurement of their concentrations) and indirect method (determining the activity of zinc- and copper-containing enzymes). Both these methods are considered reliable for the assessment of the zinc and copper levels in healthy individuals. Serum or plasma levels of these elements are also commonly used for the assessment of the correlation between zinc and copper status and CVD. But, which one is a more accurate indicator in relation to CVD is not yet clear; therefore, further studies are required in this field.

Propolis is a sticky, resinous material gather from plants and is blended with wax and other constituents. It is reported to have anti-inflammatory, anti-oxidative and blood glucose-lowering properties. This review aims to summarise evidences for the cellular and molecular mechanism of Propolis in inflammation, oxidative stress, and glycemic control. Propolis stimulate the production and secretion of anti-inflammatory cytokines and to inhibit the production of inflammatory cytokines and due to its various antioxidant and poly-phenolic compounds may has a role in control and treating some of the chronic diseases. Most studies have shown that Propolis may affect metabolic factors including plasma insulin levels, and it has proposed that it could be used in the prevention and treatment of T2D Mellitus. In general, to demonstrate the definite effects of Propolis on chronic diseases, more studies are required using larger sample sizes and various doses of Propolis, using better characterized and standardized agents.

BACKGROUND Enteral immunomodulatory nutrition is recommended as an adjuvant therapy for patients in intensive care units (ICU), but its effectiveness is incompletely understood. AIM The aim of this review was to examine the effect of a commonly used immunomodulatory formula-omega-3 fatty acids, γ-linolenic acid, and antioxidants-on clinical outcomes and mortality risk in critically ill patients. DESIGN Systematic review and meta-analysis of randomized controlled trials (RCTs). METHOD PubMed, Scopus, and Institute for Scientific Information (ISI) Web of Knowledge databases were searched until 18 February 2021. RCTs that used the immunomodulatory formula in the ICU were included. RESULTS Ten RCTs (1166 participants) were included in the meta-analysis. The immunomodulatory formula reduced the duration of ICU stay weighted mean difference [(WMD): -2.97 days; 95%CI: -5.59, -0.35)], mechanical ventilation (WMD = -2.20 days, 95%CI: -4.29, -0.10), sequential organ failure assessment and multiple organ dysfunction scores (Hedge's g: -0.42 U/L; 95% CI: -0.74, -0.11), decreased 8-day overall mortality risk (RR = 0.74, 95% CI: 0.58, 0.91), and extended the ICU-free days (WMD: 4.06 days, 95% CI: 0.02, 8.09). The improvement in respiratory function and reduction in mortality risk was more in patients with acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Furthermore, the reduction in mechanical ventilation and mortality risk was more evident in older (>60 years) vs young adults. CONCLUSION AND RELEVANCE TO CLINICAL PRACTICE Taken together, the immunomodulatory formula may enhance clinical practice for critical care nurses, such that the prevalence and/or susceptibility to secondary conditions commonly encountered in the ICU (ie, ALI and ARDS) could be attenuated, ultimately allowing critical care nurses to focus their care on the primary reason for which a patient is in the ICU. The study protocol was registered in PROSPERO.

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: Violence and aggression are considered to be important public health issues. There is limited data on the association between dietary intake and aggression score. Aim: We aimed to examine the relationship between the dietary intake and aggressive behavior in Iranian adolescent girls. Methods: The study was carried out among 670 girls aged 12–18 years. A valid and reliable food frequency questionnaire (FFQ) containing 147 food items was used to estimate dietary intake of the study participants. Aggression score was determined using a validated Persian version of the Buss–Perry questionnaire. We analyzed our data using crude and adjusted models. Results: Participants in the fourth quartile of aggression score had significantly higher energy intake compared with those in the first quartile (2808±949 vs 2629±819, p-trend = 0.01). Dietary intakes of soluble fiber (0.42±0.37 vs 0.35±0.29, p = 0.03) and insoluble fiber (2.17±1.65 vs 1.82±1.36, p = 0.02) were significantly higher in the first quartile than in the fourth quartile. In addition, the strongest negative correlations were found between aggression score and dietary soluble fiber ( p = 0.003) and insoluble fiber intake ( p = 0.001). Moreover, aggression score was negatively correlated with dietary α-carotene ( p = 0.02) and β-carotene ( p = 0.04) intake. These associations remained significant even after adjustment for potential confounders. Conclusions: Our results indicated that dietary intakes of fiber, α-carotene, and β-carotene were inversely associated with aggression score. Moreover, a significant positive association was observed between energy intake and aggression score in adolescent girls.

Background & Objective: Prior studies have shown that meal composition may affect the metabolic responses and arterial stiffness indices. Due to the lack of a comprehensive study that concurrently compares metabolic responses and vascular stiffness indices after receiving three different meals in lean and obese men, this pilot study has been conducted with a three-phase parallel design, aiming to investigate the effects of meal composition on the metabolic parameters and arterial stiffness indices of lean and obese adults. Materials and Methods: This pilot, parallel clinical trial has been performed on 20 male adults aged 18-35 years who are disease-free and selected based on the inclusion and exclusion criteria at Mashhad University of Medical Sciences, Iran. The subjects have completed three interventions at a one-week interval, including high carbohydrate (70% carbohydrates, 10% protein, 20% fat), high protein (30% protein, 50% carbohydrates, 20% fat), and high fat meal (50% fat, 40% carbohydrates, 10% protein). Postprandial effects have been assessed within 360 minutes after each meal, including the energy expenditure component (resting energy expenditure, thermic effects of feeding, respiratory quotient, and substrate oxidation) and arterial stiffness indices (augmentation index and pulse wave velocity). In addition, blood sampling has been performed to measure glucose, insulin, free fatty acids, and lipid profile. Results: The study has started since September 2020 and will continue until January 2021. The assessment of the intervention outcomes will be carried out six hours after the end of the intervention. Conclusion: The differences in the postprandial responses c affect the metabolic and vascular parameters due to different meal compositions, thereby providing beneficial data for the establishment of new strategies in terms of nutritional education and metabolic/vascular improvement.

OBJECTIVES Kidney transplantation is an essential treatment in management of kidney failure patients. The present study evaluated and compared the nutritional status of renal transplant patients before and 6 months after kidney transplantation and in comparison with healthy individuals. METHODS A multi-center, case-control study was conducted among 40 kidney transplant recipients and 40 healthy adults. Biochemical tests, anthropometric indices, and dietary intake were collected at baseline and 6 months post-transplant and compared with healthy controls. RESULTS Anthropometric indices of the participants increased in post-transplant period compared to baseline (p

Background: Systemic Inflammatory Response Syndrome (SIRS) that occurs under stressful conditions affecting all organs of the body. Previous studies have shown that propolis and melatonin have the potential to improve inflammation and oxidative stress, so the aim of this study was to investigate the effects of these supplements on SIRS treatment.Method: This was a randomized, controlled clinical trial in SIRS patients comprising 55 subjects that were randomly assigned to 3 intervention or control groups. In the 3 intervention groups, patients were treated with propolis alone (at dose of 1000 mg/day), propolis (1000 mg/day) plus melatonin (20 mg/day), and melatonin alone (20 mg/day) respectively, while there was no intervention in the control group. The inflammatory and oxidative stress markers and clinical outcomes were measured before and after of the intervention, also 28-day survival rate was assessed. Results: Propolis plus melatonin reduced serum interleukin 6 (p = 0.001) and CRP levels (p 0.001). The average survival after 28 days of follow-up in the propolis, propolis+melatonin, melatonin and control groups were 24.08, 25.69, 22.05 and 19.42 days respectively, although this was not statistically significant (p=0.07).Conclusion and relevance: Supplementation with propolis+melatonin may help to improve clinical outcomes by reducing inflammation and was probably associated with an increase in the calorie intake, leading to an increase in the survival rate in SIRS patients, although more studies are necessary to prove these effects. Trial registration: IRCT20181025041460N1.

Background: Prior studies have shown that meal composition is capable of effect on metabolic response and arterial stiffness indexes. Objective: A three-phase parallel study will be designed to investigate the effects of meal composition on metabolic parameters and arterial stiffness indexes among lean and obese adult. The planned study protocol will be presented.Methods/design: This is a pilot parallel clinical trial targeting adults (aged 18–35 years, free from any diseases) will be selected by inclusion and exclusion criteria at Mashhad University Medical Sciences. Each subject will complete three interventions with a washout period of one week: high carbohydrate, high protein and high fat meal. The postprandial effect will be assessed during 360 minutes from each meal including energy expenditure component (such as resting energy expenditure, thermic effect of feeding, respiratory quotient and substrate oxidation) and arterial stiffness indexes (such as augmentation index and pulse wave velocity) and blood sampling.Results: The study will be conducted from September 2020 to January 2021 (individual N=20). Assessment of intervention outcomes will be done in 6 hours after intervention.Conclusions: The differences in postprandial responses due to different meal composition could affect the metabolic and vascular parameters. This could provide necessary information for the establishment of new strategies in terms of nutritional education and metabolic and vascular improvement.Trial Registration: Iranian Registry of Clinical Trials: IRCT20190818044552N1. Registered on August 26, 2019

Background Prior studies have shown that meal composition may affect the metabolic responses and arterial stiffness indices, and these responses may be different in lean and obese adults. The primary objective of this study is to determine the feasibility of conducting a trial to compare the effect of three test meals in lean and obese men. Due to the lack of a comprehensive study that concurrently compares metabolic responses and vascular stiffness indices after receiving three different meals in lean and obese men, this pilot study will be conducted with a three-phase parallel design, aiming to investigate the effects of meal composition on the metabolic parameters and arterial stiffness indices of lean and obese adults. Methods This pilot, a parallel clinical trial will be performed on 24 male adults aged 18–35 years since January 2021 and will continue until March 2021 who are disease-free and selected based on the inclusion and exclusion criteria at Mashhad University of Medical Sciences, Iran. The subjects will complete three interventions at a 1-week interval, including high carbohydrate (70% carbohydrates, 10% protein, 20% fat), high protein (30% protein, 50% carbohydrates, 20% fat), and high-fat meal (50% fat, 40% carbohydrates, 10% protein). Postprandial effects will be assessed within 360 min after each meal, including the energy expenditure component (resting energy expenditure, thermic effects of feeding, respiratory quotient, and substrate oxidation) and arterial stiffness indices (augmentation index and pulse wave velocity). In addition, blood sampling will be performed to measure glucose, insulin, free fatty acids, and lipid profile. Discussion The differences in the postprandial responses can affect the metabolic and vascular parameters due to different meal compositions, thereby providing beneficial data for the establishment of new strategies in terms of nutritional education and metabolic/vascular improvement. Also, the results from this pilot study will inform intervention refinement and efficacy testing of the intervention in a larger randomized controlled trial. Trial registration Iranian Registry of Clinical Trials; code: IRCT20190818044552N1; registered on August 26, 2019

BACKGROUND Background: Prior studies have shown that meal composition is capable of effect on metabolic response and arterial stiffness indexes. OBJECTIVE Objective: A three-phase parallel study will design to investigate the effects of meal composition on metabolic parameters and arterial stiffness indexes among lean and obese adult. The planned study protocol is presented METHODS Methods/design: This is a parallel clinical trial targeting adults (aged 18–35 years, free from any diseases) selected by inclusion and exclusion criteria at Mashhad University Medical Sciences. Each subject will complete three interventions with a washout period of one week: high carbohydrate, high protein and high fat meal. The postprandial effect will be assessed during 360 minutes from each meal including energy expenditure component, pulse wave analysis and pulse wave velocity and blood sampling. RESULTS N/A CONCLUSIONS Metabolic Responses, Macronutrients Composition, Arterial Stiffness, Study Protocol: The differences in postprandial response due to different meal composition could affect of metabolic and vascular parameters. This could provide necessary information for the establishment of new strategies in terms of nutritional education and metabolic and vascular improvement. CLINICALTRIAL Trial registration: Iranian Registry of Clinical Trials: IRCT20190818044552N1. Registered on August 26, 2019

Background Traumatic brain injury (TBI) is one of the major health and socioeconomic problems in the world. Immune-enhancing enteral formula has been proven to significantly reduce infection rate in TBI patients. One of the ingredients that can be used in immunonutrition formulas to reduce inflammation and oxidative stress is pycnogenol. Objective The objective of this work is to survey the effect of pycnogenol on the clinical, nutritional, and inflammatory status of TBI patients. Methods This is a double-blind, randomized controlled trial. Block randomization will be used. An intervention group will receive pycnogenol supplementation of 150 mg for 10 days and a control group will receive a placebo for the same duration. Inflammatory status (IL-6, IL- 1β, C-reactive protein) and oxidative stress status (malondialdehyde, total antioxidant capacity), at the baseline, at the 5th day, and at the end of the study (10th day) will be measured. Clinical and nutritional status will be assessed three times during the intervention. The Sequential Organ Failure Assessment (SOFA) questionnaire for assessment of organ failure will be filled out every other day. The mortality rate will be calculated within 28 days of the start of the intervention. Weight, body mass index, and body composition will be measured. All analyses will be conducted by an initially assigned study arm in an intention-to-treat analysis. Discussion We expect that supplementation of 150 mg pycnogenol for 10 days will improve clinical and nutritional status and reduce the inflammation and oxidative stress of the TBI patients. Trial registration This trial is registered at clinicaltrials.gov (ref: NCT03777683) at 12/13/2018.

Additional file 1: Table S1. APCHE II (Acute Physiologic and Chronic Health Evaluation II) score content. Table S2. SOFA (Sequential Organ Failure Assessment) score content.

Additional file 2. Statistical analysis plan.

Background: Traumatic brain injury (TBI) is one of the major health and socioeconomic problems in the world. Immune-enhancing enteral formula has been proven to significantly reduce infection rate in TBI patient. One of the ingredients that can be used in immunonutrition formulas to reduce inflammation and oxidative stress is pycnogenol. Objective: surveying the effect of pycnogenol on the clinical, nutritional and inflammatory status of TBI patients. Methods: This is double-blind, randomized controlled trial . Block randomization will be used. Intervention group will receive pycnogenol supplementation of 150 mg for 10 days. Control group will receive placebo for the same duration. Inflammatory status (IL-6, IL- 1β, C-reactive protein) and oxidative stress status (Malondialdehyde, total antioxidant capacity), at the base line, at the 5 th day and at the end of the study (10 th day) will be measured. Clinical and nutritional status will be assessed three times during the intervention. SOFA (sequential organ failure assessment) questionnaire for assessment of organ failure will be filled out every other day. The mortality rate will be calculated within 28 days of the start of the intervention. Weight, body mass index and body composition will be measured. All analyses will be conducted by initially assigned study arm in an intention-to-treat analysis. Discussion: We expect that supplementation of 150 mg pycnogenol for 10 days will improve clinical and nutritional status and reduce the inflammation and oxidative stress of the TBI patients.

Critically ill patients are diagnosed with signs such as oxidative stress, mitochondrial function impairment, dysfunction of the immune system, and acute inflammation. Inflammation and oxidative stress play a major role in the pathogenicity of most diseases in patients, especially those in intensive care units. Because of the side effects of chemical anti-inflammatory drugs, which include large intestinal ulcers, bleeding, and perforation, it seems that the use of natural anti-inflammatory compounds like melatonin could be very helpful. Melatonin productively interacts with different receptive nitrogen and oxygen species (receptor autonomous activities), up-regulates antioxidant chemicals, and down-regulates pro-oxidant chemicals (receptor-dependent activities). Melatonin attenuates molecular and cellular damage resulting from inflammation and oxidative stress. Previous studies have shown that melatonin reduces inflammation and oxidative stress levels. Thus, the use of safe doses of melatonin can reduce inflammation and oxidative stress. However, further studies are needed to verify these results.

Obesity is a consequence of an imbalance between energy intake and energy expenditure. It affects people of both genders and all age groups, ethnicity and socioeconomic groups, and in developed and developing countries. Obesity is often accompanied by the metabolic syndrome (MetS). MetS is characterized by a clustering of cardiovascular risk factors, including high blood pressure, adiposity, dyslipidemia and glucose intolerance, which together increase the risk of atherosclerotic cardiovascular disease, type 2 diabetes mellitus and other causes of mortality. Nowadays, there is a growing interest in the use of plant-based agents instead of synthetic drugs to manage chronic diseases such as MetS; one such example is Berberis vulgaris. B. vulgaris contains isoquinonline alkaloids such as berberine, berberrubine and berbamine. Recent studies have proved that berberine exhibits pharmacological activities and positive effects on the risk factors of obesity and MetS. We have reviewed original articles related to the possible molecular mechanisms of action of berberine on obesity and MetS. Berberine suppresses adipocyte differentiation and decreases obesity. It also regulates glucose metabolism via decreasing insulin resistance and increasing insulin secretion. Other effects of berberine include antihyperlipidemic and antihypertensive activities and endothelial protection.

Aim Clinical trials on the effect of pycnogenol supplementation on cardiometabolic health have been controversial. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the potential effect of pycnogenol supplementation on cardiometabolic profile. Methods PubMed, Scopus, and ISI Web of Science databases were searched until October 2018. RCTs that evaluated the effects of pycnogenol on cardiometabolic parameters were included. DerSimonian and Laird random-effect models were used to compute the weighted mean differences (WMDs) and 95% confidence intervals (CIs). Results Twenty-four RCTs including 1594 participants were included in the meta-analysis. Pycnogenol significantly reduced fasting blood glucose (WMD: −5.86 mg/dl; 95% CI: −9.56, −2.15), glycated hemoglobin (WMD = −0.29%, 95%CI: −0.56, −0.01), systolic blood pressure (WMD: −2.54 mmhg; 95% CI: −4.08, -0.99), diastolic blood pressure (WMD: −1.76 mmhg; 95% CI: −3.12, −0.41), body mass index (WMD: −0.47 kg/m2; 95% CI: −0.90, −0.03), LDL cholesterol (WMD: −7.12 mg/dl; 95% CI: −13.66, −0.58) and increased HDL cholesterol (WMD: 3.27 mg/dl; 95% CI: 0.87, 5.66). Conclusion This meta-analysis suggests that pycnogenol may have a role in preventing cardiometabolic disease. However, further well-designed RCTs are recommended to evaluate its long-term effects and explore the optimal duration of use and dosage.

hunger and because of the consumption of bread as the staple food of most Muslims, it influences the appetite and satiety of fasting individuals. The objective of this study was to investigate the effect of barley bread on appetite and satiety compared with white wheat bread in healthy fasting participants. Methods and Materials: This study was a clinical trial performed for 3 consecutive days during Itikaf ceremony. Demographic and anthropometric characteristics of healthy participants were assessed. 24 hours dietary recall used for dietary intakes. To measure appetite and satiety, FLINT visual analogue scale was used. Results: 184 healthy men and women in Itikaf fasting participated in this study. The results showed that during the fasting period, hunger in the barley bread group was significantly lower than white wheat bread group. Rate of hunger before the Iftar in the barley bread group was significantly lower than wheat bread group. During the time, the sense of hunger decreased before the Sahur in the barley group, but its trend was not statistically significant. During the fasting period, the highest reduction in satiety was observed in the first five hours of fasting, which did not differ significantly between the two groups. Satiety was increased before the Sahur in the barley group, but its trend was not statistically significant. Conclusion: This study show that barley bread decreased appetite and increased satiety during the fasting compared with wheat bread.