Association between adherence to the Dietary Approaches to Stop Hypertension diet with food security and weight status in adult women

AIM

To investigate the association between adherence to the Dietary Approaches to Stop Hypertension (DASH) diet with food security and weight status in adult women.

METHODS

This cross-sectional study was carried out in 227 women-20-50 years of age-who were referred from 10 health centres. Dietary intakes were assessed using validated food frequency questionnaires. The DASH score was calculated using the Fung method based on eight food and nutrient components (high intake of fruits, vegetables, whole grains, nuts and legumes, low-fat dairy, low intakes of red and processed meats, sweetened beverages and sodium). The United States Department of Agriculture (USDA) household food security questionnaire was used to assess food security status.

RESULTS

The prevalence of food insecurity was 33.9%. A greater percentage of overweight and obese people were in the food insecure group (P = 0.006). In addition, the prevalence of overweight and obese people was lower with greater adherence to the DASH dietary pattern (P = 0.017). After controlling for age and energy intake, participants in the highest tertile of adherence to DASH diet had 66% lower odds of overweight and obesity than those in the lowest tertile (odds ratio (OR): 0.34; 95% confidence interval (CI): 0.15; 0.79). This relationship of DASH diet tertile and overweight and obesity was significant for both food secure women (OR: 0.54, 95% CI: 0.23; 0.97) and food insecure women (OR: 0.35, 95% CI: 0.06; 0.42).

CONCLUSIONS

Adherence to the DASH diet is associated with a reduced risk of overweight and obesity, based on body mass index, in both food secure and insecure Iranian women.

Associations between higher egg consumption during pregnancy with lowered risks of high blood pressure and gestational diabetes mellitus

Abstract. Introduction: The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide. High cholesterol intake may increase the risk of hyperglycemia, yet little research has evaluated the relation between cholesterol or egg as a main source of dietary cholesterol and GDM. We aimed to study this association among pregnant Iranian women. Methods and Participants: Four hundred sixty-two pregnant women participated in this case-control study. Participants’ dietary intake, weight, height, and blood pressure were obtained and BMI was calculated. Fasting plasma glucose and liver enzymes were also measured. Logistic regression was used to obtain odds ratios and 95% confidence intervals for GDM across tertiles of cholesterol and egg consumption. Results: Among study participants, 115 consumed less than one, 194 consumed one and the remaining participants consumed more than one egg per week (mean cholesterol intake 121.31±61.69 mg/d). Participants within the highest tertile of egg consumption had 41% lower risk of GDM (OR: 0.59; 95% CI: 0.35-0.99) compared with those in the lowest tertile (P=0.01). Higher egg consumption was associated with lower risk of having high blood pressure (P=0.01). The difference in odds of GDM and high blood pressure between the highest and the lowest tertile of cholesterol consumption was not significant, even after controlling for age, energy intake, number of children and socio-economic status. Conclusion: Higher dietary intake of egg during pregnancy was associated with lower odds of GDM. We found no significant association between cholesterol intake and odds of GDM. Further research are needed to confirm these results and determine causality.

Associations Between Dietary Energy Density in Mothers and Growth of Breastfeeding Infants During the First 4 Months of Life

Objectives: Despite the overwhelming impact of dietary energy density on the quality of the entire diet, no research has investigated dietary energy density among lactating mothers. Hence, the present study was undertaken to assess the influence of maternal dietary energy density during lactation on infant growth.Method: Three hundred healthy lactating mother-infant pairs were enrolled in the study. Detailed demographic information and dietary intake data were collected from the lactating mothers. Anthropometric features such as infant weight, height, and head circumference at birth and 2 and 4 months and mother's pregnancy and postpartum weight and height were derived from health center records. Data on physical activity were reported using the International Physical Activity Questionnaire.Results: After adjusting for confounding variables, infant weight, length, weight-for-height, and head circumference at birth, 2 months, and 4 months did not show significant differences among four dietary energy density categories (all p values > 0.01).Conclusions: Our study showed no association among quartiles of dietary energy density among lactating mothers and infant weight, length, weight-for-height, and head circumference growth by 2 and 4 months of age.

Usual energy and macronutrient intakes in a large sample of Iranian middle-aged and elderly populations

AIM

The present study aimed to assess the usual distribution of energy and macronutrient intake among a large representative sample of Iranian healthy middle-aged and elderly people.

METHODS

In this cross-sectional study, a second follow-up survey of the Isfahan Cohort Study (ICS) was carried out; 1922 people aged 40 years and older were investigated. Dietary intakes were collected using 24-hour recall and two or more consecutive food records. Distribution of energy and macronutrient intake was estimated using traditional and National Cancer Institute (NCI) methods.

RESULTS

The mean usual intake of energy was 1749.2 kcal based on the NCI method. Carbohydrate constituted 59.98% and protein 17.42% of total energy intake. The mean contributions of total fat, saturated fatty acids (SFA), polyunsaturated fatty acids (PUFA) and monounsaturated fatty acids (MUFAs) to energy intake were 25.74%, 9.5%, 4.92 and 7.75%, respectively. Approximately 7% of studied females aged 51-70 years met the recommended or higher levels for fibre. Females had significantly higher compliance of the recommended cholesterol level than males (age range of 40-70 years; P < 0.0001).

CONCLUSIONS

It appears that Iranian middle-aged and elderly people are advancing towards a high risk of obesity and non-communicable chronic diseases. Nutritional interventions for improving the diet amongst this at-risk population are necessary.

Dietary Inflammatory Index and its Association with the Risk of Cardiovascular Diseases, Metabolic Syndrome, and Mortality: A Systematic Review and Meta-Analysis

Findings from previous studies on the association between the Dietary Inflammatory Index (DII) and the risk of chronic diseases and mortality have been inconsistent. We aimed to summarize studies on the association of the DII and the risk for cardiovascular disease (CVD), metabolic syndrome (MetS), and mortality in a systematic review and meta-analysis. We performed a systematic search in PubMed/Medline, Web of Knowledge, and Scopus databases for relevant studies written in English and published until 31 December 2017. Studies that reported the relative risk (RR), odd ratio (OR) or hazard ratio (HR) for the most pro-inflammatory versus the most anti-inflammatory diets were included. Finally, 17 studies [CVD (n=6), MetS (n=5), mortality (n=6)] were included for systematic review and meta-analysis. Findings indicated a trend toward a positive relationship between the DII and the risk for CVD (pooled RR: 1.35; 95% CI: 1.13, 1.60; I²: 28.6%, p=0.21), all-cause mortality (pooled HR: 1.21; 95% CI: 1.09, 1.35; I²: 72.6%, p=0.003), CVD mortality (pooled HR: 1.30, 95% CI: 1.07, 1.57; I²: 74.0%, p=0.009) and cancer mortality (pooled HR: 1.28; 95% CI: 1.07, 1.53; I²: 62.5%, p=0.03). However, no significant association was found between the DII and the risk for MetS (pooled RR: 1.01; 95% CI: 0.82, 1.24; I²: 32.6%, p=0.20). Although in the current meta-analysis the most pro-inflammatory diet versus the most anti-inflammatory diet was not associated with the risk of MetS, we observed a substantial association between the DII and the risk for CVD and all types of mortality. However, further cohort studies in different populations are needed to clarify this association.

Dietary Total Antioxidant Capacity and Cardiovascular Disease Risk Factors: A Systematic Review of Observational Studies

OBJECTIVE

Measurement of dietary total antioxidant capacity (DTAC) is considered a new holistic dietary approach and assesses total antioxidants present in the overall diet. Our aim was to perform a comprehensive review of the literature on the association between DTAC and cardiovascular disease (CVD) risk factors.

METHODS

PubMed, Web of Science, and Scopus were used to conduct a comprehensive search for articles published on this topic through September 2017. There was no limit on earliest year of publication. The search was based on the following keywords: dietary total antioxidant capacity, nonenzymatic antioxidant capacity, total radical-trapping antioxidant parameter, ferric reducing ability of plasma, oxygen radical absorbance capacity, Trolox equivalent antioxidant capacity, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), total cholesterol (TC), waist circumference (WC), insulin resistance, homeostatic model assessment of insulin resistance (HOMA-IR), insulin, obesity, glucose, C-reactive protein (CRP), blood pressure (BP), and body mass index. In total, 16 papers were identified for inclusion in the present systematic review.

RESULTS

Most well-designed studies that evaluated associations between DTAC and CVD risk factors showed inverse associations for fasting blood glucose, CRP, BP, and WC and positive associations for HDL-C. However, there was no association between DTAC and LDL-C or TC in any of the studies. Results regarding the association of DTAC with insulin, HOMA-IR, high-sensitivity CRP, and TG in the published literature were inconsistent.

CONCLUSIONS

Findings indicated a substantial association between high DTAC and most CVD-related risk factors.

Do patterns of nutrient intake predict self-reported anxiety, depression and psychological distress in adults? SEPAHAN study

BACKGROUND & AIMS

Despite the growing evidence about dietary patterns, this study aimed at the association between patterns of nutrients intake and psychological disorders.

METHODS

In this cross-sectional study, diet and psychological factors including anxiety, depression, and general health (GHQ) were assessed through self-administered questionnaires in 3846 Iranian adults. Daily intakes of 57 nutrients and bioactive compounds were calculated. Nutrient patterns (NPs) were derived using factor analysis.

RESULTS

Three NPs were identified: 1) high in individual amino acids, cobalamin, zinc, phosphorus, saturated fatty acids, cholesterol and pantothenic acid named as "omnivore"; 2) high in thiamin, folate, selenium, iron, starch, maltose, betaine, calcium, riboflavin, and niacin; named as "grains and dairy". Mono-unsaturated fats, vitamin E and polyunsaturated fats were inversely associated with this pattern; 3) "fruits and vegetables" NP high in copper, vitamin C, glucose, fructose, potassium, dietary fiber, sucrose, vitamin A, magnesium and vitamin K. After adjustment for confounders, men in the top tertile of the omnivore NP had lower anxiety score than those in the bottom tertile (P = 0.04). Men in the highest tertile of the first NP were less likely to be depressed (OR = 0.50, 95%CI: 0.26-0.96; P-trend = 0.04). Women in the highest tertile of this pattern had lower GHQ scores than those in the bottom tertile (P = 0.01) and had lower odds of psychological distress (OR = 0.75, 95%CI: 0.57-0.99, P-trend = 0.0.04).

CONCLUSIONS

An "omnivore" like diet high in amino acids, cobalamin, zinc, phosphorus, saturated fat, cholesterol and pantothenic acid is associated with reduced psychological disorders. Prospective studies are recommended to confirm our results.

Are Isolated and Complex Fiber Supplements Good Choices for Weight Management? A Systematic Review

BACKGROUND

Previous trials have reported beneficial effects of isolated and complex fiber supplements in obesity treatment. However, recommending fiber supplements in obese subjects remains controversial. To the best of our knowledge, no systematic review has updated the data on the effects of fiber supplements on obesity since 2010 and the need exists for a systematic review on this topic. Accordingly, a systematic review was undertaken to summarize the efficacy of different types of fiber supplements as a complementary treatment for weight management.

METHODS

We searched PubMed, Scopus, Cochrane Library and Google Scholar between January 2010 to August 2016 with no language restriction. Considering the inclusion/exclusion criteria and quality assessment score, finally 17 clinical trials met the eligibility criteria and were included.

RESULTS

The present study indicated that the efficacy of various fiber supplements on losing weight is variable. Several mechanisms related to physicochemical properties of fibers such as solubility, fermentability and viscosity rates can be involved in their anti-obesity effects. Dextrin, Mannan (gum Arabic) and pectin-rich fiber (lupin kernel) with no dietary interventions indicated a reduction in body weight and energy intake, while from clinical point of view, their effects were not considerable.

CONCLUSION

Overall, findings indicated that the efficacy of fiber supplements on obesity management is dependent on their contents and physicochemical properties. It seems that fiber supplements with no weight-loss interventions did not have considerable antiobesity effects. However, due to limited studies on each type of fiber, findings should be declared by caution. Additional research is needed on comparison of different fiber supplements in similar conditions to clarify the best type and dosage of fiber supplement as a complementary therapy in obesity management.

Comparison of Energy and Nutrient Contents of Commercial and Noncommercial Enteral Nutrition Solutions

Background:

Nutritional support plays a major role in the management of critically ill patients. This study aimed to compare the nutritional quality of enteral nutrition solutions (noncommercial vs. commercial) and the amount of energy and nutrients delivered and required in patients receiving these solutions.

Materials and Methods:

This cross-sectional study was conducted among 270 enterally fed patients. Demographic and clinical data in addition to values of nutritional needs and intakes were collected. Moreover, enteral nutrition solutions were analyzed in a food laboratory.

Results:

There were 150 patients who fed noncommercial enteral nutrition solutions (NCENS) and 120 patients who fed commercial enteral nutrition solutions (CENSs). Although energy and nutrients contents in CENSs were more than in NCENSs, these differences regarding energy, protein, carbohydrates, phosphorus, and calcium were not statistically significant. The values of energy and macronutrients delivered in patients who fed CENSs were higher (P < 0.001). Energy, carbohydrate, and fat required in patients receiving CENSs were provided, but protein intake was less than the required amount. In patients who fed NCENSs, only the values of fat requirement and intake were not significantly different, but other nutrition delivered was less than required amounts (P < 0.001). CENSs provided the nutritional needs of higher numbers of patients (P < 0.001). In patients receiving CENSs, nutrient adequacy ratio and also mean adequacy ratio were significantly higher than the other group (P < 0.001).

Conclusion:

CENSs contain more energy and nutrients compared with NCENSs. They are more effective to meet the nutritional requirements of entirely fed patients.

Adherence to Dietary Approaches to Stop Hypertension (DASH) Dietary Pattern in Relation to Chronic Obstructive Pulmonary Disease (COPD): A Case-Control Study

OBJECTIVE

This case-control study was designed to investigate the association between adherences to the Dietary Approaches to Stop Hypertension (DASH) diet in patients with chronic obstructive pulmonary disease (COPD) in comparison to subjects without COPD.

DESIGN

This is a case-control study. Usual dietary intake was assessed using a validated food frequency questionnaire. Lung function was evaluated with spirometry testing, and one of the researchers inquired about other respiratory symptoms, including chronic cough, sputum, and breathlessness. Adherence to the DASH dietary pattern was assessed according to the Fung method.

SETTING

This study was conducted at Alzahra University Hospital of Isfahan, Iran, in 2015.

SUBJECTS

Eight-four patients with COPD and 80 subjects without a history of COPD participated in study.

RESULTS

The mean age of participants was 57 years. Average smoking in the case group was about 27.5 pack-years. Spirometry tests including forced expiratory volume in 1 second (FEV₁), forced vital capacity (FVC), and FEV₁/FVC were significantly lower in patients with COPD (p = 0.0001). Among COPD symptoms, cough was significantly decreased across tertiles of DASH score (p = 0.03). Significant differences were found for DASH score between patients with COPD and control subjects (19.82 + 3.63 vs 21.13 + 3.82, p = 0.02). Vitamin C, vitamin E, and dietary fiber intake were lower in patients with COPD (144.32 + 70.51 vs 166.97 + 71.88, p = 0.04, 7.49 + 3.91 vs 8.72 + 3.21, p = 0.02 and 19.34 + 7.05 vs 22.19 + 7.87, p = 0.01, respectively).

CONCLUSION

We observed that adherence to a DASH dietary pattern among patients with COPD was significantly lower compared to the control group. Cough was significantly decreased by increments in adherence to a DASH dietary pattern.

Effects of a Low-Calorie, Low-Carbohydrate Soy Containing Diet on Systemic Inflammation Among Patients with Nonalcoholic Fatty Liver Disease: A Parallel Randomized Clinical Trial

Few studies have focused on the effects of a soy containing diet on inflammation and serum leptin level among patients with nonalcoholic fatty liver disease (NAFLD). Therefore, we aimed to determine the effects of such a diet in patients with NAFLD. Forty-five patients with NAFLD participated in this parallel randomized clinical trial for 8 weeks. Patients were randomly allocated to these 3 groups: 1) a low-calorie diet, 2) low-calorie low-carbohydrate diet, and 3) low-calorie low-carbohydrate soy containing diet. Low-calorie low-carbohydrate soy containing diet reduced fasting blood sugar (FBS) and serum insulin level significantly compared to other 2 groups (-11.6±2.8 vs. -6.3±1.7 and -3.1±1.0 mg/dl for FBS; and -5.1±1.2  vs. -1.2±0.3 and -1.7±0.5 mg/dl for serum insulin level). Serum hs-CRP level was also reduced significantly following low-calorie low-carbohydrate soy containing diet (-0.8±0.1 vs. -0.1±0.06 and -0.1±0.06 mg/dl). Both systolic and diastolic blood pressures were reduced significantly. Changes in leptin level tended to be different among 3 groups. After trial, 5 patients in each intervention group did not have NAFLD. From 6 patients in grade 2 at the beginning only 1 patient remained and others moved to grade 1. Low-calorie low-carbohydrate soy containing diet could reduce glycemic indices, hs CRP, systolic and diastolic blood pressure in a significant level in patients with NAFLD. However, these effects were dependent on baseline weight and further studies are needed to clarify the effect of such interventions in subjects with different BMI categories.

Family Dinner Frequency is Inversely Related to Mental Disorders and Obesity in Adolescents: the CASPIAN-III Study

PURPOSE

Family dinner is a proxy of family connectedness that may affect mental health. The present study aimed to examine the associations of frequency of family dinner with mental disorders and obesity in a nationally-representative sample of Iranian adolescents.

METHODS

A total of 5528 Iranians adolescents aged 10-18 years were enrolled in 2009-2010 in the third survey of a national surveillance program, entitled Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable disease (CASPIAN-III) study. The frequency of family dinner meal was assessed. Mental health assessments were done as part of the World Health Organization-Global School-based Student Health Survey. The odds of having mental disorders and obesity were assessed by logistic regression.

RESULTS

No significant difference was found in dietary intake between family dinner consumers (≥5 times (night)/wk) and skippers (<5 times/wk); however, they were more likely to consume breakfast and had higher meal frequency. After controlling for some confounders, dinner consumers had lower odds for all types of mental disorders (OR = 0.55; 95% CI = 0.47-0.64), anxiety (OR = 0.47; 95% CI = 0.4-0.54), insomnia (OR = 0.6; 95% CI = 0.53-0.7), and confusion (OR = 0.7; 95% CI = 0.6-0.86), as well as the body mass index- z score (OR = 0.78; 95% CI = 0.73-0.84).

CONCLUSION

The current study showed an inverse relationship between the frequency of family dinner consuming and mental disorders and obesity in a nationally-representative sample of Iranian adolescents. Such simple recommendations for consuming family dinner for families may be feasible, sustainable, and effective for health promotion and disease prevention.

Low-Carbohydrate-Diet Score and its Association with the Risk of Diabetes: A Systematic Review and Meta-Analysis of Cohort Studies

The association between a low-carbohydrate diet (LCD) score and the risk of diabetes mellitus (DM) is contradictory. This study is a systemic review of cohort studies that have focused on the association between the LCD score and DM. We searched PubMed/Medline, Scopus, Embase, ISI Web of Science, and Google Scholar for papers published through January 2017 with no language restrictions. Cohort studies that reported relative risks (RRs) with 95% confidence intervals (CI) for DM were included. Finally, 4 studies were considered for our meta-analysis. The total number of participants ranged from 479 to 85 059. Among 4 cohort studies, 8 081 cases with DM were observed over follow-up durations ranging from 3.6 to 20 years. A marginal significant association was observed between the highest LCD score and the risk of DM (RR=1.17; 95% CI: 0.9, 1.51). Moreover, the RRs for studies with energy adjustments showed a significant association (RR: 1.32; 95% CI: 1.17, 1.49; I²: 0%). Based on our findings, study qualities score of less or equal to 7 had a significant influence on the pooled effect size (RR=1.31, 95%CI: 1.15, 1.49; I²: 0%), whereas the overall RR in the studies with quality score more than 7 was 1.09 (95% CI: 0.73, 1.63). In conclusion, we have found that the highest LCD score was marginally associated with the risk of DM. However, more prospective cohort studies are needed to clarify the effects of the LCD score on the risk of DM.

Comparison of Three Diet Quality Indices for Patients with Chronic Kidney Disease

BACKGROUND

Patients with chronic kidney disease (CKD) have specific dietary needs due to recommended dietary restrictions. However, there is no specific index for evaluating the quality of diet in patients with CKD.   OBJECTIVE: To define and compare three specific diet quality indices in patients with CKD.

METHODS

Two hundred twenty-one subjects with CKD were selected for this cross-sectional study. The patients' Dietary intake was assessed with a validated food frequency questionnaire. Total protein intake per body weight (TP/BW), animal protein intake per body weight (AP/BW) and animal protein to vegetable protein ratio (AP/VP) were defined as diet quality indices. Renal function was measured by blood urea nitrogen (BUN) and serum creatinine (Cr).

RESULTS

Patients in the highest tertile of TP/BW and tertile of AP/BW consumed more amounts of nutrients which should be limited in CKD (i.e., sodium, potassium and phosphorus). Subjects in the last tertile of AP/BW had higher BUN and Cr. A marginally significant increased risk of higher stage of CKD across the tertiles of AP/BW was observed after adjusting for potential confounders (OR = 2.20, 95% CI: 1.06, 4.56; P = 0.08).

CONCLUSION

The results showed that AP/BW is a good diet quality index and is marginally associated with being in higher stages of CKD.

Dietary glycaemic index and glycaemic load and upper gastrointestinal disorders: results from the SEPAHAN study

BACKGROUND

Little is known about the effects of carbohydrate, particularly any association between dietary glycaemic index or glycaemic load and uninvestigated heartburn or uninvestigated chronic dyspepsia in the community. The present study aimed to determine associations between dietary glycaemic index or glycaemic load and uninvestigated heartburn or uninvestigated chronic dyspepsia.

METHODS

This cross-sectional study was conducted in 2987 adults. Dietary glycaemic index and glycaemic load were estimated using a validated food-frequency questionnaire. Uninvestigated heartburn and uninvestigated chronic dyspepsia were determined using a modified and validated version of the Rome III questionnaire.

RESULTS

After controlling for various confounders, high glycaemic load was associated with an increased risk of uninvestigated heartburn [odds ration (OR) = 1.75; 95% confidence interval CI = 1.03, 2.97; P = 0.04] and uninvestigated chronic dyspepsia (OR = 2.14; 95% CI: 1.04, 4.37; P = 0.04) in men but not in women. In normal-weight individuals, high glycaemic index was related to an increased risk of uninvestigated heartburn (OR = 1.52; 95% CI: 1.07, 2.15; P = 0.02) and high glycaemic load to an increased risk of uninvestigated chronic dyspepsia (OR=1.78; 95% CI: 1.05, 3.01; P = 0.03). No significant associations were observed in subjects with excess body weight.

CONCLUSIONS

Our data suggest that there are body mass index- and sex-specific associations between dietary carbohydrate quality with uninvestigated heartburn and uninvestigated chronic dyspepsia.

Antioxidant Capability of Ultra-high Temperature Milk and Ultra-high Temperature Soy Milk and their Fermented Products Determined by Four Distinct Spectrophotometric Methods

Background:

Due to the recent emerging information on the antioxidant properties of soy products, substitution of soy milk for milk in the diet has been proposed by some nutritionists. We aimed to compare four distinct antioxidant measuring methods in the evaluation of antioxidant properties of industrial ultra-high temperature (UHT) milk, UHT soy milk, and their fermented products by Lactobacillus plantarum A7.

Materials and Methods:

Ascorbate auto-oxidation inhibition assay, 2,2-diphenyl-1-picryl-hydrazyl-hydrate (DPPH) free radical scavenging method, hydrogen peroxide neutralization assay and reducing activity test were compared for the homogeneity and accuracy of the results.

Results:

The results obtained by the four tested methods did not completely match with each other. The results of the DPPH assay and the reducing activity were more coordinated than the other methods. By the use of these methods, the antioxidant capability of UHT soy milk was measured more than UHT milk (33.51 ± 6.00% and 945 ± 56 μM cysteine compared to 8.70 ± 3.20% and 795 ± 82 μM cysteine). The negative effect of fermentation on the antioxidant potential of UHT soy milk was revealed as ascorbate auto-oxidation inhibition assay, DPPH method and reducing activity tests ended to approximately 52%, 58%, and 80% reduction in antioxidant potential of UHT soy milk, respectively.

Conclusions:

The antioxidative properties of UHT soy milk could not be solely due to its phenolic components. Peptides and amino acids derived from thermal processing in soy milk probably have a main role in its antioxidant activity, which should be studied in the future.

Alpha-lipoic acid supplement in obesity treatment: A systematic review and meta-analysis of clinical trials

BACKGROUND & AIMS

Previous studies have supported positive roles of antioxidant supplements on weight-loss. One antioxidant supplement is Alpha-lipoic acid. However, recommending ALA as an anti-obesity supplement remains controversial. Accordingly, the purpose of the present study was to perform a meta-analysis on the effects of ALA supplement on anthropometric indices among adult subjects.

METHODS

We searched five electronic databases till September 2016. Placebo-controlled clinical trials were included. Weighted Mean Difference (WMD) was pooled using a random-effects model.

RESULTS

Findings of 12 included trials indicated that ALA supplement reduced body weight (WMD: -0.69 kg; 95% CI: -1.27, -0.10; I² = 0%) and BMI (WMD: -0.38 kg/m²; 95% CI: -0.53, -0.24; I² = 0%) significantly compared to the placebo group. However, its effects on Waist Circumference (WC) was not significant (WMD: -0.30 cm; 95% CI: -1.18, 0.58; I² = 17.8%). Stratification by health status indicated that ALA decreased WC in unhealthy subjects (WMD: -2.00 cm; 95% CI: -4.19, 0.19; I² = 1.3%) more than healthy individuals (0.03 cm; 95% CI: -0.69, 0.75; I² = 0%).

CONCLUSIONS

The present study revealed that supplementation with ALA slightly but significantly decreased body weight and BMI. Safe dosage for ALA is up to 1200 mg/day. However, it seems that ALA cannot be cost-effective. Further studies are needed to clarify the effects of ALA on metabolic parameter in unhealthy obese individuals.

Healthy eating index and cardiovascular risk factors among Iranian elderly individuals

BACKGROUND

Concurrent with increase in life expectancy, the prevalence of chronic diseases such as cardiovascular diseases (CVD) has also increased. Therefore, the aim of this study was to evaluate the association between healthy eating index (HEI) score and CVD risk factors among Iranian elderly.

METHODS

This cross-sectional study was performed on a sample of elderly persons from Isfahan, Iran, in 2013. Totally, 107 retired subjects were entered in statistical analysis. A semi- quantitative food frequency questionnaire was used to assess the dietary intake of participants. Anthropometric measurements and blood pressure of participants were determined. Fasting blood samples were taken for biochemical assessments.

RESULTS

The results of linear regression determined a significant inverse association between HEI score and homeostasis model assessment of insulin resistance [HOMA-IR, β = -0.238 (-0.426, -0.048)], fasting blood glucose [β = -0.194 (-0.383, -0.004)], and high-sensitivity C-reactive protein [hs-CRP, β = -0.196, (-0.386, -0.005)]. In addition, a significant positive association was observed between HEI score and high density lipoprotein cholesterol [HDL-C, β = 0.196 (0.006, 0.385)] levels. However, after adjusting for confounding variables, these significant associations were disappeared except for hs-CRP [β = -0.074 (-0.145, -0.003)].

CONCLUSION

Healthy eating index was associated with reduced risk of cardiovascular risk factors in old people. It seems that more adherence with healthy eating index could provide cardio-protective effects in elderly persons.

Effect of Coenzyme Q10 Supplementation on Diabetes Biomarkers: a Systematic Review and Meta-analysis of Randomized Controlled Clinical Trials

BACKGROUND

Several studies have investigated the effect of Co-Q10 on diabetes biomarkers, but findings are inconsistent. This systematic review and meta-analysis of clinical trials was conducted to summarize the effect of Co-Q10 supplementation on diabetes biomarkers.

METHODS

We searched Pubmed, EMBASE, Science direct, ISI web of science, and Google Scholar for randomized controlled trials from 1989 until March 2016. We included randomized controlled trials reporting fasting blood glucose (FBG), fasting insulin and HbA1c. In total, we found 16 articles that examined the effect of Co-Q10 on fasting blood glucose, fasting insulin and HbA1c. Mean ± standard deviations (SD) of defined outcomes were used for calculating standardized mean differences (SMD) and its 95% confidence interval (95%CI) between intervention and control treatments based on Hedges' estimator.

RESULTS

Our preliminary meta-analysis on 14 eligible studies regarding the effect of Co-Q10 supplementation on FBG indicated a slightly significant decrement (SMD:-0.28 mg/d; 95% CI: -0.12, 0.04), with a substantial between-study heterogeneity (Cochrane Q test, I2 = 93.9%, P < 0.0001). After removal of three studies, heterogeneity was eliminated and a slightly significant decrease was found in FBG (SMD: -0.20 mg/dL, 95% CI: -0.38, -0.02). The effect of Co-Q10 on HbA1c and fasting insulin was not significant. SMDs for the effect of Co-Q10 on HbA1c and fasting insulin were -0.05% (95% CI: -0.22, 0.12) and 0.12 pmol/L (95% CI: -0.21, 0.44), respectively.

CONCLUSION

Co-Q10 supplementation slightly but significantly reduced fasting blood glucose, but not fasting insulin and HbA1c. More long-term studies are necessary to examine the association between Co-Q10 supplementation and diabetes biomarkers. This study was funded by the School of Nutrition and Food Science, Isfahan University of Medical Sciences.

Ovarian cancer risk and nonisoflavone flavonoids intake: A systematic review of epidemiological studies

Background:

Although several studies have investigated the association between ovarian cancer risk and nonisoflavone flavonoids intake, these findings are inconsistent. This systematic review of published epidemiological studies was conducted to summarize and clarify the evidence on the association between ovarian cancer incidence and nonisoflavone flavonoids intake.

Materials and Methods:

PubMed, Scopus, Google Scholar, and EMBASE databases were searched based on MeSH term (ovarian neoplasm in combination with flavonoids) to identify related English and non-English papers published up to June 2016. We summarized the results of the relevant studies in this review.

Results:

In total, seven studies (four with cohort and three with case–control design) included in this review. The results of conducted cohort studies show no relation between ovarian cancer risk and total nonisoflavone flavonoids intake, and only one study reported a significant reduction between ovarian cancer incidence and kaempferol and luteolin intake. Similar to those in the cohort studies, also in case–control studies, no association was found between total nonisoflavone flavonoids intake and ovarian cancer risk, just an inverse association between flavonols intake and ovarian cancer was reported.

Conclusion:

Several studies investigated the relation of nonisoflavone flavonoids intake and ovarian cancer risk; none of them reported any association for total nonisoflavone flavonoids intake, but some reported an inverse association between certain subclasses or individual flavonoids. These findings are limited, and there is a need for further and more accurate researches to be confirmed.