The Association between Nuts Intake and Non-Alcoholic Fatty Liver Disease (NAFLD) Risk: a Case-Control Study

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease. Nuts are nutrient- and calorie-dense foods with several health-promoting compounds. In this case-control study, we investigated the association between nut intake and NAFLD risk. Hundred ninety-six subjects with NAFLD and eight hundred three controls were recruited. The participants' dietary intakes were assessed by a valid and reliable semi-quantitative food frequency questionnaire (FFQ). Participants were categorized according to deciles of daily nuts intake. Multivariable logistic regression models were used with NAFLD as the dependent and deciles of daily nuts intake as an independent variables. Range of age was 18 to 75 years. Forty three percent of participants were male. Range of nuts intake was between 0 to 90.90 g/day. In model 3, after adjusting for potential confounding variables including, age, sex, BMI, alcohol consumption, smoking, diabetes and physical activity, the relation between daily nuts intake and risk of NAFLD was positive and significant in the deciles 9 and 10 compared to the lowest decile (odds ratio [OR], 3.22; 95% confidence interval [CI], 1.04–7.49; p = 0.039 and OR, 3.03; 95% CI, 1.03–8.90; p = 0.046, respectively). However, in the final model after additional adjusting for energy intake, no significant association was found. According to the findings, there is not any significant relationship between nuts intake and NAFLD risk; while higher intake of nuts is related to the higher risk of NAFLD mediated by energy intake.

Effects of l-arginine supplementation on glycemic profile: Evidence from a systematic review and meta-analysis of clinical trials / 中西医结合学报

BACKGROUND@#The effects of l-arginine supplementation on indices of glycemic control and the role of many factors influencing this intervention have been controversial in clinical trials.@*OBJECTIVE@#This meta-analysis was performed to assess the effects of l-arginine supplementation on indices of glycemic control, including fasting blood glucose (FBG), hemoglobin A1c (HbA1c), serum insulin and homeostatic model assessment of insulin resistance (HOMA-IR) levels in randomized controlled trials (RCTs).@*SEARCH STRATEGY@#This study conducted a systematic review of RCTs published in PubMed, Scopus, Web of Science, Cochrane Library and Embase, up to 5 May, 2018.@*INCLUSION CRITERIA@#Studies were included in this meta-analysis if they were RCTs with parallel design and reported sufficient data on participants before and after intervention, and outcomes of glycemic profile parameters in both the arginine supplementation and control groups.@*DATA EXTRACTION AND ANALYSIS@#The screening of titles and abstracts was performed independently by two reviewers. Selected articles were considered if they met the study's inclusion criteria. The quality of included studies was assessed by using the Cochrane Collaboration modified tool. From 710 articles retrieved in the initial search, only 10 trials were suitable for pooling the effects of arginine supplementation on serum glucose, insulin, HOMA-IR and HbA1c levels, with effect sizes of nine, eight, five and five, respectively.@*RESULTS@#Pooled random-effect analysis revealed that l-arginine supplementation could significantly decrease FBG level (weighted mean difference [WMD]: 3.35 mg/dL; 95% confidence interval [CI] = [-6.55, -0.16]; P = 0.04) and serum insulin level (WMD: -2.19 μIU/mL; 95% CI = [-3.70, -0.67]; P = 0.005). However, the effects of l-arginine supplementation on HOMA-IR and HbA1c were not significant. Results of subgroup analysis showed that supplementation with l-arginine could significantly decrease serum insulin levels when the dosage of l-arginine is > 6.5 g/d (WMD: -3.49 μIU/mL; 95% CI = [-5.59, -1.38]; P = 0.001), when the duration of supplementation is ≤ 12.8 weeks (WMD: -3.76; 95% CI = [-6.50, -0.98]; P = 0.008), when the participants are not diabetic patients (WMD: -2.54 μIU/mL; 95% CI = [-4.50, -0.50]; P = 0.01) and when the baseline serum level of insulin was > 20 μIU/mL (WMD: -3.98; 95% CI = [-6.31, -1.65]; P = 0.001).@*CONCLUSION@#Although the results of this study confirmed that supplementation with l-arginine could have significant effects on some glycemic profile indices of participants in clinical trials, the clinical importance of this reduction may not be meaningful.

The Association between Nuts Intake and Non-Alcoholic Fatty Liver Disease (NAFLD) Risk: a Case-Control Study

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease. Nuts are nutrient- and calorie-dense foods with several health-promoting compounds. In this case-control study, we investigated the association between nut intake and NAFLD risk. Hundred ninety-six subjects with NAFLD and eight hundred three controls were recruited. The participants' dietary intakes were assessed by a valid and reliable semi-quantitative food frequency questionnaire (FFQ). Participants were categorized according to deciles of daily nuts intake. Multivariable logistic regression models were used with NAFLD as the dependent and deciles of daily nuts intake as an independent variables. Range of age was 18 to 75 years. Forty three percent of participants were male. Range of nuts intake was between 0 to 90.90 g/day. In model 3, after adjusting for potential confounding variables including, age, sex, BMI, alcohol consumption, smoking, diabetes and physical activity, the relation between daily nuts intake and risk of NAFLD was positive and significant in the deciles 9 and 10 compared to the lowest decile (odds ratio [OR], 3.22; 95% confidence interval [CI], 1.04–7.49; p = 0.039 and OR, 3.03; 95% CI, 1.03–8.90; p = 0.046, respectively). However, in the final model after additional adjusting for energy intake, no significant association was found. According to the findings, there is not any significant relationship between nuts intake and NAFLD risk; while higher intake of nuts is related to the higher risk of NAFLD mediated by energy intake.

[ association between dietary fat intake and pancreatic cancer risk: a large prospective study]

Pancreatic cancer [PC] is classified as one of the most deadly cancers. Since the role of diet in modifying the effects of known risk factors of PC has been well established, exploring the dietary intakes in relation to the etiology of PC can be useful for elucidating the mechanisms of the disease progression

Materials and Methods: This study was conducted within the Golestan prospective cohort study. The estimated intake of total fat and various dietary fat sources was calculated using a validated semi-quantitative food frequency questionnaire. The relationship between these dietary intakes and risk of PC was examined using Cox Regression and hazard ratio [HR] with 95% confidence interval [CI 95%] was reported

Results: During 383,630 person-years follow-up and after excluding subjects with incomplete baseline information, a total of 48,676 adults were studied. Until October 30, 2014, 54 cases of PC were confirmed by medical professionals, based on the medical records and the exact cause of death using the criteria of the International Statistical Classification of Diseases and Related Health Problems 10 [ICD10]. After adjusting for potential confounders we did not observe any statistically significant relationship between the intake of total fat and various dietary fat sources and risk of PC. There was only a significant positive association between the risk of PC and daily intake of butter, cream, and solid vegetable oil in the age-adjusted regression models [HR=2.10; 95% CI=1.04-4.21; P for trend=0.03]. However, this relationship was not remained significant anymore in the fully adjusted models

Conclusion: Based on the results of the current research, after taking into account all of the potential confounding factors, dietary intake of total fat as well as various dietary fat sources had no significant association with the risk of PC. However, it is likely that consuming substantially less saturated and trans fat sources such as dairy fats as well as solid vegetable oils may be beneficial to reduce the risk of this cancer

[Higher intake of dietary fiber, but not fruits or vegetables is associated with lower risk of pancreatic cancer: a large prospective study]

Background: pancreatic cancer [PC] is classed as the 7th leading cause of cancer-related death in the world. Previous evidence indicates that hyperglycemia, insulin resistance, diabetes, and obesity are implicated in pancreatic carcinogenesis. Thus, evaluation of the dietary intakes in the etiology of PC can be useful to identify the risk factors of the disease

Materials and Methods: we examined the association between total intake of fruits, vegetables, and dietary fiber and the risk of PC in 50,045 participants aged 40-75 years within the Golestan Cohort Study. Dietary data were collected using a validated semi-quantitative food-frequency questionnaire, which was administered at baseline. Cox proportional hazards models were used to estimate multivariate hazard ratio with 95% confidence interval

Results: during 383,630 person-years of follow-up and after excluding the participants with incomplete baseline information, a total of 48,676 adults were evaluated. Until October 30, 2014, 54 cases of PC were confirmed based on the exact cause of death using ICD10 criteria. After considering all potential confounding factors, there was only a statistically significant inverse association between the risk of PC for the highest tertile of daily fiber intake compared with the lowest tertile [HR=0.41; 95% CI= 0.15-1.05; P for trend= 0.05]. However, the relationship between fruits and vegetables and PC risk was not statistically significant

Conclusion: in summary, based on the findings of this study, increased dietary fiber may reduce the risk of PC. This result highlights the importance of a diet rich in fiber in order to prevent PC progression. Finally, given the limited number of studies in this field and inconclusive results, there is still a need for new prospective studies with long follow-up

A novel treatment for weight reduction by the recombinant "Pichia pastoris" yeast expressing the hybrid protein of "irisin-furin-transferrin" / 中西医结合学报

Obesity is a major health problem across the world, but there are few ways to effectively treat or manage it in the long term. Researchers are searching for more convenient, cost-effective and noninvasive therapies for overweight and obese people. Recent studies have illustrated that the microbiome of the body's different organs can be used as a vehicle for in-situ gene therapy. We suggest that the recombinant form of "Pichia pastoris" yeast expressing the hybrid protein of "irisin-furin-transferrin" under the control of the enolase 1 promoter is a new nutraceutical strategy to absorb fewer calories from intestinal nutrients, and induce a higher metabolic rate to expend more calories, similar to that from engaging in physical activity. By comparison, this method can be a long-term, noninvasive treatment and can be used for obese patients who have movement limitations.

nail as a biomonitor of trace element status in Golestan cohort study

Background: In the Golestan Cohort Study that was launched to investigate the causes of esophageal cancer, a complete biospecimen bank was established for storage of collected blood, urine, hair, and nail samples. The objective of this study was to evaluate the feasibility of nail samples as a biomarker of selected trace elements status

Methods: Thirty toenail samples were selected randomly from the participants of Golestan Cohort Study [GCS]. The samples were cleaned and analyzed for selenium, mercury, chromium, iron, zinc, and scandium by instrumental neutron activation analysis at the University of Missouri Research Reactor Center. Pearson correlation coefficients were computed for selected trace elements concentration versus scandium concentration to assess terrestrial contamination

Results: The selenium, zinc, and mercury were not correlated with scandium, suggesting they were free from substantial contamination. The high correlations of scandium with iron and chromium suggest that the iron and chromium levels may be compromised by terrestrial contamination. The coefficients of variation for duplicate samples for selenium and zinc were 2.6% and 7.2%, respectively

Conclusion: The nail samples from Golestan Cohort Study appears to be useable as a biomarker of selenium, zinc, and mercury and could be considered for use in future studies

Manganese intake and risk of esophageal cancer in golestan cohort study

Background: Infections attributed to Helicobacter pylori [H. pylori] involve almost half of the world's population. One of the effects is auto-antibody induction and cross-reaction with numerous proteins in the body. As a result of its widespread prevalence and importance, this study evaluates the associations between H. pylori and thyroid auto-antibodies

Materials and Methods: This study enrolled 100 patients who were candidates for gastroesophageal endoscopy that referred to the Yazd Gastrointestinal Clinic. Patients underwent the following laboratory analyses: urease test, anti-H. pylori [IgG], TSH, T4, T3 and thyroid auto-antibodies [anti-thyroglobulin, anti-thyroid peroxides] Patients were divided into two groups of H. pylori positive and negative according to the results of the anti-H. pylori IgG and urease tests. The level of thyroid auto-antibodies and thyroid function tests were compared between groups. Data were analyzed with chi-square and t-tests. SPSS software version 17 was used for data analysis

Results: Overall, 61 % of patients were H. pylori positive. The mean anti-Thyroid peroxidase level in the H. pylori positive group was significantly more than the negative group [p<0.01]. In addition, 19.7% of H, pylori positive patients and 5.1% of H. pylori negative patients had positive anti-TPO levels, which the difference between both groups was significant [p<0.04]. There was no significant difference in thyroid fimction between the two groups

Conclusion: Although no significant difference in thyroid function was seen in the two groups more patients tested positive for anti-TPO levels in the H. pylori positive group, which was suggestive of thyroid auto-antibody induction by H. pylori

accessible and pragmatic experimental model of nonalcoholic fatty

Background: There is no convenient cheap pragmatic experimental model for Nonalcoholic Fatty Liver Disease [NAFLD]/Nonalcoholic Steatohepatitis [NASH]. We aimed to create a pragmatic model of NAFLD/NASH

Method: Sprague-Dawley rats were fed a high-fat, high sugar homemade diet ad libitum for seven weeks. The high-fat, high sugar diet included 59% of energy derived from fat, 30% from carbohydrates, and 11% from protein. Serum levels of fasting glucose, triglyceride, cholesterol, liver enzymes, insulin, and hepatic tumor necrosis factor-alpha [TNF-alpha] gene expression were determined. Hepatic histology was examined by H and E stain

Results: Rats fed the high-fat, high sugar diet developed hepatic steatosis, and a moderate inflammation, which was associated with increased serum levels of liver enzymes, glucose, insulin, triglyceride, cholesterol, and hepatic TNF-alpha gene expression

Conclusion: This rat model resembles the key features of human NAFLD/NASH and provides a simple pragmatic experimental model for elucidating the disease prevention and treatment

association between dietary carbohydrate intake and pancreatic cancer risk: a large prospective study

Background: Pancreatic cancer [PC] is ranked as the 7th leading cause of cancer death worldwide and is one of the most deadly cancers. Several lines of evidence indicate that insulin resistance, diabetes, and obesity are implicated in its carcinogenesis

Materials and Methods: We examined the association between the consumption of carbohydrate foods and risk of PC in 50,045 participants [21241 men and 28804 women aged 40 to 75 years] of the Golestan Cohort Study in northeastern Iran. Dietary data were collected using a validated semi-quantitative food-frequency questionnaire. Cox proportional hazards models were used to estimate multivariate hazard ratio with 95% confidence interval

Results: During 8.5 years [383,630 person-years] of follow-up and after excluding participants with incomplete data, a total of 48,676 adults [20,683 men and 27,993 women] were studied. Until October 30, 2014, 54 cases of pancreatic cancer were confirmed by a medical team, based on the medical records and the exact cause of death according to ICD10 criteria. After adjusting for age, total energy intake, history of diabetes, smoking status, education, opium consumption, body mass index, waist to hip ratio, ethnicity, sex, the metabolic equivalent of task [MET], residential area, and socioeconomic status, we did not observe any statistically significant relationship between consumption of total carbohydrate and carbohydrate foods including whole grains, refined grains, sugars, and potatoes and risk of PC

Conclusion: Based on the results of the present study, dietary intake of total carbohydrate as well as various carbohydrate food sources had no significant association with the risk of PC. Finally, given the limited number of studies in this field and their inconclusive results, there is still a need for new prospective studies with long follow-up

Soy isoflavones supplementation for patients with irritable bowel syndrome: a randomized double blind clinical trial

Irritable bowel syndrome [IBS] is one of the common gastrointestinal disorders with unknown etiology. In experimental models, it is proposed that soy isoflavones may suppress the clinical and psychological symptoms of IBS by alteration of gut barrier tight junctions. We conducted this study to evaluate the effects of soy isoflavones on IBS symptoms and patients' quality of life. In a randomized double blind placebo-controlled clinical trial, 67 patients with IBS were allocated to consume either soy isoflavones capsules or a placebo for 6 weeks. The primary outcome was a significant reduction in symptoms severity score and the secondary outcome was a significant improvement in quality of life. 45 participants completed the study. There was no significant changes in mean differences of symptoms severity score between the two groups; however soy isoflavone supplementation could significantly improve the quality of life scores [p=0.009]. Soy isoflavones supplementation could improve the quality of life in patients with IBS; however it did not suppress the symptoms seventy in 6 weeks. Further research with a longer duration is needed to determine the sustained clinical efficacy. This study was registered at clinicaltrials.gov as NCT02026518

Systematic review of zinc biomarkers and esophageal cancer risk

It is hypothesized that poor zinc nutritional status is associated with an increased risk of esophageal cancer [EC], but current evidence is contradictory. Since some factors may influence zinc absorption, its status may be better evaluated thorough biomarkers. The objectives of this study were to perform a systematic review on the association of zinc biomarkers with EC in observational studies and to evaluate the efficacy of zinc supplements in preventing EC in randomized trials. The MEDLINE database was searched in December 2013 for studies written in English with relevant keywords. Articles which met inclusion criteria were included in this study. Eleven observational studies that measured zinc biomarkers and eight randomized trials which evaluated supplements containing zinc, met our inclusion criteria. The majority of studies suggested that higher zinc status was inversely associated with EC risk. Most of the evidence for this hypothesis comes from case-control studies, which may introduce bias. Cohort studies are needed to establish whether poor zinc status is associated with increased risk for EC. Findings from trials are inconclusive as there is no data from single agent trials. However, the evidence is not still strong enough to conclude a protective role of zinc in EC

[Diet therapy in irritable bowel syndrome; a review]

Irritable Bowel Syndrome [IBS] has the most common functional gastrointestinal disease and has among the most common reasons for outpatients doctor visit both in primary and specialty clinics. Patients suffer from lifelong chronic abdominal pain, diarrhea, constipation, bloating and flatus often associated with anxiety depression which significant opposing effect on the quality of life and have to use the patients to use the healthcare system and induce a huge cost for health care system. It has also result in abstinence from work and its economic consequences. Treatment of irritable bowel syndrome has symptom base which were most challenging aspect of clinical practice. Recently there was accumulating evidence in favor of dietary therapy as one of the cheapest and most effective therapy for IBS. However, there was need for a review which concludes these results. Purpose of this study was to look at the recent literatures about the role of diet in controlling IBS symptoms. Studies published in recent 5 years in Pub Med and SID databases were searched with relevant keywords. Human studies, English or Persian and original articles were included. Studies which were not relevant to medical nutrition therapy were excluded. From 81 studies, 31 studies were included. Foods containing gluten, lactose, fructose, galactane, sorbitol, fructane and allergen foods should be limited or omitted. Patients should be advised to use fibers, prebiotics and probiotics more often. Medical nutrition therapy is a useful method for controlling symptoms of these patients and should be advised

Beneficial role of antioxidants on clinical outcomes and erythrocyte antioxidant parameters in rheumatoid arthritis patients

Background: This study aims to investigate the effect of antioxidants supplement on clinical outcomes and antioxidant parameters in rheumatoid arthritis [RA]

Methods: The pre post study was conducted on 40 female patients with RA in 12 weeks that taken daily one "Selenplus" capsule contained 50 microg selenium, 8 mg zinc, 400 microg vitamin A, 125 mg vitamin C, and 40 mg vitamin E. About 5 mL venous blood sample was taken from all participants and disease activity score [DAS] was determined by DAS 28 formula and high sensitive C-reactive protein [hs-CRP]. Glutathione peroxidase [GPX] and superoxide dismutase [SOD] were measured by spectrophotometric kit and catalase [CAT] was measured by Abei method. Total antioxidant capacity [TAC] was determined by spectrophotometric kit. Distribution of the variables was assessed using histogram with normal curve as well as Kolmogorov-Smirnov test and data were analyzed with paired t-test for differences between pre-post data using SPSS software version 13.5

Results: Out of 40 patients, 39 completed the study. DAS-28 score and hs-CRP have changed [P < 0.01 for both], while the number of swollen and painful joints did not reduce significantly. TAC, GPX, SOD, and CAT increased significantly [P < 0.01 for all variables]

Conclusions: Our findings showed that antioxidants may improve disease activity significantly, but it did not affect the number of painful and swollen joints and increased erythrocyte antioxidant levels. Antioxidants may be useful for controlling of clinical outcomes and oxidative stress in RA

Effect of a probiotic and metformin on liver aminotransferases in non-alcoholic steatohepatitis: a double blind randomized clinical trial

Non-alcoholic steatohepatitis [NASH] is a clinicopathological entity that is being recognized more frequently in recent years. This study aimed to evaluate the effects of Metformin, with and without a probiotic supplement on liver aminotransferases in patients with NASH. Sixty four patients 18-75 years with NASH confirmed by biopsy and histological assessment were enrolled to study. Patients were randomized to one of the following treatments for 6 months: Group I, probiotic [Protexin two tablets per day] plus Metformin 500 mg two tablets per day [Met/Pro], or group II, Metformin 500 mg two tablets per day plus two placebo tablet [Met/P]. After 6 month alanine aminotransferase [ALT], aspartate aminotransferase, and ultrasound grading of NASH were assessed. In group I, serum alanine aminotransferase [ALT: 133.7 +/- 70 vs. 45.2 +/- 32.5; P < 0.00], and aspartate aminotransferase activity [AST: 123.1 +/- 72 vs. 44.2 +/- 33.9; P < 0.001], and ultrasound grading of NASH [P < 0.001] all decreased significantly by the end of the treatment period. In group II, while serum alanine aminotransferase [ALT] was not significantly reduced [118.4 +/- 67.9 vs. 112.5 +/- 68.7; P < 0.064], aspartate aminotransferase activity [AST: 125.3 +/- 71 vs. 113.4 +/- 71; P < 0.001], and ultrasound grading of NASH did fall significantly [P < 0.01]. Body mass index [BMI], fasting blood sugar [FBS], cholesterol, and triglyceride fell significantly in both groups. Probiotic combination with Metformin improves liver aminotransferases better than metformin alone in patients with NASH

Probiotics and nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease [NAFLD] is the most common chronic liver disease worldwide, both in adults and in children. NAFLD represents a spectrum of liver diseases that range from hepatic steatosis to steatohepatitis and cirrhosis. However, NAFLD is more prevalent in overweight and obese individuals. Evidences thus far suggest that hepatic triglyceride accumulation is not always derived from obesity; gut microbiota can also play a role in the development of insulin resistance, hepatic steatosis, necroinflammation and fibrosis. On the other hand, probiotics can strengthen the intestinal wall, reducing its permeability, bacterial translocation, and endotoxemia according to animal and human studies. They can also reduce oxidative and inflammatory liver damage, while improving the histological state in certain situations. This review article focuses on research that has been conducted on probiotics and NAFLD, highlighting their efficacy as a novel therapeutic option for the treatment of this condition

[ effects of combined docosahexaenoic acid and vitamin E supplements on spermatogram in asthenozoospermic males: a randomized, triple-blind, placebo-controlled clinical trial]

Considering the decrease of omega-3 fatty acids in spermatozoa of asthenozoospermic men, the aim of the present study was to investigate the effects of combined docosahexaenoic acid [DHA] and vitamin E supplements on spermatogram in asthenozoospermic males. In this randomized, triple-blind, placebo-controlled clinical trial, out of 275 men who referred to Avicenna infertility clinic, fifty asthenozoospermic males, defined as less than 50% sperm motility or less than 25% with rapid progressive motility, were randomly assigned to one of two groups according to the stratified blocked randomization. Participants in the intervention group took daily 465 mg of DHA and 600 IU of vitamin E; and those in the control group took daily two placebos for 12 weeks. Sperm characteristics, dietary intakes, anthropometric measurements and physical activity were measured at the baseline and at the end of the study. Statistical analyses were performed using the SPSS software, the statistical tests being analysis of covariance, Student's t-test, paired-samples t-test, Wilcoxon and Mann-Whitney. Out of 50 participants, 22 men in the intervention group and 20 men in the control group completed the protocol of the study. Number of sperms, sperm concentration, percentage of motile sperms and percentage of motile sperms with a straight direction increased in the intervention group, as compared with the control values [p<0.05]. According to this research, combined DHA and vitamin E supplements led to increasing sperm concentration and sperm motility; however no significant changes occurred in sperm morphology and vitality in asthenozoospermic men. DHA and vitamin E, as an antioxidant, may improve sperm motility