The investigation of serum phenylalanine levels based on infant feeding method: a cross-sectional study of children less than two years old with phenylketonuria (PKU).

BACKGROUND: Clinical advice may suggest discontinuing breastfeeding after the diagnosis of phenylketonuria in infants as the only effective way to monitor the newborn's intake and accurate measurement of phenylalanine (Phe). This study aims to investigate the prevalence and duration of breastfeeding, as well as its effect on serum Phe levels in infants with phenylketonuria at Education and Therapy Medical Center, Be'sat Hospital, Iran. METHODS: We conducted a cross-sectional study of 34 children under two years old diagnosed with phenylketonuria between September 2018 and December 2022. Infants were categorized as breastfed and non-breastfed (bottle-fed) based on their feeding method after diagnosis. Data on age at diagnosis, medical records, demographic information, and anthropometric indices were collected, and infants with incomplete data or mixed feeding (formula + breast milk) were excluded from the study. RESULTS: Of 94 infants managed in our hospital, 34 had complete medical records. Among the all patients 13 (38%) continued to be breastfed combined with phenylalanine-free amino acid-based protein substitute, while 21 (62%) were did not receive breast milk. The mean duration of breastfeeding was 2.57 ± 0.59 (1-3) months. The mean age at diagnosis was 22.6 ± 18.4 days. Phenylalanine concentrations at diagnosis were mean 10, SD 5.44; range 4-24 mg/dL [0.22-1.33 µmol/L] in the breastfed group and mean 14.3, SD 10.2; range 5-37 mg/dL [0.27-2.05 µmol/L] in the non-breastfed group.Non-breastfed infants had lower serum Phe levels than breastfed infants: mean 3.76, SD 2.10; range 1-7 mg/dL [0.05-0.38 µmol/L] and mean 4.89, SD 3.68; range 2-19 mg/dL [0.11-1.05 µmol/L], respectively, although not statistically significant [(t (34) = 118.0, P = 0.51]. Also we found no significant associations in body measurements for weight, height, and head circumference at birth and final assessment. CONCLUSIONS: In conclusion, during treatment, there were no statistically significant associations between breastfeeding and serum Phe levels with growth in children with phenylketonuria.

Comparative effects of nutraceuticals on body weight in adults with overweight or obesity: A systematic review and network meta-analysis of 111 randomized clinical trials.

There is no research on the comparative effects of nutraceuticals on weight loss in adults with overweight or obesity. This study aimed at quantifying and ranking the effects of different nutraceuticals on weight loss. We searched PubMed, Scopus, and Web of Science to November 2022. We included randomized trials evaluating the comparative effects of two or more nutraceuticals, or compared a nutraceutical against a placebo for weight loss in adults with overweight or obesity. We conducted random-effects network meta-analysis with a Frequentist framework to estimate mean difference [MD] and 95% confidence interval [CI] of the effect of nutraceuticals on weight loss. One hundred and eleven RCTs with 6171 participants that investigated the effects of 18 nutraceuticals on body weight were eligible. In the main analysis incorporating all trials, there was high certainty of evidence for supplementation of spirulina (MD: -1.77 kg, 95% CI: -2.77, -0.78) and moderate certainty of evidence that supplementation of curcumin (MD: -0.82 kg, 95% CI: -1.33, -0.30), psyllium (MD: -3.70 kg, 95% CI: -5.18, -2.22), chitosan (MD: -1.70 kg, 95% CI: -2.62, -0.78), and Nigella sativa (MD: -2.09 kg, 95%CI: -2.92, -1.26) could result in a small improvement in body weight. Supplementations with green tea (MD: -1.25 kg, 95%CI: -1.68, -0.82) and glucomannan (MD: -1.36 kg, 95%CI: -2.17, -0.54) demonstrated small weight loss, also the certainty of evidence was rated low. Based on our findings, supplementations with nutraceuticals can result in a small weight loss in adults with overweight or obesity.

Orange juice intake and lipid profile: a systematic review and meta-analysis of randomised controlled trials.

Dyslipidaemia is a metabolic anomaly which has been related to numerous morbidities. Orange juice (OJ) is a popular flavonoid-rich drink consumed worldwide. Due to the existing controversies regarding its impact on blood lipids, we decided to investigate the impact of OJ supplementation on lipid profile parameters. Major scientific databases (Cochrane library, Scopus, PubMed and Embase) were searched. Pooled effects sizes were reported as weighted mean difference (WMD) and 95 % confidence intervals (CIs). Out of 6334 articles retrieved by the initial search, 9 articles met our inclusion criteria. Overall, supplementation with OJ did not exert any significant effects on blood levels of TG (WMD -1·53 mg/dl, 95 % CI -6·39, 3·32, P = 0·536), TC (WMD -5·91 mg/dl, 95 % CI -13·26, 1·43, P = 0·114) or HDL-C (WMD 0·61 mg/ dl, 95 % CI -0·61, 1·82, P = 0·333). OJ consumption did reduce LDL-C levels significantly (WMD -8·35 mg/dl, 95 % CI -15·43, -1·26, P = 0·021). Overall, we showed that the consumption of OJ may not be beneficial in improving serum levels of TG, TC or HDL-C. Contrarily, we showed that daily intake of OJ, especially more than 500 ml/d, might be effective in reducing LDL-C levels. In the light of the existing inconsistencies, we propose that further high-quality interventions be conducted in order to make a solid conclusion.

Relationship between caffeine intake and small for gestational age and preterm birth: a dose-response meta-analysis.

Our meta-analysis aimed to determine the dose-response relationship between caffeine intake and risk of small for gestational age (SGA) and preterm birth (PB). A systematic search of PubMed, Web of science and Scopus was done from inception to January 2023 using relevant keywords. All case-control and cohort studies reported in English were included if the exposure of interest was caffeine intake during pregnancy, the outcome of interest was spontaneous SGA and PB, and multivariable-adjusted odds ratios (ORs) or risk ratios were provided or could be calculated. In all, 22 studies (15 cohort studies and seven case-control studies) were included in this review. Examining the association of caffeine intake with risk of PB, no significant relationship was found (Pooled ES: 1.04; 95% CI: 0.95 to 1.14, P = 0.019). Findings from this meta-analysis demonstrated that caffeine intake had a significantly higher risk of SGA respectively (Pooled ES: 1.28; 95% CI: 1.16 to 1.41, P < 0.001). A dose-response analysis proposed that an increase of 100 mg caffeine per day was associated with a 13% greater risk of SGA. This study confirmed that caffeine intake raises the risk of SGA. However, the risk of PB was not found to be reliably associated with maternal caffeine consumption.

The association between meal-based diet quality index-international (DQI-I) with obesity in adults.

BACKGROUND AND OBJECTIVE: Due to the growing global trend of obesity, it is necessary to study the diet quality as a modifiable factor to reduce the dangerous consequences of obesity. Therefore, the aim of this study was to evaluate the association between meal-based diet quality index-international (DQI-I) with obesity in adults. METHODS: This cross-sectional study was performed on 850 men and women in Tehran (aged 20-59 y). Dietary intakes were assessed using three 24-h dietary recalls. Meal-based Diet quality was assessed based on the construction of DQI-I. The total DQI-I score ranged from 0 to 100, with higher scores denoting better diet quality. Multiple linear regression analysis was used to examine the association of DQI-I and BMI in each meal and Logistic regression analysis was used to examine the association of DQI-I and obesity in each meal. RESULTS: The mean (± SD) of age, body mass index (BMI), waist circumference (WC) and waist to hip ratio (WHR) were 42.35(± 10.90) years, 27.32(± 5.61) kg/m2, 89.09 (± 12.04) cm and 0.86 (± 0.11), respectively. In none of the meals, after adjusting for confounders, no significant difference in BMI was observed in the both women and men groups. After controlling of confounders, there was not any relationship between meal-based DQI-I and BMI resulted from multiple linear regression analysis also there was not any significant association between meal-based DQI-I and obesity resulted from Logistic regression analysis. CONCLUSION: In this study, we did not find any significant association between meal-specified DQI with obesity. To reach the better evaluation, more prospective studies with large sample size are needed.

Association of the Mediterranean Dietary Quality Index with handgrip strength and muscle endurance: A cross-sectional study.

Mediterranean diet is a healthy eating pattern associated with various health advantages. Different scoring methods of adherence to this diet have been used to investigate the association between the Mediterranean diet and muscle outcomes. The present study aimed to investigate the association of the Mediterranean Dietary Quality Index (Med-DQI) with handgrip strength (HS) and muscle endurance (ME). The current cross-sectional study involved 268 Iranian adults aged 18-70 years. Anthropometric measures were evaluated. We used the 168-item food frequency questionnaire (FFQ) to develop the Med-DQI score. The Med-DQI score ranges from 0 to 14 (lower score suggests higher adherence to Mediterranean diet). HS was measured by a digital handgrip dynamometer, and ME was the amount of time to reach a maximum of 50% of grip strength. Multiple regression analysis was used to determine the association of Med-DQI and its components with HS and ME. Med-DQI score was not associated with mean handgrip strength (MHS) (p = .34) and mean muscle endurance (MME) (p = .69) in the crude model. The associations remained insignificant after the adjustment of covariates (p = .16, .31, respectively). Among the components of Med-DQI, cholesterol, meats, fish, and cereals were positively correlated with MHS (p < .001 for all). Meats (p = .02), olive oil (p < .001), cereals (p = .04), fruits and vegetables (p < .001 for all) were also positively correlated with MME. According to our findings, Med-DQI score is not associated with MHS and MME in a population of Iranian adults. Further longitudinal studies are required to confirm these findings.

Effects of Artichoke Supplementation on Liver Enzymes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Studies examining the effect of artichoke on liver enzymes have reported inconsistent results. This systematic review and meta-analysis aimed to assess the effects of artichoke administration on the liver enzymes. PubMed, Embase, the Cochrane Library, and Scopus databases were searched for articles published up to January 2022. Standardized mean difference (Hedges' g) were analyzed using a random-effects model. Heterogeneity, publication bias, and sensitivity analysis were assessed for the liver enzymes. Pooled analysis of seven randomized controlled trials (RCTs) suggested that the artichoke administration has an effect on both alanine aminotransferase (ALT) (Hedges' g, -1.08; 95% confidence interval [CI], -1.76 to -0.40; p = 0.002), and aspartate aminotransferase (AST) (Hedges' g, -1.02; 95% CI, -1.76 to -0.28; p = 0.007). Greater effects on ALT were detected in trials that lasted ≤8 weeks. Also, greater effects on AST were detected in trials using > 500 mg artichoke. Overall, this meta-analysis demonstrated artichoke supplementation decreased ALT and AST.

Habitual- and Meal-Specific Carbohydrate Quality Index and Their Relation to Metabolic Syndrome in a Sample of Iranian Adults.

Aim: Most studies on diet quality have focused on the habitual and overall intake of foods without considering intakes at specific eating occasions. This study aimed to assess the association between habitual- and meal-specific carbohydrate quality index (CQI) and metabolic syndrome (MetS) in Iranian adults. Methods: In this cross-sectional study, data from 850 participants were analyzed. Dietary information was obtained from a 3-day nonconsecutive 24 h recall. CQI was calculated from three criteria: dietary fiber, glycemic index, and solid carbohydrate/total carbohydrate ratio. The association between CQI and MetS was assessed by logistic regression. Results: The prevalences of MetS in the lowest and highest tertile of CQI were 30.1 and 33.7, respectively (P = 0.6). In habitual diet and all the three meals, we failed to find any significant association between tertiles of CQI and MetS either before or after adjustment for covariates. However, in the habitual meals [odds ratio (OR): 0.69, 95% CI: 0.47-0.96] and lunch meals (OR: 0.66; 95% CI: 0.47-0.94), the highest CQI in comparison to the lowest one, significantly decreased the low high-density lipoprotein (HDL). In addition, the trend of low-HDL with CQI in habitual meal and lunch meal was statistically significant. Conclusion: The results of this study showed that CQI was not associated with MetS and its components. Further investigations into the mechanisms underlying the role of carbohydrate quality in developing metabolic disorders are warranted.

Joint association of meal frequency and diet quality with metabolic syndrome in Iranian adults.

BACKGROUND: Metabolic syndrome (MetS) is a common complication that has been shown in various studies to be related to the frequency and timing of eating. We aimed to evaluate the relationship between meal timing and frequency with diet quality and prevalence of MetS. STUDY DESIGN: Cross-sectional. METHODS: We analyzed data from 850 adults (20 to 59 years) and divided the participants into different categories in terms of frequency of eating occasions (EO) (5 ≥ , 6-7 and 7 <), meal (2 ≥ and 3) and snack (2 ≥ , 3 and 4 ≤) in a day. Daily food consumption was assessed using the structured three 24-h recalls. The quality of diet we calculated using the food quality score (FQS). Metabolic syndrome was defined based on the guidelines of the national cholesterol education program adult treatment panel III (ATP III). The covariates-adjusted relationships between exposures and outcomes were investigated using a logistic regression test and two-way ANOVA. RESULTS: The overall prevalence of MetS in participants was 34.2%. The average FQS was 28.0. Increased frequency of EOs and snacks was related to the higher prevalence of MetS ((OR, 1.72; 95% CI, 1.24, 2.37; P < 0.01) and (OR, 1.34; 95% CI, 1.07, 1.68; P, 0.01), respectively). The adjusted mean of FQS was not significantly different between the EO as well as meals and snack categories. The joint association of EO frequency and snack frequency with diet quality showed a higher chance of having MetS ( (OR, 2.36; 95% CI, 1.19, 4.66; P, 0.01 and (OR, 1.68; 95% CI, 1.06, 2.68; P,0.02), respectively). Also, we observed a higher mean of high density level cholesterol in people with the highest FQS and lowest EO frequency (P,0.02). CONCLUSION: Our findings suggest that the EO and snack frequency may be associated with the higher chance of MetS. We also found when the frequency of EO increases, the beneficial associations of the diet quality were overshadowed. To confirm our findings, well designed randomised clinical trials are needed.

The Association of Dietary Energy Density and Body Composition Components in a Sample of Iranian Adults.

Background: We aimed to investigate the association between the energy density (ED) of diet and body composition components in Iranian adults. Methods: We conducted a cross-sectional study on 267 adults in Tehran. We obtained ED (kcal/g) using the two most common methods: ED1, ED from foods only with the exclusion of all beverages and ED2, from foods and all beverages. Body composition was measured using a multifrequency bio-impedance analysis. To find a strong association, we used both the linear and binary regression analysis in the three adjusted models. Results: The mean of ED1 and ED2 was 1.34 ± 0.23 and 0.89 ± 0.20 kcal/g, respectively. Increasing the ED of diet in both methods was associated with a high intake of dietary fat, of saturated fatty acid (SFA), of monounsaturated fatty acid (MUFA), of polyunsaturated fatty acid (PUFA), of oleic and linoleic acids, accompanied by a low intake of fruits, vegetables, and some vitamins and minerals. There was a significant positive relationship between fat-free mass index (FFMI) and ED1 (ß = 4.44, p = 0.02). However, we found no significant association between the consumption of ED1 and fat mass index (FMI) (0.28; 95% CI 0.08, 0.98; p = 0.07), and abdominal obesity (0.91; 95% CI 0.43, 1.94; p = 0.82). Also, ED2 had no association with FMI (0.86; 95% CI 0.26, 2.80; p = 0.81) and abdominal obesity (0.78; 95% CI 0.35, 1.72; p = 0.54). No significant associations were found between ED and other anthropometric indices and body composition components after considering the confounders. Conclusion: This study supports the positive association between ED and poor dietary quality. However, our findings did not show significant associations of dietary energy density (DED) with anthropometric indices and body composition components. Further well-designed studies are required to investigate the exact link between DED and body composition.

The association between meal specific low carbohydrate diet score and cardiometabolic risk factors: A cross-sectional study of Iranian adults.

BACKGROUND AND AIM: Since evidence regarding low-CHO diet and cardiometabolic risk factors is controversial, this study aimed to assess the relation between low-CHO diet score and metabolic syndrome (MetS) and cardiometabolic risk factors among a group of Iranian adults. METHODS: This cross-sectional study was conducted with 840 subjects with the age range of 20-65 years. Dietary intakes were assessed by completing three 24-hour recalls. Total, animal- and vegetable-based low-CHO diet score were calculated. We used logistic regression with different models to determine whether there were relationships between low-CHO diet score and MetS and MetS components. RESULTS: We found that there was no significant association between low-CHO diet, animal-based and vegetable-based low-CHO diet scores and risk of MetS in three meals. Except for the animal-based low-CHO diet score, which was significantly associated with general obesity at lunch meal (OR: 1.17, 95% CI: 0.76-1.82, P = .03). There were a significant association between low-CHO diet and high-density lipoprotein cholesterol (HDL-C) levels in lunch meal (OR: 1.50, 95% CI: 1.06-2.14, P = .03). Vegetable-based low-CHO diet score was associated with a lower risk of elevated TG in lunch meal in the fully adjusted model (OR: 0.59, 95% CI: 0.39-0.90, P = .04). CONCLUSION: Diets with lower amounts of carbohydrate and higher contents of fat and protein were not significantly associated with the risk for MetS in Iranian adults. Only animal-based low-CHO diet score was significantly associated with general obesity at lunch meal.

Effects of artichoke leaf extract supplementation or artichoke juice consumption on lipid profile: A systematic review and dose-response meta-analysis of randomized controlled trials.

Accumulating evidence regarding the effect of artichoke on lipid profile is equivocal. We updated a previous meta-analysis on the effect of artichoke extract supplementation on lipid profile and performed dose-response analysis. We searched PubMed, Scopus, Web of Science, and Cochrane Library from inception to June 2021 using relevant keywords. Papers from identified articles were collected. Two researchers rated the certainty in the estimates using the GRADE approach. Combining 15 effect sizes from 14 studies based on the random-effects analysis, we found that artichoke significantly reduced TG (weighed mean difference [WMD]: -17.01 mg/dl, 95% CI: -23.88, -10.13, p = .011), TC (WMD: -17.01 mg/dl, 95% CI: -23.88, -10.13, p < .001), and LDL-C (WMD: -17.48 mg/dl, 95%CI: -25.44, -9.53, p < .001). No significant effect of artichoke on HDL-C level was detected (WMD: 0.78 mg/dl, 95%CI: -0.93, 2.49, p = .371). Combining the two effect sizes revealed that artichoke juice supplementation significantly reduced TG (WMD: -3.34 mg/dl, 95%CI: -5.51, -1.17, p = .003), TC (WMD: -18.04 mg/dl, 95%CI: -20.30, -15.78, p < .001), LDL-C (WMD: -1.75 mg/dl, 95%CI: -3.02, -0.48, p = .007), and HDL-C levels (WMD: -4.21 mg/dl, 95%CI: -5.49, -2.93, p < .001). In conclusion, we found that artichoke supplementation may favor CVD prevention by acting in improving the lipid profile.

The association of dietary energy density and the risk of obesity, type 2 diabetes and metabolic syndrome: A systematic review and meta-analysis of observational studies.

OBJECTIVES: There is a growing body of evidence linking dietary energy density (DED) with metabolic disorders like obesity, type 2 diabetes (T2D) and metabolic syndrome (MetS). However, according to our knowledge, there has been no systematic review and mate-analysis on T2D and MetS with DED. Therefore, this study aimed to investigate the association between DED with the risk of obesity, T2D and MetS in a systematic review and meta-analysis of observational studies. METHODS: We searched all published studies according to the defined keywords up to march 2020 in the PubMed/Medline and Scopus databases. We excluded those that did not calculate DED for total intake, no observed association between obesity, T2D, MetS as the primary or one of the outcomes with DED, no reported odds ratio (OR), relative risk (RR) or hazard ratio (HR) estimates with 95% confidence intervals (CIs), studies in children under 2 years old, patients with cancer and pregnant women. RESULTS: From 2282, after deleting the duplicates and irrelevant studies, we entered 58 articles ( 47 systematic reviews and 11 meta-analyse). We indicated an increased risk of T2D in relation to DED (OR: 1.25, 95% CI: 1.18-1.33, P < .001). But studies reviewed were inconsistent. All studies which examined the relationship between DED and MetS showed a positive relationship with an increased significant risk (OR: 1.59, 95% CI: 1.22-2.07, P < .001). Most articles reported a direct association between DED and obesity but the relationship between DED and risk of obesity was not significant (OR: 1.04, 95% CI: 0.92-1.17, P = .543). CONCLUSION: In this systematic review and meta-analysis of observational studies, we found that the DED increased the risk of T2D and MetS but was not significant with the risk of obesity.

Association of Vitamin D status with Visceral Adiposity Index and Lipid Accumulation Product Index among a Group of Iranian People.

There is a growing body of evidence linking vitamin D and its antiadipogenic activity with body composition. The aim of this study was to investigate the association between vitamin D levels, visceral adiposity index (VAI), and lipid accumulation product index among a group of Iranian people. This cross-sectional study was conducted with 270 Iranian adults. Body composition was measured via bio-impedance analysis. The 25-hydroxyvitamin D [25(OH)D] was also measured using the enzyme-linked immunosorbent assay method. The VAI and lipid accumulation product index were calculated. Multiple linear and logistic regression after controlling for confounder was used to report the results. Multiple linear regression showed that serum 25(OH)D levels were positively correlated with age (crude: ß ± standard error [SE] = 0.23 ± 0.06, p ≤ 0.001; model I: ß ± SE = 0.18 ± 0.05, p = 0.002) and percent body fat (crude: ß ± SE = 0.10 ± 0.04, p = 0.02). Binary logistic regression analysis showed a higher chance of greater percent body fat and lipid accumulation product index in the crude model (odds ratio [OR], 2.05; 95% confidence interval [CI], 1.13-3.72 for percent body fat and OR, 2.07; 95% CI, 1.14-3.76 for lipid accumulation product index), which disappeared after adjusting for covariates. Adults with higher vitamin D levels had higher scores of percent body fat and lipid accumulation product index. More longitudinal studies are needed to confirm these results.

The effects of capsinoids and fermented red pepper paste supplementation on blood pressure: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND & AIMS: The present systematic review and meta-analysis were conducted to investigate the effects of capsinoids and fermented red pepper paste (FRPP) supplementation on Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP). METHODS: Relevant studies, published up to May 2020, were searched through PubMed/Medline, Scopus, ISI Web of Science, Embase, and Google Scholar. All randomized clinical trials investigating the effect of capsinoids and FRPP supplementation on blood pressure including SBP and DBP were included. RESULTS: Out of 335 citations, 7 trials that enrolled 363 subjects were included. Capsinoids and FRPP resulted in significant reduction in DBP (Weighted mean differences (WMD): -1.90 mmHg; 95% CI, -3.72 to -0.09, P = 0.04) but no significant change in SBP (WMD: 0.55 mmHg, 95% CI: -1.45, 2.55, P = 0.588). FRPP had a significant reduction in SBP. Greater effects on SBP were detected in trials, lasted ≥12 weeks, and sample size >50. Capsinoids with dosage ≤200 and FRPP with dosage of 11.9 g significantly decreased DBP. CONCLUSION: Overall, these data suggest that supplementation with FRPP may play a role in improving SBP and DBP but for capsinoids no effects detected in this analysis on SBP and DBP.

Association of Nutrient Patterns with Metabolic Syndrome and Its Components in Iranian Adults.

We aimed to examine the association between nutrient patterns and metabolic syndrome (MetS) in Iranian adults. In a cross-sectional study of 850 self-certified healthy women and men aged 20-59 years old, dietary data were assessed using three 24-hour recall. Anthropometric measures were done and blood samples were collected to measure serum fasting serum glucose and lipid profile. The MetS was defined using the International Diabetes Federation. Major nutrient patterns were identified using principle competent analysis. In the first nutrient pattern, the individuals in the fifth quintile had a higher intake of vitamins B1, B2, B3, B5, B6, B12, zinc, iron, saturated fatty acids (SFAs), and protein. In the second nutrient pattern, individuals in the first quintile had lower consumption of zinc, SFAs, vitamin E, α-tocopherol, oleic acid, polyunsaturated fatty acids, ß-carotene, linolenic acid, and monounsaturated fatty acids, compared to the fifth quintile. Furthermore, in the third nutrient pattern, the individuals in the fifth quintile had a higher intake of potassium, magnesium, phosphorous, calcium, protein, carbohydrate, vitamin C, and folate compared to other quintiles. We identified the second pattern had an indirect association with systolic and diastolic blood pressure, triglycerides, fasting blood sugar (p < 0.001 for all), and total cholesterol (p = 0.04) when it was controlled for body weight. Our findings showed that nutrient patterns may have an association with MetS components with mediating body weight.