Association of dietary and lifestyle inflammation score with type 2 diabetes mellitus and cardiometabolic risk factors in Iranian adults: Sabzevar Persian Cohort Study.

Systemic inflammation may contribute to the initiation and progression of type 2 diabetes mellitus (T2DM) through diet and lifestyle. We examined the association of dietary inflammation score (DIS), lifestyle inflammation score (LIS) and dietary and lifestyle inflammation score (DLIS) with T2DM and cardiometabolic risk factors among Iranian adults. In this study, we identified and recruited 619 patients with T2DM and 2113 without T2DM from 35 to 75 years old men and women in the baseline phase of the Sabzevar Persian Cohort Study. Using a validated 115-item semi-quantitative FFQ, we calculated a 19-component DIS and a 3-component LIS weighted by circulating inflammation biomarkers. The DIS, LIS and DLIS associations with diabetes were assessed by multivariable logistic regression analysis. The average age of the participants was 48·29 (sd 8·53) (without T2DM: 47·66 (sd 8·42); with T2DM: 50·44 (sd 8·57)). Individuals in the highest compared with the lowest tertiles of DLIS (OR: 3·40; 95 % CI 2·65, 4·35; Ptrend < 0·001), DIS (OR: 3·41; 95 % CI 2·66, 4·38; Ptrend < 0·001) and LIS (OR: 1·15; 95 % CI 0·90, 1·46; Ptrend = 0·521) had an increased risk of T2DM. For those in the highest relative to the lowest joint DIS and LIS tertiles, the results were OR: 3·37; 95 % CI 2·13, 5·32; Pinteraction < 0·001. No significant associations were found between DLIS and cardiometabolic risk factors, including blood pressure, liver enzymes and glycaemic and lipid profiles, except for waist circumference (P < 0·001) and waist-to-hip ratio (P = 0·010). A higher DIS and DLIS score was associated with a higher risk of T2DM, while the LIS score was not associated with T2DM risk.

The improvement effect of apple cider vinegar as a functional food on anthropometric indices, blood glucose and lipid profile in diabetic patients: a randomized controlled clinical trial.

Background: Numerous medical costs are spent each year on treating and preventing the progression of diabetes. The positive effect of apple cider vinegar (ACV) has been shown on post-prandial hyperglycemia. This study aimed to evaluate the effects of prolonged consumption of ACV on blood glucose indices and lipid profile in patients with type 2 diabetes. Methods: This study was a randomized clinical trial and the participants were adults with type 2 diabetes. Participants were divided into two groups: ACV and control. The ACV group was treated with 30 ml of ACV per day. Both the intervention and control groups received the same recommendation for a healthy diet. Before and after eight weeks, fasting blood glucose, insulin, hemoglobin A1C, insulin resistance, total cholesterol (Chol), low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglyceride were measured. Results: Fasting blood glucose decreased after intervention in both groups, which was only significant in the ACV group (p = 0.01). There was a significant difference in hemoglobin A1C levels between the two groups (p < 0.001) after eight weeks. LDL was decreased in the ACV group (p < 0.001). Total Chol, LDL/HDL and Chol/HDL ratio decreased after the intervention period in the ACV group compared to the control group (p = 0.003, p = 0.001 and p = 0.001, respectively). Conclusion: Daily consumption of ACV may have beneficial effects in controlling blood glucose indices and lipid profile in patients with type 2 diabetes. Clinical trial registration: http://www.irct.ir, identifier IRCT20140107016123N13.

A fuzzy based dietary clinical decision support system for patients with multiple chronic conditions (MCCs).

Due to the multifaceted nature of Multiple Chronic Conditions (MCCs), setting a diet for these patients is complicated and time-consuming. In this study, a clinical decision support system based on fuzzy logic was modeled and evaluated to aid dietitians in adjusting the diet for patients with MCCs. Mamdani fuzzy logic with 1144 rules was applied to design the model for MCCs patients over 18 years who suffer from one or more chronic diseases, including obesity, diabetes, hypertension, hyperlipidemia, and kidney disease. One hundred nutrition records from three nutrition clinics were employed to measure the system's performance. The findings showed that the diet set by nutritionists had no statistically significant difference from the diet recommended by the fuzzy model (p > 0.05), and there was a strong correlation close to one between them. In addition, the results indicated a suitable model performance with an accuracy of about 97%. This system could adjust the diet with high accuracy as well as humans. In addition, it could increase dietitians' confidence, precision, and speed in setting the diet for MCCs patients.

Vitamin D, testosterone and depression in middle-aged and elderly men: a systematic review.

Depression is one of the common psychiatric disorders during elderly. This systematic review aims to present the relationship between vitamin D deficiency, depression and testosterone serum concentration in the middle-aged and elderly men. We performed a comprehensive search in the Google Scholar, PubMed, ProQuest, Web of Science, Cochrane, Science Direct, and Scopus databases to collect any relevant published studies. The data of the articles that had been investigated the relationship between depression and 25-hydroxy vitamin D (25[OH]D) serum concentration (nine studies), or testosterone and 25[OH]D (six studies), as the primary outcomes, were included in our review. The results of the cohort and cross-sectional studies have shown that vitamin-D deficiency is associated with the incidence of depression in older men. In addition, documents have reported the positive association between vitamin D and testosterone, and previous studies have shown that testosterone can involve in the mood. We have proposed scientific mechanisms that have shown vitamin D may also play a protective role in depression through its effect on the testosterone. Therefore, it is a low risk and safe recommendation for the middle-aged and elderly men to use the vitamin D supplement or exposure to the sunlight to prevent depression.

Effectiveness of the pomegranate extract in improving hepatokines and serum biomarkers of non-alcoholic fatty liver disease: A randomized double blind clinical trial.

BACKGROUND AND AIM: Pomegranate as a functional food has various properties and effects on health. The aim of the study was to evaluate the effect of pomegranate extract on serum levels of liver enzymes, hepatokines, interleukin-6 (IL-6), and total antioxidant capacity in non-alcoholic fatty liver disease (NAFLD). METHODS: In this double-blind randomized clinical trial, 44 patients with NAFLD were divided into two groups: pomegranate extract tablets and placebo. The intervention period was 12 weeks. At the beginning and end of the study, serum levels of alanine transaminase (ALT), aspartate transaminase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), fetuin-A, fibroblast growth factor 21 (FGF-21), interleukin-6 (IL-6), and total antioxidant capacity were assessed in both groups. RESULTS: Pomegranate extract reduced the level of ALT (P < 0.001), AST (P < 0.001), GGT (P < 0.001), fetuin-A (P < 0.001), FGF-21(P < 0.001) and IL-6 (P = 0.04) compared to the placebo. Pomegranate extract also led to an increase in total antioxidant capacity (P˂0.001) but had no effect on ALP. CONCLUSION: It seems that the pomegranate extract improves several markers of NAFLD, and can be useful as a treatment supplement. The clinical trial approved by Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences (grant No. NRC-9811). TRIAL REGISTRATION: Iranian Registry of Clinical Trials (IRCT), IRCT20140107016123N14, https://www.irct.ir/trial/42739.

The effect of vitamin D and calcium supplementation on inflammatory biomarkers, estradiol levels and severity of symptoms in women with postpartum depression: a randomized double-blind clinical trial.

Objectives: Postpartum depression (PPD) is a major depressive disorder. Vitamin D deficiency may play a role in PPD pathogenesis. This study was designed to determine the effect of vitamin D and calcium supplementation on the severity of symptoms and some related inflammatory biomarkers in women with PPD.Materials and Methods: Eighty-one women with a PPD score >12 participated in this study. A total of 27 patients were randomly assigned into three groups (1:1:1 ratio) to receive either 50,000 IU vitamin D3 fortnightly + 500 mg calcium carbonate daily; or 50,000 IU vitamin D3 fortnightly + placebo of calcium carbonate daily, or placebo of vitamin D3 fortnightly + placebo of calcium carbonate daily (placebo group) for 8 weeks. At the baseline and end of the study, the severity score of PPD, levels of 25-hydroxy vitamin D, calcium, tumor necrosis factor-alpha (TNFα), interleukin 6 (IL6) and estradiol were measured.Results: The PPD score had more reduction in the vitamin D + calcium and vitamin D + calcium placebo groups than that of the placebo group (-1.7 ± 3.44, -4.16 ± 5.90 and 0.25 ± 2.81, respectively; p = 0.008). The effect of vitamin D on the PPD score was larger when vitamin D was given alone than given together with calcium (p = 0.042 and p = 0.004, respectively). No significant differences in estradiol, IL6 and TNFα were observed between the three groups.Discussion: Vitamin D may be effective in improving the clinical symptoms of PPD; however, the mechanism of the effect might not entirely operate through inflammatory and/or hormonal changes.

The effect of pomegranate extract on anthropometric indices, serum lipids, glycemic indicators, and blood pressure in patients with nonalcoholic fatty liver disease: A randomized double-blind clinical trial.

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease. The beneficial effects of pomegranate have been shown on insulin resistance and obesity, which are linked to NAFLD pathogenesis. The aim of this study was to investigate the efficacy of pomegranate extract in patients with NAFLD. Forty-four NAFLD patients were randomly assigned to receive two pomegranate extract tablets or placebo for 12 weeks. Anthropometric measurements, serum lipids, glycemic indicators, and blood pressure were assessed at baseline and the end of the study. Pomegranate was associated with a reduction in the total cholesterol (p Ë‚ .001), triglyceride (p Ë‚ .001), low-density lipoprotein cholesterol (LDL-C)-to-high-density lipoprotein cholesterol (HDL-C) ratio (p Ë‚ .003), fasting blood sugar (p Ë‚ .001), homeostatic model assessment of insulin resistance (p = .02), diastolic blood pressure (p = .04), weight (p Ë‚ .001), body mass index (p Ë‚ .001), and waist circumference (p = .002), as compared to placebo. A significant increase was observed in serum HDL-C (p Ë‚ .001) after intervention with the pomegranate extract. However, no significant difference was shown between the two groups in serum insulin and LDL-C. The pomegranate extract supplement could be used as a complementary therapy along with existing therapies to improve glycemic indicators, serum lipids, anthropometric indices, and blood pressure in patients with nonalcoholic fatty liver.

A dietary pattern rich in fruits and dairy products is inversely associated to gestational diabetes: a case-control study in Iran.

BACKGROUND: Gestational diabetes mellitus (GDM) causes many problems for mother and her neonate. A healthy diet plays an important role in preventing GDM. This study aimed to investigate the relationship between major dietary patterns and the GDM. METHODS: 386 healthy and 306 GDM pregnant women (total 693) completed this case-control study. Basic information and anthropometric indices were recorded, and a food frequency questionnaire was completed. For extracting major dietary patterns, the principal component analysis was performed. Multivariable logistic regression models were used to examine whether specific dietary patterns are associated to the GDM. RESULTS: Four dietary patterns were identified: "fruits and dairy products", "red meat and plant-based foods", "snacks and high-fat foods" and "carbohydrate-rich foods". Among these major extracted dietary patterns, "fruits and dairy products" showed an inverse association to the GDM (odds ratio adjusted for confounders: 0.50, confidence interval: 0.284-0.882, p-trend = 0.019, for highest vs. lowest quartile). CONCLUSIONS: It seems using a healthy dietary pattern such as "fruits and dairy products" may decrease GDM risk.

The effect of melatonin supplementation on liver indices in patients with non-alcoholic fatty liver disease: A systematic review and meta-analysis of randomized clinical trials.

Several randomized clinical trials (RCTs) evaluated the effect of melatonin supplementation on liver enzymes in patients with non-alcoholic fatty liver disease (NAFLD) and reported conflicting results. To meet these discrepancies, a meta-analysis was conducted to evaluate the eff ;ect of melatonin on liver indices in patients with NAFLD. To collect the required data, a thorough search was conducted through Web of science, Pubmed, Cochrane database, Embase, Google Scholar, ProQuest, and Scopus databases. The aim was to find clinical trials over the effect of melatonin supplementation on liver indices up to 16 May 2019. As a result, five eligible articles were selected and analysed in this meta-analysis using a fixed-effects model. Heterogeneity test was performed by I2 statistics and Cochrane Q test. The results showed that melatonin had a significant effect on aspartate aminoteransferase (AST) (WMD = 2.29, [95 %CI: 1.14, 3.43] IU/L, p = <0.001), alkaline phosphatase (ALP) (WMD = -8.40, [95 %CI -11.33, -5.48] IU/L, p < 0.001), and gamma-glutamyltransferase (GGT) (WMD = -33.37, [95 %CI: -37.24, -29.49] IU/L, p= < 0.001). Melatonin had no significant effect on alanine aminotransferase (ALT) regarding the overall effect size. Based on this meta-analysis, melatonin supplementation can improve liver indices. However, more RCTs are required with larger sample sizes and better control of confounding variables such as weight, body mass index, and gender to determine the effect of melatonin on patients with non-alcoholic fatty acid disease.

The effect of melatonin on treatment of patients with non-alcoholic fatty liver disease: a randomized double blind clinical trial.

OBJECTIVES: Many factors implicated in the pathogenesis of non-alcoholic fatty liver disease (NAFLD) are including oxidative stress, insulin resistance and abnormal production of adipokines. The aim of this clinical trial was to evaluate the effect of melatonin supplement on some important biochemical markers and signs related to NAFLD. DESIGN: A randomized double-blind, placebo-controlled, clinical trial. SETTING: Twenty-four participants in the melatonin group and 21 participants in the placebo group completed the study. INTERVENTION: Participants received 6 mg melatonin or placebo daily, 1 h before bedtime. The intervention period was 12 weeks. MAIN OUTCOME MEASURES: Anthropometric measurements, systolic and diastolic blood pressure, liver enzymes, high sensitive C­reactive protein (hs-CRP), fatty liver grade, also leptin and adiponectin serum levels, were measured at the baseline and the end of intervention. RESULTS: A significant improvement was observed in weight (p = 0.043), waist circumference (p = 0.027), abdominal circumference (p = 0.043), systolic (p = 0.039), and diastolic (p = 0.015) blood pressure, leptin serum levels (p = 0.032), hs-CRP (p = 0.024), alanine aminotransferase (p = 0.011), aspartate aminotransferase (p = 0.034), also the grade of fatty liver (p = 0.020) in melatonin treated group compared with the placebo. CONCLUSIONS: Administration of 6 mg/day melatonin had improvement effect on many factors related to NAFLD such as liver enzymes, hs-CRP, anthropometric measurements, blood pressure, leptin serum levels and the grade of fatty liver.

A longitudinal study on the relationship between mother's personality trait and eating behaviors, food intake, maternal weight gain during pregnancy and neonatal birth weight.

BACKGROUND: Many factors such as social and behavioral are related to appropriate weight gain during pregnancy, and there is much of importance to find them. The aim of the study was to explore the association of personality traits, with eating behaviors, food intake, maternal weight gain during pregnancy as well as the neonatal birth weight. METHODS: This is a longitudinal and cross-sectional study. Eating behaviors were assessed using the Dutch Eating Behavior Questionnaire (DEBQ), and the NEO personality inventory was used to assess personality in pregnant subjects. A validated food frequency questionnaire was used to determine food intake. Three hundred and sixty pregnant subjects from Ahvaz (the capital city of Khuzestan province, Iran) were followed from the 20th week of pregnancy until delivery. RESULTS: High neuroticism was associated with higher consumption of highly energetic foods (p < 0.05) and less consumption of vegetables (p < 0.01), also was related with lower weight gain during pregnancy and neonatal birth weight (p < 0.05). Openness to experience, extraversion and agreeableness were linked with higher consumption of vegetables (p < 0.05). Conscientiousness predicted lower neonatal weight (odds ratio: 1.20, confidence interval: 1.07-1.34, p < 0.01). CONCLUSIONS: Identification of personality traits would help to change the lifestyle and improve management guidelines.

Association of the dietary patterns with the risk of non-alcoholic fatty liver disease among Iranian population: a case-control study.

BACKGROUND: Diet-based recommendations can be developed for preventing and treating non-alcoholic fatty liver disease (NAFLD) after investigating the effects of whole diets on NAFLD. The aim of this study was to identify major dietary patterns and their association with the risk of NAFLD. METHODS: A total of 244 individuals (122 NAFLD patients and 122 controls) participated in this case-control study. The patients with NAFLD were diagnosed by a gastroenterologist. The participants' dietary intake data were collected using a 147-item semi-quantitive food frequency questionnaire and major dietary patterns were identified by principal component analysis. Adherence to dietary patterns was divided into tertiles and its association with odds of NAFLD was investigated by multivariate logistic regression. RESULTS: The results showed four major dietary patterns, among which adherence to the "ordinary pattern" was positively associated with NAFLD risk. After adjusting for all confounding factors, individuals in the highest tertile of "ordinary pattern" exhibited a significantly elevated risk of NAFLD compared to the lowest tertile (OR = 3.74, 95%CI = 1.23-11.42, P trend< 0.001). As well as, Individuals in the second and third tertiles of the "traditional pattern" were associated with the risk of NAFLD compared to the lowest tertile (medium vs. lowest tertile OR = 2.37, 95%CI = 1.02-5.53; highest vs. lowest tertile OR = 3.58, 95% CI = 1.48-8.68, P trend< 0.001). The highest tertile of "vegetable and dairy pattern" compared to the lowest tertile was inversely associated with NAFLD risk (OR = 0.23, 95%CI = 0.09-0.58, P trend = 0.02). No significant association was found between "fast food type pattern" and the risk of NAFLD. CONCLUSION: A significant association was observed between different dietary patterns and the risk of NAFLD. These results can potentially serve as a dietary strategy for preventing NAFLD in individuals who are at a high risk for progression of NAFLD.

Comparing between the effect of energy-restricted diet and yoga on the resting metabolic rate, anthropometric indices, and serum adipokine levels in overweight and obese staff women.

BACKGROUND: Weight management is an important strategy to prevent the consequences of obesity. The aim of the study was to compare the effect of yoga practice and energy-restricted diet on resting metabolic rate (RMR), anthropometric indices, and serum adiponectin and leptin in overweight and obese women. MATERIALS AND METHODS: Obese or overweight women were divided into two groups: yoga practicing and energy-restricted diet. Exercise trials consisted of 60-min Hatha yoga equal to 200 kilocalories (kcal) combined with 300 kcal restriction per day, and an energy-restricted diet consisted of 500 kcal restriction per day. The intervention period for both the groups was 8 weeks. RMR, anthropometric indices, and serum adiponectin, leptin, and lipid profiles were measured at baseline and at the end of the study. RESULTS: RMR was increased in yoga but not in the diet group (P = 0.001). The level of adiponectin was increased in the yoga group compared with the diet (P = 0.035). The concentration of high-density lipoprotein-cholesterol was decreased in the diet group significantly but not in yoga (P = 0.006). The level of leptin was decreased in both the groups (P = 0.001), and there were no significant differences between the two groups. CONCLUSION: The findings of the study demonstrated the effect of yoga practicing on RMR, and serum adiponectin, in overweight and obese women. It seems yoga practice with less energy restriction compared with a common energy restriction diet and is more effective in weight management for those who are in weight loss programs.

The effects of extra virgin olive oil and canola oil on inflammatory markers and gastrointestinal symptoms in patients with ulcerative colitis.

BACKGROUND/OBJECTIVES: Ulcerative colitis (UC) is an immune-mediated disease that causes inflammation in the gastrointestinal tract. Diet has an important role in the treatment of UC. This study aimed to compare the effects of extra virgin olive oil (EVOO), as a functional food, with canola oil in the treatment of UC. SUBJECTS/METHODS: Forty patients were participating in this crossover clinical trial. Thirty two patients completed two intervention rounds. Blood samples were taken before and after 20 days intervention. Disease activity score and gastrointestinal symptoms were evaluated using the Mayo score and gastrointestinal symptom rating scale (GSRS) respectively. RESULTS: Erythrocyte sedimentation rate (p = 0.03) and high-sensitivity C-reactive protein (p < 0.001) were decreased significantly after EVOO consumption. Bloating, constipation, fecal urgency, incomplete defecation, and final GSRS were reduced significantly after EVOO consumption (p < 0.05). CONCLUSIONS: Intake of EVOO decreased the inflammatory markers and improved gastrointestinal symptoms in UC patients. It seems this functional food can be beneficial in the treatment of UC as a complementary medicine.

The effect of education through mobile phone short message service on promoting self-care in pre-diabetic pregnant women: A randomized controlled trial.

INTRODUCTION: Gestational diabetes is increasing in developed and developing countries. This study aimed to evaluate the effect of SMS messaging on the self-care among pre-diabetic pregnant women. METHODS: This randomized controlled trial conducted on 100 pre-diabetic pregnant women referred to Ahvaz Health Centers, Iran, Sep to Dec, 2016. Women were randomly assigned into the face to face education group and short message systems in addition to the face to face education group. Self-care variables were compared between the groups. Data was analyzed using chi-square, independent and paired t-tests. RESULTS: There was no difference regard to FBG and OGTT, but there was a significant difference between groups in physical activity level (P<0.001) and in all food groups except bread and cereals after the intervention (P<0.05). CONCLUSION: The education through a short text message system seem couldn't control the blood sugar, but it could promote physical activity and food additives of pre-diabetic pregnant women.

The relationship between maternal vitamin D status during third trimester of pregnancy and maternal and neonatal outcomes: A longitudinal study.

BACKGROUND: Vitamin D deficiency is a common nutritional concern and leads to several problems among some population groups. OBJECTIVE: The aim of the current study was to evaluate the relationship between maternal vitamin D status and gestational weight gain, maternal biochemical parameters, mode of delivery, and infants' growth indices at birth. MATERIALS AND METHODS: A longitudinal study between March and June 2017 was carried on 82 mothers in Ahvaz. Blood samples of each mother were obtained at the mean of the third trimester to assay lipid indices (total cholesterol, triglycerides, low-density lipoprotein, and high-density lipoprotein cholesterol), fasting blood sugar, and 25-hydroxy vitamin D. Anthropometric assessment of newborns was recorded from neonatal health card at birth. RESULTS: Mean maternal 25-hydroxy vitamin D level was 22.52 nmol/L; 7.33% of mothers had vitamin D deficiency, 76.6% had vitamin D insufficiency, and 15.9% were normal. The mean neonate birth weight, length, and head circumference of mothers who were on the third tercile of 25-hydroxy vitamin D serum level was significantly higher than those in the first tercile (p < 0.001, p = 0.004 and p < 0.001, respectively). Maternal vitamin D serum level had an adverse relationship with fasting blood sugar. CONCLUSION: Low levels of serum vitamin D may cause adverse pregnancy outcomes and delivery of infants with insufficient growth at birth.

Does Turmeric/curcumin Supplementation Change Anthropometric Indices in Patients with Non-alcoholic Fatty Liver Disease? A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Curcumin is the principal polylphenol of turmeric that has been used to treat various disorders. However, its anti-obesity effects in patients with non-alcoholic fatty liver disease (NAFLD) remain controversial. Therefore, we aimed to perform a meta-analysis on the effects of supplementation with turmeric/curcumin on body weight, body mass index (BMI) and waist circumference (WC) in these patients. PubMed, Scopus, Cochrane Library, and ISI Web of Science were searched until January 2019, without any restrictions. Clinical trials that reported body weight, BMI and WC in patients with NAFLD were included. Weighted mean differences (WMDs) were pooled using a random-effects model. Eight studies (449 participants) fulfilled the eligibility criteria of the present meta-analysis. Overall, meta-analysis could not show any beneficial effect of turmeric/curcumin supplementation on body weight (WMD, -0.54 kg; 95% confidence interval [CI], -2.40, 1.31; p = 0.56; I2 = 0.0%), BMI (WMD, -0.21 kg/m2; 95% CI, -0.71, 0.28; p = 0.39; I2 = 0.0%) and WC (WMD, -0.88 cm; 95% CI, -3.76, 2.00; p = 0.54; I2 = 0.0%). Subgroup analysis based on participants' baseline BMI, type of intervention, and study duration did not show any significant association in all subgroups. The results showed that turmeric/curcumin supplementation had no significant effect on body weight, BMI and WC in patients with NAFLD. Further studies with large-scale are needed to find out possible anti-obesity effects of turmeric/curcumin.

Visual Cues and Food Intake: Distortion Power of Plate and Spoon Size on Overweight and Obese University Staff.

BACKGROUND: This study was designed to evaluate the effect of the size of plate, spoon, and fork on food and energy intake during a meal in obese or overweight staff. METHODS: This was a crossover randomized controlled trial that was conducted on 40 obese or overweight clerical staff of the university. The staff was invited to have lunch randomly, receiving either a large or a small set of plate, spoon, and fork. Washout period was 3 weeks, and the participants were then invited to have lunch in a second intervention period and received opposite sizes of dishes compared to the first period sizes. The meal was composed of roasted chicken (kebab), cooked rice, vegetable salad, dairy drink, and soda. Changes in food intake between large and small utensils (plate, spoon, and fork) were analyzed with paired t-test. RESULTS: Rice intake using small or large eating utensils was different (P = 0.02). But total energy intake was not different. The Pearson correlation test demonstrated a positive and significant correlation between rice consumption and waist-to-hip ratio (P = 0.02). Soda (P = 0.02), carbohydrate (P = 0.01), and total energy intake (P = 0.03) were negatively correlated with the age of the participant. CONCLUSIONS: It seems that only the amount of grain products consumption changes with changing in dishware size with no significant effect on total energy intake. It is recommended that the independent effect of visual cues on food intake for foods with different textures be investigated in future studies.

An evaluation of the effects of saffron supplementation on the asthma clinical symptoms and asthma severity in patients with mild and moderate persistent allergic asthma: a double-blind, randomized placebo-controlled trial.

BACKGROUND: Asthma is a heterogeneous disease which is usually associated with chronic airway inflammation. Saffron has anti-inflammatory effects and may has beneficial effects on asthma. HYPOTHESIS: The present study was intended to survey the effects of saffron supplementation on blood pressure, lipid profiles, basophils, eosinophils and clinical symptoms in patients with allergic asthma. STUDY DESIGN: Our study was a clinical trial. METHODS: Subjects (N = 80, 32 women and 48 men, 41.25 ± 9.87 years old) with mild and moderate allergic asthma were randomized into two groups: the intervention group who received two capsules of saffron (100 mg/d), and the control group who received two capsules of placebo for 8 weeks. SPSS software (version 16.0) was used for the data analysis. RESULTS: Saffron improved the frequency of clinical symptoms of the patients (i.e., frequency of the shortness of breath during the day and night time, use of salbutamol spray, waking up due to asthma symptoms and activity limitation) in comparison to the placebo (p < 0.001). Besides, asthma severity decreased almost significantly in the saffron group (p = 0.07). It was also found that saffron, in comparison with the placebo, significantly reduced the systolic and diastolic blood pressure, triglycerides and low density lipoprotein cholesterol. Moreover, eosinophils and basophils concentration reduced in the saffron group (p = 0.06 and 0.05 respectively). CONCLUSION: Saffron seems to be an effective and safe option (in 8 weeks supplementation) to improve clinical symptoms of patients with allergic asthma but the toxicity and/or long-term effects of saffron intake are not known. Registration ID in IRCT (IRCT2017012132081N2).

The effect of retinyl-palmitate on the level of pro and anti-inflammatory cytokines in multiple sclerosis patients: A randomized double blind clinical trial.

OBJECTIVE: Multiple sclerosis (MS) is an inflammatory and autoimmune disease associated with the imbalance of cytokines secreted from CD4+ T cells. Studies have shown that vitamin A and its active derivatives are able to modulate the immune system in MS patients. The aim of the present study was to investigate the effect of supplementation of retinyl palmitate (RP), the dietary form of vitamin A, on pro- and anti-inflammatory cytokines in the plasma and supernatants of cultured peripheral blood mononuclear cells (PBMCs) of MS patients. PATIENTS AND METHODS: Thirty-six relapsing-remitting MS patients were enrolled in this double-blind randomized clinical trial. Participants received one capsule of 25,000 IU RP or a placebo per day for six months. Blood samples were taken before and after intervention. After intervention, the PBMCs were isolated and cultured. The levels of pro- and anti-inflammatory cytokines in the plasma and supernatant of cells stimulated with myelin oligodendrocyte glycoprotein, phytohemagglutinin or vehicle (media) were determined. The sample t-test and Mann Whitney U test were used to compare data between groups. RESULTS: The changes in pro-inflammatory cytokine levels (IL-1ß, TNF-α, IFN- γ, IL-2, IL-6, and IL-17) in the serum and supernatant of MS patients were not significant (p > 0.05). There were also no significant changes in the levels of anti-inflammatory cytokines (IL-10, IL-13, IL-4, and TGF-ß) (p > 0.05). CONCLUSION: Unexpectedly, this study found no significant changes in cytokine levels after six months of RP supplementation in MS patients. The results of other studies by our team have shown significant changes in the gene expression of the cytokines in response to RP supplements. Therefore, we recommend that periodic follow-up of RP supplementation may be needed to reveal changes in the level of the cytokines in the plasma and PBMCs and to clarify the real effect of RP on the immune factor levels in the serum of MS patients.