A narrative review on the role of hesperidin on metabolic parameters, liver enzymes, and inflammatory markers in nonalcoholic fatty liver disease.

Insulin resistance, oxidative stress, hyperlipidemia, and inflammation play main roles in the development of nonalcoholic fatty liver disease (NAFLD). Some studies have reported that hesperidin can reduce hyperglycemia and hyperlipidemia by inhibiting inflammatory pathways. In the current study, our purpose was to evaluate whether it can influence the primary parameters in NAFLD and improve the treatment effectiveness for future trials. Various studies have found that hesperidin involves multiple signaling pathways such as cell proliferation, lipid and glucose metabolism, insulin resistance, oxidative stress, and inflammation, which can potentially affect NAFLD development and prognosis. Recent findings indicate that hesperidin also regulates key enzymes and may affect the severity of liver fibrosis. Hesperidin inhibits reactive oxygen species production that potentially interferes with the activation of transcription factors like nuclear factor-κB. Appropriate adherence to hesperidin may be a promising approach to modulate inflammatory pathways, metabolic indices, hepatic steatosis, and liver injury.

The association of dietary phytochemical index and nonalcoholic fatty liver disease.

Consumption of phytochemical-rich foods relates to the prevention of chronic diseases. In this study we assessed the dietary phytochemical index (PI) in metabolic parameters, liver enzymes, and severity of fibrosis among nonalcoholic fatty liver disease patients. This cross-sectional study was conducted on 210 patients with NAFLD. Fibrosis-4 index (FLB4), nonalcoholic fatty liver disease fibrosis score (NFS), FBS, lipids profile, AST, ALT, ALP, and GGT were measured. PI was calculated through the information obtained from a validated semi-quantitative food frequency. Multiple regression models were used to estimate mean difference changes in the evaluated variables associated with various dietary PI. Participants' mean ± SD of age and BMI were 39.23 ± 10.52 and 24.40 ± 2.64, respectively. We found that DPI is inversely associated with serum TG, TC, and LDL-C and directly associated with serum HDL-C and a higher score in DPI is associated with lower scores in NFS and FIB-4. Multivariate linear regression showed that there is an inverse association between DPI and AST, ALT, ALP, GGT, NFS, and FIB-4. Higher dietary PI could impact on reduction of NAFLD progression and improvement of metabolic parameters.

The effects of flaxseed supplementation on concentration of circulating adipokines in patients with ulcerative colitis.

Aim: This study aimed to evaluate the effect of supplementation with ground flaxseed (GF) on the concentrations of adiponectin, resistin, and visfatin in patients with ulcerative colitis (UC). Background: Inflammatory bowel disease (IBD) is one of the most common gastrointestinal diseases affecting people of all ages. Adipokines secreted from adipose tissue have been shown to play an essential role in the pathogenesis of UC. Methods: This trial is an open-labeled randomized controlled trial conducted on 70 patients with UC. The patients were randomly divided into two groups: flaxseed and control. The patients in the intervention received 30 g/day flaxseed powder for 12 weeks. Patients' anthropometric, nutritional, and biochemical factors were evaluated at the beginning and end of the intervention period. Results: Totally, 64 patients (36 men and 28 women) with a mean age of 31.12±9.67 were included in the final analysis. There was no significant difference between the two groups regarding baseline weight and height (P>0.05). After the 12-week intervention, flaxseed supplementation led to a significant reduction in the resistin (-4.85±1.89 vs. -1.10±2.25, P<0.001) and visfatin concentration (-1.33±1.14 vs. -0.53±1.63, P=0.018). Further, we found a significant increase in the adiponectin levels after the GF supplementation (3.49±1.29 vs. -0.35±0.96, P<0.001). Conclusion: Flaxseed supplementation could exert beneficial effects on adipokine levels in patients with UC.

Impact of low-carbohydrate diet on serum levels of leptin and adiponectin levels: a systematic review and meta-analysis in adult.

Background: Various studies have evaluated the effects of low-carbohydrate diet (LCD) on serum concentrations of adipokines. Although the association between LCD and serum levels of leptin and adiponectin has been studied extensively, the results were not consistent. Objective: The purpose of this study was to systematically evaluate the effect of LCD on serum levels of leptin and adiponectin. Design: Electronic databases were retrieved in PubMed, Embase, Scopus and Web of Science to search relevant publications. Pooled standard mean difference (SMD) with 95% confidence interval (CI) was calculated by the random-effect model. Cochrane Q test and I2 statistic were used to test heterogeneity. Subgroup analysis and meta-regression were applied to assess possible sources of heterogeneity. Results: A total of thirty-five articles were included in final analysis. Meta-analysis results revealed no statistical association between LCD and adiponectin concentration (WMD: 0.32 ng/ml, 95% CI: - 0.02, 0.66, p=0.062). Subgroup analysis showed that LCD increased adiponectin concentration in subjects under 45 years old and in studies with long term duration intervention. Also, did not observe a significant effect from the LCD on serum concentration of leptin (WMD: - 0.77 ng/ml, 95% CI: -3.15, 1.61, P=0.409). Subgroup analysis did not show any new information. The results of this study did not support the evidence for the positive effects of LCD on serum leptin and adiponectin levels.

Nutritional management of inflammatory bowel disease; an overview of the evidences.

BACKGROUND AND AIMS: Inflammatory bowel disease (IBD) is a chronic relapsing-remitting systemic disease and one of the most common gastrointestinal diseases that affect many people. This review designed to report the latest findings on the association between some nutrients and IBD. METHODS: A review was performed to summarize the effect of various aspects of nutrition and diet on clinical course, the severity of disease, intestinal epithelial inflammation, inflammatory and oxidative stress markers. Literature searches were conducted in PubMed and Google Scholar up to June 27, 2021. RESULTS: Various studies have shown that an unhealthy diet and deficiency of some nutrients are involved in the etiology of IBD. It has also been shown that intestinal dysbiosis can increase the risk of developing IBD. The results of some studies have shown that supplementation with some nutrients such as omega-3 polyunsaturated fatty acids and vitamin D and probiotics may have beneficial results in patients with IBD. Adherence to some restrictive diets has also been helpful in some studies. CONCLUSIONS: Following proper nutritional approaches can play an essential role in managing IBD symptoms. Further studies are needed to substantiate some of these findings.

The effect of wheat germ-enriched enteral formula on clinical and anthropometric factors in mechanically ventilated patients admitted to the intensive care unit.

BACKGROUND & AIMS: Nutritional support is considered as an important therapeutic strategy among critically ill patients. To evaluate the effect of a wheat germ-enriched formula in patients admitted to the intensive care unit (ICU). METHODS: This randomized controlled clinical trial study was conducted on 100 patients admitted to the ICU. Patients randomly received a wheat germ-enriched formula or a standard formula from the first day of admission until weaning from the ventilator. Then, the duration of mechanical ventilation, the length of ICU, hospital admission, body composition and mortality rate were compared between the two groups. RESULTS: Based on the results, wheat germ-enriched formula caused a significant reduction in the length of mechanical ventilation (29.80 ± 21.99 days vs. 36.48 ± 8.78 days, P < 0.001), the ICU length of stay (32.92 ± 21.04 days vs. 37.70 ± 8.76, P < 0.001), and the SOFA score (4.60 ± 1.28 vs. 5.68 ± 1.25, P < 0.001) compared to the control group. However, the intervention group demonstrated a significant increase in the basal metabolic rate, mid upper arm circumference, skeletal muscle mass, body cell mass, and GCS score compared to the control group (P < 0.05). Finally, no significant difference was observed between the two groups in terms of the hospital length of stay, ICU mortality, and body fat percentage (P > 0.05). CONCLUSION: In general, wheat germ enriched formula may exert beneficial effect on clinical and anthropomorphic variables in patients admitted to the ICU. TRIAL REGISTRATION: The study was approved by the Ethics Committee of the Urmia University of Medical Sciences under number IR.umsu.rec.1396.88 and registered at the Iranian Registry of Clinical Trials Website as IRCT20171221037983N3.

The effects of flaxseed supplementation on metabolic syndrome parameters, insulin resistance and inflammation in ulcerative colitis patients: An open-labeled randomized controlled trial.

The present study aimed to evaluate the efficacy of flaxseed supplementation in the management of metabolic syndrome (MetS)-related parameters among the patients with mild-to-moderate ulcerative colitis (UC). A randomized controlled clinical trial was conducted on 70 patients with UC. Participants were randomized in the intervention group, which received 30 g/day ground flaxseed powder or control group. Anthropometric and biochemical variables were assessed at the beginning and end of 12 weeks of intervention. Of the 70 patients enrolled in this study, 64 subjects were included in the final analysis. From baseline to 12 weeks' intervention, flaxseed supplementation resulted in a significant reduction in the serum concentration of insulin (p < .001), HOMA-IR (p < .001), triglyceride (p = .001), total cholesterol (p < .001), and significant increase in the serum levels of HDL (p = .008). Also, we found a significant improvement in the SCCAI score (p < .001), TNF-α (p = .03), and CRP (p < .001) following the flaxseed supplementation. However, we not observed any significant differences between two groups regarding the body weight, BMI, waist circumferences, systolic, and diastolic blood pressure (p > .05). Overall, 12 weeks of flaxseed supplementation resulted in greater improvement in the some MetS-related parameters.

The effects of flaxseed supplementation on gene expression and inflammation in ulcerative colitis patients: An open-labelled randomised controlled trial.

AIMS: Inflammatory bowel disease, a chronic inflammatory disorder of the intestinal mucosa, is a clinical presentation of Crohn's disease and ulcerative colitis (UC). This study investigated the effect of grounded flaxseed (GF) and flaxseed oil (FO) on clinical biomarkers, quality of life and diseases activity in patients with UC. This research was conducted among 90 patients with UC for 12 weeks using an open-labelled randomised controlled trial design. METHODS: The participants were randomly assigned into two intervention groups supplemented with GF (30 gr/day) and FO (10 gr/day) as well as a control group. The participants' data were collected prior to and 12 weeks after the intervention. The one-way analysis of variance was run to compare variables. RESULTS: A total of 75 patients completed the study. After the intervention, hs-CRP (P < .001) and Mayo score (P < .001) were reduced significantly, but quality of life was increased significantly (P < .001) in the GF and FO groups compared with the control. A significant increase was observed in IL-10 concentration in the FO group, but no significant change was found in serum levels of IL-10 in the control group. Moreover, the decrease in Mayo score was greater in patients at more severe stages of the disease (P < .05). No difference was observed between the intervention groups and control group in mRNA expression level of TLR4 at the 12th week. CONCLUSION: In conclusion, grounded flaxseed and FO attenuated systemic inflammation and improved disease severity in UC patients.

Does the inflammatory potential of diet affect disease activity in patients with inflammatory bowel disease?

BACKGROUND: Diet is an important modulator of inflammation, which is associated with inflammatory bowel disease (IBD). In this study, we examined whether the inflammatory properties of diets are associated with disease activity in patients with IBD. METHODS: A cross-sectional study was conducted on 143 IBD patients, including 32 patients with Crohn's disease (CD) and 111 patients with ulcerative colitis (UC). Dietary intakes were assessed by a valid 168-item food frequency questionnaire (FFQ). The inflammatory potential of the diet was assessed by calculating the two scores of Dietary Inflammatory Index (DII®), and the Empirical Dietary Inflammatory Pattern (EDIP), and CD and UC disease activity were determined by the Crohn's disease activity index (CDAI) and the Mayo score, respectively. Associations of the inflammatory indices as median and as tertiles with disease activity were analyzed using logistic regression in a univariate model and after adjusting for total energy intake (continuous), type of disease (CD and UC) and drug consumption (no drugs, single drug, and multiple drugs). RESULTS: Sixty-four IBD patients (44.8%) in this study had active disease.The DII® score and the EDIP did not differ significantly between active and inactive patients (- 1.45 ± 1.04 vs.- 1.20 ± 1.24; 0.56 ± 0.22 vs. 0.53 ± 0.28, respectively). After adjusting for energy intake, drug use, and IBD type, the odds (95%CIs) of active disease among patients in tertile 3 compared to those in tertile 1 were 0.84 (0.32-2.17) for DII and 1.50 (0.61-3.72) for EDIP; neither of which were statistically significantly different from the rates in tertile 1. CONCLUSIONS: Although point estimates were in the expected direction of increased risk, the inflammatory potential of diet, assessed using DII or EDIP, was not associated with severity of disease in IBD patients. Whether diet-related inflammation affects disease activity in patients with IBD deserves further investigations.

Effects of flaxseed and flaxseed oil supplement on serum levels of inflammatory markers, metabolic parameters and severity of disease in patients with ulcerative colitis.

OBJECTIVE: The present study aimed to evaluate the possible effect of grounded flaxseed and flaxseed oil on serum levels of inflammatory markers, metabolic parameters, and the severity of disease in patients with UC. METHODS: In this open-labeled randomized controlled trial, 90 UC patients were randomly assigned to one of the 3 groups for 12 weeks: grounded flaxseed (GF; 30 g/day), flaxseed oil (FO; 10 g/day) and control group. The weight, waist circumference, systolic and diastolic blood pressure, serum inflammatory markers (interleukin-6 (IL-6), interferon gamma (INF-γ), transforming growth factor beta (TGF-ß), and Erythrocyte Sedimentation Rate (ESR)), and fecal calprotectin were measured at the baseline and end of the study. RESULTS: Totally, 75 patients (43 men and 32 women) with a mean age of 31.54 ±â€¯9.84 years participated in the present study. Comparing the change of the variables indicated a significant decrease in fecal calprotectin (P < 0.001), Mayo score (P < 0.001), ESR (P < 0.001), INF-γ (P < 0.001), IL-6 (P < 0.001), waist circumference (P = 0.02), Diastolic Blood Pressure (DBP) (P < 0.001), and Systolic Blood Pressure (SBP) (P < 0.001) and a significant increase in TGF-ß (P < 0.001) and Inflammatory Bowel Disease Questionnaire-Short form (IBDQ-9) score (P < 0.001) in the GF and FO groups compared to the control. No difference was obvious between the FO and GF groups except for TGF-ß. CONCLUSION: The present study showed that both flaxseed and flaxseed oil, attenuate inflammatory markers, disease severity, blood pressure, and WC. However, the effect of flaxseed on weight and BMI was not evident.

Effects of ginger supplementation on anthropometric, glycemic and metabolic parameters in subjects with metabolic syndrome: A randomized, double-blind, placebo-controlled study.

BACKGROUND: Metabolic syndrome (MetS) is one of the worldwide most chronic endocrine disorders. The disease can also lead to several other chronic disorders such as type 2 diabetes mellitus, cardiovascular diseases, renal diseases and cancers. This study aimed to evaluate the safety and efficacy of ginger powder on biochemical and anthropometric parameters in patients with MetS. METHODS: This randomized controlled clinical trial was conducted on 37 patients with MetS. We supplemented the individuals with MetS with either 2 g per day ginger powder or placebo for 12 weeks. Biochemical and anthropometric parameters before and after the intervention were compared between the two groups. RESULTS: After 12 weeks of treatment, the levels of triglyceride (TG), FBS, and insulin resistance were significantly improved in the patients receiving ginger in compare to the placebo group (P < 0·05). Moreover, significant changes were observed in terms of weight, waist circumference, LDL, HDL, total cholesterol, systolic and diastolic blood pressure and energy intake between the groups. CONCLUSION: In general, our findings demonstrated that the ginger supplementation offers beneficial effects on patients with MetS, at least, in part due to the modulatory effects on TG, FBS, and insulin resistance.

Can coenzyme Q10 supplementation effectively reduce human tumor necrosis factor-α and interleukin-6 levels in chronic inflammatory diseases? A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND/OBJECTIVE: Systematic inflammation plays a major role in all stages of chronic diseases. Recent evidence suggests that Coenzyme Q10 (CoQ10), as an anti-inflammatory agent, has shown beneficial effects on the inflammatory process of various human diseases. However, several trials have examined the effects of CoQ10 on pro-inflammatory cytokines with contrasting results. The objective of this systematic review and meta-analysis of randomized clinical trials (RCTs) was to assess the efficacy of CoQ10 supplementation on tumor necrosis factor- α (TNF-α) and interleukin-6 (IL-6) levels. MATERIALS AND METHODS: A systematic literature was performed on databases including PubMed/Medline, EMBASE, Web of Science, SCOPUS, Cochrane Library databases, Clinical Trials.gov and historical search of reference lists from selected studies up to December 2018. Two reviewers independently investigated study eligibility, extracted data, and assessed risk of bias of relevant studies using a standardized protocol. Heterogeneity was measured by the I2 statistic. Data were pooled, using the fix or random-effect model based on the heterogeneity test results and the efficacy of CoQ10 expressed as the standardized mean difference (SMD) with 95% confidence interval (CI). Random-effects meta-regression was done to examine the effect of putative confounders or potential moderators on TNF-α and IL-6 levels. RESULTS: Overall, nine RCTs with a total of 509 patients (269 in the CoQ10 arm and 240 in the control arm) provided the inclusion criteria and were included in the analysis. Our meta-analysis indicated that oral CoQ10 supplementation (60-500 mg/day for 8-12 weeks) resulted in significant reduction of TNF-α (SMD: -0.44, 95% CI: [-0.81 to -0.07] mg/dl; I2 = 66.1%, p  = 0.00) and IL-6 levels (SMD: -0.37, 95% CI: [-0.65 to -0.09]; I2 = 57.2, p  = 0.01), respectively. Subgroup analyses represented a significant reduction of TNF-α and IL-6 levels in patients with BMI < 26. Due to the small number of studies and patients included in each subgroup, these subgroup analyses need to be interpreted cautiously. CONCLUSION: This meta-analysis of RCTs reported a significant effect of CoQ10 on some of the inflammatory markers among patients with chronic diseases which could attenuate the inflammatory state. However, well-designed studies with a larger sample size are required. Note that the results should be interpreted with caution because of the evidence of heterogeneity and limited number of studies.

Resolvin D1 impacts on insulin resistance in women with polycystic ovary syndrome and healthy women.

AIMS: The aim of this study was to determine the association between the intake of omega-3 PUFAs and the serum level of resolvin D1 and insulin resistance in women with Polycystic Ovary Syndrome (PCOS) compared to healthy women. METHODS: A cross-sectional study was conducted in 2015-2016 in Tehran, Iran, among females referred to the infertility clinic at Valie-Asr Reproductive Health Research Centre. Thirty-one patients with PCOS (according to the criteria of the European Society for Human Reproduction and Embryology (ESHRE) and the American Society for Reproductive Medicine (ASRM)) and 29 healthy, normal cycling (NC) women of similar age, weight and height were enrolled. Anthropometric measurements, levels of resolvin D1, fasting insulin, glucose levels and insulin resistance index (HOMA) for each of the patients were determined. RESULTS: Intakes of macronutrients (protein, carbohydrates, and total fat) and omega-3 PUFAs were higher in the PCOS group compared to the control group; also, the PCOS group had significantly higher resolvin D1, fasting insulin, glucose levels and HOMA when compared with the control group. Moreover, resolvin D1 correlated negatively with HOMA and fasting insulin levels among both the PCOS and control women. CONCLUSION: PCOS is associated with insulin resistance. We showed that omega-3 PUFAs can increase the synthesis of resolvin D1. Resolvin D1 is involved in insulin sensitivity by affecting insulin signaling and inflammatory pathways. Therefore, it can be a contributing factor in reducing insulin resistance in PCOS patients.

Association between dietary glycemic index and glycemic load with depression: a systematic review.

BACKGROUND: A combination of genetic and environmental factors is involved in depression etiology. During the last years, the prevalence of depression has increased in both developed and developing countries. Several studies indicated an association between dietary glycemic index (GI) and glycemic load (GL) with risk of depression. This systematic review was undertaken to summarize the effect of these diet indicators in depression pathogenesis. METHODS: A comprehensive search strategy was performed in the Pubmed, Embase, Cochrane Library and Scopus databases from 1966 to March 2017. Finally, six studies (three prospective cohort studies and three cross-sectional) were ultimately selected for inclusion in the systematic review. RESULTS: 75298 adults and elderly entered the reviewed studies. All of the included studies had high methodological quality. The present study indicated that the intake of foods with higher GI is associated with disease risk. However, the relationship was found to be inverse for GL, though the association was rather weak. CONCLUSIONS: Overall, the findings indicated that a diet with lower dietary glycemic index may be effective to reduce the risk or risk of depression.

Association Between Adipokines Levels with Inflammatory Bowel Disease (IBD): Systematic Reviews.

BACKGROUND: A combination of genetic and environmental factors is involved in the etiology of inflammatory bowel disease (IBD). Recent studies have shown that adipocytes play a crucial role, by actively participating in systemic immune responses in IBD patients. But findings remain controversial. To the best of our knowledge, no systematic review has evaluated the roles of adipokines in IBD, considering which this systematic review was undertaken to summarize the effects of these adipokines in IBD pathogenesis. METHODS: For this review, articles published between 1980 and 2016 were identified from the PubMed, EMBASE, Scopus, and Cochrane and Google scholar databases. Thirteen articles were ultimately selected for inclusion in this systematic review. RESULTS: Findings of the present study indicate that some of the adipokines such as leptin, adiponectin and resistin are associated with disease severity, body composition and glucose hemostasis in IBD patients, although some of these associations are stronger than others. CONCLUSIONS: Overall findings indicate that some adipokines may play a crucial role in IBD severity or other IBD related outcomes. Further studies are recommended to confirm the results.

Signaling pathways linking inflammation to insulin resistance.

Inflammation is closely linked to the pathogenesis of type 2 diabetes (T2D) and chronic inflammation is one of the main causes of insulin resistance. Insulin pathway is very important for the regulation of glucose, lipid, and energy homeostasis, growth and mitogenic. Proinflammatory mediators can be related to obesity and induce insulin- resistance in adipose tissue. Signaling pathways of transcription factors, particularly NF-κB signaling, are involved in insulin-sensitivity. In addition, the crosstalk between M1-M2 macrophage polarizing plays an essential role in insulin resistance by switching from an M1 to an M2 phenotype and also activation of transcription factors such as NF-κB and AP1. Here, we focus on the roles of transcription factors in inflammation-induced insulin resistance and their involvement in pathogenesis of insulin resistance.

Serum C1q and tumor necrosis factor (TNF)-related protein 9 in women with Polycystic Ovary Syndrome.

AIMS: To compare CTRP9 levels in women with Polycystic Ovary Syndrome (PCOS) and without PCOS. Furthermore, to determine the correlation between serum CTRP9 levels and some variety of anthropometric and biochemical parameters. METHODS: The study included 29 PCOS patients and 27 healthy volunteers of the same age and BMI. Body weight, height and waist circumference were assessed. Blood samples were taken for assessment of serum CTRP9 by enzyme-linked immunosorbent assay (ELISA) technique. In addition, blood samples were collected for fasting insulin, glucose, and lipid profiles, and homeostasis model of assessment-insulin resistance (HOMA-IR) values were calculated. RESULTS: Similar serum CTRP9 were found in PCOS subjects and controls (8.8±19.9 vs 5.0±7.6ng/mL). Serum CTRP9 concentration positively correlated with serum LDL-C and total cholesterol in patient group. However, no correlation between CTRP9 and other biochemical and anthropometric variables was found. CONCLUSION: Serum CTRP9 logs of PCOS participants exhibit a positive association with unfavorable lipid profile in this report.