Shining a Light on Trace Elements: A Systematic Review and Meta-analysis of Serum Concentrations in Febrile seizure.

Febrile seizures (FS) are a common occurrence in pediatric patients and are typically triggered by high fevers above 100.4°F (38°C), often associated with viral or bacterial infections such as respiratory or gastrointestinal infections. Recent research suggests that the serum concentration of trace elements may play a role in the occurrence of FS. This study aimed to assess the association between serum levels of trace elements and FS in pediatric patients. A comprehensive search of four databases, including Scopus, Web of Science, PubMed, and Google Scholar, was conducted up to February 2024. The study followed the PICO structure, focusing on the Population (pediatric patients with FS), Intervention (serum concentrations of selenium, zinc, magnesium, and copper), Comparison (with or without controls), and Outcome (occurrence of FS). The methodological quality of the included observational studies was assessed using the Newcastle-Ottawa Scale (NOS) tool. Out of a total of 168 papers, 37 met the inclusion criteria for this meta-analysis, covering studies published between 2018 and 2023. Lower serum zinc levels were observed in pediatric patients with FS compared to control groups (SMD: -1.25, 95% CI: -1.47, -1.03). Conversely, higher serum copper levels were found in control groups compared to those with FS (SMD: 0.43, 95% CI: 0.04, 0.82). Additionally, lower serum magnesium levels were detected in the FS group compared to controls (SMD: -0.76, 95% CI: -1.57, 0.05), while serum selenium levels were approximately two times lower in the FS group than in controls (SMD: -2.23, 95% CI: -2.76, -1.70). Our meta-analysis suggests that pediatric patients with FS have lower serum concentrations of trace elements compared to controls. Further research is warranted to elucidate the potential role of trace elements in the pathogenesis of FS. This meta-analysis and systematic review was registered in the International prospective register of systematic reviews (PROSPERO ID: CRD42024519163). Registry URL: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024519163 registry number: CRD42024519163.

The association between enteral nutrition with survival of critical patients with COVID-19.

BACKGROUND: Coronavirus disease 2019 (COVID-19) results in several complications and mortality in intensive care unit (ICU) patients. Limited studies have investigated the effect of enteral nutrition (EN) on the survival of COVID-19 patients in the ICU. The aim of this study was to investigate the association of EN with biochemical and pathological indices associated with mortality in ICU patients with COVID-19. METHODS: This case-control study was conducted on 240 patients with COVID-19 hospitalized in the ICU including 120 eventual nonsurvived as the cases and 120 survived patients as the controls. All of the patients received EN as a high protein high volume or standard formula. Data on general information, anthropometric measurements, and the results of lab tests were collected. RESULTS: The recovered patients received significantly more high protein (60.8% vs. 39.6%, p = .004) and high volume (61.6% vs. 42.3%, p = .005) formula compared to the nonsurvived group. Mortality was inversely associated with high volume (odds ratio [OR]: 0.45 confidence interval [CI]95%, p = .008) and high protein (OR: 0.42 CI95%, p = .003) formula. The results remained significant after adjusting for age and sex. Further adjustment for underlying diseases, smoking, body mass index, and the acute physiology and chronic health evaluation II (APACHE II) score did not change the results. CONCLUSION: The findings of the study showed that there was a significant inverse association between mortality and high volume and high protein formula in patients with COVID-19. Further investigation is warranted.

A systematic review of the beneficial effects of prebiotics, probiotics, and synbiotics on ADHD.

BACKGROUND: Children with attention deficit hyperactivity disorder (ADHD) may benefit from probiotics and prebiotics, but the effects are unclear. To determine whether probiotics and prebiotics affect children with ADHD, a systematic review was conducted. METHODS: The present systematic review analyzed cohort studies and randomized controlled trials that examined whether prebiotics and probiotics are associated with ADHD. Seven randomized controlled trials and two cohort studies met our inclusion criteria. RESULTS: Research on Lactobacillus rhamnosus GG (LGG) probiotic supplementation showed that children with ADHD had better emotional, physical, social, and school functioning, and a higher health-related quality of life compared to the placebo group. The studies also showed that Synbiotic 2000 reduces markers of intestinal and vascular inflammation in children with ADHD, in part through increasing SCFA levels. CONCLUSION: The use of probiotics and prebiotics as adjuvants therapy in patients with ADHD is beneficial. Further studies with longer duration, including more participants and a variety of age groups, and using various evaluation techniques such as in vivo observation are required to examine the effects of prebiotics and probiotics on ADHD.

Efficacy of a Comprehensive Weight Reduction Intervention in Male Adolescents With Different FTO Genotypes.

BACKGROUND: The FTO gene polymorphisms may influence the effects of lifestyle interventions on obesity. The present study aimed to assess the influence of the rs9930506 FTO gene polymorphism on the success of a comprehensive weight loss intervention in male adolescents with overweight and obesity. METHODS: This study was carried out on 96 adolescent boys with overweight and obesity who were randomly assigned to the intervention (n = 53) and control (n = 43) groups. The blood samples of the participants were collected, and the FTO gene was genotyped for the rs9930506 polymorphism. A comprehensive lifestyle intervention including changes in diet and physical activity was performed for 8 weeks in the intervention group. RESULTS: Following the lifestyle intervention, BMI and fat mass decreased significantly in the intervention group compared with the control group (both p < 0.05), while no change was found in weight, height or body muscle percentage between the groups. The participants in the intervention group with the AA/AG genotype and not in carriers of the GG genotype had a significantly higher reduction in BMI (-1.21 vs. 1.87 kg/m2, F = 4.07, p < 0.05) compared with the control group. CONCLUSION: The intervention in individuals with the AA/AG genotype has been significantly effective in weight loss compared with the control group. The intervention had no association effect on anthropometric indices in adolescents with the GG genotype of the FTO rs9930506 polymorphism. TRIAL REGISTRATION: Name of the registry: National Nutrition and Food Technology Research Institute; Trial registration number: IRCT2016020925699N2; Date of registration: 24/04/2016; URL of trial registry record: https://www.irct.ir/trial/21447.

The Association of Iron Intake and Hypertension, Does Iron Intake Decrease Blood Pressure?

Previous studies reported that iron may have an indispensable role in the risk of hypertension (HTN). However, the result of the studies on the relationship between iron and risk of HTN is inconsistent. This study aimed to assess the association between the association of dietary iron intake and HTN in the Iranian population. This case-control study was conducted on 4184 people aged 35 to 70, including 1239 people with HTN and 2945 people with normal blood pressure (BP) in Sabzevar, Iran. Dietary intake was assessed using a food frequency questionnaire (FFQ). The Nutritionist IV software was used in terms of the assessment of dietary intake of iron. An inverse association was found between iron intake and HTN (OR = 0.97, CI 95%: 0.94-0.99, P = 0.04). The association remained significant after adjustment for age, gender, smoking, drinking alcohol, calorie intake, and BMI (OR = 0.94, CI 95%: 0.89-0.98, P = 0.01). As a conclusion, iron intake was inversely associated with HTN. Further longitudinal studies on the effect of iron intake on BP are required to confirm this finding.

Association of dietary fats with ischemic heart disease (IHD): a case-control study.

BACKGROUND: This study aimed to investigate the association between different types of dietary fats with ischemic heart disease (IHD). METHODS: This case-control study was conducted on 443 cases and 453 controls aged 40-80 years in Tehran, Iran. The semi-quantitative 237-item food frequency questionnaire (FFQ) was used to assess the amount of food intake. Nutritionist IV was applied to test the amount of consumption of dietary fats. RESULTS: The case group had a lower intake of docosahexaenoic acid (DHA) (11.36 ± 12.58 vs. 14.19 ± 19.57, P = 0.01) than the control group. A negative association was found between IHD and DHA (OR 0.98, CI 95% 0.97-0.99, P = 0.01). No significant association was observed between IHD with the intake of cholesterol, trans fatty acids (TFA), saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), polyunsaturated fatty acids (PUFA), eicosatetraenoic acid (EPA), and α-Linolenic acid (ALA). CONCLUSION: It was found that DHA may reduce the risk of IHD, whereas there was no significant association between other types of dietary fats with the odds of IHD. If the results of this study are confirmed in future research, a higher intake of DHA in diet can be recommended as a strategy to prevent IHD events.

Does dietary intake of caffeine have an effect on transient global amnesia?

AIM: Amnesia is a cognitive disorder that may lead to memory loss. Caffeine is a psychoactive substance which have an effect on memory and cognitive functions. This study aimed to assess the association of transient global amnesia (TGA) with dietary intake of caffeine. METHODS: This cross-sectional study was conducted on the Sabzevar Persian cohort data of 258 patients with TGA and 520 healthy individuals in Sabzevar, Iran. The Nutritional data were gathered in face-to-face interviews using a valid Food Frequency Questionnaire. Different models of logistic regression were used to determine the association between TGA and dietary caffeine intake after adjusting the confounders including age, sex, education, job, marital status, physical activity, BMI, and calorie intake. RESULTS: There was no significant difference in terms of dietary calorie intake of (2279.5 ± 757.9 vs. 2365.5 ± 799.5, p = 0.19), protein (70.79 ± 25.27 vs. 72.94 ± 24.83, p = 0.31), fat (59.97 ± 23.79 vs. 60.13 ± 26.38, p = 0.93), carbohydrate (376 ± 134 vs. 393.1 ± 137.8, p = 0.14), and caffeine (196.4 ± 127.9 vs. 186.3 ± 128.5, p = 0.36) between the groups. No significant association was found between TGA and dietary intake of caffeine (OR: 0.99, 95% CI: 0.99-1.01, p = 0.36). The results did not change after adjusting the confounders. CONCLUSIONS: No significant association was found between TGA and dietary intake of caffeine. Further prospective studies are required to confirm this finding.

Egg consumption and risk of cardiovascular disease: a PERSIAN cohort-based study.

BACKGROUND: Cardiovascular diseases (CVDs) are one of the main causes of death worldwide. Data on the effect of eggs consumption on the risk of CVDs are still unreliable. Therefore, this study aimed to investigate the association between CVDs and the consumption of eggs. METHODS: In this case-control study, the required data were extracted from the Prospective Epidemiologic Research Studies in Iran (PERSIAN) cohort in Sabzevar, Iran. A total of 4241 adults participated including 1535 patients with CVDs as the case group and 2706 healthy people as controls. Egg consumption was assessed using a valid food frequency questionnaire (FFQ). RESULTS: A significant association was observed between eggs consumption and stroke after adjustment for physical activity, body mass index (BMI), smoking, systolic blood pressure (SBP), diastolic blood pressure (DBP), using alcohol, lipid profile, diabetes, and the intake of energy, lipid, protein, carbohydrate, and cholestrol (OR:1.007, 95% CI:1.001-1.013, P = 0.03). No association was found between egg consumption with hypertension, cardiac ischemia, and myocardial infarction. CONCLUSIONS: There was a significant association between the consumption of eggs and stroke. However, more studies are needed to examine the effect of eggs on CVDs.

Association between type 2 diabetes and branched chain amino acids (BCAA); a case-control study.

Background: Several amino acids and their derivatives have been implicated in insulin resistance (IR) and Type 2 Diabetes Mellitus (T2DM). This research sought to establish a relationship between the dietary levels of branched-chain amino acids (BCAA) and the risk of T2DM. Methods: This case-control study was carried out on 4200 participants consisting of 589 people with T2DM and 3611 non-diabetic aged 35 to 70 years residents in Sabzevar, Iran. Data on the economic-social, employment status, medical history, lifestyle, and sleep habits were collected via interview. The food frequency questionnaire (FFQ) was used to check the nutritional status. Participants' dietary BCAA consumption was estimated using Nutritionist IV software. Results: A significant negative association between the incidence of T2DM and the dietary levels of BCAAs after adjustment for age and sex (OR = 0.972, CI 95%:0.648-0.996, P = 0.022). The negative association remained significant after additional adjustments for body mass index (BMI) and physical activity (OR = 0.967, CI 95%: 0.943-0.992, P = 0.010). Interestingly, a positive association was found between T2DM and total BCAAs (OR = 1.067, CI 95%: 1.017-1.119, P = 0.008), Isoleucine (OR = 1.248, CI 95%: 1.043-1.494, P = 0.016), Leucine (OR = 1.165, CI 95%: 1.046-1.299, P = 0.006) and Valine (OR = 1.274, CI 95%: 1.088-1.492, P = 0.003) after further adjustment for calorie intake. Conclusions: Our results demonstrate branched-chain amino acids (BCAAs) including isoleucine, leucine, and valine are negatively associated with the incidence of type 2 diabetes (T2DM) after adjusting for age and sex, BMI, and physical activity. However, adjusting for calorie intake reversed the association between T2DM and BCAAs. These findings suggest that the association between BCAAs and T2DM may be influenced by calorie intake. Future longitudinal studies are warranted. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-023-01247-9.

The association between obesity with treatment duration, ICU length of stay and the risk of death in critically ill patients with COVID-19.

BACKGROUND: Despite the confirmed association between higher BMI with increased risk of the acute respiratory distress syndrome (ARDS), the association between obesity with mortality in critically ill patients with coronavirus disease 2019 (COVID-19) is not clear. The present study aimed to investigate the association between obesity with treatment duration, ICU length of stay, and the risk of death in critically ill patients with COVID-19. METHODS: This case-control study was performed on 223 patients with COVID-19 including 148 surviving patients as the control group and 75 eventually dead patients as the case group in Rasht, Iran. Data on demographic factors, comorbidities, anthropometric measurements, the length of hospitalization and the mortality were obtained from patients' medical records. RESULTS: The mortality rate was significantly associated with weight (OR = 1.04, 95% CI: 1.002-1.083, p = .04), but not with BMI after adjustments for age, gender, length of stay in ICU, chronic diseases and smoking. The results did not change after further adjustments for biochemical and pathological factors. CONCLUSIONS: Weight was positively associated with mortality after controlling for confounding variables. Further studies should consider the patient's body composition such as fat mass to establish the relationship between obesity and COVID-19 outcomes.

The effects of dietary supplements in patients with cervical cancer: a comprehensive systematic review.

Background: Recent studies reported that complementary therapy including dietary supplements may has a beneficial role in cervical cancer. However, the results are inconsistent. This study aimed to investigate the association between cervical cancer and dietary supplements. Methods: A systematic literature review was conducted to summarize and quantify the most recent findings on dietary supplement and cervical cancer. Several databases were checked for relevant publications published in English up to March 2023. Of the 32 articles identified, only 20 met the inclusion criteria and were included. Results: Women with cervical intraepithelial neoplasia may benefit from folate supplementation against oxidative stress and inflammation. Vitamin D may reduce oxidative stress and may have a therapeutic effect. Zinc promotes the clearance of the human papilloma virus and reduces the chance of viral infection. The use of probiotic supplements may improve the complications associated with chemotherapy in patients with cervical cancer, such as diarrhea and abdominal pain. Radiotherapy and chemotherapy complications may also be reduced by omega-3 fatty acids. Conclusion: Some dietary supplements including folate, vitamin D, zinc, probiotics, and omega-3 fatty acids may have beneficial effects in patients with cervical cancer. Further studies are warranted to confirm these results.

Association between ischemic heart disease and dietary intake of lycopene: a case-control study.

Aim: The effect of dietary lycopene on ischemic heart disease (IHD) is not clear. Hence, this study aimed to determine the association between dietary lycopene and IHD. Methods: This case-control study was conducted on 443 patients with physician confirmed diagnosis of IHD as the case group and 443 healthy individuals as the control group. Data on demographic, medical history, anthropometric, and physical activity of the participants were collected. Food intake was evaluated using a 237-item semi-quantitative food frequency questionnaire (FFQ). The dietary intake of lycopene was assessed using Nutritionist IV software. Results: A negative association was found between IHD and lycopene (OR: 0.98, CI 95%: 0.963-0.996, p = 0.02). The results remained significant after adjustment for age and sex, additional adjustment for dietary intake of calorie and fat, further adjustments for BMI, and additional adjustment for smoking, drinking alcohol, and physical activity. The risk of IHD in people with the highest quartile of dietary intake of lycopene was significantly lower than those with the lowest quartile (OR = 0.67, CI 95%: 0.46-0.97, p = 0.036). Conclusion: There was a significant inverse relationship between intake of lycopene and IHD. Further prospective studies in different populations are required to elucidate the roles of lycopene against IHD.