The association between inflammatory and immune system biomarkers and the dietary inflammatory index in patients with COVID-19.

Background: Inflammation and cytokine storm have been reported to be the main cause of acute symptoms of coronavirus disease (COVID-19). Diet-induced inflammation may affect the condition of patients with COVID-19. Therefore, this study aimed to investigate the relationship between disease severity, inflammatory and immune system biomarkers, and the dietary inflammatory index (DII) in patients with COVID-19. Methods: This cross-sectional study was conducted on 500 adult patients with COVID-19. Patients were divided into mild, moderate, and severe conditions based on clinical and laboratory evidence. A validated food frequency questionnaire (FFQ) was used to determine DII and energy-adjusted DII (E-DII) scores. The serum C-reactive protein (CRP) level and blood cell count were measured for all patients. Multiple linear regression was used to explore the association between DII and E-DII and CRP, blood cell counts, and hospitalization in patients with COVID-19. Results: Coronavirus disease (COVID-19) patients with higher DII had higher consumption of fat and carbohydrate and lower intakes of protein, anti-inflammatory nutrients, garlic, caffeine, tea, onion, and fiber (P < 0.05). There was a positive association between DII and CRP (ß = 1.024, P < 0.001), hospitalization (ß = 1.062, P < 0.001), WBC count (ß = 0.486, P < 0.009), neutrophil count (ß = 0.565, P < 0.001), and neutrophil-to-lymphocyte ratio (ß = 0.538, P < 0.001) and a negative association between DII and the lymphocyte count (ß = -0.569, P < 0.001). There was a positive association between E-DII and hospitalization (ß = 1.645, P < 0.001), WBC count (ß = 0.417, P < 0.02), and neutrophil-to-lymphocyte ratio (ß = 0.35, P < 0.03). Conclusion: There is a positive correlation between DII and inflammation, immune hyperactivation, and length of hospital stay in patients with COVID-19. Further longitudinal studies are necessary.

Effect of herbal antioxidant-rich formula on improvement of antioxidant defense system and heat shock protein-70 expression in recreational female athletes: A randomized controlled trial.

BACKGROUND: The aim of the present study was to evaluate the effect of natural antioxidant formula (blend of herbs: ginger root, cinnamon bark and raw almond fruit powder, rosemary leaf powder, and honey) on oxidative status, antioxidant enzyme activity, and relative heat shock protein (HSP-70) expression in recreational female athletes. MATERIALS AND METHODS: Eighteen female participants trained for 4 weeks and randomly received either antioxidant formula (FormEX) (n = 8) or placebo (PlcEX) (n = 10) in a randomized controlled trial. Blood samples were obtained 1-h before, 1 h and 24 h postexercise to measure malondialdehyde (MDA), total antioxidant capacity (TAC), superoxide dismutase (SOD), glutathione peroxidases (GPx), and HSP70 mRNA expression. Data analysis was performed using 2 (treatment = grouping factor) ×6 (time = within-factor) repeated measurements analysis of variance or generalized estimating equations (GEE) test. We used the independent t-test to evaluate any significant differences for real-time polymerase chain reaction data. RESULTS: Antioxidant formula increased the relative HSP-70 mRNA expression more than Plc-EX group in all time points (P = 0.001). The time main effect was significant with regard to TAC and SOD concentrations (P = 0.001 and 0.002, respectively). However, there were no statistically significant differences between groups for TAC, SOD, and MDA (P = 0.25, 0.06, and 0.38, respectively). Neither the time main effect for MDA nor time and intervention interaction was not statistically significant for MDA, TAC, and SOD (P = 0.19, 0.13, and 0.10, respectively). GEE results for GPx showed that there were no significant differences between the groups (P = 0.11). CONCLUSION: The results presented herein revealed that natural antioxidant rich formula had variable effects on oxidative status. However, in contrast to many antioxidant supplements, this formulation increases the HSP-70 mRNA expression which might improve the antioxidant ability of cells in the long-term period and exercise-induced adaptation.

Waist Circumference to Height Ratio: Better Correlation with Fat Mass Than Other Anthropometric Indices During Dietary Weight Loss in Different Rates.

BACKGROUND: The first-line strategy for the treatment of obesity is weight loss (WL) through decreasing calorie intake. However, a diet that is capable of attenuating fat free mass decline following WL is preferred. Furthermore, it is required to choose proper measurements and appropriate obesity-assessment indices to monitor weight and body composition during WL program. METHODS: A total of 68 adults with overweight and/or obesity underwent a WL program (rapid and slow WL). Dependent variables include: weight, resting metabolic rate (RMR), body composition, and related measurements such as waist circumference (WC), waist to height ratio (WHtR), body adiposity index (BAI), a body shape index (ABSI), fat mass to lean body mass (FM/LBM), and percentage body fat (PBF). RESULTS: Obesity measurements decreased in both groups (all P < 0.05) while LBM and RMR decreased more in the rapid WL group (P < 0.05). After age and sex adjustment, a robust correlation was observed between FM/LBM and PBF (r = 0.918), LBM% and PBF (r = -0.949), LBM% and FM/LBM (r = -0.904), WHtR and WC (r = 0.986), and BAI% and HC (r = 0.986) (P < 0.001 for all correlations). FM has the highest correlation with WHtR among other indices (r = 0.706). CONCLUSIONS: Compared to fast WL, our data support that slow and gradual WL is more effective to improve body composition and obesity-assessment indices. The robust relationship was observed between FM and WHtR, among other indices such as BMI or ABSI. Therefore, in order to evaluate FM, where the FM is not measurable, the WHtR might be the reasonable index.

Effect of L-arginine and selenium added to a hypocaloric diet enriched with legumes on cardiovascular disease risk factors in women with central obesity: a randomized, double-blind, placebo-controlled trial.

BACKGROUND/AIMS: We aimed to discover if L-arginine and selenium alone or together can increase the effect of a hypocaloric diet enriched in legumes (HDEL) on central obesity and cardiovascular risk factors in women with central obesity. METHODS: This randomized, double-blind, placebo-controlled trial was undertaken in 84 premenopausal women with central obesity. After a 2-week run-in period on an isocaloric diet, participants were randomly assigned to a control diet (HDEL), L-arginine (5 g/day) and HDEL, selenium (200 µg/day) and HDEL or L-arginine, selenium and HDEL for 6 weeks. Cardiovascular risk factors were assessed before intervention and 3 and 6 weeks afterwards. RESULTS: After 6 weeks, L-arginine had significantly reduced waist circumference (WC); selenium had significantly lowered fasting concentrations of serum insulin and the homeostasis model assessment of insulin resistance index; the interaction between L-arginine and selenium significantly reduced the fasting concentration of nitric oxides (NO(x)), and HDEL lowered triglycerides (TG) and WC and significantly increased the fasting concentration of NO(x). HDEL reduced high-sensitivity C-reactive protein levels in the first half of the study and returned them to basal levels in the second half. CONCLUSION: These data indicate the beneficial effects of L-arginine on central obesity, selenium on insulin resistance and HDEL on serum concentrations of NO(x) and TG.

The effect of hypocaloric diet enriched in legumes with or without L-arginine and selenium on anthropometric measures in central obese women.

BACKGROUND: Identifying new ways to decrease adiposity will be very valuable for health. The aim of this study was to find out whether L-Arginine (Arg) and selenium alone or together can increase the effect of hypocaloric diet enriched in legumes (HDEL) on anthropometric measures in healthy obese women. METHODS: This randomized, double-blind, placebo-controlled trial was undertaken in 84 healthy premenopausal women with central obesity. After 2 weeks of run-in on an isocaloric diet, participants were randomly considered to eat HDEL, Arg (5 g/d) and HDEL, selenium (200 µg/d) and HDEL or Arg, selenium and HDEL for 6 weeks. The following variables were assessed before intervention and 3 and 6 weeks after it: weight, waist circumference, hip circumference, waist to hip ratio (WHR), body mass index (BMI), and fasting nitrite/nitrate (NO(x)) concentrations. Other variables (arm, thigh, calf and breast circumferences, subscapular, triceps, biceps and suprailiac skinfold thicknesses, sum of skinfold thicknesses (SSF), body density (D) and estimated percent of body fat (EPF)) were assessed before and after intervention. RESULTS: HDEL showed a significant effect in reduction of waist, hip, arm, thigh, calf and breast circumferences, triceps, biceps, subscapular and suprailiac skinfold thicknesses, WHR, SSF, D and EPF. HDEL + Arg + selenium significantly reduced suprailiac skinfold thicknesses; and there was no significant effect of HDEL, Arg, selenium and Arg plus selenium on weight, BMI and fasting NO(x). CONCLUSIONS: The study indicates that HDEL + Arg + selenium reduce suprailiac skinfold thicknesses which represents the abdominal obesity reduction.