Evaluation of the effect of Modafinil in the improvement of the level of consciousness in patients with COVID-19 encephalopathy: A randomized controlled trial.

AIM: COVID-19 can lead to encephalopathy and loss of consciousness. This double-blinded randomized clinical trial conducted in Tehran, Iran, aimed to assess the potential effectiveness of modafinil in patients with COVID-19-related encephalopathy. METHODS: Nineteen non-intubated COVID-19 patients with encephalopathy were randomized into two groups: a treatment group receiving crushed modafinil tablets and a placebo group receiving starch powder. Modafinil was administered at a dose of 100 mg every 2 h, reaching a peak dosage of 400 mg. The level of consciousness was assessed using the Glasgow Coma Score (GCS) at multiple time points on the day of medication administration. The trial was registered under IRCT20170903036041N3 on 23/5/2021. RESULTS: The average age in the modafinil and placebo groups was 75.33 and 70 years, respectively. No significant differences were observed between the two groups in terms of chronic conditions, clinical symptoms, or laboratory data. GCS scores were similar between the groups at baseline (p-value = 0.699). After four doses of modafinil, GCS scores were slightly higher in the treatment group, but this difference was not statistically significant (p-value = 0.581). GCS scores after each round of drug administration didn't significantly differ between the treatment and placebo groups (p-value = 0.908). CONCLUSION: Modafinil exhibited a slight improvement in the level of consciousness among COVID-19 patients with encephalopathy, although this improvement did not reach statistical significance when compared to the control group. Further research with larger sample sizes and longer treatment durations is recommended to explore modafinil's potential benefits in managing altered consciousness in COVID-19 patients.

Relation between nutritional status on clinical outcomes of critically ill patients: emphasizing nutritional screening tools in a prospective cohort investigation.

BACKGROUND: Malnutrition is a significant concern reported in adult critically ill patients, yet there is no gold standard to assess nutritional status in this population. This study examines the association between nutritional status and clinical outcomes in intensive care unit (ICU) patients using nutritional risk assessment tools and aims to look for the best tool. METHOD: In a single-center prospective cohort study among 165 patients, the predictive performance of high or low malnutrition risk assessed by Nutritional Risk Screening (NRS), Modified Nutrition Risk in Critically Ill (m-NUTRIC), Mini-Nutritional-Assessment Short-Form (MNA-SF), Controlling Nutritional status (CONUT), and Prognostic Nutritional Index (PNI) were evaluated and compared for mortality, organ failure, length of hospitalization, and mechanical ventilation (MV). RESULTS: Different assessment tools showed various nutritional statuses. m-NUTRIC and NRS-2002 were found to be associated more strongly relative to other tools with mortality (RR = 1.72; 95% CI, 1.42-2.08) and (RR = 1.37; 95% CI, 1.08-1.72), organ failure (RR = 1.69; 95% CI, 1.44-1.96) and (RR = 1.22; 95% CI, 0.99-1.48), MV (RR = 1.46; 95% CI, 1.27-1.65) and (RR = 1.21; 95% CI, 1.04-1.39) respectively. There was no correlation between malnutrition levels assessed by mentioned tools except for NRS-2002 and length of hospitalization. In predicting mortality or illness severity, the cut points were different for some tools like NUTRIC-score and all assessed outcomes (3.5), MNA-SF and mortality (6.5), CONUT with mortality, and MV (6.5). CONCLUSIONS: A considerable proportion of patients admitted to the ICU are at high risk for malnutrition. Compared to other tools, m-NUTRIC and NRS-2002 proved superior in predicting clinical outcomes in critically ill patients. Other tools overestimated the risk of malnutrition in the ICU so couldn't predict clinical outcomes correctly.

Beneficial effects of Se/Zn co-supplementation on body weight and adipose tissue inflammation in high-fat diet-induced obese rats.

This research investigated the effect of co-supplementation of selenium with zinc on weight control and the inflammatory and oxidative status in relation to obesity. Male Wistar rats (N = 32) were randomly divided into four groups after induction of obesity model: 1) "Zn" was supplemented with zinc sulfate (15 mg/kg BW), 2) "Se" supplemented with selenium as sodium selenate (0.5 mg/kg BW), 3) "Zn + Se" which received Zn (15 mg/kg BW) + Se (0.5 mg/kg BW), and 4) "HFD" as the control group. The intervention was done for eight weeks. At the end of treatment, serum and tissue level of Zn, Se, SOD, GSH-Px, MDA, leptin, TNF-α, and IL-6 was evaluated. Weight and food intake were significantly reduced in the Se group(p < .001), while in the Zn group, weight gain due to obesity was prevented compared to the control group (p = .48). There was a significant and stronger increase in SOD, GSH-Px levels and a remarkable decrease in MDA, leptin, TNF-α, and IL-6 in the group receiving the combination of two supplements than either alone(p < .001). Leptin had a positive correlation with inflammatory factors and lipid peroxidation marker and showed an inverse relationship with Zn and Se levels and anti-oxidative enzymes(p < .05). The analysis showed the mediating role of leptin in the effects of zinc. Co-supplementation of selenium and zinc may have a synergistic effect in reduction of oxidative and inflammatory markers. Regarding the effect of zinc on inflammatory factors and lipid peroxidation, leptin can play a mediating role.

Effects of coenzyme Q10 on health-related quality of life, clinical disease activity and blood pressure in patients with mild to moderate ulcerative colitis: a randomized clinical trial.

Background: Ulcerative colitis (UC) is specified by a chronic mucosal inflammation that has a deleterious impact on the quality of life (QoL). Coenzyme Q10 (CoQ10) appears to influence disease activity by its obvious properties. Therefore, the current research intends to assess the impacts of CoQ10 on QoL, disease activity, and blood pressure in UC patients. Methods: This clinical trial performed on men and women with UC in 2017 who were attended the gastrointestinal center of Hazrat Rasool Akram Hospital and private clinic. Eighty-eight UC patients were randomly allocated to receive either CoQ10 (200 mg/day) or placebo for 8 weeks. The anthropometric parameters, blood pressure, inflammatory bowel disease questionnaire-32 (IBDQ-32) score, and the Simple Clinical Colitis Activity Index (SCCAI) score were measured pre and post-intervention. P-value <0.05 was considered to be statistically significant. All statistical analysis was done using SPSS software version 24. Results: Eighty-six UC patients (44 males) with a mean age of 39.29 (10.19) years completed the trial. The results of between- and within-group analysis revealed that the SCCAI score (p<0.001 and p<0.001, respectively), diastolic blood pressure (p=0.025 and p=0.001, respectively), and systolic blood pressure (p=0.001 and p<0.001, respectively) decremented significantly; while, the mean IBDQ-32 (p<0.001 and p=0.001, respectively) increased substantially in the CoQ10 group; whereas there was no significant difference in anthropometric indices in both groups. Conclusion: Findings suggest that CoQ10 can be used as a potential intervention for diminishing the disease severity and blood pressure and may improve QoL and UC patients. IRCT number: IRCT20090822002365N17.

A randomized controlled trial on the coloprotective effect of coenzyme Q10 on immune-inflammatory cytokines, oxidative status, antimicrobial peptides, and microRNA-146a expression in patients with mild-to-moderate ulcerative colitis.

PURPOSE: Coenzyme Q10 (CoQ10), having potent antioxidant and anti-inflammatory pharmacological properties, has recently been shown to be a safe and promising agent in maintaining remission of ulcerative colitis (UC). This trial was, therefore, designed to determine CoQ10 efficacy on inflammation and antioxidant status, antimicrobial peptides, and microRNA-146a expression in UC patients. METHODS: In this randomized double-blind controlled trial, 88 mild-to-moderate UC patients were randomly allocated to receive CoQ10 (200 mg/day) or placebo (rice flour) for 2 months. At the baseline and at an 8-week follow-up, serum levels of Nrf2, cathelicidin LL-37, ß-defensin 2, IL-10, IL-17, NF-κB p65 activity in peripheral blood mononuclear cells (PBMCs), simple clinical colitis activity index questionnaire (SCCAIQ), and quality of life (IBDQ-32 score), as well as an expression rate of microRNA-146a were measured. RESULTS: A significant reduction was detected in the serum IL-17 level, activity of NF-κB p65 in PBMCs, and also SCCAI score in the CoQ10 group compared to the placebo group, whereas IL-10 serum concentrations and IBDQ-32 score of the CoQ10 group considerably increased versus the control group; the changes of these variables were also significantly different within and between groups at the end of the study. Furthermore, CoQ10 remarkably increased serum levels of cathelicidin LL-37. A significant change in serum cathelicidin LL-37 levels was also observed between the two groups. No statistical difference, however, was seen between the two groups in terms of the serum levels of Nrf2 and ß-defensin 2 and the relative expression of microRNA-146a. CONCLUSIONS: Our results indicate that CoQ10 supplementation, along with drug therapy, appears to be an efficient reducer of inflammation in patients with mild-to-moderate UC at a remission phase. TRIAL REGISTRATION: The research has also been registered at the Iranian Registry of Clinical Trials (IRCT): IRCT20090822002365N17.

Television food advertisements and childhood obesity: A systematic review.

The prevalence of childhood obesity has increased worldwide and various environmental factors have accelerated this trend. Several reports have suggested that food advertising causes childhood obesity. We proposed a review study to evaluate the relationship between TV food advertisements and obesity in children. By searching over electronic databases (including PubMed, Web of Science, Scopus, and Google Scholar), the reference lists of original studies, and reviews using key search terms, 1181 articles were identified. Out of these, only 9 articles met the inclusion and quality criteria. Most of the longitudinal study carried out at the national level have reported a significant association between commercial viewing and BMI in children. The duration of these studies varied between 7 months and 5 years. The children's TV viewing time was between 1.5 and 3.5 hours per day. Results of the reviewed studies have revealed a controversial attitude about the influence of TV food advertisements on obesity. However, three of four modeling studies indicated an increment in the prevalence of overweight and obesity following exposure to food advertisements. Further interventional and longitude studies are needed to achieve more precise results.

The effect of Capsaicinoids or Capsinoids in red pepper on thermogenesis in healthy adults: A systematic review and meta-analysis.

The outcomes of the earlier trials are controversial concerning the effect of Capsaicinoids/Capsinoids on thermogenesis. We carried out this systematic review and meta-analysis to examine the effect of Capsaicinoids/Capsinoids on thermogenesis indices including resting metabolic rate (RMR) and respiratory quotient (RQ) in healthy adults. An electronic literature search was conducted between 1990 and 2019, using the following databases: PubMed, Web of Sciences, Scopus, Cochrane Central Register of Controlled Trials, and EMBASE. Placebo-controlled clinical trials were considered as eligible papers. Effect sizes were pooled using weighted mean difference (WMD), with a random-effects model. Of the 4,092 articles, 13 studies were included in the meta-analysis. Pooled effect sizes revealed that compared with placebo, Capsaicinoids/Capsinoids significantly increased RMR (WMD: 33.99 Kcal/day, 95% CI: 15.95, 52.03; I2 : 0%, p = .94), energy expenditure, and fat oxidation. It also significantly lessened RQ (WMD: -0.01, 95% CI: -0.02, -0.01; I2 : 5.4%, p = .39) and carbohydrate oxidation. Moreover, intervention in capsule form for longer duration had a more considerable influence on RMR than comparative groups. We observed moderate improvement in RMR, RQ, and fat oxidation following supplementation with Capsaicinoids/Capsinoids. However, further high-quality studies are required to clarify the thermogenic properties of Capsaicinoids/Capsinoids.

Is there any association between fruit consumption and the risk of gestational diabetes mellitus? A systematic review and meta-analysis.

AIM: Although a considerable number of studies have illustrated the positive effects of fresh fruits on metabolic status, the impacts of fruits on the risk of gestational diabetes mellitus (GDM) are inconsistent. In consideration of this issue, we aimed to systematically summarize the findings of cohort studies with respect to the link between fresh fruits and the risk of GDM. METHOD: We selected cohort studies with English language indexed in PubMed/Medline, Scopus, Web of Science, and Embase from 2000 to 31 January 2018. To examine the link between fresh fruits and the risk of GDM development, relative risk (RR) and 95 % confidence intervals (CIs) for the highest versus the lowest consumption of fruits were pooled using a random effect model and the DerSimonian and Laird method. RESULTS: Out of 2522 publications, finally 5 cohort studies were obtained. No significant association between fruit consumption and GDM incidence was found (Pooled RR: 0.95; 95 % CI: 0.84, 1.08; I2: 90.3 %, p = 0001). In women who consumed higher amount of fruits before pregnancy, the risk of GDM was 5% lower than in those who consumed lower amount of fruits (0.95; 95 %CI: 0.91, 0.99, I2: 0%, p = 0.85). No link was obtained between fruit consumption during the pregnancy and GDM onset (1.18, 95 % CI: 0.48, 2.91; I2:94.6 %, p = 0.0001). CONCLUSION: In women who consumed greater fruits before pregnancy, the risk for GDM was 5 % lower than those consumed lower amounts of fruits, while there was no link between fruit consumption throughout the pregnancy and GDM onset. However, due to limited studies and considerable heterogeneity, the findings must be interpreted with great caution.

The effects of royal jelly and tocotrienol-rich fraction on impaired glycemic control and inflammation through irisin in obese rats.

The effects of royal jelly (RJ) and tocotrienol-rich fraction (TRF) on obesity-induced glucose intolerance and inflammation were assessed in the current study. Regarding irisin as an important adipomyokine that attenuates obesity-induced disorders, we evaluated whether RJ and TRF could exert their metabolism regulatory effects through irisin. Obese rats were fed a high-fat diet (HFD) with or without supplementation of RJ, TRF, or both, for 8 weeks. At the end of the intervention, weight, irisin, glycemic, and inflammatory indices were measured. The weight of the rats did not remarkably reduce in any of the groups. Glucose homeostasis and inflammation were improved when we added RJ and TRF to HFD. RJ elevated irisin concentration, but the effect of TRF on irisin was not noticeable. Our results indicated that, despite the lack of significant weight loss, RJ and TRF promoted healthy obesity. This improvement was mediated by irisin in RJ consuming rats. PRACTICAL APPLICATIONS: Obesity is a public health concern associated with several chronic disorders. The beneficial effects of irisin on obesity-related disorders are well-established. It is the first study assessing the effect of RJ and TRF as functional foods, with pharmacological and nutritional activities on obesity complications, through irisin mediation. Our study demonstrated that RJ exerts its metabolic regulatory effects by irisin as a mediator. Our investigation makes a remarkable contribution to the literature, because it suggests a new mechanism for the anti-obesity properties of RJ and TRF.

The effect of royal jelly and tocotrienol-rich fraction along with calorie restriction on hypothalamic endoplasmic reticulum stress and adipose tissue inflammation in diet-induced obese rats.

OBJECTIVES: Endoplasmic reticulum (ER) stress causes adipose tissue dysfunction and chronic inflammation in obesity. Royal jelly (RJ) and tocotrienol-rich fraction (TRF) are reported to ameliorate inflammation. However, the improving effects of RJ and TRF on inflammation from ER stress modulating view have not been assessed so far. Hence, we investigated the effect of RJ and TRF on ER stress and some adipose tissue-derived inflammatory markers in the high-fat diet (HFD)-induced obesity. Wistar obese rats randomly allocated into 5 groups: HFD, calorie restriction diet (CRD), RJ + CRD, TRF + CRD, RJ + TRF + CRD. After 8-week intervention, adipose tissues and hypothalamus were dissected and serum was collected. RESULTS: RJ reduced glucose-regulated protein-78 (GRP78) expression as ER stress indicator in WAT and hypothalamus compared to CRD. Besides, RJ diminished the expression of inflammatory markers in white adipose tissue (WAT) and also decreased the serum concentration of them. TRF reduced inflammatory markers in the serum without remarkable effects on ER stress. Overall, RJ has protective effect against adipose tissue dysfunction and inflammation then suggested as a therapeutic approach to reduce some obesity-related complications. The impact of TRF in this regard is lower than RJ and limited to systemic inflammation improvement without remarkable changes in adipose tissue inflammation.

Effects of Royal Jelly and Tocotrienol Rich Fraction in obesity treatment of calorie-restricted obese rats: a focus on white fat browning properties and thermogenic capacity.

BACKGROUND: Obesity has reached an alarming rate worldwide. Promoting thermogenesis via increasing the function of brown adipose tissue (BAT) or white adipose tissue (WAT) browning has been proposed as a new protective approach against obesity. The goal of this study was to evaluate the effects of Royal Jelly (RJ) and tocotrienol rich fraction (TRF) on BAT activation and WAT browning during calorie restriction diet (CRD) in obesity model. METHODS: In this experimental study, 50 obese Wistar rats were randomly divided into 5 groups and then received one of the following treatments for a period of 8-week: High-fat diet (HFD), CRD, RJ + CRD, TRF + CRD, and RJ + TRF + CRD. Effects of RJ and TRF, individually and in combination on body weight and the expression of key thermoregulatory genes in WAT and BAT were examined by quantitative real-time (qRT-PCR). Also, morphological alterations were assessed by hematoxylin and eosin staining. RESULTS: RJ (- 67.21 g ±4.84 g) and RJ + TRF (- 73.29 g ±4.51 g) significantly reduced weight gain relative to the CRD group (- 40.70 g ±6.50 g, P < 0.001). In comparison with the CRD group, RJ and RJ + TRF remarkably enhanced the uncoupling protein1 (UCP1) expression in WAT (5.81, 4.72 fold, P < 0.001) and BAT (4.99, 4.75 fold, P < 0.001). The expression of PR domain containing 16(PRDM 16), cAMP response element-binding protein1 (CREB1), P38 mitogen-activated protein kinases (P38MAPK), and Bone morphogenetic protein8B (BMP8B) have significantly increased following RJ and RJ + TRF treatments (P < 0.001). However, the expression levels of CCAAT/enhancer-binding protein beta (CEBPß) and Bone morphogenetic protein7 ( BMP7) did not remarkably change. Multilocular beige cells in WAT and compacted dense adipocytes were also observed in BAT of RJ and RJ + TRF received groups. TRF showed no substantial effects on the expression of the mentioned thermoregulatory genes and brown fat-like phenotype. CONCLUSION: Our results suggest that, Royal Jelly promotes thermogenesis and browning of WAT, contributing to an increase in energy expenditure. Thus, Royal Jelly may give rise to a novel dietary choice to attenuate obesity.

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.

The effects of supplementation with conjugated linoleic acid on anthropometric indices and body composition in overweight and obese subjects: A systematic review and meta-analysis.

Clinical trials have indicated conflicting results on the effects of conjugated linoleic acid (CLA) on obesity. The present study aimed to systematically review controlled clinical trials examining the effects of CLA on anthropometric indices and body composition in overweight and obese subjects. Pubmed, Scopus, Web of science, and Cochrane databases were searched between 2000 and December 2017 with no language restriction. Placebo-controlled clinical trials that reported anthropometric indices and body composition in overweight and obese subjects were included. Random-effect model was used to pool the effect estimates. Of 4032 publications, 13 trials were included for the meta-analysis. Pooled effect sizes indicated that CLA significantly reduced body weight (WMD: -0.52 kg, 95% CI: -0.83, -0.21; I2: 48.0%, p = 0.01), BMI (WMD: -0.23 kg/m2, 95% CI: -0.39, - 0.06; I2: 64.7%, p = 0.0001), FM (WMD: -0.61 kg, 95% CI: -0.98, -0.24; I2: 53.8%, p = 0.01) and increased LBM (WMD: 0.19 kg, 95% CI: 0.04, 0.34; I2: 81.4%, p = 0.0001) compared to the placebo group. However, the effects of CLA on WC (WMD: 0.05 cm, 95% CI: -0.01, 0.1; I2: 0%, p = 0.93) was not significant. Additionally, its impact on body weight in subjects older than 44 year (WMD: -1.05 kg, 95% CI: -1.75, -0.35; I2: 57.0%, p = 0.01), with longer duration (more than 12 weeks) (WMD: -1.29 kg, 95% CI: -2.29, -0.29; I2: 70.3%, p = 0.003) and dosage more than 3.4 g/day (WMD: -0.77 kg, 95% CI: -1.28, -0.25; I2: 62.7%, p = 0.004) were greater than comparative groups. Supplementation with CLA can slightly reduce body weight and FM and increase LBM in overweight and obese subjects. However, its efficacy was not clinically considerable. Further studies with high methodological quality are needed to shed light on the effects of CLA on anthropometric indices in overweight and obese subjects.

The association between fat mass and the risk of breast cancer: A systematic review and meta-analysis.

BACKGROUND & AIMS: Several cohort and case-control studies examined the association between fat mass (FM) and the risk of breast cancer; however, findings are conflicting. The purpose of the present study was to systematically review this association and conducted a meta-analysis, if possible. METHOD: A systematic search of PubMed/Medline, Scopus, Web of Science and Embase databases was conducted for cohort and case-control studies, between January 2000 and 31 March 2018 with no language limitations. Multivariate adjusted relative risk (RR) estimates with 95% confidence intervals (CI) for each category of FM were pooled to examine the association. RESULTS: Finally, 12 papers were considered for quantitative synthesis. The pooled RR for the highest vs. the lowest FM (%) of cohort studies was 1.44 (95% CI: 1.33, 1.56; I2: 63.3%, p = 0.008). The overall effect size for adjusted case-control studies showed no significant association (1.49, 95% CI: 0.77, 2.90; I2: 93.2%; p = 0.001). After stratification by menopause, it was revealed that the association between FM and the risk of breast cancer in post menopausal women (2.29, 95% CI: 1.12, 4.68; I2: 92%, p = 0.0001) was significant, while there was no significant association in pre-menopausal women (0.68, 95% CI: 0.18, 2.58; I2: 81.3%; p = 0.02). CONCLUSION: Cohort studies showed that higher FM is positively associated with the risk for breast cancer. However, only case-control studies on post-menopausal women showed a positive link. Due to limited studies and high heterogeneity, findings should be interpreted with caution. More cohort studies are needed to clarify this association.

Can coenzyme Q10 supplementation effectively reduce human tumour necrosis factor-α and interleukin-6 levels in chronic diseases? Protocol for a systematic review and meta-analysis of randomised controlled trials.

INTRODUCTION: Inflammation, as a critical factor, can cause numerous chronic diseases by creating various proinflammatory cytokines. Coenzyme Q10 (CoQ10) can potentially exert an anti-inflammatory agent; in turn, this agent can reduce the systemic inflammatory response. The aims of this study are to conduct a comprehensive systematic review and a meta-analysis for the determination of the CoQ10 efficacy on the changes in serum interleukin-6 (IL-6) and the tumour necrosis factor-α (TNF-α) levels in unhealthy subjects. METHOD AND ANALYSIS: We will conduct an electronic search for articles published between January 1990 and January 2017 using a prespecified search strategy in MEDLINE, SCOPUS, EMBASE, CENTRAL and Web of Science.Our search will focus only on randomised controlled clinical trials in unhealthy subjects that employ either a parallel or a crossover design; this search will involve concurrent control groups. The primary outcomes of the literature are to determine the CoQ10 efficacy on the changes in the serum IL-6 and the TNF-α levels in unhealthy subjects. Secondary outcomes such as body mass index, serum adiponectin and high-sensitivity C-reactive protein levels, lipid profile and the heterogeneity assessment of the primary studies will be evaluated. The stages of screen articles, the extracts of relevant data and the assessment of study quality using the Cochrane risk of bias tool will be conducted independently by the two reviewers. Any disagreement will be resolved by discussion with a third person. If the number of eligible studies is sufficient, we will carry out a meta-analysis according to both outcomes. ETHICS AND DISSEMINATION: This study is the protocol for a systematic review and no ethics approval is needed. The findings from the full systematic review will be published in a peer-reviewed journal, and they will also be exhibited at national/international academic and clinical conferences. TRIAL REGISTRATION NUMBER: CRD42016052200.

Does grape seed oil improve inflammation and insulin resistance in overweight or obese women?

Grape seed oil (GSO) is reported to improve oxidative stress and lipid profile. However, the ameliorating effect of GSO on inflammation and insulin resistance has not being noticed so far. We aimed to examine the effects of GSO consumption on inflammation and insulin resistance in overweight or obese females. The subjects (n = 44) were randomly assigned into intervention group as "GSO" (consuming 15% of energy from GSO) and control group as sunflower oil "SFO" (consuming 15% of energy from SFO) through a weight loss diet for 8 weeks. Anthropometric measurements, dietary recall and fasting serum glucose, insulin, high sensitive C-reactive protein (hs-CRP) and tumor necrosis factor-alpha (TNF-α) were assessed before and after the intervention. Homeostatic model assessment of insulin resistance (HOMA-IR) scores, hs-CRP and TNF-α decreased in the GSO group. The hs-CRP was lower in GSO than the SFO group (p < 0.03). GSO consumption seems to improve inflammatory condition and insulin resistance in overweight/obese women.