Synbiotic as an ameliorating factor in the health-related quality of life in women with polycystic ovary syndrome. A randomized, triple-blind, placebo-controlled trial.

BACKGROUND: There are complicated mechanisms that link the disruption of the gut microbiome to the symptoms and complications of polycystic ovary syndrome (PCOS). In this study, an attempt was made to assess the effects of synbiotics on the health-related quality of life (HRQoL) in women with PCOS . METHODS: Fifty-six women with PCOS were enrolled in a triple-blind controlled trial for 12 weeks. They were randomly assigned to receive a daily 2-gram synbiotic sachets (containing Bacillus coagulans (GBI-30), Lactobacillus rhamnosus, Lactobacillus helveticus, and fructooligosaccharide) (n = 28) or placebo (n = 28). To evaluate the impact on the HRQoL, participants were required to fill 26-Item Polycystic Ovary Syndrome Health-Related Quality of Life Questionnaire (PCOSQ-26), 12-Item Short-Form Health Survey (SF-12) and Perceived Stress Scale (PSS-10) pre and post the intervention. RESULTS: Finally, statistical analyses were performed on 52 participants who finished the trial. Synbiotic supplementation improved the scores of emotional (P = 0.044), body hair (P = 0.016), weight (P = 0.033) and infertility domains (P = 0.027) of PCOSQ-26 compared to placebo group. The physical score within SF-12 also had a significant enhancement (P = 0.035). No significant improvement was seen in the PSS-10 score at the end of the trial. CONCLUSION: This study illustrated the advantageous effects of synbiotics on the health-related quality of life in women with PCOS. Further studies are required to confirm our findings. TRIAL REGISTRATION: http://www.irct.ir : IRCT20211108053007N1; date of registration: 14/02/2023.

Effects of Synbiotic-Containing Bacillus coagulans (GBI-30) on the Cardiovascular Status of Patients With Polycystic Ovary Syndrome: A Triple-blinded, Randomized, Placebo-controlled Study.

PURPOSE: Despite the high risk of cardiovascular diseases in women with polycystic ovary syndrome, fewer studies have addressed the improvement of cardiometabolic status of these patients. This study was conducted with the aim of investigating the effects of synbiotic-containing, spore-forming Bacillus coagulans on cardiometabolic indicators, including lipid profile, C-reactive protein, and atherogenic indexes in patients with polycystic ovary syndrome. METHODS: In the present 12-week, triple-blinded, randomized, placebo-controlled clinical trial, 72 women with polycystic ovaries were randomized to receive either 2 g of synbiotic sachet (n = 36) or placebo (n = 36) plus lifestyle modification. Fasting blood samples were taken before and after the intervention. FINDINGS: Statistical analysis was performed in 60 participants with a mean (SD) age of 28.25 (5.98) years who completed the intervention (synbiotic group [n = 34] and placebo group [n = 26]). A significant mean (SD) decrease in C-reactive protein level was observed in the synbiotic group compared with the placebo group (-0.12 [9.57] v. -0.008 [4.69], P = 0.03). No significant differences in mean changes of lipid profile and atherogenic indexes were seen between the 2 groups. Although the estimated mean changes in atherogenic indexes in the synbiotic group indicates a greater reduction than the placebo group, no significant difference was detected. IMPLICATIONS: Our 12-week synbiotic intervention improved the inflammatory status in women with polycystic ovaries without affecting lipid profile or atherogenic indexes.

The effects of rice bran supplementation for management of blood lipids: A GRADE-assessed systematic review, dose-response meta-analysis, and meta-regression of randomized controlled trials.

BACKGROUND: We aimed to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to investigate the effects of rice bran supplementation on serum lipid profile levels. METHODS: We searched PubMed/Medline, Scopus, ISI Web of Science, and Google Scholar using related keywords. Published RCTs exploring the effects of rice bran consumption on lipid profile were searched up to June 2022. Evidence certainty was assessed on the basis of the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. The data were pooled using a random-effects model and reported as weighted mean difference (WMD) and 95% confidence interval (CI) for each outcome. RESULTS: Meta-analysis of eight RCTs (with 11 effect sizes) showed no significant effect of rice bran supplementation on serum levels of triglyceride (WMD: -11.38 mg/dl; 95% CI: -27.73, 4.96; P = 0.17), total cholesterol (WMD: -0.68 mg/dl; 95% CI: -7.25, 5.88; P = 0.834), low-density lipoprotein cholesterol (WMD: -1.68 mg/dl; 95% CI: -8.46, 5.09; P = 0.627) and high-density lipoprotein cholesterol (WMD: 0.16 mg/dl; 95% CI: -1.52, 1.85; P = 0.848) compared to control group. CONCLUSION: Our meta-analysis suggests that rice bran supplementation has no significant effects on serum levels of lipid profile components. However, larger studies with longer durations and improved methodological quality are needed before firm conclusions can be reached.

Does symbiotic supplementation which contains Bacillus Coagulans Lactobacillus rhamnosus, Lactobacillus acidophilus and fructooligosaccharide has favourite effects in patients with type-2 diabetes? A randomised, double-blind, placebo-controlled trial.

This study aimed to determine the effect of Bacillus Coagulans symbiotic supplementation on metabolic factors and inflammation in patients with type-2 diabetes. In this clinical trial, 50 patients with type-2 diabetes were randomly assigned to the symbiotic (containing Bacillus Coagulans + Lactobacillus rhamnosus + Lactobacillus acidophilus and fructooligosaccharide) or placebo groups to receive one sachet daily for 12 weeks. Glycaemic Index, lipid profile, and hs-CRP were measured at the beginning and end of the study. Analysis of covariance demonstrated that fasting blood glucose (FBG), insulin, homeostatic Model Assessment for Insulin Resistance (HOMA-IR), ß-cell function (HOMA-ß) (p <.05) and hs-CRP (p <.05) significantly declined in the treatment group compared with the placebo group. So, the current study indicated that Bacillus Coagulans symbiotic supplementation could improve metabolic factors and inflammation in patients with type-2 diabetes.

Effects of concentrated beetroot juice consumption on glycemic control, blood pressure, and lipid profile in type 2 diabetes patients: randomized clinical trial study.

BACKGROUND: While the prevalence of type 2 diabetes (T2D) is growing worldwide, dietary intake plays a remarkable role in the management of disease complications. Evidence suggests that beetroot has health-promoting potentials, including anti-inflammatory, antioxidant, and antidiabetic properties. Therefore, the present clinical trial aimed to investigate the effects of concentrated beetroot juice (BJ) supplementation on anthropometric measures, glycemic control, blood pressure (BP), and lipid profile in T2D patients. METHODS: In the simply randomized, parallel-group, controlled, and open-label trial, forty-six patients with T2D were randomly allocated to either the intervention group (BJ group), who consumed 24 ml concentrated BJ daily for 12 weeks, or the control group without any intervention. Anthropometric measurements, physical activity, dietary intakes, glycemic measures, lipid profile, and blood pressure were assessed at the baseline and the end of the study. RESULTS: Plasma nitric oxide (NO) in the intervention group had a higher nonsignificant increase after 12 weeks compared with the control group (8.57 ± 23.93 vs. 2.31 ± 15.98, P = 0.128). Compared with the baseline, significant reductions in plasma insulin (14.55 ± 7.85 vs. 10.62 ± 6.96, P = 0.014) and homeostasis model assessment of ß-cell function (HOMA-B) (3.96 ± 0.83 vs. 3.63 ± 0.75, P = 0.038), as well as a marginally significant reduction in high-density lipoprotein cholesterol (HDL-C) (70.81 ± 11.24 vs. 65.44 ± 6.46, P = 0.058) were observed in the control group after 12 weeks. Diastolic blood pressure (DBP) was significantly reduced in the BJ group compared with the baseline (74.73 ± 16.78 vs. 72.36 ± 16.09, P = 0.046). After adjusting for baseline values, no significant effect on the levels of fasting plasma glucose (FPG), insulin, hemoglobin A1c (HgA1c), HOMA-ß, homeostatic model assessment for insulin resistance (HOMA-IR), total cholesterol (TC), low-density lipoprotein (LDL), HDL, triglycerides (TG), and blood pressure (BP) was observed. CONCLUSIONS: Our study showed that daily consumption of 24 ml concentrated BJ did not affect the levels of glycemic measures, blood pressure, and lipid profile. More studies are necessary to confirm these findings. TRIAL REGISTRATION: This present clinical trial has been registered in the Iranian Registry of Clinical Trials with registration number IRCT20150815023617N5.

A randomized clinical trial of beetroot juice consumption on inflammatory markers and oxidative stress in patients with type 2 diabetes.

Oxidative stress and chronic inflammation are both major underlying factors for the initiation and progression of diabetes, as well as for the development of long-term diabetes-related consequences in patients with type 2 diabetes mellitus (T2DM). This study was designed to evaluate the effects of beetroot juice (BJ) consumption on oxidative stress and inflammatory markers in patients with T2DM. In this trial, 52 patients with T2DM were randomly assigned to either the concentrated BJ or the control group. The BJ group received 12 ml concentrated BJ twice daily, whereas the control group received no intervention. At the baseline and the end of week 12, plasma levels of malondialdehyde (MDA), high sensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and nuclear factor-κB (NF-κB) were measured. Compared with the control group, BJ reduced IL-6 (-0.1 vs. 0.83, P = 0.001), TNF-α (-1.28 vs. 5.51, P = 0.001), and NF-κB (-0.03 vs. 0.36, P = 0.005) after 12-week intervention; plasma concentration of MDA and hs-CRP did not change between groups after intervention. Intra-group comparison disclosed that daily BJ consumption could not change oxidative stress and inflammatory markers except for TNF-α (-1.28 ± 2.31, P = 0.026) compared with the baseline. However, the concentrations of IL-6, TNF-α, and NF-κB increased significantly in the control group at the end of week 12 compared to baseline (19.5%, P = 0.001; 120%, P = 0.001; and 69%, P = 0.021, respectively). In conclusion, our study indicates that daily consumption of BJ reduces the concentrations of some inflammatory markers, including IL-6, TNF-α, and NF-κB, which are involved in the pathogenesis of complications of T2DM. PRACTICAL APPLICATION: Beetroot juice concentrate contains nutrients such as antioxidants that can improve the health status of people with type 2 diabetes.

Growth and Nutritional Status of Phenylketonuric Children and Adolescents.

BACKGROUND: The goal of this study was to assess the anthropometric and biochemical parameters of children and adolescents with phenylketonuria (PKU). METHODS: The participants in this cross-sectional study ranged in age from four to 18 years old. Biochemical markers such as vitamin B12, folic acid, iron, ferritin, calcium, 25-hydroxy vitamin D3, zinc, plasma phenylalanine (Phe) and tyrosine (Tyr) levels in blood were evaluated, as well as demographics and anthropometric measurements. A three-day dietary recall questionnaire was completed by all individuals. RESULTS: 80% (64) of the 80 patients (42 females, 52.5%) had typical PKU. Consanguineous marriages were found in 57.5% (46) of the patients' parents. According to the height for age index, 17.5% of the study group (n = 14) were short or very short. According to age-related weight and body mass index (BMI), 37.5% (n = 30) and 43.8% (n = 35) of people are obese or overweight, respectively. Biochemical tests revealed increased vitamin B12 levels and 25-hydroxy vitamin D3 deficiency in 35% (n = 28) of the patients, insufficient folic acid in 12.5% (n = 10), and elevated phenylalanine levels in 70.3% (n = 45) of children under 12 years old, and adolescents 62.5% (n = 10). A high Phe intake (OR = 4.44, CI %95 = 1.27-15.57) is a risk factor for obesity and overweight. CONCLUSION: Patients with PKU had a high rate of overweight and obesity. PKU patients who are overweight or obese do not differ from normal-weight patients in terms of dietary intake or laboratory findings (except for serum iron levels). One-third of patients with phenylketonuria were vitamin D deficient and had a BMI/A index of overweight/obese. It is recommended to use special medical food to help solve energy and nutrient deficiencies.

Efficacy of the Synbiotic Supplementation on the Metabolic Factors in Patients with Metabolic Syndrome: A Randomized, Triple-Blind, Placebo-Controlled Trial.

Background: Metabolic syndrome is overwhelmingly increasing and is a significant risk factor for cardiovascular disorder, so effective treatment strategies are considered high priority. This study aimed to determine the effects of synbiotic supplementation on metabolic factors in patients with metabolic syndrome. Methods: In this triple-blind, randomized, placebo-controlled, clinical trial, 108 participants were divided into two groups to receive synbiotic supplementation or placebo for 12 weeks. All participants were also educated about maintaining a healthy lifestyle and consuming low-calorie nutritious meals, along with dietary intake and physical activity monitoring. Anthropometric measures, blood pressure, glycemic indices, lipid profile, hepatic enzymes, and hs-CRP were evaluated at the baseline and end of the trial. Results: Synbiotic supplementation significantly reduces fasting blood glucose (FBG) levels in the intervention group versus placebo group [-14.69 ± 15.11 mg/dl vs. -8.23 ± 7.90 mg/dl; p=0.007], but there was no difference between groups in other metabolic factors. Conclusions: These findings suggest that synbiotic supplementation while following a healthy lifestyle and nutrition improved FBG in patients with metabolic syndrome.

A comprehensive insight into the potential effects of resveratrol supplementation on SIRT-1: A systematic review.

BACKGROUND AND AIMS: Silent information regulator 1 (Sirt1) involved in histone stability, transcriptional activity, and translocation. This systematic review aimed to summarize the effects of Resveratrol on Sirt1 expression. MATERIALS AND METHODS: Electronic databases including Scopus, Medline and web of knowledge were searched up to March 2020. RESULTS: Out of 801 studies identified in our search finally 12 articles included. Totally six studies evaluated the effects of resveratrol on SIRT1 gene expression, and six articles investigate protein expression. CONCLUSION: The results of the included studies showed that resveratrol supplementation had beneficial effects on protein and gene expression of SIRT1.

Correlation of Low Levels of α-1 Antitrypsin and Elevation of Neutrophil to Lymphocyte Ratio with Higher Mortality in Severe COVID-19 Patients.

BACKGROUND: Variations in COVID-19 prevalence, severity, and mortality rate remain ambiguous. Genetic or individual differences in immune response may be an explanation. Moreover, hyperinflammation and dysregulated immune response are involved in the etiology of severe forms of COVID-19. Therefore, the aim of the present study was to analyze serum alpha-1 antitrypsin (AAT) levels, as an acute-phase plasma protein with immunomodulatory effect and neutrophil to lymphocyte ratio (NLR) as a marker of inflammation response in severe COVID-19 illness. METHODS: In this retrospective observational cohort study, 64 polymerase chain reaction (PCR) positive COVID-19 hospitalized patients were studied for AAT, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), troponin, complete blood count (CBC), random blood sugar, serum glutamate oxaloacetate transaminase (SGOT), serum glutamate pyruvate transaminase (SGPT), and arterial oxygen saturation (O2sat) at admission and during hospitalization. RESULTS: The results showed that hospitalized patients with COVID-19 had low serum levels of AAT and high CRP levels at the first days of hospitalization. In particular, the percentages of individuals with low, normal, and high AAT levels were 7.80%, 82.80%, and 9.40%, respectively, while high and low values of CRP accounted for 86.70% and 13.30% of patients. Most of the patients had an upward neutrophil to lymphocyte ratio (NLR) trend, with a higher mortality rate (p < 0.05) and troponin levels (p < 0.05). However, comorbidities, CRP alterations, ESR alterations, nonfasting blood sugar, SGOT, SGPT, O2sat, RBC, and PLT values were not significantly different between the NLR downward and upward trend groups. CONCLUSIONS: The current study revealed that severe COVID-19 patients had low serum AAT levels related to CRP values. Therefore, AAT response may be considered as a new mechanism by which some COVID-19 patients show immune dysregulation and more severe symptoms.

The effects of nano-curcumin supplementation on glycemic control, blood pressure, lipid profile, and insulin resistance in patients with the metabolic syndrome: A randomized, double-blind clinical trial.

Metabolic syndrome (MetS) is one of the most important health hazards. Curcumin is extracted from Curcuma longa (turmeric), which can affect the components of MetS. To increase the oral bioavailability of curcumin, nano-micelle curcumin is used instead of curcumin powder. In this randomized, double-blind, controlled clinical trial, 50 patients with MetS were randomly assigned to two groups to receive either 80 mg/day nano-curcumin (n = 25) or placebo (n = 25), for 12 weeks anthropometric measurements, blood pressure, and biochemical factors-including fasting blood sugar (FBS), Hemoglobin A1c (HbA1c), homeostatic model assessment (HOMA) for insulin resistance (HOMA-IR), pancreatic ß cell function (HOMA-ß) and lipid profile-were assessed at the baseline and the end of the study. Statistical analyses were done using SPSS software (Version 23). The analysis between the two groups has illustrated a significant reduction in the average change of triglyceride (TG) levels (-60.5 ± 121.7 vs. 13.1 ± 78.1 mg/dL; p < .05) and HOMA-ß (-5.7 ± 48.2 vs. -4.01 ± 16.9; p < .05). But there were no significant differences in anthropometric measurements, blood pressure and biochemical factors-including FBS, HbA1c, HOMA-IR, HOMA-ß, and lipid profile variables include (total cholesterol, LDL-C, and HDL-C) at the end of the study. In conclusion, supplementation with nano-micelle curcumin significantly improved serum TG in MetS patients.

Inflammatory markers response to crocin supplementation in patients with type 2 diabetes mellitus: A randomized controlled trial.

Inflammation and oxidative stress is a risk factor for the development of long-term consequences in patients with type 2 diabetes mellitus (T2DM). This study was designed to investigate the effects of crocin consumption on oxidative stress and inflammatory markers in patients with T2DM. In this clinical trial with a parallel-group design, 50 patients with T2DM were randomly assigned to either the crocin or the placebo group. The crocin group received 15 mg crocin twice daily, whereas the placebo group received corresponding placebos. At baseline and the end of week 12, serum high sensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-ɑ (TNF-ɑ), nuclear factor-κB (NF-κB), and malondialdehyde (MDA) were measured. Compared with placebo group, crocin reduced hs-CRP (-1.03 vs. 1.42, p = .007), TNF-ɑ (-0.8 vs. 0.28, p = .009), and NF-κB (-0.39 vs. 0.01, p = .047) after 12 weeks intervention; these improvements were also significant in comparison with the baseline values. Plasma IL-6 decreased significantly in the crocin group at the end of week 12 compared to baseline (p = .037), whereas no significant change was observed in the placebo group. Plasma concentration of MDA did not change within and between groups after intervention. This study indicates that daily administration of 30 mg crocin supplement to patients with T2DM reduces the concentrations of hs-CRP, TNF-ɑ, and NF-κB which are involved in the pathogenesis of complications of T2DM.

Dietary nutrient patterns and the risk of colorectal cancer and colorectal adenomas: a case-control study.

Although the association between food patterns and the risk of colorectal cancer (CRC) and colorectal adenomas (CRA) has been explored previously, a distinct paucity of studies has evaluated the association of nutrient pattern and the risk of CRC and CRA as precursors of CRC. Thus, the purpose of this case-control study was to investigate nutrient patterns and their relationship with CRC and CRA in Iran. Two hundred forty hospital control, 129 newly diagnosed CRC and 130 newly diagnosed CRA patients were asked about their dietary intakes using validated questionnaires. To define the major nutrient patterns, principal component analysis was applied based on preselected nutrients, and four explainable nutrient patterns were obtained: Factor 1 (mixed), factor 2 (the antioxidant), factor 3 (dairy) and factor 4 (the high fat). Logistic regression was used to determine odds ratios (OR) with 95% confidence interval (CI) of CRC and CRA according to categories of nutrient patterns. After adjusting for confounders, factor 2 was significantly associated with lower risk for the CRC and CRA in the second category compared with the first, respectively (OR = 0.20, 95% CI: 0.12-0.34, OR = 0.34, 95% CI: 0.21-0.56). Participants in the highest category of factor 4 showed an increase in the risk of CRC and CRA, respectively, than those in the low category, in both crude and multivariate analysis (OR = 1.77, 95% CI: 1.57-2.95, OR = 1.85, 95% CI: 1.13-3.02). Among derived nutrient patterns, 'the antioxidant pattern' was inversely associated with CRC/CRA, whilst 'high fat pattern' showed a direct association with these diseases.

Diet-dependent acid load and the risk of colorectal cancer and adenoma: a case-control study.

OBJECTIVES: Colorectal cancer (CRC) is the third and second most prevalent cancer in men and women, respectively. Various epidemiological studies indicated that dietary factors are implicated in the aetiology of CRC and its precursor, colorectal adenomas (CRA). Recently, much attention has been given to the role of acid-base balance in the development of chronic diseases including cancers. Therefore, the aim of the current study is to examine the association of diet-dependent acid load and the risk of CRC and CRA. DESIGN: In this case-control study, potential renal acid load (PRAL) was computed based on dietary intake of participants assessed via a validated FFQ. Negative PRAL values indicated a base-forming potential, while positive values of PRAL implied acid-forming potential of diet. Logistic regression was used to derive OR and 95 % CI after adjusting for confounders. SETTING: Tehran, Iran. PARTICIPANTS: A total of 499 participants aged 30-70 years were included in the study (240 hospital controls, 129 newly diagnosed CRC and 130 newly diagnosed CRA). The current study was conducted between December 2016 and September 2018. RESULTS: After adjusting for potential confounders, a higher PRAL was associated with increased odds of CRC and CRA. The highest v. the lowest tertile of PRAL for CRC and CRA was OR 4·82 (95 % CI 2·51-9·25) and OR 2·47 (95 % CI 1·38-4·42), respectively. CONCLUSIONS: The findings of the current study suggested that higher diet-dependent acid load is associated with higher risk of CRC and CRA.

Dietary intake of polyphenols and total antioxidant capacity and risk of prostate cancer: A case-control study in Iranian men.

BACKGROUND: Prostate cancer (PCa) is one of the leading causes, globally, of cancer-related mortality. Previous studies have reported an inverse relationship between some food items or dietary patterns and prostate cancer risk. Polyphenols, as antioxidant and anti-inflammatory dietary components, have been associated with a reduced risk of PCa, whilst dietary indices such as total antioxidant capacity are good predictors of PCa risk. OBJECTIVE: The purpose of this study was to conduct a case-control study on the association between polyphenol intake and DTAC (dietary total antioxidant capacity) and PCa risk in men. METHOD: 205 hospital-based controls and 97 newly diagnosed PCa patients were asked about their dietary intakes using a validated questionnaire. The polyphenol contents (flavonoids, lignans, stilbenes and phenolic acids) of foods and beverages were calculated. TAC was obtained using a comprehensive database consisting of the total antioxidant content of more than 3000 food and beverages. Logistic regression was used to determine the odds ratios (OR), with 95% confidence intervals (CI), of PCa according to categories of polyphenol intake and TAC. RESULTS: When comparing the highest and the lowest tertile of total polyphenol (OR: 0.12; 95% CI: 0.03-0.41), lignans (OR: 0.14; 95% CI: 0.04-0.41), phenolic acids (OR: 0.18; 95% CI: 0.05-0.57) and some flavonoid subgroups intake including flavan-3-ols (OR: 0.24; 95% CI: 0.08-0.67), flavanones (OR: 0.10; 95% CI: 0.03-0.31) and flavones (OR: 0.33; 95% CI: 0.12-0.87), we observed a significant decreasing trend in the risk of PCa (p for trend<0.05). CONCLUSION: The results suggest that the consumption of some polyphenols can significantly reduce the risk of PCa.

The effect of green coffee extract supplementation on lipid profile: A systematic review of clinical trial and in-vivo studies.

BACKGROUND AND AIMS: Dyslipidemia is an important and common risk factor for cardiovascular disease and increases the risk of mortality. Green coffee extract (GCE) contains bioactive polyphenols, especially Chlorogenic acid (CGA), that due to the antioxidant characteristic, have a desirable effect on metabolic factors. This review conducted to focus on the effect of GCE on lipid profiles. METHODS: PubMed, Scopus, and web of science were searched until November 2019. All clinical studies and in-vivo studies that provide sufficient information about outcomes include to this review. RESULTS: Out of 3270 studies obtained in our searching, only 32 articles were eligible for analysis. Five double-blind, randomized clinical trial studies, two Cross-over studies, one Quasi-experimental study, and twenty animal studies were included in this systematic review-all articles evaluated according to the checklist of aim and inclusion and exclusion criteria. Generally, the results of the included studies showed there is controversy about the effect of GCE and CGA on lipid profile improvement. CONCLUSIONS: Although, a higher dosage of GCE and administration of CGA with longer duration leads to better results. However, investigating the effectiveness and safety dosage as a lipid-lowering agent needs further studies with differential dosage and periods.

The effect of crocin supplementation on glycemic control, insulin resistance and active AMPK levels in patients with type 2 diabetes: a pilot study.

BACKGROUND: Crocin as a carotenoid exerts anti-oxidant, anti-inflammatory, anti-cancer, neuroprotective and cardioprotective effects. Besides, the increasing prevalence of diabetes mellitus and its allied complications, and also patients' desire to use natural products for treating their diseases, led to the design of this study to evaluate the efficacy of crocin on glycemic control, insulin resistance and active adenosine monophosphate-activated protein kinase (AMPK) levels in patients with type-2 diabetes (T2D). METHODS: In this clinical trial with a parallel-group design, 50 patients with T2D received either 15-mg crocin or placebo, twice daily, for 12 weeks. Anthropometric measurements, dietary intake, physical activity, blood pressure, glucose homeostasis parameters, active form of AMPK were assessed at the beginning and at the end of the study. RESULTS: Compared with the placebo group, crocin improved fasting glucose level (P = 0.015), hemoglobin A1c (P = 0.045), plasma insulin level (P = 0.046), insulin resistance (P = 0.001), and insulin sensitivity (P = 0.001). Based on the within group analysis, crocin led to significant improvement in plasma levels of glucose, insulin, hemoglobin A1c, systolic blood pressure, insulin resistance and insulin sensitivity. The active form of AMPK did not change within and between groups after intervention. CONCLUSIONS: The findings indicate that crocin supplementation can improve glycemic control and insulin resistance in patients with T2D. Further studies are needed to confirm these findings.Trial Registration This study has been registered at Clinicaltrial.gov with registration number NCT04163757.

Effects of low fructose diet on glycemic control, lipid profile and systemic inflammation in patients with type 2 diabetes: A single-blind randomized controlled trial.

BACKGROUND AND AIM: Type 2 diabetes is one of the global epidemic disorders, which causes many side effects on the body. Fructose is a lipogenic monosaccharide. Recent studies have reported the adverse effects of this carbohydrate on diabetes. This study aimed to evaluate the clinical efficacy of a low-fructose diet on the metabolic alterations in patients with type 2 diabetes. METHODS: This study was a randomized, single-blind clinical trial on 50 patients with type 2 diabetes. Participants randomly allocated to two groups, to receive either diabetic-diet or diabetic-diet with low-fructose for 8-weeks. Anthropometric measurements, systolic blood pressure (SBP), Diastolic blood pressure (DBP) and metabolic factors were assessed at baseline and the end of the trial. RESULTS: At the end of trial, reduction in body weight, waist circumference, and blood pressure were not significant except for DBP (P = 0.013). Statistical analysis showed that low-fructose diet compared to control group significantly declined fasting blood glucose (FBG), Hemoglobin A1c (HbA1c), Triglyceride (TG), high-density lipoprotein-cholesterol (HDL-C) and high-sensitivity C-reactive protein (hs-CRP) (P = 0.015, P = 0.001, P=<0.0001, P= <0.0001 and P= <0.0001 respectively). CONCLUSION: Our results showed that eight weeks of low-fructose diet results in a significant improvement in FBG, HbA1c, TG, HDL-C and hs-CRP in patients with type 2 diabetes.

Overview of dietary supplements on patients with type 2 diabetes.

BACKGROUND AND AIMS: The primary approach for managing type 2 diabetes mellitus (T2DM) involves lifestyle modification and diet therapy along with pharmacologic interventions. Many patients are interested to identify nutritional supplements that may provide benefit in prevention and management of diabetes. However, the efficacy and safety of nutritional supplements such as chromium, n-3 polyunsaturated fatty acids (PUFAs), vitamin D, zinc and magnesium in disease treatment is a worrying and controversial matter. In this narrative review, patients and health care providers are introduced to the effects of mentioned dietary supplements that may help in choosing or not choosing these supplements in treatment of diabetes. METHODS: This review was carried out using comprehensive and systematic literature reports on the dietary supplements in the management of diabetes. Empirical searches were conducted using Google Scholar, Science Direct and PubMed databases. Searches were also undertaken using keywords, in English, such as "chromium" OR "vitamin D" OR "omega-3 fatty acids" OR "zinc" OR "magnesium" in combination with "type 2 diabetes". RESULTS: The available evidence is insufficient to create a definite conclusion that nutritional supplements including chromium, n-3 PUFAs, vitamin D, zinc and magnesium might be beneficial for the prevention and treatment of T2DM and therefore, the general recommendation to use these supplements in the management of diabetes cannot be justified. The results of most studies lack uniformity across multiple aspects, including different dose and formation of supplements, duration, and subjects under intervention. CONCLUSIONS: There is a need for well-designed, high quality, large and long-term studies to strengthen the available evidence and ensure the safety and efficacy of products.

The relationship between the index of nutritional quality and the risk of colorectal cancer and adenoma : a case-control study.

OBJECTIVE: Colorectal cancer is one of the most common cancers in the world, whereas dietary factors are its most modifiable risk factors. The index of nutritional quality is considered as a general overview of the nutrient content of diet. The aim of this study is to determine the relationship between the index of nutritional quality and the risk of colorectal cancer and adenomas. METHODS: Overall, 129 colorectal cancer and 130 colorectal adenoma cases and 240 healthy controls were studied in three major general hospitals in Tehran province, Iran. Index of nutritional quality scores were calculated based on information on the usual diet that was assessed by a valid and reliable Food Frequency Questionnaire. Multivariate logistic regression was used to estimate the relationship between the index of nutritional quality scores and the risk of colorectal cancer and adenoma. RESULTS: After controlling for several confounding factors, the index of nutritional quality of calcium, vitamin C, riboflavin, folate and fiber were associated with decreased risk of colorectal cancer [ORcalcium: 0.21 (0.08-0.52), ORvitC: 0.16 (0.09-0.28), ORvitB2: 0.35 (0.18-0.65), ORfolate: 0.33 (0.16-0.65), ORfiber: 0.35 (0.21-0.58)]. Also, the inverse association were observed between risk of CRA and the index of nutritional quality of calcium, vitamin C, riboflavin, folate and fiber [OR calcium: 0.32 (0.14-0.74), ORvitC: 0.51 (0.34-0.73), ORvitB2: 0.48 (0.28-0.82), OR folate: 0.44 (0.23-0.81), OR fiber: 0.62 (0.42-0.92)]. CONCLUSION: This study showed that individuals who have a healthier diet, high in calcium, vitamin C, riboflavin, folate and fiber and food groups like fruits, vegetables and whole-grain and less in sweets and red or process meats are at a lower risk of colorectal cancer and CRA than those with unhealthy and poor diet.