This is a comprehensive systematic review and dose–response meta-analysis evaluating the effects of oral magnesium supplementation on inflammatory biomarkers including C-reactive protein (CRP), ...interleukin‐6 (IL‐6), and tumor necrosis factor-alpha (TNF‐α) among adults. The major databases including PubMed, Web of Science, Embase, and Google Scholar were searched for relevant publications until December 14, 2020, using appropriate keywords. The Cochrane Collaboration tool was used to assess the quality of each study. We also performed a subgroup analysis to identify probable sources of heterogeneity. A total of 18 studies with 927 participants fulfilled the eligibility criteria and included in this meta-analysis. Our results indicate that the supplementation with magnesium had no statistically significant effect on serum concentrations of CRP (WMD, − 0.49; 95% CI, − 1.72 to 0.75 mg/L; P = 0.44), IL-6 (WMD, − 0.03; 95% CI, − 0.40 to 0.33 pg/mL; P = 0.86), and TNF‐α (WMD, 0.12; 95% CI, − 0.08 to 0.31 pg/mL; P = 0.24) compared with controls. In addition, based on dose–response assessment, no significant non-linear association was found between magnesium supplementation dosage or duration on serum CRP and IL-6 concentrations. The findings of the present systematic review and meta-analysis did not support the notion that oral magnesium supplementation could have favorable effects on CRP, IL-6, and TNF-α in the adult population.
We performed a systematic review and dose-response meta-analysis of observational studies assessing the association between UPF consumption and adult mortality risk. A systematic search was conducted ...using ISI Web of Science, PubMed/MEDLINE, and Scopus electronic databases from inception to August 2021. Data were extracted from seven cohort studies (totaling 207,291 adults from four countries). Using a random-effects model, hazard ratios (HR) of pooled outcomes were estimated. Our results showed that UPF consumption was related to an enhanced risk of all-cause mortality (HR = 1.21; 95% CI: 1.13, 1.30; I
= 21.9%;
< 0.001), cardiovascular diseases (CVDs)-cause mortality (HR = 1.50; 95% CI: 1.37, 1.63; I
= 0.0%;
< 0.001), and heart-cause mortality (HR = 1.66; 95% CI: 1.50, 1.85; I
= 0.0%;
= 0.022), but not cancer-cause mortality. Furthermore, our findings revealed that each 10% increase in UPF consumption in daily calorie intake was associated with a 15% higher risk of all-cause mortality (OR = 1.15; 95% CI: 1.09, 1.21; I
= 0.0%;
< 0.001). The dose-response analysis revealed a positive linear association between UPF consumption and all-cause mortality (
= 0.879,
=
< 0.001), CVDs-cause mortality (
= 0.868,
=
< 0.001), and heart-cause mortality (
= 0.774,
=
< 0.001). It seems that higher consumption of UPF is significantly associated with an enhanced risk of adult mortality. Despite this, further experimental studies are necessary to draw a more definite conclusion.
The relationship between thyroid hormones metabolism and trace element levels has biological plausibility; however, previous reports that compared trace element levels in patients with hypothyroidism ...and healthy individuals yielded conflicting results. Therefore, the aim of this meta-analysis was to investigate the association between selected trace elements (i.e., selenium (Se), zinc (Zn), iron (Fe), manganese (Mn), copper (Cu), lead (Pb)), and magnesium (Mg) concentrations in patients with hypothyroidism and healthy controls. Electronic databases, including PubMed, Scopus, Embase, and Science Direct, were searched systematically until September 2019. Thirty-two observational studies were included in the final analyses. Hedges’
g
tests were used to estimate effect sizes, as trace element concentrations were reported using different measurement units across the studies. Selenium (Hedges’
g
= − 0.52; 95% CI = − 1.05, − 0.002;
P
= 0.049) and Zn (Hedges’
g
= − 0.86; 95% CI = − 1.66, − 0.06;
P
= 0.035) concentrations were significantly lower, whereas Pb concentrations were significantly higher (Hedges’
g
= 0.34; 95% CI = 0.10, 0.59;
P
= 0.006) in patients with hypothyroidism compared with healthy controls. There were no differences in the concentrations of Fe, Cu, Mn, and Mg between the groups. Patients with hypothyroidism exhibited lower Se and Zn and increased Pb concentrations compared with healthy controls. High-quality studies with larger sample sizes are required to explicate the link between trace element status and hypothyroidism.
Abstract
Introduction
Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in females characterized by ovulatory dysfunction, hyperandrogenism, and other metabolic ...disorders. Both intermittent fasting and specific probiotics have been suggested to help improve patients with PCOS through changes in gut microbial composition, circadian clock, and metabolic regulation. Therefore, the present study aims to investigate the effects of intermittent fasting alone or in combination with probiotic supplementation compared to the calorie-restricted (CR) diet on anthropometric measures, metabolic status, inflammation, and oxidative stress in women with PCOS.
Methods
We will carry out a randomized clinical trial for 8 weeks. Participants will be randomly assigned (1:1:1) to one of the three groups: (1) a 14:10 early time-restricted feeding (TRF) diet with probiotic supplementation (
n
= 30); (2) a 14:10 early TRF diet with placebo supplementation (
n
= 30); (3) a CR diet (energy-restricted 25% of required calories) with placebo supplementation as a control group (
n
= 30). The primary outcomes will be changes in body weight and insulin resistance. However, glycemic control, lipid profile, metabolic parameters, sex hormone-binding globulin, dehydroepiandrosterone, anti-Mullerian hormone, free androgen index, hirsutism, acne, antioxidant and oxidant status, inflammation, anthropometric measures, mental health, sleep quality, appetite, eating behavior, food craving, and blood pressure are secondary outcomes. All outcomes of this study will be evaluated in pre- and post-intervention.
Discussion
We hypothesized that 10-h TRE administered alone or in combination with probiotic supplementation to overweight and obese PCOS subjects would lead to weight loss and improved metabolic, hormonal, inflammatory, and antioxidant markers compared to control subjects following a standard 3-meal-per-day CR diet.
Ethical aspects
The current trial received approval from the Medical Ethics Committee of Tehran University of Medical Sciences, Tehran, Iran (IR.TUMS.MEDICNE.REC.1401.425).
Trial registration
Iranian Registry of Clinical Trials IRCT20121110011421N5. Registered on 3 October 2022.
Cardiovascular diseases (CVDs) are globally the major causes of morbidity and mortality. Evidence shows that smaller and denser low-dense lipoprotein (sdLDL) particles are independent atherogenic ...risk factors for CVD due to their greater susceptibility to oxidation, and permeability in the endothelium of arterial walls. sdLDL levels are an independent risk factor and of more predictive value than total LDL-C for the assessment of coronary artery disease and metabolic syndrome. Functional food ingredients have attracted significant attention for the management of dyslipidemia and subsequently increase cardio-metabolic health. However, to date there is no study that has investigated the effect of these bioactive natural compounds on sdLDL levels. Therefore, the aim of the present review is to summarize the evidence accrued on the effect of special dietary ingredients such as omega-3 polyunsaturated fatty acids, nutraceuticals and herbal medicines on the levels of sdLDL, LDL particle number, and LDL particle size. Based on the results of the existing clinical trials this review suggests that natural products such as medicinal plants, nutraceuticals and omega-3 fatty acids can be used as adjunct or complementary therapeutic agents to reduce sdLDL levels, LDL particle numbers or increase LDL particle size and subsequently may prevent and treat CVD, with the advantage that theses natural agents are generally safe, accessible, and inexpensive.
We evaluated associations between food insecurity (FI) and the quality and quantity of sleep in adults (≥18 years).
The current study represented a systematic review and meta-analysis of ...observational studies.
Databases of PubMed, Scopus, Embase and Web of Science were searched from inception until 6 June 2022. Meta-analyses were conducted using random-effects models, and effect sizes were reported as OR and 95 % CI.
Data from ten eligible observational studies, including 83 764 participants, were included.
FI was associated with an increased risk of poor sleep quality (OR = 1·45; 95 % CI (1·24, 1·70),
= 95,
< 0·001,
7). Besides, subgroup analysis showed increased risk of poor sleep quality corresponding to the severity of FI across mild (OR = 1·31; 95 % CI (1·16, 1·48),
= 0 %,
< 0·001,
5), moderate (OR = 1·49; 95 % CI (1·32, 1·68),
= 0 %,
< 0·001,
5) and severe (OR = 1·89; 95 % CI (1·63, 2·20),
= 0 %,
< 0·001,
5) levels. Similarly, subgroup analysis by sleep problems showed that FI was associated with an increased the risk of trouble falling asleep (OR = 1·39; 95 % CI (1·05, 1·83),
= 91 %,
= 0·002,
3) and trouble staying asleep (OR = 1·91; 95 % CI (1·37, 2·67),
= 89 %,
< 0·001,
3). Moreover, FI was associated with the odds of shorter (OR = 1·14; 95 % CI (1·07, 1·21),
= 0 %,
< 0·001,
4) and longer sleep duration (OR = 1·14; 95 % CI (1·03, 1·26),
= 0 %,
= 0·010,
4).
Collective evidence supports that FI is associated with poor sleep quality and quantity in adults. Preventative and management strategies that address FI may provide health benefits beyond improving nutritional status per se.
Diminished ovarian reserve (DOR) is associated with reduced fertility and poor reproductive outcomes. The association between dietary patterns and DOR was not well studied. The purpose of this study ...was to evaluate the relationship between adhering to the healthy eating index (HEI-2015) and the risk of DOR. In this case–control study, 370 Iranian women (120 with DOR and 250 age- and BMI-matched controls) were examined. A reliable semi-quantitative food frequency questionnaire was used to collect diet-related data. We analyzed the HEI-2015 and their dietary intake data to determine major dietary patterns. The multivariable logistic regression was used in order to analyze the association between HEI-2015 and risk of DOR. We found no significant association between HEI-2015 score and risk of DOR in the unadjusted model (OR 0.78; 95%CI 0.59, 1.03). After controlling for physical activity and energy intake, we observed that women in the highest quartile of the HEI-2015 score had 31% decreased odds of DOR (OR 0.69; 95%CI 0.46, 0.93). This association remained significant even after adjusting for all potential confounders. Overall, increased adherence to HEI may lead to a significant reduction in the odds ratio of DOR. Clinical trials and prospective studies are needed to confirm this association.
Pervious epidemiologic evidence indicates that soluble fiber is protective against hypertention: however, randomized controlled trials (RCTs) have presented varying results. In the present study, we ...aimed to conduct a systematic review and dose-response meta-analysis to summarize published RCTs which assess the effect of soluble fiber supplementation on systolic blood pressure (SBP) and diastolic blood pressure (DBP). Scopus, PubMed, and ISI Web of Sciences were searched to identify relevant studies up to Aug 2022. We estimated the change in blood pressure for each 5 g/d increment in soluble fiber supplementation in each trial and then calculated the weighted mean difference (WMD) and 95%CI using a random-effects model. We estimated dose-dependent effects using a dose-response meta-analysis of differences in means. The risk of bias for study was assessed using the Cochrane tool. Publication bias was evaluated via funnel plot and Begg's test and Egger's test. Eighty-three eligible studies with total sample size of 5,985 participants were included in the meta-analysis. Soluble fiber supplementation significantly decreased SBP (WMD: -1.36 mmHg, 95% CI: -2.13 to -0.60, P < 0.001; I.sup.2 = 47.1%, P < 0.001) and DBP (WMD: -0.72 mmHg, 95% CI: -1.26 to -0.18, P = 0.009; I.sup.2 = 45.4%, P < 0.001). Each 5 g/d increment in soluble fiber supplementation had a significant reduction in SBP (WMD: -0.54 mmHg; 95%CI: -0.86, -0.22, P = 0.001; I.sup.2 = 52.2, P.sub.het < 0.001) and DBP (WMD: -0.28 mmHg; 95%CI: -0.49, -0.80, P = 0.007; I.sup.2 = 43.1%, P.sub.het < 0.001). The levels of SBP decreased proportionally with the increase in soluble fiber supplementation up to 20 g/d (MD.sub.20g/d: -1.79 mmHg, 95%CI: -2.86, -0.71). Current evidence indicated the beneficial effect of soluble fiber supplementation on blood pressure. Our findings suggest that soluble fiber supplementation could contribute to the management of hypertension and the reduction of cardiovascular disease risk.
Given the increasing incidence of negative outcomes during pregnancy, our research team conducted a dose-response systematic review and meta-analysis to investigate the relationship between ...ultra-processed foods (UPFs) consumption and common adverse pregnancy outcomes including gestational diabetes mellitus (GDM), preeclampsia (PE), preterm birth (PTB), low birth weight (LBW), and small for gestational age (SGA) infants. UPFs are described as formulations of food substances often modified by chemical processes and then assembled into ready-to-consume hyper-palatable food and drink products using flavors, colors, emulsifiers, and other cosmetic additives. Examples include savory snacks, reconstituted meat products, frozen meals that have already been made, and soft drinks.
A comprehensive search was performed using the Scopus, PubMed, and Web of Science databases up to December 2023. We pooled relative risk (RR) and 95% confidence intervals (CI) using a random-effects model.
Our analysis (encompassing 54 studies with 552,686 individuals) revealed a significant association between UPFs intake and increased risks of GDM (RR = 1.19; 95% CI: 1.10, 1.27; I
= 77.5%; p < 0.001; studies = 44; number of participants = 180,824), PE (RR = 1.28; 95% CI: 1.03, 1.59; I
= 80.0%; p = 0.025; studies = 12; number of participants = 54,955), while no significant relationships were found for PTB, LBW and SGA infants. Importantly, a 100 g increment in UPFs intake was related to a 27% increase in GDM risk (RR = 1.27; 95% CI: 1.07, 1.51; I
= 81.0%; p = 0.007; studies = 9; number of participants = 39,812). The non-linear dose-response analysis further indicated a positive, non-linear relationship between UPFs intake and GDM risk P
= 0.034, P
= 0.034), although no such relationship was observed for PE (P
= 0.696, P
= 0.812).
In summary, both prior to and during pregnancy, chronic and excessive intake of UPFs is associated with an increased risk of GDM and PE. However, further observational studies, particularly among diverse ethnic groups with precise UPFs consumption measurement tools, are imperative for a more comprehensive understanding.
There is inconsistent evidence relating to the effects of megestrol acetate (MA) supplementation on cancer patients suffering from anorexia–cachexia syndrome. This review aimed to examine the ...dose–response effect of MA supplementation in patients with cancer‐associated anorexia/cachexia. Relevant keywords were searched in PubMed, Scopus and ISI Web of Science from inception to June 2023 for randomized controlled trials (RCTs) examining the effect of MA on pathologies in patients with cancer‐associated cachexia. Our primary outcomes were changes in body weight and appetite. However, fatigue and quality of life were secondary outcomes. The mean difference (MD) and 95% confidence interval (95% CI) were estimated using the random‐effects method. Thirteen trials comprising 1229 participants (mean age 60 years) were identified. The results of our highest versus lowest analysis revealed that MA supplementation was not associated with any increase in body weight (MD: 0.64 kg, 95% CI −0.11, 1.38, P = 0.093, I2 = 69.1%; GRADE = very low certainty). Twelve trials, including 14 effect sizes derived from 1369 patients (intervention = 689, control = 680), provided data on the effect of MA on body weight. Subgroup analyses showed a significant increase in body weight following short‐term intervention (≤8 weeks) and a combination of radiation/chemotherapy as concurrent treatment. A linear dose–response meta‐analysis indicated that each 200 mg/day increment in MA consumption had a significant increase in weight gain (MD: 0.44; 95% CI 0.13, 0.74, P = 0.005; I2 = 97.1%); however, the magnitude of the effect was small. MA administration significantly affected the quality of life based on pooled effect sizes (MD: 1.15, 95% CI 0.76, 1.54, P < 0.001, I2 = 0%; n = 2 RCTs including 176 patients; GRADE = very low certainty). However, no significant effect of MA supplementation was observed on appetite (MD: 0.29, 95% CI −0.05, 0.64, P = 0.096, I2 = 18.3%; n = 3 RCTs including 163 patients; GRADE = very low certainty) and fatigue (MD: 0.14, 95% CI −0.09, 0.36, P = 0.236, I2 = 0%; n = 2 RCTs including 300 patients; GRADE = very low certainty). With very low certainty of the evidence, MA supplementation may not lead to a significantly increased weight gain and other outcomes.
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