Publications by authors named "Ehsan Hejazi"

23 Publications

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Dietary acid load and mortality from all causes, CVD and cancer: results from the Golestan Cohort Study.

Br J Nutr 2021 Aug 16:1-7. Epub 2021 Aug 16.

Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Given the limited studies and controversial results on association between dietary acid load and mortality from CVD and cancers, we aimed to investigate this association in a large population cohort study in Middle East, with a wide range of dietary acid load. The study was conducted on the platform of the Golestan Cohort Study (GCS), which enrolled 50 045 participants in 2004-2008. Dietary intake was assessed using a validated FFQ. Dietary potential renal acid load (PRAL) score was calculated from nutrient intake. Death and its causes were identified and confirmed by two or three physicians. Cox proportional hazards regression was used to estimate hazard ratio (HR) and 95 % CI for total and cause-specific mortalities. Then, the associations were modelled using restricted cubic splines. PRAL range was -57·36 to +53·81 mEq/d for men and -76·70 to +49·08 for women. During 555 142 person-years of follow-up, we documented 6830 deaths, including 3070 cardiovascular deaths, 1502 cancer deaths and 2258 deaths from other causes. For overall deaths, in final model after adjustment for confounders, participants in the first and fifth quintiles of PRAL had a higher risk of mortality compared with the second quintile of PRAL (HR: 1·08; 95 % CI1·01, 1·16 and HR: 1·07; 95 % CI 1·01, 1·15, respectively); Pfor trend < 0·05). Participants in the first and fifth quintiles of PRAL had a 12 % higher risk of CVD mortality compared with the Q2 of PRAL (HR: 1·12; 95 % CI 1·01-1·25 and HR: 1·12; 95 % CI 1·01, 1·26, respectively; Pfor trend < 0·05). We found that all-cause and CVD mortality rates were higher in the lowest and highest PRAL values, in an approximately U-shaped relation (P-values for the overall association and the non-linear association of energy-adjusted PRAL with total mortality were < 0·001 and < 0·001, and with CVD mortality were 0·008 and 0·003, respectively). Our results highlight unfavourable associations of high acidity and alkalinity of diet with the increased total and CVD mortality risk. It may be important to consider a balanced acid-base diet as a protective strategy to prevent pre-mature death, especially from CVD.
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http://dx.doi.org/10.1017/S0007114521003135DOI Listing
August 2021

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

Arch Physiol Biochem 2021 Jun 2:1-8. Epub 2021 Jun 2.

Clinical Nutrition and dietetics Department, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences Tehran, Tehran, Iran.

This study aimed to determine the effect of 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 + + 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), β-cell function (HOMA-β) ( <.05) and hs-CRP ( <.05) significantly declined in the treatment group compared with the placebo group. So, the current study indicated that symbiotic supplementation could improve metabolic factors and inflammation in patients with type-2 diabetes.
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http://dx.doi.org/10.1080/13813455.2021.1928225DOI Listing
June 2021

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

Eur J Cancer Care (Engl) 2021 Mar 11;30(2):e13364. Epub 2020 Nov 11.

Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology, Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

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.
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http://dx.doi.org/10.1111/ecc.13364DOI Listing
March 2021

A review of fasting effects on the response of cancer to chemotherapy.

Clin Nutr 2021 04 23;40(4):1669-1681. Epub 2020 Oct 23.

Department of Clinical Nutrition and Dietetics, School of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address:

Background & Aims: Studies suggest that fasting before or during chemotherapy may induce differential stress resistance, reducing the adverse effects of chemotherapy and enhancing the efficacy of drugs. In this article, we review the effects of fasting, including intermittent, periodic, water-only short-term fasting, and caloric restriction on the responsiveness of tumor cells to cytotoxic drugs, their protective effect on normal cells, and possible mechanisms of action.

Methods: We could not perform a systematic review due to the wide variation in the study population, design, dependent measures, and outcomes (eg, type of cancer, treatment variation, experimental setting, etc.). However, a systematic approach to search and review literature was used. The electronic databases PubMed (MEDLINE), Scopus, and Embase were searched up to July 2020.

Results: Fasting potentially improves the response of tumor cells to chemotherapy by (1) repairing DNA damage in normal tissues (but not tumor cells); (2) upregulating autophagy flux as a protection against damage to organelles and some cancer cells; (3) altering apoptosis and increasing tumor cells' sensitivity to the apoptotic stimuli, and preventing apoptosis-mediated damage to normal cells; (4) depleting regulatory T cells and improving the stimulation of CD8 cells; and (5) accumulating unfolded proteins and protecting cancer cells from immune surveillance. We also discuss how 'fasting-mimicking diet' as a modified form of fasting enables patients to eat a low calorie, low protein, and low sugar diet while achieving similar metabolic outcomes of fasting.

Conclusion: This review suggests the potential benefits of fasting in combination with chemotherapy to reduce tumor progression and increase the effectiveness of chemotherapy. However, with limited human trials, it is not possible to generalize the findings from animal and in vitro studies. More human studies with adequate sample size and follow-ups are required to confirm these findings.
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http://dx.doi.org/10.1016/j.clnu.2020.10.037DOI Listing
April 2021

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

Public Health Nutr 2021 Oct 22;24(14):4474-4481. Epub 2020 Oct 22.

Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran1985711151, Iran.

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.
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http://dx.doi.org/10.1017/S1368980020003420DOI Listing
October 2021

Habitual dietary intake of flavonoids and all-cause and cause-specific mortality: Golestan cohort study.

Nutr J 2020 09 28;19(1):108. Epub 2020 Sep 28.

Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Background And Objectives: Flavonoids are the most important group of polyphenols with well-known beneficial effects on health. However; the association of intake of total flavonoid or their subclasses with all-cause or cause-specific mortality is not fully understood. The present study aims to evaluate the association between intake of total flavonoid, flavonoid subclasses, and total and cause-specific mortality in a developing country.

Methods: A total number of 49,173 participants from the Golestan cohort study, who completed a validated food frequency questionnaire at recruitment, were followed from 2004 till 2018. Phenol-Explorer database was applied to estimate dietary intakes of total flavonoid and different flavonoid subclasses. Associations were examined using adjusted Cox proportional hazards models.

Results: During a mean follow-up of 10.63 years, 5104 deaths were reported. After adjusting for several potential confounders, the hazard ratios (HRs) of all-cause mortality for the highest versus the lowest quintile of dietary flavanones, flavones, isoflavonoids, and dihydrochalcones were 0.81 (95% confidence interval = 0.73-0.89), 0.83(0.76-0.92), 0.88(0.80-0.96) and 0.83(0.77-0.90), respectively. However, there was no association between total flavonoid intake or other flavonoid subclasses with all-cause mortality. In cause-specific mortality analyses, flavanones and flavones intakes were inversely associated with CVD mortality [HRs: 0.86(0.73-1.00) and 0.85(0.72-1.00)] and isoflavonoids and dihydrochalcones were the only flavonoid subclasses that showed a protective association against cancer mortality [HR: 0.82(0.68-0.98)].

Conclusion: The results of our study suggest that certain subclasses of flavonoids can reduce all-cause mortality and mortality rate from CVD and cancer.
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http://dx.doi.org/10.1186/s12937-020-00627-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7523365PMC
September 2020

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

Eur J Cancer Prev 2020 05;29(3):222-228

Department of Clinical Nutrition and Dietetics, School of Nutrition Sciences and Food Technology.

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.
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http://dx.doi.org/10.1097/CEJ.0000000000000550DOI Listing
May 2020

Dietary total antioxidant capacity and colorectal cancer and colorectal adenomatous polyps: a case-control study.

Eur J Cancer Prev 2021 01;30(1):40-45

Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology, Research Institute, Shahid Beheshti University of Medical Sciences.

Colorectal cancer (CRC) is the third most common and the third most deadly cancer worldwide. In Iran, CRC is the third and fifth most common cancer in females and males, respectively. Chronic oxidative stress has been implicated in the development of CRC and its precursor, colorectal adenomatous polyps (CAP). While there were a few studies that suggested a favorable role of individuals antioxidants on the CRC risk, the total antioxidant capacity (TAC) of diet has been less investigated. Consequently, the aim of this study is to investigate the association of TAC with the odds of CRC and CAP. This is a case-control study. The participants were 130 cases with incident, histologically confirmed CRC, 134 cases with incident of CAP and 243 hospital-based controls. TAC has been assessed with dietary ferric-reducing antioxidant potential and oxygen radical absorbance capacity method based on collected dietary intake data through a reproducible and valid food frequency questionnaire. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the association between the TAC and CRC and CAP odds were estimated by multiple logistic regression. After controlling for potential confounders, TAC was significantly associated with CRC and CAP odds. (ORQ3-Q1 for CRC = 0.25, 95% CI: 0.13-0.46, Ptrend = 0.001. ORQ3-Q1 for CAP = 0.48, 95% CI: 0.27-0.85, Ptrend = 0.01). The findings of this study suggested an inverse association between TAC and CRC and CAP risk.
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http://dx.doi.org/10.1097/CEJ.0000000000000577DOI Listing
January 2021

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

Eur J Cancer Prev 2021 01;30(1):46-52

Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology, Research Institute, Shahid Beheshti University of Medical Sciences.

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.
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http://dx.doi.org/10.1097/CEJ.0000000000000579DOI Listing
January 2021

Healthy Eating Index-2010 and Mediterranean-Style Dietary Pattern Score and the risk of colorectal cancer and adenoma: a case-control study.

Nutr Cancer 2020 5;72(8):1326-1335. Epub 2019 Nov 5.

Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology, Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Several studies have examined the relationship between diet quality indices and colorectal cancer (CRC). However, data on the association of these indices and colorectal adenomas (CRA) as a precursor of CRC are scarce. Our objective was to investigate the association of Healthy Eating Index (HEI-2010) and Mediterranean-Style Dietary Pattern Score (MSDPS) with CRC and CRA risk. This is a hospital-based case-control study including 259 cases (129 CRC and 130 CRA patients) and 240 controls with non-neoplastic conditions. Dietary intake of subjects was examined using a valid and reliable food frequency questionnaire. The HEI-2010 and MSDPS were then calculated based on a-priori methods. Multivariate logistic regression analyses were conducted to estimate the relationship between HEI-2010 and MSDPS and the risk of CRC and CRA. After adjustment for confounders, compared with the first tertiles, the highest tertiles of HEI-2010 and MSDPS were significantly associated with lower odds of CRC (OR = 0.04; 95% CI = 0.01-0.12, OR = 0.19; 95% CI = 0.09-0.38, respectively). Similarly, the highest tertiles of HEI-2010 (OR = 0.04; 95% CI = 0.08-0.32) and MSDPS (OR = 0.19; 95% CI = 0.17-0.58) were associated with reduced odds of CRA compared to the lowest tertiles. The findings of this study suggested that a high-quality diet assessed by HEI-2010 and MSDPS is inversely associated with the risk of CRC and CRA.
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http://dx.doi.org/10.1080/01635581.2019.1683212DOI Listing
June 2021

Dietary patterns and the risk of colorectal cancer and adenoma: a case control study in Iran.

Gastroenterol Hepatol Bed Bench 2019 ;12(3):217-225

Department of Clinical Nutrition and Dietetics, School of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Aim: The aim of this study is to examine the relationship between dietary patterns and the risk of Colorectal Cancer (CRC) and adenomas.

Background: Dietary patterns have been shown to be associated with risk of CRC, but there are a few data on this context and its relationship with risk of colorectal adenomas as the precursors of the CRC.

Methods: This hospital-based case-control study was conducted in three major general hospitals in Tehran province, Iran. Data was collected (October 2016 to May 2018) from 129 colorectal cancer and 130 colorectal adenoma patients that confirmed by pathology and colonoscopy findings and 240 controls with non-neoplastic conditions and not afflicted with diet related chronic diseases. Dietary data were evaluated by 147-items semi-quantitative food frequency questionnaire. Multivariate logistic regression was used to estimate the relationship between dietary patterns and risk of colorectal cancer and colorectal adenoma.

Results: Three dietary patterns (healthy, western and traditional) were derived. After adjusting for confounders, the Healthy dietary pattern was associated with a decreased risk of Colorectal Cancer (OR=0.22, 95% CI=0.14-0.37) and Colorectal Adenoma (OR=0.43, 95% CI=0.27-0.69). Higher intake of the Westernized pattern was positively associated with risk of Colorectal Cancer (OR=3.5, 95% CI=2.13-5.19) and Colorectal Adenoma (OR=2.47, 95% CI=1.49-4.08). There was no significant association between traditional pattern and the Colorectal Cancer (OR=99, 95% CI=0.61-1.59) and Colorectal Adenoma (OR=0.85, 95% CI=0.54-1.35) risk.

Conclusion: Our study suggested that the "Healthy" dietary pattern reduces the risk of Colorectal Cancer and Colorectal Adenoma, while the "Western" dietary pattern increases the risk of both Colorectal Cancer and Colorectal Adenoma.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6668762PMC
January 2019

Dietary intake of polyphenols and risk of colorectal cancer and adenoma-A case-control study from Iran.

Complement Ther Med 2019 Aug 23;45:269-274. Epub 2019 Apr 23.

Department of Clinical Nutrition and Dietetics, School of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address:

Objectives: The aim of this study is to examine the relationship between dietary polyphenols' classes and individual polyphenol subclasses and also the risk of Colorectal cancer (CRC) and colorectal adenomas (CRA).

Design: A hospital-based case-control study on the association between CRC and CRA and dietary polyphenols was conducted.

Setting: Overall, 129 colorectal cancers, 130 colorectal adenoma cases and 240 healthy controls were studied in three major general hospitals in Tehran province, Iran.

Results: In a multivariate-adjusted model for potential confounders, higher consumption of stilbenes (OR 0.49 for the highest vs. the lowest quartile; 95% CI = 0.24-0.99; p for trend = 0.013) was associated with the decreased risk of CRA. Moreover, an inverse association between the risk of CRC and the intake of total polyphenols (OR 0.05 for the highest vs. the lowest quartile; 95% CI = 0.01-0.19; p for trend=<0.001), total flavonoids (OR 0.36 for the highest vs. the lowest quartile; 95% CI = 0.16-0.79; p for trend = 0.005), total phenolic acids (OR 0.24 for the highest vs. the lowest quartile; 95% CI = 0.10-0.56; p for trend = 0.002), anthocyanin (OR 0.21 for the highest vs. the lowest quartile; 95% CI = 0.08-0.55; p for trend = 0.001) and flavanols (OR 0.38 for the highest vs. the lowest quartile; 95% CI = 0.17-0.85; p for trend = 0.001) was observed.

Conclusion: The present study showed that a higher intake of total polyphenols, total flavonoids, total phenolic acids anthocyanin and flavanols was related to the decreased risk of CRC. The higher consumption of stilbenes was also inversely associated with the risk of CRA.
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http://dx.doi.org/10.1016/j.ctim.2019.04.011DOI Listing
August 2019

Is Bacillus coagulans supplementation plus low FODMAP diet superior to low FODMAP diet in irritable bowel syndrome management?

Eur J Nutr 2020 Aug 20;59(5):2111-2117. Epub 2019 Jul 20.

Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Purpose: The aim of this study was to assess the superiority of low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) diet plus Bacillus coagulans supplementation to low FODMAP diet alone in the reduction of irritable bowel syndrome (IBS) symptoms.

Methods: In this randomized clinical trial, fifty IBS patients who met Rome IV criteria for IBS were randomly assigned to receive a low FODMAP diet plus either a probiotic or a placebo capsule for 8 weeks. Probiotic capsules contained 10B. coagulans spores and 400 mg inulin, while placebo capsules consisted of 500 mg rice starch.

Results: Significant improvements were observed in abdominal pain intensity and frequency, abdominal distension, satisfaction with bowel habits, quality of life, defecation consistency, and patient-reported severity score in both groups; however, only improvement in severity score was significantly higher in probiotic group compared with placebo group (P = 0.001). Moreover, the frequency of patients with clinical improvement in IBS-symptom severity scale (IBS-SSS) was significantly more in probiotic group compared to placebo group (P = 0.038).

Conclusion: Our results indicate that the addition of probiotic supplement containing B. coagulans to the low FODMAP diet might be superior to low FODMAP diet in alleviating IBS symptoms.
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http://dx.doi.org/10.1007/s00394-019-02060-yDOI Listing
August 2020

Dietary Inflammatory Index and Odds of Colorectal Cancer and Colorectal Adenomatous Polyps in A Case-Control Study from Iran.

Nutrients 2019 May 28;11(6). Epub 2019 May 28.

Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology, Research Institute, Shahid Beheshti University of Medical Sciences, Tehran 11369, Iran.

Background: Chronic inflammation is implicated in the development of colorectal cancer (CRC) and its precursor; colorectal adenomatous polyps (CAP). Some dietary factors are important triggers for systemic inflammation. Therefore, the present study aimed to investigate the association between the dietary inflammatory index (DII) and the risk of CRC and CAP in an Iranian case-control study.

Methods: 134 newly diagnosed CRC patients, 130 newly diagnosed CAP patients, and 240 hospitalized controls were recruited using convenience sampling. Energy-adjusted DII (E-DII) scores were computed based on dietary intake assessed using a reproducible and valid 148-item food frequency questionnaire. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CI) after adjusting for confounders.

Results: The E-DII score ranged between -4.23 (the most anti-inflammatory score) to +3.89 (the most pro-inflammatory score). The multivariable-adjusted ORs for participants in the 3 tertile compared to the 1 tertile was 5.08 (95%CI: 2.70-9.56; P-trend < 0.0001) for CRC and 2.33 (95% CI: 1.30-4.02; P-trend = 0.005) for CAP.

Conclusions: Our findings suggest that more pro-inflammatory diets, indicated by higher E-DII scores, might increase the risk of both CRC and CAP. Future steps should include testing these associations in a prospective setting in Iran.
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http://dx.doi.org/10.3390/nu11061213DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6628332PMC
May 2019

Dietary Nutrient Patterns and Prostate Cancer Risk: A Case-Control Study from Iran

Asian Pac J Cancer Prev 2019 May 25;20(5):1415-1420. Epub 2019 May 25.

Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Email:

Background: Prostate cancer is the second common cancer in the world. Although some associations between dietary intakes and prostate cancer have been found, the effects of dietary nutrients interactions have not yet evaluated. The aim of this study is to assess the association between nutrient patterns and risk of prostate cancer. Methods and Materials: Ninety-seven patients with prostate cancer and 205 controls were asked about their demographic and dietary intakes using validated questionnaires. To extract nutrient patterns, Principal Component Analysis (PCA) based on the 35 nutrient items were applied. Varimax rotation was used for improving interpretation and minimizing correlation between the factors. Logistic regression was used to determine the odds ratio (OR) with 95% confidence interval (CI) of prostate cancer by higher scores on the nutrient patterns. Results: High adherence to the “plant source” pattern was negatively associated with prostate cancer risk (OR 0.29 for the highest vs. the lowest score tertile; 95% CI= 0.13 – 0.65; P value for trend:<0.003). Similarly, the “antioxidant and fiber” pattern was associated with decreasing risk of prostate cancer (OR 0.06 for the highest vs. the lowest score tertile;95% CI=0.02 – 0.19; P value for trend:<0.001). There was no significant association for the “mixed” and “vitamin and minerals” pattern with risk of prostate cancer. Conclusion: This study confirms the potential and important role of nutrients on prostate cancer risk. Our finding revealed that “antioxidant and fiber” and “plant source” pattern is inversely associated with prostate cancer risk; however, further longitudinal and trial studies are needed to make a firm conclusion.
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http://dx.doi.org/10.31557/APJCP.2019.20.5.1415DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6857882PMC
May 2019

Index-Based Dietary Patterns and the Risk of Prostate Cancer among Iranian Men

Asian Pac J Cancer Prev 2019 May 25;20(5):1393-1401. Epub 2019 May 25.

Department of Clinical Nutrition and Dietetics, School of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Email:

Background and objective: The second most common cancer in men after lung cancer is prostate cancer (PC). Previous studies assessed the association between food items or food groups and the risk of PC, but diet quality indices are unique approaches to study any relations between diet and disease. Our objective was to investigate the effect of healthy eating index (HEI-2010) and Mediterranean-Style Dietary Pattern Score (MSDPS) on PC risk. Methods: In this case-control study, we recruited 97 patients with MS and 205 control subjects . Dietary intake was evaluted using a valid and reliable food frequency questionnaire. The HEI and MSDPS were calculated. Logistic regression was used to evaluate the relationship between HEI and MSDP scores and PC risk after adjusting the confounders. Results: In comparison to controls, cases had lower score on HEI (61 vs. 70.07; P< 0.001), and higher score on MSDP (26.20 vs. 24.49; P= 0.44). After comparing the highest and the lowest tertile of HEI, we observed a significant decreasing trend in the risk of PC (p for trend<0.001). Conclusion: Our findings suggested that a high quality diet, according to HEI, may decrease the risk of PC.
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http://dx.doi.org/10.31557/APJCP.2019.20.5.1393DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6857881PMC
May 2019

Legume intake and risk of nonalcoholic fatty liver disease.

Indian J Gastroenterol 2019 Feb 22;38(1):55-60. Epub 2019 Feb 22.

Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology, Research Institute, Shahid Beheshti University of Medical Sciences, No 7, West Arghavan St., Farahzadi Blvd., 1981619573, P.O.Box: 19395-4741, Tehran, Iran.

Background: It is known that diet plays a pivotal role in the pathogenesis and management of nonalcoholic fatty liver disease (NAFLD); however, the knowledge on the role of different food groups such as legumes is not enough.

Methods: We designed this study to assess the relationship between legume intake and risk of NAFLD in framework of a case-control study among Tehrani adults. One hundred and ninety-six newly diagnosed patients with NAFLD and 803 controls were studied, and their dietary intake was assessed using a valid and reliable food frequency questionnaire. Conditional logistic regression was used to determine the odds ratio (OR) of NAFLD per increase of one serving/week dietary legumes, lentil, and beans adjusting for potential confounders.

Results: In energy-adjusted model, greater intake of legumes, lentils, and beans was associated with a lower risk of NAFLD. These risk associations remained significant after adjusting for all known risk factors of NAFLD. OR of NAFLD in adjusted models for higher dietary intake of legumes, lentils, and beans were 0.73 (0.64-0.84), 0.61 (0.46-0.78), and 0.35 (0.17-0.74), respectively.

Conclusion: Our findings suggest that higher intake of total legumes (beans, lentils, and peas) was associated with lower risk of NAFLD.
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http://dx.doi.org/10.1007/s12664-019-00937-8DOI Listing
February 2019

Investigating the Antiangiogenic, Anti-drug Resistance and Apoptotic Effects of Soy Isoflavone Extract Alone or in Combination with Docetaxel on Murine 4T1 Breast Tumor Model.

Nutr Cancer 2017 Oct 22;69(7):1036-1042. Epub 2017 Sep 22.

b Reproductive Immunology Research Center, Avicenna Research Institute , ACECR , Tehran , Iran.

Background: One major concern in the treatment of cancer patients during chemotherapy is drug resistance. Here we investigated the effects of soy isoflavone extracts alone or in combination with Docetaxel on the drug resistance, angiogenesis, apoptosis, and tumor volume in mouse 4T1 breast tumor model.

Methods: Sixty female BALB/c mice were randomly divided into 4 groups: control, dietary soy isoflavone extract [Iso, 100 mg/kg diet (0.01%)], Docetaxel (10 mg/kg) injection, and the combination of dietary soy isoflavone extract and intravenous Docetaxel injection (Docetaxel + Iso). One week after the third injection, the breast tumors of eight mice from each group were excised to analyze NF-κBp65' vascular endothelial growth factor receptor-2 (VEGFR2) and Pgp gene and protein expressions and the other seven mice were monitored for survival rate analysis until they died.

Results: NF-κBp65 gene and protein expressions were significantly lower in the Docetaxel + Iso group in comparison with that of the Docetaxel group. VEGFR2 protein expression in the Docetaxel + Iso and Iso groups was significantly lower than that of the Docetaxel group.

Conclusion: These findings may indicate that the combined use of isoflavone extracts together with chemotherapeutic agents has more efficient anti-carcinogenic effects than their individual use.
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http://dx.doi.org/10.1080/01635581.2017.1359316DOI Listing
October 2017

Tuning cell adhesion on polymeric and nanocomposite surfaces: Role of topography versus superhydrophobicity.

Mater Sci Eng C Mater Biol Appl 2016 Jun 8;63:609-15. Epub 2016 Mar 8.

School of Chemical Engineering, University of Tehran, P.O. Box 11155-4563, Tehran, Iran.

Development of surface modification procedures which allow tuning the cell adhesion on the surface of biomaterials and devices is of great importance. In this study, the effects of different topographies and wettabilities on cell adhesion behavior of polymeric surfaces are investigated. To this end, an improved phase separation method was proposed to impart various wettabilities (hydrophobic and superhydrophobic) on polypropylene surfaces. Surface morphologies and compositions were characterized by scanning electron microscopy and X-ray photoelectron spectroscopy, respectively. Cell culture was conducted to evaluate the adhesion of 4T1 mouse mammary tumor cells. It was found that processing conditions such as drying temperature is highly influential in cell adhesion behavior due to the formation of an utterly different surface topography. It was concluded that surface topography plays a more significant role in cell adhesion behavior rather than superhydrophobicity since the nano-scale topography highly inhibited the cell adhesion as compared to the micro-scale topography. Such cell repellent behavior could be very useful in many biomedical devices such as those in drug delivery and blood contacting applications as well as biosensors.
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http://dx.doi.org/10.1016/j.msec.2016.03.021DOI Listing
June 2016

Effect of Curcumin Supplementation During Radiotherapy on Oxidative Status of Patients with Prostate Cancer: A Double Blinded, Randomized, Placebo-Controlled Study.

Nutr Cancer 2016 15;68(1):77-85. Epub 2016 Jan 15.

e Division of Urology, Department of Regenerative and Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University , Niigata , Japan.

Curcumin is an antioxidant agent with both radiosensitizing and radioprotective properties. The aim of the present study was to evaluate the effect of curcumin supplementation on oxidative status of patients with prostate cancer who undergo radiotherapy. Forty patients treated with radiotherapy for prostate cancer were randomized to the curcumin (CG, n = 20) or placebo group (PG, n = 20). They received curcumin (total 3 g/day) or placebo during external-beam radiation therapy of up to 74 Gy. Plasma total antioxidant capacity (TAC) and activity of superoxide dismutase (SOD), catalase, and glutathione peroxidase (GPx) were measured at baseline and 3 mo after radiotherapy completion. Analysis of covariance was used to compare the variables between groups following the intervention. Serum PSA levels and MRI/MRS images were investigated. In CG, TAC significantly increased (P < 0.001) and the activity of SOD decreased (P = 0.018) after radiotherapy compared with those at baseline. In CG, however, the activity of SOD had a significant reduction (P = 0.026) and TAC had a significant increase (P = 0.014) compared with those in PG. PSA levels were reduced to below 0.2 ng/ml in both groups, 3 mo after treatment, however, no significant differences were observed between the 2 groups regarding treatment outcomes.
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http://dx.doi.org/10.1080/01635581.2016.1115527DOI Listing
December 2016

Effects of Combined Soy Isoflavone Extract and Docetaxel Treatment on Murine 4T1 Breast Tumor Model.

Avicenna J Med Biotechnol 2015 Jan-Mar;7(1):16-21

Reproductive Immunology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran.

Background: Emergence of drug resistance has brought major problems in chemotherapy. Using nutrients in combination with chemotherapy could be beneficial for improvement of sensitivity of tumors to drug resistance. Soybean-derived isoflavones have been suggested as chemopreventive agents for certain types of cancer, particularly breast cancer. In this study, the synergistic effects of soy isoflavone extract in combination with docetaxel in murine 4T1 breast tumor model were investigated.

Methods: In this study, mice were divided into 4 groups (15 mice per group) of control, the dietary Soy Isoflavone Extract (SIE, 100 mg/kg diet), the Docetaxel (DOCE, 10 mg/kg) injection and the combination of dietary soy isoflavone extract and intravenous docetaxel injection (DOCE+SIE). After 3 injections of docetaxel (once a week), 7 mice were sacrificed to analyze MKI67 gene and protein expressions and the rest were monitored for diet consumption, tumor growth and survival rates.

Results: In DOCE+SIE group, diet consumption was significantly higher than DOCE group. While lifespan showed a trend towards improvement in DOCE+SIE group, no significant difference was observed among the 4 studied groups. Tumor volume was not significantly affected in treated groups. A lower but not significant MKI67 protein expression was detected in western blot in DOCE+SIE group. The mRNA expression was not significantly different among groups.

Conclusion: The results suggest that the combination of soy isoflavone as an adjunct to docetaxel chemotherapy can be effective in improving diet consumption in breast cancer.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4388885PMC
April 2015

Investigating the role of surface micro/nano structure in cell adhesion behavior of superhydrophobic polypropylene/nanosilica surfaces.

Colloids Surf B Biointerfaces 2015 Mar 7;127:233-40. Epub 2015 Feb 7.

Leibniz-Institut für Polymerforschung Dresden e.V., Hohe Strasse 6, D-01069 Dresden, Germany; Iran Polymer and Petrochemical Institute, P.O. Box 14965/115, Tehran, Iran.

The main aim of the current study was to investigate the effects of different topographical features on the biological performance of polypropylene (PP)/silica coatings. To this end, a novel method including combined use of nanoparticles and non-solvent was used for preparation of superhydrophobic PP coatings. The proposed method led to a much more homogeneous appearance with a better adhesion to the glass substrate. Moreover, a notable reduction was observed in the required contents of nanoparticles (100-20 wt% with respect to the polymer) and non-solvent (35.5-9 vol%) for achieving superhydrophobicity. Surface composition and morphology of the coatings were also investigated via X-ray photoelectron spectroscopy and scanning electron microscopy. Based on both qualitative and quantitative evaluations, it was found that the superhydrophobic coatings with only nano-scale roughness strongly prevented adhesion and proliferation of 4T1 mouse mammary tumor cells as compared to the superhydrophobic surfaces with micro-scale structure. Such results demonstrate that the cell behavior could be controlled onto the polymer and nanocomposite-based surfaces via tuning the surface micro/nano structure.
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http://dx.doi.org/10.1016/j.colsurfb.2015.01.054DOI Listing
March 2015

Comparison of Antioxidant Status and Vitamin D Levels between Multiple Sclerosis Patients and Healthy Matched Subjects.

Mult Scler Int 2014 14;2014:539854. Epub 2014 Apr 14.

Department of Epidemiology, School of Public Health, Jundishapur University of Medical Sciences, Ahvaz, Iran.

Objective. The aim of the present study was to compare the serum levels of total antioxidant status (TAS) and 25(OH) D3 and dietary intake of multiple sclerosis (MS) patients with those of normal subjects. Method. Thirty-seven MS patients (31 women) and the same number of healthy matched controls were compared for their serum levels and dietary intake of 25(OH) D3 and TAS. Sun exposure and the intake of antioxidants and vitamin D rich foods were estimated through face-to-face interview and food frequency questionnaire. Results. Dietary intake of antioxidants and vitamin D rich foods, vitamin C, vitamin A, and folate was not significantly different between the two groups. There were also no significant differences in the mean levels of 25(OH) D3 and TAS between the study groups. Both groups had low serum levels of 25(OH) D3 and total antioxidants. Conclusion. No significant differences were detected in serum levels and dietary intake of vitamin D and antioxidants between MS patients and healthy controls. All subjects had low antioxidant status and vitamin D levels.
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http://dx.doi.org/10.1155/2014/539854DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4009321PMC
May 2014
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