Publications by authors named "Mahdi Vajdi"

21 Publications

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Citrus peel derived' Poly-Methoxylated Flavones (PMF).

Int J Vitam Nutr Res 2021 May 27:1-16. Epub 2021 May 27.

Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

The prevalence of obesity has increased substantially over the last several decades and several environmental factors have accelerated this trend. Poly-methoxy flavones (PMFs) exist abundantly in the peels of citrus, and their biological activities have been broadly examined in recent years. Several studies have examined the effects of PMFs on obesity and its-related diseases. This systematic review conducted to focus on the effect of PMFs on obesity and its related conditions management. The PubMed, Google Scholar, Scopus, and Science Direct databases were searched for relevant studies published before November 2020. Out of 1,615 records screened, 16 studies met the study criteria. The range of dosage of PMFs was varied from 10 to 200 mg/kg (5-26 weeks) and 1-100 μmol (2h-8 days) across selected animal and studies, respectively. The literature reviewed shows that PMFs modulate several biological processes associated with obesity such as lipid and glucose metabolism, inflammation, energy balance, and oxidative stress by different mechanisms. All of the animal studies showed significant positive effects of PMFs on obesity by reducing body weight (e.g. reduced weight gain by 21.04%), insulin resistance, energy expenditure, inhibiting lipogenesis and reduced blood lipids (e.g. reduced total cholesterol by 23.10%, TG by 44.35% and LDL by 34.41%). The results of the reviewed studies have revealed that treatment with PMFs significantly inhibits lipid accumulation in adipocytes (e.g. reduced lipid accumulation by 55-60%) and 3T3-L1 pre-adipocyte differentiation as well by decreasing the expression of PPARγ and C/EBPα and also reduces the number and size of fat cells and reduced TG content in adipocytes by 45.67% and 23.10% and 16.08% for nobiletin, tangeretin and hesperetin, respectively. Although current evidence supports the use of PMFs as a complementary treatment in obesity, future research is needed to validate this promising treatment modality.
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http://dx.doi.org/10.1024/0300-9831/a000710DOI Listing
May 2021

An updated systematic review and dose-response meta-analysis of the randomized controlled trials on the effects of Alpha-Lipoic acid supplementation on inflammatory biomarkers.

Int J Vitam Nutr Res 2021 Apr 8:1-14. Epub 2021 Apr 8.

Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran.

Data about the effects of alpha-lipoic acid (ALA) supplementation on inflammatory markers are inconsistent. This systematic review and dose-response meta-analysis of randomized controlled trials was performed to summarize the effects of ALA supplementation on inflammatory markers such as C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in adults. A comprehensive literature search was conducted in the electronic databases of PubMed, Web of Science, ProQuest, Embase, and SCOPUS from inception to February 2020. Among all of the eligible studies, 20 articles were selected. The weighted mean differences (WMD) and 95% confidence intervals (CI) were calculated to evaluate the pooled effect size. Between-study heterogeneity was evaluated using Cochran's Q test and I. Subgroup analysis was done to evaluate the potential sources of heterogeneity. The dose-response relationship was evaluated using fractional polynomial modeling. Twenty eligible studies with a total sample size of 947 participants were included in the current meta-analysis. The findings of the meta-analysis showed that ALA supplementation significantly reduced CRP (WMD: -0.69 mg/L, 95% CI: -1.13, -0.26, P=0.002), IL-6 (WMD: -1.83 pg/ml, 95% CI: -2.90, -0.76, P=0.001), and TNF-α concentrations (WMD: -0.45 pg/ml, 95% CI: -0.85, -0.04, P=0.032). No evidence of departure from linearity was observed between dose and duration of the ALA supplementation on serum CRP, IL-6 and TNF-α concentration. In subgroup analysis, ALA dosage, baseline concentrations of the parameter, sample size, and gender were considered as possible sources of heterogeneity. In summary, ALA supplementation improves inflammatory markers without any evidence of non-linear association to dose or duration of the trial.
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http://dx.doi.org/10.1024/0300-9831/a000702DOI Listing
April 2021

The association between Sugars Sweetened Beverages (SSBs) and lipid profile among children and youth: A systematic review and dose-response meta-analysis of cross-sectional studies.

Pediatr Obes 2021 Jul 24;16(7):e12782. Epub 2021 Feb 24.

Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Background: The relationship between sugar-sweetened beverages (SSBs) intake and serum lipids among children and youth has been reported in several studies, but the results are still controversial.

Objective: In the current study, we summarized the results of studies that assessed the relationship between SSBs consumption and serum lipids among children and youth in a systematic review and dose-response meta-analysis.

Methods: The PubMed, Web of Sciences, Cochrane and Scopus electronic databases were searched for observational studies reporting an association between SSBs intake and serum lipids among children and youth that were published before May 2020. For data extracted from cohort studies, only cross-sectional baseline data were included in the current meta-analysis. The Random effects model was used to estimate the pooled weighted mean difference (WMD) and 95% confidence intervals (CI). Heterogeneity was assessed with the Cochran Q test and I statistics.

Results: In our search, 1845 studies were retrieved of which 13 studies (two cohorts and eleven cross-sectional) were included. High SSB consumption was associated with 1.21 mg/dL increase in low-density lipoprotein cholesterol (LDL-C; pooled WMD: 1.21 mg/dL; 95% CI: 0.23, 2.20; P = .01), 1.45 mg/dL decrease in high-density lipoprotein cholesterol (HDL-C, pooled WMD: -1.46 mg/dL; 95% CI, -2.25, -0.67; P < .0001) and 2.49 mg/dL decrease in total cholesterol (TC, pooled WMD: -2.49 mg/dL; 95% CI, -2.89, -2.10; P < .0001). In dose-response meta-analysis, there was an evidence of departure from linearity in the relationship between SSB consumption and change in LDL-C (P-  = .03) and TC (P-  = .01). However, no departure from linearity was observed between SSB intake and change in HDL-C (P-  = .56) or triglyceride (TG) values (P-  = .85).

Conclusion: According to our results, high SSB consumption was significantly associated with higher LDL-C and lower HDL-C and TC among children and youth. However, owing to the limited number of the included studies, further well-designed interventional studies are needed to better elucidate causality.
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http://dx.doi.org/10.1111/ijpo.12782DOI Listing
July 2021

A Comprehensive insight into the effect of chromium supplementation on oxidative stress indices in diabetes mellitus: A systematic review.

Clin Exp Pharmacol Physiol 2021 03 18;48(3):291-309. Epub 2021 Jan 18.

Nutrition Research Center, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.

Diabetes mellitus is a metabolic disorder defined as an increase in blood glucose levels (hyperglycaemia) and insufficient production or action of insulin produced by the pancreas. Chronic hyperglycaemia leads to increased reactive oxygen species (ROS) production and oxidative stress, which consequently results in insulin resistance, beta cell degeneration, dyslipidaemia, and glucose intolerance in diabetic patients. Chromium has an essential role in the metabolism of proteins, lipids, and carbohydrates through increasing insulin efficiency. This systematic review aimed to evaluate chromium supplementation's potential roles in oxidative stress indices in diabetes mellitus. A systematic search was performed in PubMed, Scopus, Google Scholar, Cochrane, and Science Direct databases until November 2020. All clinical trials and animal studies that assessed chromium's effect on oxidative stress indices in diabetes mellitus and were published in English-language journals were included. Finally, only 33 out of 633 articles met the required criteria for further analysis. Among 33 papers, 25 studies were performed on animals, and eight investigations were conducted on humans. Twenty-eight studies of chromium supplementation lead to reducing oxidative stress indices. Also, 23 studies showed that chromium supplementation markedly increased antioxidant enzymes' activity and improved levels of antioxidant indices. In conclusion, chromium supplementation decreased oxidative stress in diabetes mellitus. However, further clinical trials are suggested in a bid to determine the exact mechanisms.
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http://dx.doi.org/10.1111/1440-1681.13462DOI Listing
March 2021

Gut microbiota-associated trimethylamine N-oxide and increased cardiometabolic risk in adults: a systematic review and dose-response meta-analysis.

Nutr Rev 2021 Aug;79(9):1022-1042

Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Context: Several studies suggest a relationship between trimethylamine N-oxide (TMAO) concentrations and increased cardiometabolic risk, but findings are controversial.

Objective: The aim of this systematic review and meta-analysis was to summarize evidence of the relationship between circulating TMAO levels and risk of hypertension and increased serum lipids in a dose-response and 2-class meta-analysis of discrete and continuous variables.

Data Sources: PubMed, Scopus, Cochrane, and ProQuest databases were searched.

Study Selection: Observational studies that reported disease status of participants (≥ 18 years), type of sample in which TMAO was measured (serum or plasma), and results based on at least 2 categories of TMAO concentrations, including relative risks, hazard ratios, or odds ratios with 95%CIs for cardiometabolic risk factors in association with circulating TMAO levels were selected. Papers were reviewed independently by both authors. The Newcastle-Ottawa Scale was used to assess the quality of included studies.

Data Extraction: The following data were extracted: first author's name, publication year, study design, study location, demographic information of participants, and concentrations of circulating TMAO.

Results: Eighteen studies were included in the meta-analysis. There was a dose-response relationship between circulating TMAO and increased odds of hypertension in cohort studies (P  for nonlinearity = 0.049), in plasma-derived TMAO samples (P  for nonlinearity = 0.043), in patients with cardiovascular disease (P  for nonlinearity = 0.048), and in apparently healthy individuals from community-based studies (P  for nonlinearity = 0.005). Moreover, the highest category of TMAO concentrations was associated with a 2.36 mmHg increase in systolic blood pressure when compared with the lowest category. The dose-response meta-analysis of continuous variables revealed that an increase in TMAO is associated with reduced high-density lipoprotein cholesterol in apparently healthy individuals and reduced high-density lipoprotein cholesterol and increased total cholesterol in patients with cardiovascular disease.

Conclusions: Circulating TMAO is positively associated with an increased risk of hypertension and other cardiometabolic disorders in adults.

Systematic Review Registration: PROSPERO identification number CRD42019138296.
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http://dx.doi.org/10.1093/nutrit/nuaa111DOI Listing
August 2021

An updated systematic review and dose-response meta-analysis of the effects of α-lipoic acid supplementation on glycemic markers in adults.

Nutrition 2021 02 17;82:111041. Epub 2020 Oct 17.

Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address:

This systematic review and dose-response meta-analysis was conducted to summarize data from available clinical trials on the effects of α-lipoic acid (ALA) supplementation on glycemic markers including glucose, hemoglobin A (HbA), insulin, homeostatic model assessment of insulin resistance (HOMA-IR), HOMA-β, and quantitative insulin check index in adults. A comprehensive literature search was conducted in the electronic databases of PubMed, Web of Science, ProQuest, Embase and SCOPUS from inception to February 2020. Among all of the eligible studies, 28 articles were selected. The weighted mean differences (WMD) and 95% confidence intervals (CI) were calculated to evaluate the pooled effect size. Between-study heterogeneity was evaluated using Cochran's Q test and I. Subgroup analysis was done to evaluate the potential sources of heterogeneity. The dose-response relationship was evaluated using fractional polynomial modeling. Twenty eight eligible studies with a total sample size of 1,016 participants were included in the current meta-analysis. The findings of the meta-analysis showed that ALA supplementation significantly reduced insulin (WMD: -0.64; CI: -1.287 to 0.004, P = .04), HOMA-IR (WMD: -0.48; 95% CI: -0.79 to -0.16; P = .002). No change in glucose or HbA1C was reported. Moreover, the effect of ALA on insulin was duration-dependent (P = 0.04). No evidence of departure from linearity was observed between dose and duration of the ALA supplementation on other markers. The subgrouping revealed that ALA dosage and duration of ALA supplementation, health status of participants, geographic locations and the studies' quality are possible sources of heterogeneity. In summary, ALA supplementation improves serum insulin and insulin resistance in a two-class and duration dependent non-linear analysis.
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http://dx.doi.org/10.1016/j.nut.2020.111041DOI Listing
February 2021

Dietary inflammatory index significantly affects lipids profile among adults: An updated systematic review and meta-analysis.

Int J Vitam Nutr Res 2020 Nov 5:1-17. Epub 2020 Nov 5.

Molecular Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

: The available data on the relationship between dietary inflammatory index (DII) and serum lipids are controversial. This systematic review and meta-analysis aimed to investigate the relationship between DII and serum lipids, including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) in general populations. : PubMed, Web of Science, SCOPUS, and Cochrane electronic databases were systematically searched from inception to December 2019. Case-control, cohort or cross-sectional studies that evaluated the relationship between DII and serum lipids were included. The random-effects model was applied to evaluate the pooled weighted mean difference (WMD) and 95% confidence intervals (CI). : In total, twenty-four cross-sectional and one case-control studies with a total sample size of 129,759 were included in the meta-analysis. The pooled results showed that the highest category of DII was associated with 5.16 mg/dl increase in TC (Pooled WMD: 5.16; 95% CI: 0.58-9.73,  = 0.02) and 3.99 mg/dl increase in LDL-C (Pooled WMD: 3.99; 95% CI: 1.16-6.81,  = 0.006). However, no significant association between DII scores, HDL-C and TG was found. In subgroup analysis, the geographical region, gender, and dietary assessment methods were potent sources of heterogeneity. : This study showed that a higher level of DII was associated with higher levels of TC and LDL-C in apparently healthy populations. Since the included studies had observational designs, therefore, no conclusion of causality was possible. More studies with interventional designs are required to elucidate the causality of the observed association between DII and the risk of abnormal lipid profile.
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http://dx.doi.org/10.1024/0300-9831/a000688DOI Listing
November 2020

A systematic review of the association between dietary patterns and health-related quality of life.

Health Qual Life Outcomes 2020 Oct 12;18(1):337. Epub 2020 Oct 12.

Drug Applied Research Center, Tabriz University of Medical Sciences, Attar Neyshabouri Street, Tabriz, Iran.

Background: Health related quality of life (HRQOL) is a potent indicator of individual's happiness and life satisfaction. The way in which the HRQOL is affected by the diet is a topic of constant interest and debate among researchers. Evaluating the association between single nutrients or foods and HRQOL fails to take into consideration the complex interactions between nutrients. Also, the findings from previous investigations on the relationship between dietary patterns and HRQOL have been inconsistent. Therefore, our aim was to assess the existing evidence regarding the relationship between the dietary patterns and HRQOL by conducting a systematic review.

Methods: A literature search was conducted in PubMed, Scopus, Web of Sciences and Google scholar databases from inception to March 2020, to identify studies that investigated associations between the dietary patterns (regardless of methods used to define dietary patterns) and HRQOL domains. Two researchers independently checked titles and abstracts, evaluated full-text studies, extracted data, and appraised their quality using the Newcastle-Ottawa Scale (NOS).

Results: Thirteen studies (four longitudinal, and nine cross-sectional studies), with a total of 43,445 subjects, were included. Of the studies included in this review, eight studies evaluated the association between "Mediterranean" dietary patterns (MDP) and HRQOL, while five studies examined the association between different dietary patterns ("Healthy", "Unhealthy", "Western", "Fruit and vegetable", "Bread and butter" and etc.) and HRQOL. Excluding three studies which showed no significant association, healthy dietary patterns such as MDP, "Healthy" and "Fruit and vegetable" dietary patterns were associated with better HRQOL in physical and mental components scores. The quality assessment of included studies according to NOS criteria were ranged between medium to high quality.

Conclusion: According to the current evidence, "Healthy" dietary patterns and "Mediterranean" dietary patterns are associated with better dimension scores of HRQOL in both physical and mental summaries. While, unhealthy dietary patterns and "Western" dietary patterns are associated with lower scores of HRQOL. Further longitudinal studies are required to clarify the association between dietary patterns and HRQOL.
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http://dx.doi.org/10.1186/s12955-020-01581-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7552532PMC
October 2020

Dietary total antioxidant capacity (TAC), general and central obesity indices and serum lipids among adults: An updated systematic review and meta-analysis.

Int J Vitam Nutr Res 2020 Aug 11:1-17. Epub 2020 Aug 11.

Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

: In the present meta-analysis, we aimed to summarize the relationship between dietary total antioxidant capacity (TAC), general and central obesity indices and lipid profile in adult population. : The electronic databases of Web of Sciences, PubMed, Scopus and Cochrane library were searched for relevant studies from inception to October 2019. The effect size was indicated as weighted mean difference (WMD) and 95% confidence intervals (CI) by using random effects model. The I index and Cochran's Q-test were used for evaluating heterogeneity. : From 2,469 studies identified, thirty-four studies (nineteen cross-sectional studies, thirteen cohort studies, two case-control studies) were included in the meta-analysis. According to our results, higher categories of TAC were associated with significantly lower serum triglyceride concentartions (TG; WMD: -7.58; CI: -11.42, -3.75; P < 0.001) and waist circumference (WC; WMD: -1.17; 95% CI: -1.47, -0.87; P < 0.001); while no significant change in body mass index (BMI; WMD: -0.17; 95% CI: -0.35, 0.01; P = 0.12), high density lipoprotein cholesterol (HDL-C; WMD: 0.61; 95% CI: -0.16, 1.40; P = 0.12), low density lipoprotein cholesterol (LDL-C; WMD: 1.34; 95% CI: -0.61, 3.30; P = 0.17) and total cholesterol (TC; WMD: 1.19; 95% CI: -1.46, 3.855; P = 0.37) was reported. : Higher dietary TAC was related to reduced prevalence of central obesity, reduced WC and TG concentrations in the current meta-analysis. Moreover, subgroup analysis showed that TAC measurement index, geographical area, dietary assessment tool, health status and gender were potential sources of heterogeneity.
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http://dx.doi.org/10.1024/0300-9831/a000675DOI Listing
August 2020

Gut microbiota-associated metabolite trimethylamine N-Oxide and the risk of stroke: a systematic review and dose-response meta-analysis.

Nutr J 2020 07 30;19(1):76. Epub 2020 Jul 30.

Road Traffic Injury Research Center, Department of Epidemiology and Biostatistics, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran.

Aims: Several epidemiological studies have examined the association between trimethylamine N-Oxide (TMAO) and stroke risk; however, the results are still inconclusive. The purpose of this meta-analysis was to evaluate the relationship between TMAO concentrations and stroke risk.

Methods: PubMed, Scopus, Cochrane and ProQuest search engines were systematically searched up to 18 June 2019. All of the studies that evaluated the relationship between TMAO and stroke were included in the systematic review and eligible studies were included into the meta-analysis. Meta-regression and subgroup analysis were also employed to find the source of heterogeneity.

Results: Eight studies (two cross-sectional studies, two cohort studies, three case-control studies and one nested case-control study) with a total of 6150 participants were included in the meta-analysis. The overall result showed that being in the highest category of TMAO increased the odds of stroke by 68% (OR: 1.675; CI: 0.866-3.243; P = 0.047) and mean TMAO concentrations was 2.201 μmol/L higher in patients with stroke rather than non-stroke controls (weighted mean difference (WMD): 2.20; CI: 1.213-3.188; P < 0.001). Furthermore, we observed revealed a non-linear association between increased TMAO levels and increased odds of stroke (P- for nonlinearity < 0.001). In addition, visual inspection of the funnel plot revealed a significant asymmetry among studies examining the differences in TMAO in patients with stroke versus control group.

Conclusion: This is the first meta-analysis to show positive dose-dependent relations between circulating TMAO concentration and stroke risk. However, further interventional studies and long-term studies are needed to better explain causality.
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http://dx.doi.org/10.1186/s12937-020-00592-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7393891PMC
July 2020

Lifestyle patterns and their nutritional, socio-demographic and psychological determinants in a community-based study: A mixed approach of latent class and factor analyses.

PLoS One 2020 23;15(7):e0236242. Epub 2020 Jul 23.

Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Background: Lifestyle risk factors, such as unhealthy diet, physical inactivity or tobacco smoking can have detrimental effects on health and well-being. Therefore, it is important to examine multiple lifestyle risk factors instead of single ones. Cluster analysis allows the combination of single health behaviors in order to recognize distinguished behavior patterns. This study aimed to evaluate lifestyle patterns of general adult population in northwest of Iran with particular focus on dietary patterns, physical activity, and smoking status.

Methods: The current cross-sectional study consists of 525 adults aged 18-64 years from East-Azarbaijan Iran. Latent class analysis (LCA) was applied to recognize patterns of lifestyle behaviors with ingredients of diet, physical activity, and smoking status. Dietary intake was assessed using a validated food frequency questionnaire and dietary patterns were derived using factor analysis. Biochemical parameters including fasting blood sugar (FBS), serum lipids, liver enzyme and serum 25(OH)-D3 were measured with commercial ELIZA kits.

Results: Mean ages of participants were 42.90 ± 11.89 years. Using principal component analysis (PCA) three major dietary patterns were extracted including traditional dietary pattern (e.g. nuts and dry fruits), unhealthy dietary pattern (e.g. fast foods, refined grains) and the healthy dietary patterns (e.g. fruits, vegetables). Using LCA, three classes of lifestyles pattern were identified: 1st class was characterized by a healthy dietary pattern, moderate physical activity, and low probability of smoking. 2nd class was characterized by a traditional dietary pattern, low level of physical activity and low probability of smoking and 3rd class was characterized by a unhealthy dietary pattern, low level of physical activity and low probability of smoking and further analysis found that there were significant differences in body mass index (BMI), Waist-to-hip ratio (WHR), FBS, Hemoglobin (Hb), education levels and anxiety status between classes (P <0.05).

Conclusion: This study attempts to classify Iranian adults by their own health behavior. Healthcare professionals should be aware of associations between different lifestyle risk factors and health promotion strategies should further focus on multiple behaviors at the same time. In our country, more studies about the adult population are needed to support the observed findings of our study and therefore allow for a certain generalization of the observations.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0236242PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7377498PMC
September 2020

The interaction between dietary Non-Enzymatic Antioxidant Capacity (NEAC) with variants of Melanocortin-4 receptor (MC4R) 18q21.23-rs17782313 locus on hypothalamic hormones and cardio-metabolic risk factors in obese individuals from Iran.

Nutr Neurosci 2020 Oct 19;23(10):824-837. Epub 2020 Jun 19.

Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

In the current study, we aimed to evaluate the interaction between dietary Non-Enzymatic Antioxidant Capacity (NEAC) and rs17782313 polymorphism on hypothalamic hormones and cardio-metabolic risk factors. A total of 287 subjects (aged 20-50 years, 147 males and 140 females) enrolled in the cross-sectional study. Dietary NEAC was assessed using databases of NEAC measurements compiled from outcomes for three different analyses: oxygen radical absorbance capacity (ORAC), ferric reducing-antioxidant power (FRAP), and total radical-trapping antioxidant parameter (TRAP) and genotyping for the near MC4R rs17782313 was carried out by Polymerase chain reaction-restriction fragments length polymorphism (PCR-RFLP) method. The significant interactions were found between adherence to the dietary NEAC and MC4R rs17782313 in relation to high-density lipoprotein-cholesterol (HDL-C), glucose, α-melanocyte stimulating hormone (α-MSH), insulin and quantitative insulin sensitivity check index (QUICKI) (  = 0.03, 0.01, 0.04, 0.04 and 0.04, respectively). In homozygous subjects for the minor allele, the serum insulin level and QUICKI in participants with the highest adherence to TRAP were significantly higher than those with the lowest adherence ( < 0.001). There was a significant inverse association between high ORAC score and risk of metabolic syndrome even after adjusting for potential confounders (OR: 0.33; 95%CI:0.13-0.81) and also a significant inverse association between high NEAC (ORAC, FRAP and TRAP assays) score and high triglyceride (TG) level was found in obese adults. In conclusion, our study found for the first time that the NEAC significantly interacts with the genotypes to influence several metabolic risk factors in obesity.
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http://dx.doi.org/10.1080/1028415X.2020.1780738DOI Listing
October 2020

Dietary Total Antioxidant Capacity (TAC) Significantly Reduces the Risk of Site-Specific Cancers: An Updated Systematic Review and Meta-Analysis.

Nutr Cancer 2021 28;73(5):721-739. Epub 2020 May 28.

Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Objectives: We aimed to evaluate the possible role of dietray TAC against different types of cancers in a systematic review and meta-analyses of observational studies. A literature search of authentic electronic resources had been performed to obtain the relevant studies up to February 2020. Twenty-one studies including nine prospective and twelve case-control studies were included in the current systematic review and meta-analysis. These studies have included 1404297 individuals. Higher TAC categories were associated with 21% reduced risk of colorectal cancer, 27% reduced risk of endometrial cancer, 42% reduced risk of gastric cancer, and 32% reduced risk of pancreatic cancer. In meta-analysis of prospective studies also highest category of TAC was associated with reduced incidence of breast cancer (RR= 0.68; CI: 0.54, 0.86;  = 0.025), colon cancer (RR= 0.92; CI: 0.74, 1.16;  = 0.01), hepatocellular carcinoma (RR= 0.49; CI: 0.35, 0.69;  < 0.001), gastric cancer (RR= 0.65; CI: 0.50, 0.84;  = 0.001), lung cancer (RR= 0.90; CI: 0.85, 0.95;  = 0.001) while increased risk of rectal cancer (RR= 1.02; CI: 0.69, 1.52;  = 0.005). Higher intake of dietary TAC was in association with reduced risk of different types of cancers in meta-analysis of observational studies.
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http://dx.doi.org/10.1080/01635581.2020.1771385DOI Listing
August 2021

Novel findings of the association between gut microbiota-derived metabolite trimethylamine oxide and inflammation: results from a systematic review and dose-response meta-analysis.

Crit Rev Food Sci Nutr 2020 28;60(16):2801-2823. Epub 2020 May 28.

Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

The gut microbiota-derived metabolite trimethylamine -oxide (TMAO) has been regarded as one of the potent risk factors of cardiovascular events and diabetes. However, its association with possible inflammatory mediators has not been revealed yet. In the current meta-analysis, we quantitatively summarized the results of studies regarding the association between TMAO and inflammation. Electronic databases including PubMed, ProQuest, Scopus, and Embase were systematically searched and a total of 586 manuscripts were retrieved. After removing 223 duplicates, 363 manuscripts were reviewed. All of the studies regarding the association between TMAO and inflammatory factors were included in the systematic review and eligible studies were included in to the meta-analysis. Accordingly, 13,783 number of participants were included and the results showed that being in the highest category of TMAO Accordingly was associated with 0.27 mg/L (weighted mean difference: 0.268; 95% confidence interval [CI]: 0.058-0.479;  = 0.013) increase in CRP concentrations compared with lowest category. The results of subgrouping and meta-regression revealed the location, CRP sample source, disease status, male percent, proportion of diabetes and smoking as the source of heterogeneity. Moreover, the dose-response meta-analysis revealed a non-linear association between increased TMAO concentrations and increased CRP concentrations ( for nonlinearity = 0.015). To our knowledge, this is first dose-response meta-analysis that summarized the results of studies about the association between circulating TMAO concentrations and inflammation risk.
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http://dx.doi.org/10.1080/10408398.2020.1770199DOI Listing
September 2020

Diet-derived nutrient patterns and components of metabolic syndrome: a cross-sectional community- based study.

BMC Endocr Disord 2020 May 19;20(1):69. Epub 2020 May 19.

Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.

Background: Metabolic syndrome (MetS) is one of the main public health problems worldwide. Although some relations between dietary intakes and MetS have been found, few studies have focused on association between dietary nutrients interactions and the risk of the MetS and its components. The aim of the present study was to examine the association between nutrient patterns and MetS and its components among Iranian adult population.

Methods: A total of 588 subjects (aged 18-64 years, 271 males and 317 females) enrolled in the cross sectional study. Dietary consumption was evaluated using an 80-item food frequency questionnaire (FFQ). Biochemical assessments including fasting blood sugar (FBS), aspartate aminotransferase (AST), alanine amino transferase (ALT) and serum lipids were performed by enzymatic methods. Nutrient patterns were obtained by factor analysis procedure using principal component method. Multinational logistic regression analysis was used to evaluate the association between nutrient patterns and MetS and its components.

Results: Three nutrient patterns explaining 53.66% of the variance in dietary nutrients intake, were recognized in the current study. Animal-sourced nutrient pattern was significantly associated with the higher odds of MetS and high triglyceride (TG) levels. Plant-sourced nutrient pattern (high intake of fiber, carbohydrate, vitamins B, B, C, B, E, D, magnesium, potassium, and linoleic acid) was significantly associated with lower risk of MetS and lower blood pressure (p < 0.05). Third nutrient pattern (mixed-source) was significantly related to higher risk of MetS, high waist circumference (WC) and high systolic blood pressure (SBP).

Conclusion: This present study confirms the important effect of nutrients and their patterns on MetS risk. Our results suggest that adherence to the nutrient pattern rich in fiber, carbohydrate, vitamins D, B, B, C, B, E, magnesium, potassium, linoleic acid, and docosahexaenoic acid (DHA) is associated with a lower risk of MetS, while animal- and mixed-sourced nutrient patterns are positively associated with greater odds of MetS; However, further longitudinal and interventional studies are required to make a clear conclusion.
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http://dx.doi.org/10.1186/s12902-020-0547-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7236137PMC
May 2020

The association between dietary inflammatory index and risk of central obesity in adults: An updated systematic review and meta-analysis.

Int J Vitam Nutr Res 2020 Oct 4;90(5-6):535-552. Epub 2020 Mar 4.

Research Center for Evidence Based Medicine, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.

: Central obesity, as a pivotal component of metabolic syndrome is associated with numerous co-morbidities. Dietary factors influence central obesity by increased inflammatory status. However, recent studies didn't evaluate the association between central obesity and dietary inflammation index (DII) that give score to dietary factors according to their inflammatory potential. In the current systematic review and meta-analysis, we summarized the studies that investigated the association between DII with central obesity indices in the general populations. : In a systematic search from PubMed, SCOPUS, Web of Sciences and Cochrane electronic databases, we collected relevant studies written in English and published until 30 October 2019. The population of included studies were apparently healthy subjects or individuals with obesity or obesity-related diseases. Observational studies that evaluated the association between DII and indices of central obesity including WC or WHR were included. : Totally thirty-two studies were included; thirty studies were cross-sectional and two were cohort studies with 103071 participants. Meta-analysis of observational studies showed that higher DII scores were associated with 1.81 cm increase in WC (Pooled weighted mean difference (WMD) = 1.813; CI: 0.785-2.841; p = 0.001). Also, a non-significant increase in the odds of having higher WC (OR = 1.162; CI: 0.95-1.43; p = 0.154) in the highest DII category was also observed. In subgroup analysis, the continent, dietary assessment tool and gender were the heterogeneity sources. : The findings proposed that adherence to diets with high DII scores was associated with increased WC. Further studies with interventional designs are necessary to elucidate the causality inference between DII and central obesity indices.
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http://dx.doi.org/10.1024/0300-9831/a000648DOI Listing
October 2020

Alpha-lipoic acid supplementation significantly reduces the risk of obesity in an updated systematic review and dose response meta-analysis of randomised placebo-controlled clinical trials.

Int J Clin Pract 2020 Jun 26;74(6):e13493. Epub 2020 Mar 26.

Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Background: There are numerous trials reported the effect of alpha-lipoic acid (ALA) on obesity measurements; while no summarised dose-response meta-analysis is available to address the effects of dose and duration of ALA supplementation on obesity measurements. We aimed to summarise the results of studies evaluating the effects of ALA supplementation on obesity measurements in a systematic review and dose-response meta-analysis.

Methods And Materials: In a systematic search from Scopus, PubMed, Embase, Proquest electronic databases up to January 2020 relevant studies were retrieved. Randomised, placebo-controlled trials investigating the effect of ALA supplementation on obesity measurements including weight, body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) and fat mass (FM) were included. Two class and dose-response meta-analysis were performed to data analysis.

Results: Totally, 18, 21 and 8 studies were included for the meta-analysis of ALA-weight, ALA-BMI, ALA-WC, respectively. In the two-class meta-analysis, ALA treatment significantly reduced weight (WMD: -2.29 kg, 95% CI: -2.98, 1.60, P < .01) and BMI (WMD: -0.49 kg/m , 95% CI:-0.83,-0.15, P = .005) but no effect on WC (WMD: -2.57 cm, 95% CI: -8.91, 3.76; P = .426). While the dose-response meta-analysis revealed that the duration of ALA treatment is a significant factor affecting WC reduction (P  = .047). While no evidence of departure from linearity was observed for other variables; moreover, subgrouping also revealed that gender could be an important factor affecting the ALA impact on WC which was significant among women (WMD: -4.099; CI: -7.837, -0.361; P = .032).

Conclusion: According to our finding, ALA treatment significantly reduced BMI, weight in a two-class meta-analysis without evidence of departure from linearity in terms of dose or duration. While the association of ALA treatment on WC is dependent to the duration of the study. Although further trials evaluating the other obesity measurements specially central obesity will be helpful to infer a more reliable result.
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http://dx.doi.org/10.1111/ijcp.13493DOI Listing
June 2020

Interaction between Vascular Endothelial Growth Factor-A (rs2010963) Gene Polymorphisms and Dietary Diversity Score on Cardiovascular Risk Factors in Patients with Metabolic Syndrome.

Lifestyle Genom 2020 29;13(1):1-10. Epub 2019 Nov 29.

Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Background: The vascular endothelial growth factor-A (VEGFA) family of cytokines regulates proliferation, angiogenesis, and migration of endothelial cells, increases vascular permeability, and controls thrombogenicity. Recent studies have suggested that the VEGFA gene plays an important role in the pathogenesis of metabolic syndrome and its related disorders. Dietary diversity score (DDS) has also been shown to have potential favorable effects against features of metabolic syndrome. This study examined the interactions between +405 VEGFA C/G (rs2010963) polymorphism and DDS on the metabolic and biochemical profile of metabolic syndrome. Therefore, in the current study, we aimed to evaluate the interaction between DDS and VEGFA rs2010963 gene polymorphisms in modification of metabolic risk factors including serum lipids, blood pressure, serum adiponectin, and matrix metalloproteinase (MMP)-3 concentrations in patients with metabolic syndrome.

Methods And Materials: In the current cross-sectional study, 254 patients with metabolic syndrome were recruited. Measurements of blood pressure, anthropometric parameters, and dietary intakes were performed and the DDS was calculated. Biochemical variables including serum adiponectin concentrations, lipid profile, serum glucose, and MMP-3 concentrations were measured by enzyme-linked immunosorbent assay method (ELISA) and enzymatic colorimetric methods. Determination of +405 C/G VEGFA gene polymorphisms was performed using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique.

Results: Patients in the lowest DDS quartile had higher insulin and homeostatic model assessment of insulin resistance (HOMA-IR), while patients in the highest DDS quartile had higher quantitative insulin check index (QUICKI; p < 0.05). Higher serum triglyceride and systolic blood pressure (SBP) values and lower serum adiponectin concentrations were also observed in lower DDS quartiles (p < 0.05). Patients with the CC genotype in the VEGFA rs2010963 polymorphism had significantly higher body mass index (BMI), fasting blood glucose, aspartate aminotransferase (AST), and alanine aminotransferase (ALT; p < 0.05) compared to patients with the other 2 genotypes. In lower quartiles of DDS, 30% of patients with metabolic syndrome had the GG genotype, while 30.4 and 30.8% of patients with metabolic syndrome in higher DDS quartiles had GC and CC genotypes, respectively (p = 0.04).

Conclusion: Our study found lower insulin resistance, serum triglyceride, and SBP and higher adiponectin concentrations among patients with metabolic syndrome in highest quartiles of DDS. Moreover, patients with the CC genotype were more likely to have higher BMI, fasting blood glucose, AST, and ALT. This significant interaction gives a possible evidence of a VEGFA-DDS association that may be relevant to metabolic syndrome. Further studies are warranted to clarify the underlying mechanisms of these interactions.
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http://dx.doi.org/10.1159/000503789DOI Listing
August 2021

Dietary acid load significantly predicts 10-years survival in patients underwent coronary artery bypass grafting (CABG) surgery.

PLoS One 2019 17;14(10):e0223830. Epub 2019 Oct 17.

Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.

Backgrounds: Numerous studies have revealed the role of dietary acid load as a potential risk factor for cardiovascular events and blood pressure. However, its role in predicting the mortality rate in patients underwent coronary artery bypass grafting surgery (CABG) has not been reported. In the current study we aimed to evaluate the relationship of dietary acid load and cardio-metabolic risk factors with ten year survival among patients underwent CABG.

Methods: The current prospective cohort study comprises 454 patients underwent CABG. Anthropometric, clinical and biochemical measurements were performed. Dietary acid load was calculated as either potential renal acid load (PRAL) or net endogenous acid production (NEPA) using the data obtained from a semi-quantitative food frequency questionnaire (FFQ). Survival analysis was performed using Kaplan-Meier method followed by log-rank test. The association between all-cause mortality and study parameters was performed with Cox-proportional hazard model.

Results: Patients in the higher PRAL and NEAP quartiles had lower BMI and lower ejection fraction rate (P <0.05). Moreover, lower hematocrit values were observed in patients of higher PRAL quartiles. Higher PRAL scores were associated with higher mortality rate and reduced survival days (adjusted hazard ratio: 1.023 (1.00-1.04; P-value = 0.01). However, there was no relationship between NEAP and survival.

Conclusions: We revealed that high PRAL scores are positive predictors of 10-year mortality in patients underwent CABG. The results of our study suggest that maintaining an adequate acid-base balance can contribute to longevity by reducing the risk of mortality.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0223830PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6797202PMC
March 2020

The interaction between dietary inflammatory index and 6 P21 rs2010963 gene variants in metabolic syndrome.

Eat Weight Disord 2020 Aug 13;25(4):1049-1060. Epub 2019 Jun 13.

Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Background: The Vascular endothelial growth factor (VEGF) regulates endothelial cell proliferation, migration and angiogenesis, promotes vascular and capillary permeability and also is involved in inflammation. VEGF gene has been suggested to play an important role in the pathogenesis of metabolic syndrome. The aim of this study was to investigate the association between inflammatory potential of a diet and + 405 VEGF C/G (rs2010963) polymorphism and metabolic components in patients with metabolic syndrome.

Methods: One hundred fifty patients with metabolic syndrome and fifty healthy individuals were enrolled. A semi-quantitative food-frequency questionnaire (FFQ) was used for dietary assessments and dietary inflammatory index (DII) calculation. Biochemical assays including fasting serum glucose (FSG), serum insulin, matrix metalloproteinase-3 (MMP-3), liver enzymes and lipid profile were measured. Polymerase chain reaction-restriction fragments length polymorphism (PCR-RFLP) method was used for the determination of gene polymorphism.

Results: In the current study, patients with metabolic syndrome had higher serum low density lipoprotein (LDL) and lower high density lipoprotein (HDL) concentrations compared with healthy subjects. Patients with lower DII quartiles and lower inflammatory potential of the diet had lower waist to hip ratio (WHR) and lower diastolic blood pressure (DBP) compared with patients in higher DII quartiles (P < 0.05). Moreover, patients and healthy subjects in second quartile of DII had significantly higher aspartate aminotransferase (AST) and alanine aminotransferase (ALT) concentrations compared with subjects in the first quartile; also healthy subjects in third quartile had significantly higher triglyceride (TG) and total cholesterol (TC) concentrations compared with subjects in second quartile (P < 0.05). Among different genotypes of 6 P21 rs2010963 gene variants in patients with metabolic syndrome, CC genotype indicated the highest DII compared with other genotypes (P < 0.05).

Conclusion: The current study revealed the association between DII and metabolic risk factors of metabolic syndrome.

Level Of Evidence: Level III, case-control analytic study.
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http://dx.doi.org/10.1007/s40519-019-00729-1DOI Listing
August 2020

Potential roles of carnitine in patients with polycystic ovary syndrome: a systematic review.

Gynecol Endocrinol 2019 Jun 26;35(6):463-469. Epub 2019 Feb 26.

c Nutrition Research Center, Faculty of Nutrition and Food Sciences , Tabriz University of Medical Sciences , Tabriz , Iran.

Polycystic ovary syndrome (PCOS) is recognized as the most prevalent endocrinopathy in reproductive-aged women. This systematic review was performed with focus on the current knowledge on carnitine concerning metabolic variables in PCOS. PubMed, Scopus, Embase, ClinicalTrials.gov and Google Scholar databases were searched from inception until May 2018. All clinical trials and observational studies published in English-language journals were eligible. Studies that provided insufficient outcomes, animal and in vitro studies were excluded. Out of 451 articles identified in our search, only six articles were eligible for analysis. Two observational studies evaluated the association of serum carnitine levels with metabolic variables, and four clinical trials examined the effect of carnitine supplementation in patients with PCOS. Serum carnitine levels had inverse relationship with glycemic status, body mass index (BMI) and waist circumference. Also, carnitine supplementation resulted in improved weight loss, glycemic status, oxidative stress, follicles and size of ovarian cells; no significant effects were reported on sex hormones and lipid profile. According to the current evidence, carnitine might improve weight loss, glycemic status and oxidative stress. However, to explore the exact mechanisms of carnitine role in patients with PCOS, further studies are recommended.
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http://dx.doi.org/10.1080/09513590.2019.1576616DOI Listing
June 2019
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