Publications by authors named "Saman Khalesi"

41 Publications

Effects of probiotic supplementation on anthropometric and metabolic characteristics in adults with metabolic syndrome: A systematic review and meta-analysis of randomized clinical trials.

Clin Nutr 2021 Jun 8;40(7):4662-4673. Epub 2021 Jun 8.

Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University, Ithaca, NY, USA. Electronic address:

Aims: We conducted a systematic review and meta-analysis to evaluate evidence from randomized controlled trials (RCTs) documenting the effectiveness of supplementation with pro-/synbiotics versus placebo controls on anthropometric and metabolic (glucoregulatory status, lipid profile) indices in adults with metabolic syndrome (MetS).

Methods: Databases of MEDLINE, Scopus, Embase, Web of Science, and Cochrane Library were searched through March 2020 to identify eligible RCTs evaluating the effects of pro-/synbiotic consumption in adults (≥18 years) with MetS. Mean differences (MDs) and 95% confidence intervals (CIs) were pooled using random-effects models.

Results: Ten eligible publications (9 RCTs, n = 344 participants) were included. Supplementation with pro-/synbiotics reduced total cholesterol (TC) in adults with MetS versus placebo (MD: -6.66 mg/dL, 95% CI: -13.25 to -0.07, P = 0.04, I = 28.8%, n = 7), without affecting weight, body mass index, waist circumference, fasting blood sugar, homeostasis model assessment for insulin resistance, insulin, triglyceride, low-density lipoprotein cholesterol, or high-density lipoprotein cholesterol (P > 0.05).

Conclusions: Pro-/synbiotic consumption may be beneficial in reducing TC levels in adults with MetS. However, our observations do not support the effectiveness of pro-/synbiotics consumption on other anthropometric or metabolic outcomes of MetS. Further investigations with larger sample sizes are required to confirm these findings.
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http://dx.doi.org/10.1016/j.clnu.2021.05.027DOI Listing
June 2021

The Relationship Between Diet and Sleep in Older Adults: a Narrative Review.

Curr Nutr Rep 2021 Jun 14. Epub 2021 Jun 14.

Physical Activity Research Group, Central Queensland University, 160 Ann St, Brisbane, QLD, 4000, Australia.

Purpose Of Review: Older adults more frequently experience reduced sleep quality and quantity compared to younger adults. Diet is one modifiable lifestyle factor that may influence sleep outcomes in older adults. The purpose of this review is to synthesise the current literature investigating the impact of diet, including foods and nutrients, on the sleep quality and quantity of older adults.

Recent Findings: Overall, the observational and intervention studies suggest that following a Mediterranean diet, and the consumption of certain food items (e.g. milk), and nutrients (e.g. vitamin D and vitamin E) may influence (improve or reduce) sleep quality and quantity. This review describes the potential efficacy for dietary factors to improve sleep outcomes in older adults. However, given the heterogeneity of included studies in this review (i.e. aims, methodologies, and outcomes assessed), it is difficult to consolidate the available evidence to make specific recommendations. More targeted research exploring the relationship between diet and sleep in older adults is needed to strengthen the current evidence base.
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http://dx.doi.org/10.1007/s13668-021-00362-4DOI Listing
June 2021

Willingness to Vaccinate against COVID-19 Declines in Australia, Except in Lockdown Areas.

Vaccines (Basel) 2021 May 10;9(5). Epub 2021 May 10.

Appleton Institute, Central Queensland University, Rockhampton 4701, Australia.

This study investigates changes in willingness to vaccinate against COVID-19 and the effect of the extended restrictions in metropolitan Victoria on this change. Longitudinal and repeated cross-sectional data were collected from online surveys distributed in April, between July and August, and December 2020. Australian adults who were ≥18 years old were recruited through email lists, social media networks, and paid Facebook advertisement. Willingness to vaccinate against COVID-19 was self-reported. The results showed that participants were more willing to vaccinate if the vaccine was safe at survey 1 (longitudinal: adjusted OR (aOR) = 1.88, 95%CI = 1.38, 2.56; cross-sectional: aOR = 3.73, 95%CI = 2.55, 5.45) and survey 2 (longitudinal: aOR = 1.54, 95%CI = 1.19, 2.00; cross-sectional: aOR = 2.48, 1.67, 3.67), compared to survey 3. The change in willingness to vaccinate if the vaccine was safe and effective was not significant for those in Metropolitan Victoria; but was for those living in other Australian locations at survey 1 (OR = 2.13, 95%CI = 1.64, 2.76) and survey 2 (OR = 1.62, 95%CI = 1.30, 2.01), compared to survey 3. Willingness to vaccinate even if a vaccine had not been proven safe decreased at survey 3 (OR = 2.02, 95%CI = 1.14, 3.57) for those living in Metropolitan Victoria. In conclusion willingness to vaccinate against COVID-19 decreased over time among Australians, except for those living in metropolitan Victoria, where an additional strict and prolonged lockdown was implemented around the time of survey 2. Either the experience of the lockdown, or the presence of the COVID-19 virus itself had a positive influence on participants' willingness to vaccinate, even if such a vaccine was not yet proven to be safe and effective.
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http://dx.doi.org/10.3390/vaccines9050479DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8150580PMC
May 2021

Associations between health behaviors and mental health in Australian nursing students.

Nurse Educ Pract 2021 May 16;53:103084. Epub 2021 May 16.

Physical Activity Research Group, Appleton Institute, School of Health Medical and Applied Sciences, CQUniversity, Rockhampton, Australia. Electronic address:

Aim: Nursing students experience high levels of stress, anxiety and depression. This study examined associations between health behaviors and stress, anxiety and depression in Australian nursing students.

Design: this was a cross-sectional study.

Methods: Participants completed an online survey providing demographic information and responses to the 21-item Depression Anxiety Stress Scale, Fagerström Test for Nicotine Dependence, short Food Frequency Questionnaire, Alcohol Use Disorders Identification Test, International Physical Activity Questionnaire and Workforce Sitting Questionnaire. Associations were evaluated using multivariate linear regression.

Results: Mild to extremely severe stress (46.6%), anxiety (52.8%) and depression (42.2%) were prevalent. Intake of snack-foods was associated with higher depression (β = 8.66, p < 0.05) and stress (β = 3.92, p = 0.055) scores. More time spent sitting was associated with higher depression (β = 0.48, p < 0.001) and stress (β = 0.28, p < 0.05) scores. Skipping meals correlated with higher stress, anxiety and depression scores.

Conclusion: More support must be provided to nursing students to manage psychological distress and mental health during university study.
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http://dx.doi.org/10.1016/j.nepr.2021.103084DOI Listing
May 2021

Effect of synbiotic supplementation on migraine characteristics and inflammatory biomarkers in women with migraine: Results of a randomized controlled trial.

Pharmacol Res 2021 Jul 12;169:105668. Epub 2021 May 12.

Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Iran. Electronic address:

Literature suggests a relationship between gut microbiome and migraine headache pathogenesis. However, the effect of manipulating gut microbiome on migraine remains unclear. This study aimed to investigate the effect of synbiotics on migraine characteristics and inflammatory markers in women with migraines. Sixty-nine participants completed a randomized double-blind controlled trial, receiving synbiotic (10 CFU of 12 types of probiotics + fructooligosaccharides prebiotic) or placebo supplementation, twice per day for 12 weeks. Migraine severity, migraine days per month, frequency and duration of attacks, number of painkillers consumed, gastrointestinal problems, serum High sensitive C-Reactive Protein (Hs-CRP) (a marker of inflammation) and zonulin (a marker of gut permeability) levels were measured at baseline and the end of the intervention. Bivariate comparison and intention-to-treat (ITT) were used for analysis. Synbiotic supplementation compare to the placebo resulted in a significant reduction in the mean frequency of migraine attacks (-1.02 vs -0.30, respectively, P = 0.011), percentage change of the number of painkillers used (-7.5% vs 27.5%, respectively, P = 0.008) and gastrointestinal problems (-35% vs -2.5%, respectively, P = 0.005), zonulin level (-4.12 vs 0.85 ng/ml, respectively, P = 0.034), and Hs-CRP level (-0.43 vs -0.09 mg/l, respectively, P = 0.022). Reduction in the migraine severity and duration did not reach a statistically significant level. Synbiotic supplementation may be considered as a complementary treatment for women with migraines to improve migraine characteristics and markers of inflammation and gut permeability and reduce the burden of disease.
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http://dx.doi.org/10.1016/j.phrs.2021.105668DOI Listing
July 2021

Associations between health-related quality of life and health behaviors in Australian nursing students.

Nurs Health Sci 2021 Jun 15;23(2):477-489. Epub 2021 Apr 15.

Physical Activity Research Group, Appleton Institute, School of Health Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia.

Health-related quality of life (HRQoL) is being increasingly studied as an indicator of wellbeing. This study evaluated the HRQoL of nursing students and relationships between lifestyle behaviors including smoking, diet, alcohol intake and physical activity. A cross-sectional study was conducted in 2018 using the Short-Form 12V2 to measure the HRQoL of 475 students from both regional and metropolitan universities in Queensland, Australia. z-scores were aggregated into a Physical Composite Score (PCS) and a Mental Composite Score (MCS). Multivariate linear regression was used to explore the associations. Nursing students (94.5% female) had lower HRQoL scores relative to the general Australian population. Students enrolled at the regional university, with higher income; higher intakes of vitamin A, calcium, and iodine; and more physical activity had a higher Mental Composite Score, but those with health conditions and high intakes of meat, fat, carbohydrates, and sugar reported lower Physical Composite Score compared to their counterparts. Skipping breakfast, physical inactivity, and alcohol score were inversely associated with HRQoL. This study highlights the need for strategies to address the poor lifestyle and HRQoL in nursing students to support their physical and mental health.
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http://dx.doi.org/10.1111/nhs.12832DOI Listing
June 2021

The effect of probiotic fermented milk products on blood lipid concentrations: A systematic review and meta-analysis of randomized controlled trials.

Nutr Metab Cardiovasc Dis 2021 04 31;31(4):997-1015. Epub 2020 Dec 31.

Student Research Committee, Department of Community Nutrition, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Aim: Fermented milk products are suggested as a supplementary therapy to help reduce blood lipid levels. However, the results of clinical studies are conflicting.

Data Synthesis: This study systematically reviewed 39 randomized controlled trials (n = 2237 participants) to investigate the effect of probiotic fermented milk products on blood lipids. A meta-analysis was performed using random effects models, with weighted mean differences (WMDs) and 95% confidence interval (CI). Statistically significant reductions in blood low-density lipoprotein cholesterol (LDL-C) (WMD: -7.34 mg/dL, 95% CI: from -10.04 to -4.65, and P < 0.001) and total cholesterol (TC) concentrations (WMD: -8.30 mg/dL, 95% CI: from -11.42 to -5.18, and P < 0.001) were observed. No statistically significant effect of probiotic fermented milk was observed on blood high-density lipoprotein cholesterol (HDL-C) and triacylglycerol (TAG) levels. The effect on TC and LDL-C level was more pronounced in men, and a greater reduction in TAG was observed in trials with longer interventions (≥8 weeks) as compared to their counterparts.

Conclusions: Available evidence suggests that probiotic fermented milk products may help to reduce serum TC and LDL-C cholesterol levels, particularly in men and when they are consumed for ≥8 weeks.
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http://dx.doi.org/10.1016/j.numecd.2020.12.023DOI Listing
April 2021

Analysis of dietary intake, diet cost and food group expenditure from a 24-hour food record collected in a sample of Australian university students.

Nutr Diet 2021 04 2;78(2):174-182. Epub 2021 Feb 2.

School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia.

Aim: University students often cite increased monetary cost as a major barrier to improved eating behaviours. Here, we examine food expenditure behaviours in a sample of Australian university students.

Methods: Students (n = 147) collected and analysed a 24-hour food record to determine their food group and nutrient intakes, then costed the food and non-tap water beverages consumed in the amounts recorded. Diet cost and food group expenditure (absolute and relative to total diet cost) were calculated and compared across socio-demographic characteristics. Spearman's Rho correlations and partial correlations (controlling for energy intake) were also used to identify associations between diet cost and intake.

Results: The median (IQR) 24-hour diet cost was $12.42 ($7.06). However, students who worked ≥20 h·wk had a higher diet cost than those who worked <20 h·wk (P = .002) or were unemployed (P = .002). Relative food group expenditure also differed by sex, employment status and whether special dietary requirements were reported (P's < .05). For instance, males reported spending a smaller relative amount on the fruit and vegetables food groups and a larger relative amount on discretionary choices than females (P's < 0.05). Higher diet costs were also associated with greater intakes of the fruit, vegetables and lean meat and alternatives food groups, protein, alcohol, water and calcium, and lower intakes of the grain foods food group and carbohydrate (P's < .05).

Conclusions: These findings provide insight into university students' food expenditure behaviours and may assist health professionals to develop targeted strategies and tailored advice aimed at improving their dietary behaviours.
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http://dx.doi.org/10.1111/1747-0080.12662DOI Listing
April 2021

The Discrepancy between Knowledge of Sleep Recommendations and the Actual Sleep Behaviour of Australian Adults.

Behav Sleep Med 2021 Jan 25:1-12. Epub 2021 Jan 25.

Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide, Australia.

: Inadequate sleep is a major public health concern, with large economic, health, and operational costs to Australia. Despite the implementation of public sleep health campaigns, approximately 40% of Australian adults do not obtain the recommended 7-9 hours of sleep. Thus, while people may know how much sleep is required, this knowledge may not be adequately translated to actual sleep behavior. Consequently, this study aims to examine the discrepancy between knowledge of sleep recommendations and self-reported sleep behaviors.: A sample of 1265 Australian adults (54% female, aged 18-65) completed a phone interview as part of the 2017 National Social Survey and were asked questions about their knowledge of sleep guidelines and their actual sleep behavior. Binary logistic regression was used to determine the factors associated with awareness of sleep recommendations and whether this corresponded with reported sleep duration.: The final sample size was 998. Although 94% of the sample were aware of current sleep recommendations, 23% of participants did not self-report regularly obtaining 7-9 h sleep per night. These participants were less likely to want to obtain more sleep, less likely to view sleep as a priority before stressful events, and less likely to self-report good health.: Although a majority of the sample were aware of sleep recommendations, almost a quarter of the participants' behavior did not align with their knowledge. Future sleep health campaigns should consider options beyond education, including emphasis on practical strategies and modifiable lifestyle factors to assist individuals to obtain the recommended amount of sleep.
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http://dx.doi.org/10.1080/15402002.2021.1876693DOI Listing
January 2021

As the Pandemic Progresses, How Does Willingness to Vaccinate against COVID-19 Evolve?

Int J Environ Res Public Health 2021 Jan 19;18(2). Epub 2021 Jan 19.

School of Health, Medical and Applied Sciences, Building 7, Central Queensland University, Bruce Highway, Rockhampton, QLD 4702, Australia.

Controversy around the safety and efficacy of COVID-19 vaccines may lead to low vaccination rates. Survey data were collected in April and August 2020 from a total of 2343 Australian adults. A quarter ( = 575, 24%) completed both surveys. A generalized linear mixed model analysis was conducted to determine whether willingness to vaccinate changed in the repeated sample, and a multinominal logistic regression was conducted in all participants to determine whether willingness to vaccinate was associated with demographics, chronic disease, or media use. Willingness to vaccinate slightly decreased between April (87%) and August (85%) but this was not significant. Willingness to vaccinate was lower in people with a certificate or diploma (79%) compared to those with a Bachelor degree (87%), < 0.01 and lower in infrequent users of traditional media (78%) compared to frequent users of traditional media (89%), < 0.001. Women were more likely to be unsure if they would be willing to vaccinate (10%) compared to men (7%), < 0.01. There were no associations between willingness to vaccinate and age, chronic disease, or social media use. Promotion of a COVID-19 vaccine should consider targeting women, and people with a certificate or diploma, via non-traditional media channels.
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http://dx.doi.org/10.3390/ijerph18020797DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7832839PMC
January 2021

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

Clin Nutr 2021 Apr 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

Barriers to healthy lifestyle behaviors in Australian nursing students: A qualitative study.

Nurs Health Sci 2020 Dec 22;22(4):921-928. Epub 2020 Jul 22.

School of Health Medical and Applied Sciences, Central Queensland University, Brisbane, Queensland, Australia.

Studying at university is stressful, which can lead to unhealthy lifestyle behaviors. This study aimed to explore perceived reasons and barriers preventing Australian nursing students from engaging in a healthy lifestyle and strategies to overcome barriers. Fifty-four bachelor of nursing students participated in seven focus groups between July and November 2018. Participants defined healthy lifestyle behaviors as eating well; regular physical activity; regular water consumption; limiting alcohol, caffeine, and nicotine; good sleep quality; stress management and relaxation; and regular social interaction and support. They identified individual (lack of motivation, existing bad habits, lack of knowledge), environmental (time, finances, limited access to healthy food and physical activity resources), and psychosocial (competing priorities, increased learning cognitive load, lack of social interaction and support, compassion fatigue, and shift work) barriers preventing healthy lifestyle. Participants proposed several individual and system-related strategies to overcome barriers. Despite portraying a comprehensive understanding of healthy lifestyle behaviors, students reported finding difficulty in attaining healthy lifestyles. Strategies proposed by students may inform targeted interventions aiming to increase overall health of students, reduce attrition rates, and promote workforce retention post-graduation.
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http://dx.doi.org/10.1111/nhs.12749DOI Listing
December 2020

Depression, Anxiety and Stress during COVID-19: Associations with Changes in Physical Activity, Sleep, Tobacco and Alcohol Use in Australian Adults.

Int J Environ Res Public Health 2020 Jun 7;17(11). Epub 2020 Jun 7.

School of Health, Medical and Applied Sciences, Central Queensland University, Bruce Highway, Rockhampton, Queensland 4702, Australia.

The novel coronavirus (COVID-19) has enforced dramatic changes to daily living including economic and health impacts. Evidence for the impact of these changes on our physical and mental health and health behaviors is limited. We examined the associations between psychological distress and changes in selected health behaviors since the onset of COVID-19 in Australia. An online survey was distributed in April 2020 and included measures of depression, anxiety, stress, physical activity, sleep, alcohol intake and cigarette smoking. The survey was completed by 1491 adults (mean age 50.5 ± 14.9 years, 67% female). Negative change was reported for physical activity (48.9%), sleep (40.7%), alcohol (26.6%) and smoking (6.9%) since the onset of the COVID-19 pandemic. Significantly higher scores in one or more psychological distress states were found for females, and those not in a relationship, in the lowest income category, aged 18-45 years, or with a chronic illness. Negative changes in physical activity, sleep, smoking and alcohol intake were associated with higher depression, anxiety and stress symptoms. Health-promotion strategies directed at adopting or maintaining positive health-related behaviors should be utilized to address increases in psychological distress during the pandemic. Ongoing evaluation of the impact of lifestyle changes associated with the pandemic is needed.
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http://dx.doi.org/10.3390/ijerph17114065DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7312903PMC
June 2020

Effects of probiotics and paraprobiotics on subjective and objective sleep metrics: a systematic review and meta-analysis.

Eur J Clin Nutr 2020 11 20;74(11):1536-1549. Epub 2020 May 20.

Physical Activity Research Group, Appleton Institute & School of Health Medical and Applied Sciences, Central Queensland University, Brisbane, QLD, Australia.

Inadequate sleep (i.e., duration and/or quality) is becoming increasingly recognized as a global public health issue. Interaction via the gut-brain axis suggests that modification of the gut microbial environment via supplementation with live microorganisms (probiotics) or nonviable microorganisms/microbial cell fractions (paraprobiotics) may improve sleep health. This systematic review and meta-analysis aimed to clarify the effect of consuming probiotics/paraprobiotics on subjective and objective sleep metrics. Online databases were searched from 1980 to October 2019 for studies involving adults who consumed probiotics or paraprobiotics in controlled trials, during which, changes in subjective and/or objective sleep parameters were examined. A total of 14 studies (20 trials) were included in meta-analysis. Random effects meta-analyses indicated that probiotics/paraprobiotics supplementation significantly reduced Pittsburgh Sleep Quality Index (PSQI) score (i.e., improved sleep quality) relative to baseline (-0.78-points, 95% confidence interval: 0.395-1.166; p < 0.001). No significant effect was found for changes on other subjective sleep scales, nor objective parameters of sleep (efficiency/latency) measured using polysomnography or actigraphy. Subgroup analysis for PSQI data suggested that the magnitude of the effect was greater (although not statistically) in healthy participants than those with a medical condition, when treatment contained a single (rather than multiple) strain of probiotic bacteria, and when the duration of treatment was ≥8 weeks. Probiotics/paraprobiotics supplementation may have some efficacy in improving perceived sleep health, measured using the PSQI. While current evidence does not support a benefit of consuming probiotics/paraprobiotics when measured by other subjective sleep scales, nor objective measures of sleep; more studies using well-controlled, within-subject experimental designs are needed.
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http://dx.doi.org/10.1038/s41430-020-0656-xDOI Listing
November 2020

Consumption of a smoothie or cereal-based breakfast: impact on thirst, hunger, appetite and subsequent dietary intake.

Int J Food Sci Nutr 2021 Feb 18;72(1):123-133. Epub 2020 May 18.

School of Allied Health Sciences and Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.

Smoothies are a popular breakfast option. However, liquids may evoke weaker satiation than nutritionally comparable semi-solid and solid foods. This study examined consumption of cereal and milk (CM) or a nutritionally comparable fruit smoothie (FS) for breakfast on subsequent dietary behaviours, in a controlled laboratory setting. Twenty-five participants (age 25 ± 6 y) completed three trials, receiving either CM or FS for breakfast. Afterwards, participants remained isolated for 4 h with access to foods/beverages. A repeat trial (CM or FS) allowed exploration of normal variability. Post-breakfast energy intake (EI) (CM = 1465(2436) vs. FS = 1787(3190) kJ, Median (IQR),  = 0.099), time to intake of next food/fluid (meal latency) (CM = 146(97) vs. FS = 180(100) min,  = 0.127), and subjective hunger, desire to eat, fullness and thirst ratings were similar between conditions ( > 0.05). The mean coefficient of variation for EI and meal latency were 41% and 21%, respectively. Consumption of a FS does not negatively impact acute EI and meal latency.
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http://dx.doi.org/10.1080/09637486.2020.1767041DOI Listing
February 2021

Hot, Tired and Hungry: The Snacking Behaviour and Food Cravings of Firefighters During Multi-Day Simulated Wildfire Suppression.

Nutrients 2020 Apr 21;12(4). Epub 2020 Apr 21.

School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide 5034, Australia.

Firefighters are exposed to numerous stressors during wildfire suppression, including working in hot temperatures and sleep restricted conditions. Research has shown that when sleep restricted, individuals choose foods higher in carbohydrates, fat, and sugar, and have increased cravings for calorie dense foods. However, there is currently no research on the combined effect of heat and sleep restriction on snacking behaviour. Conducting secondary analyses from a larger study, the current study aimed to investigate the impact of heat and sleep restriction on snacking behaviour and food cravings. Sixty-six firefighters completed three days of simulated physically demanding firefighting work and were randomly allocated to either the control ( = 18, CON; 19 °C, 8h sleep opportunity), sleep restricted ( = 16, SR; 19 °C, 4-h sleep opportunity), hot ( = 18, HOT; 33 °C, 8h sleep opportunity), or hot and sleep restricted ( = 14 HOT + SR; 33 °C, 4-h sleep opportunity) condition. During rest periods firefighters were able to self-select sweet, savoury, or healthy snacks from a ration pack and were asked to rate their hunger, fullness, and cravings every two hours (eating block). Mixed model analyses revealed no difference in total energy intake between conditions, however there was a significant interaction between eating block and condition, with those in the CON, HOT, and HOT + SR condition consuming significantly more energy between 1230 and 1430 compared to the SR condition ( = 0.002). Sleep restriction and heat did not impact feelings of hunger and fullness across the day, and did not lead to greater cravings for snacks, with no differences between conditions. These findings suggest that under various simulated firefighting conditions, it is not the amount of food that differs but the timing of food intake, with those that are required to work in hot conditions while sleep restricted more likely to consume food between 1230 and 1430. This has potential implications for the time of day in which a greater amount of food should be available for firefighters.
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http://dx.doi.org/10.3390/nu12041160DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230571PMC
April 2020

Effects of synbiotic consumption on lipid profile: a systematic review and meta-analysis of randomized controlled clinical trials.

Eur J Nutr 2020 Oct 22;59(7):2857-2874. Epub 2020 Apr 22.

Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Background And Aims: Existing evidence on the possible effects of synbiotics on lipid profile is inconclusive. The aim of the present systematic review was to clarify the effects of synbiotics consumption on lipid profile.

Methods: A systematic literature search of online databases PubMed, Scopus, ISI Web of science, Cochrane's library and Google Scholar was conducted up to January 2019. Randomized controlled trials (RCTs) investigating the effects of synbiotics on lipid profile in adults were included. The overall effect was presented as weighted mean difference (WMD) and 95% confidence interval (CI) in a random-effects meta-analysis model.

Results: A total of 23 RCTs with 1338 participants were included. Synbiotic consumption resulted in a significant decrease in plasma concentrations of total cholesterol (WMD = - 10.17 mg/dL; 95% CI - 15.74 to - 4.60; p < 0.001), triglyceride (WMD = - 14.30 mg/dL; 95% CI - 25.32 to - 3.28; p = 0.01), low-density lipoprotein cholesterol (WMD  = - 8.32 mg/dL; 95% CI - 13.21 to - 3.43; p < 0.001), and an increase in plasma high-density lipoprotein cholesterol (WMD = 1.3 mg/dL; 95% CI 0.03 to 2.56; p = 0.04) levels compared to control (placebo supplements/control foods/conventional products). The effects are more pronounced when synbiotics supplements are consumed for > 8 weeks.

Conclusion: Synbiotic supplements may be beneficial to improve lipid profile, especially when they are consumed for > 8 weeks.
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http://dx.doi.org/10.1007/s00394-020-02248-7DOI Listing
October 2020

Effects of Diet on Sleep: A Narrative Review.

Nutrients 2020 Mar 27;12(4). Epub 2020 Mar 27.

Central Queensland University, School of Health, Medical and Applied Sciences and Appleton Institute, Brisbane 4000, Queensland, Australia.

Many processes are involved in sleep regulation, including the ingestion of nutrients, suggesting a link between diet and sleep. Aside from studies investigating the effects of tryptophan, previous research on sleep and diet has primarily focused on the effects of sleep deprivation or sleep restriction on diet. Furthermore, previous reviews have included subjects with clinically diagnosed sleep-related disorders. The current narrative review aimed to clarify findings on sleep-promoting foods and outline the effects of diet on sleep in otherwise healthy adults. A search was undertaken in August 2019 from the Cochrane, MEDLINE (PubMed), and CINAHL databases using the population, intervention, control, outcome (PICO) method. Eligible studies were classified based on emerging themes and reviewed using narrative synthesis. Four themes emerged: tryptophan consumption and tryptophan depletion, dietary supplements, food items, and macronutrients. High carbohydrate diets, and foods containing tryptophan, melatonin, and phytonutrients (e.g., cherries), were linked to improved sleep outcomes. The authors posit that these effects may be due in part to dietary influences on serotonin and melatonin activity.
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http://dx.doi.org/10.3390/nu12040936DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230229PMC
March 2020

Effects of acute caffeine consumption following sleep loss on cognitive, physical, occupational and driving performance: A systematic review and meta-analysis.

Neurosci Biobehav Rev 2020 01 16;108:877-888. Epub 2019 Dec 16.

School of Allied Health Sciences, Griffith University, Gold Coast, Australia.

Caffeine is widely used to counteract the effects of sleep loss. This systematic review and meta-analysis examined the impact of acute caffeine consumption on cognitive, physical, occupational and driving performance in sleep deprived/restricted individuals. 45 publications providing 327 effect estimates (EEs) were included in the review. Caffeine improved response time (44 EEs; g = 0.86; 95 % CI: 0.53-0.83) and accuracy (27 EEs; g = 0.68; 95 % CI: 0.48-0.88) on attention tests, improved executive function (38 EEs; g = 0.35; 95 % CI: 0.15-0.55), improved reaction time (12 EEs; g = 1.11; 95 % CI: 0.75-1.47), improved response time (20 EEs; g = 1.95; 95 % CI: 1.39-2.52) and accuracy (34 EEs; g = 0.43; 95 % CI: 0.30-0.55) on information processing tasks, and enhanced lateral (29 EEs; g = 1.67; 95 % CI: 1.32-2.02) and longitudinal (12 EEs; g = 1.60; 95 % CI: 1.16-2.03) measures of vehicular control on driving tests. Studies also typically indicated benefit of caffeine on memory (25 EEs), crystallized intelligence (11 EEs), physical (39 EEs) and occupational (36 EEs) performance. Ingestion of caffeine is an effective counter-measure to the cognitive and physical impairments associated with sleep loss.
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http://dx.doi.org/10.1016/j.neubiorev.2019.12.008DOI Listing
January 2020

Healthy Dietary Patterns and Incidence of CKD: A Meta-Analysis of Cohort Studies.

Clin J Am Soc Nephrol 2019 10 24;14(10):1441-1449. Epub 2019 Sep 24.

Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia.

Background And Objectives: Whether a healthy dietary pattern may prevent the incidence of developing CKD is unknown. This study evaluated the associations between dietary patterns and the incidence of CKD in adults and children.

Design, Setting, Participants, & Measurements: This systematic review and meta-analysis identified potential studies through a systematic search of MEDLINE, Embase and references from eligible studies from database inception to February 2019. Eligible studies were prospective and retrospective cohort studies including adults and children without CKD, where the primary exposure was dietary patterns. To be eligible, studies had to report on the primary outcome, incidence of CKD (eGFR<60 ml/min per 1.73 m). Two authors independently extracted data, assessed risk of bias and evidence certainty using the Newcastle-Ottawa scale and GRADE.

Results: Eighteen prospective cohort studies involving 630,108 adults (no children) with a mean follow-up of 10.4±7.4 years were eligible for analysis. Included studies had an overall low risk of bias. The evidence certainty was moderate for CKD incidence and low for eGFR decline (percentage drop from baseline or reduced by at least 3 ml/min per 1.73 m per year) and incident albuminuria. Healthy dietary patterns typically encouraged higher intakes of vegetables, fruit, legumes, nuts, whole grains, fish and low-fat dairy, and lower intakes of red and processed meats, sodium, and sugar-sweetened beverages. A healthy dietary pattern was associated with a lower incidence of CKD (odds ratio [OR] 0.70 (95% confidence interval [95% CI], 0.60 to 0.82); =51%; eight studies), and incidence of albuminuria (OR 0.77, [95% CI, 0.59 to 0.99]; =37%); four studies). There appeared to be no significant association between healthy dietary patterns and eGFR decline (OR 0.70 [95% CI, 0.49 to 1.01], =49%; four studies).

Conclusions: A healthy dietary pattern may prevent CKD and albuminuria.
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http://dx.doi.org/10.2215/CJN.00530119DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6777603PMC
October 2019

Association between dietary patterns and sociodemographics: A cross-sectional study of Australian nursing students.

Nurs Health Sci 2020 Mar 30;22(1):38-48. Epub 2019 Aug 30.

Appleton Institute, School of Health Medical and Applied Sciences, Brisbane, Queensland, Australia.

Lack of time, financial issues, and stressful clinical and educational environments in nursing studies promote higher intakes of convenience and fast foods loaded with fat and sugar, which are linked to reduced mental and physical health. In this study, we examined the dietary patterns of nursing students and their associated sociodemographic factors to inform the development of future health-promotion interventions. A total of 548 Bachelor of Nursing students were invited to complete a survey. Associations were explored using χ and logistic regression. Three dietary patterns were identified: healthy (fruit, vegetables, and legumes), Western (loaded with fat, sugar, and salt), and unbalanced. Only 21% of participants were classified as following a healthy dietary pattern, and more likely to be older (>35 years old) and have a personal annual income between $AUD20 000-$59 999 and $60 000-$99 999. Students with one to two and three or more children were more likely to follow a Western dietary pattern. There is a need to develop interventions to improve the dietary behaviors of nursing students by health-promoting activities and the provision of online health resources.
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http://dx.doi.org/10.1111/nhs.12643DOI Listing
March 2020

Oral administration of Lactobacillus casei Shirota can ameliorate the adverse effect of an acute aflatoxin exposure in Sprague Dawley rats.

Int J Vitam Nutr Res 2018 Jun 6;88(3-4):199-208. Epub 2019 May 6.

3 Physical Activity Research Group, Appleton Institute and School of Health, Medical and Applied Sciences, Central Queensland University, Brisbane, Australia.

Aflatoxin B(AFB) is a toxic compound commonly found in some crops with an adverse health effect on human and animals. Some beneficial microorganisms (or probiotics) such as lactic acid bacteria have shown the ability to reduce the bioavailability of aflatoxins and its intestinal absorption. However, the dose and duration of aflatoxins exposure and probiotic treatment can influence the ability of probiotics to remove aflatoxins. Therefore, this research aimed to investigate the efficacy of oral probiotic Shirota strain (LcS) induction in an acute exposure to AFB in rats. Experimentally, Sprague Dawley rats were divided into three groups: AFB only (n = 9); AFB treated with LcS (n = 9); and control (no AFB exposure) (n = 6) groups. The blood AFB level of rats treated with LcS was slightly lower than the untreated AFB induced rats (11.12 ± 0.71 vs 10.93 ± 0.69 ng g). Also, LcS treatment slightly moderated the liver and kidney biomarkers in AFB induced rats. However, a trend for a significant difference was only observed in ALT of AFB induced rats treated with LcS compared to their counterparts (126.11 ± 36.90 vs 157.36 ± 15.46, = 0.06). Rats' body weight decreased in all animals force-fed with AFB with no significant difference between LcS treatment compared to the counterpart. In conclusion, this experiment indicated that probiotic LsC was able to slightly ameliorate the adverse effect of an acute exposure to AFB in rats. However, future studies with longer probiotics treatment or higher probiotics dose is required to confirm these findings.
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http://dx.doi.org/10.1024/0300-9831/a000513DOI Listing
June 2018

Effect of probiotics and synbiotics on selected anthropometric and biochemical measures in women with polycystic ovary syndrome: a systematic review and meta-analysis.

Eur J Clin Nutr 2020 04 3;74(4):543-547. Epub 2019 May 3.

School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

This study aimed to systematically review randomized clinical trials (RCTs) to clarify the effects of pro-/synbiotic supplementation on anthropometric and biochemical measurements in women with polycystic ovary syndrome (PCOS). PubMed, Scopus, ISI Web of Science, Cochrane Library, and Google Scholar were searched through September 2018. Eight RCTs (nine treatment arms) were included. Pro-/synbiotic supplementation significantly reduced fasting blood sugar (-2.52 mg/dl, 95% confidence interval (CI): -4.10 to -0.95), insulin (-2.27 µIU/mL, 95% CI: -3.40 to -1.14), homeostasis model assessment for insulin resistance index (-0.69, 95% CI: -0.98 to -0.40), C-reactive protein (-1.69 Hedges', 95% CI: -3.00 to -0.38), and total testosterone (-0.12 ng/mL, 95% CI: -0.17 to -0.08) in women with PCOS. However, changes in the mean difference of weight and body mass index did not reach a statistically significant level. The findings suggest that pro-/synbiotic supplementation may improve glucose homeostasis parameters, hormonal, and inflammatory indices in women with PCOS.
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http://dx.doi.org/10.1038/s41430-019-0434-9DOI Listing
April 2020

Challenges following a personalised diet adhering to dietary guidelines in a sample of Australian university students.

Nutr Health 2019 Sep 11;25(3):185-194. Epub 2019 Apr 11.

School of Allied Health Sciences, Griffith University, Gold Coast, Australia.

Background: Food-based dietary guidelines are designed to support populations to adopt a healthy diet. University students studying nutrition related courses are typically en-route to professional roles that involve advocating a healthy diet.

Aim: The present study compared the dietary intake of university students enrolled in a foundation nutrition course against the Australian Dietary Guidelines (ADGs) and Nutrient Reference Values (NRVs), and explored students' experiences of following a 3-day self-determined diet plan adhering to the ADGs/NRVs.

Methods: Students ( = 115) initially collected, and subsequently analysed a 3-day prospective diet record to determine food group/nutrient intake. Individuals then modified their diet to comply with recommendations (ADGs/NRVs) and attempted to implement the diet plan. Challenges associated with meeting the ADGs/NRVs were described in an online survey form.

Results: Baseline food group and nutrient intakes deviated from the guidelines, with 'lean meats & alternatives' the only group consumed in recommended quantities. Students demonstrated the capacity to plan a modified personal diet adhering to the ADGs food group recommendations. However, when following this, several key challenges to dietary adherence were identified. Challenges were categorised as personal/behavioural factors (e.g. the quantity/type of food) and societal factors (e.g. time, cost, social factors).

Conclusion: Overall, this study highlights challenges influencing adherence to dietary guidelines in a sample of undergraduate university students. Understanding these factors may help tailor advice to facilitate improved dietary patterns in this population group.
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http://dx.doi.org/10.1177/0260106019841247DOI Listing
September 2019

The influence of a fruit smoothie or cereal and milk breakfast on subsequent dietary intake: a pilot study.

Int J Food Sci Nutr 2019 Aug 2;70(5):612-622. Epub 2019 Jan 2.

a School of Allied Health Sciences , Griffith University , Southport , Australia.

Smoothies are popular breakfast foods. This study examined the effect of consuming Cereal & Milk (CM) or a nutritionally-comparable Fruit Smoothie (FS) for breakfast on daily energy intake (EI) in free-living adults and the extent to which individuals compensated for calories ingested in a High Energy Fruit Smoothie (HE). Ten participants (28.4 ± 2.2y; 23.3 ± 1.0 kg·m , Mean ± SEM) attended the laboratory on 3 consecutive days per week for 3 weeks. Each week, they received a CM, FS or HE breakfast, then recorded all food/beverages consumed across the remainder of the day. The CM and FS were energy-matched to participants' usual breakfast (1675 ± 283 kJ), while the HE contained an additional 100 kJ·kg of maltodextrin (3019 ± 335 kJ). Mean 3-day EI was similar on CM and FS (7894 ± 547 vs. 7570 ± 463 kJ,  > .05), but elevated on HE (8861 ± 726 kJ,  =  .012). Thus, individuals who substitute CM for a FS breakfast should be mindful that energy-dense beverages may result in increased daily EI.
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http://dx.doi.org/10.1080/09637486.2018.1547690DOI Listing
August 2019

A review of probiotic supplementation in healthy adults: helpful or hype?

Eur J Clin Nutr 2019 01 26;73(1):24-37. Epub 2018 Mar 26.

Menzies Health Institute, School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.

Probiotic supplements have a positive impact on several health outcomes. However, the majority of published studies have focused on populations with specific health pathologies. Therefore, this study reviewed the current literature on the health effects of probiotic consumption in "healthy adults." The findings from this review may help guide consumers, researchers, and manufacturers regarding probiotic supplementation. Relevant literature published between 1990 and August 2017 was reviewed. Studies were included if they were experimental trials, included healthy adults, used live bacteria, and had accessible full-text articles published in English. Included studies were classified according to common foci that emerged. Forty-five studies were included in this review. Five foci emerged: gut microbiota changes (n = 15); immune system response (n = 16); lipid profile and cardiovascular disease risk (n = 14); gastrointestinal discomfort (n = 11); and female reproductive health (n = 4). Results suggest that probiotic supplementation in healthy adults can lead to transient improvement in gut microbiota concentration of supplement-specific bacteria. Evidence also supports the role of probiotics in improving immune system responses, stool consistency, bowel movement, and vaginal lactobacilli concentration. There is insufficient evidence to support the role of probiotics to improve blood lipid profile. Probiotic consumption can improve in the immune, gastrointestinal, and female reproductive health systems in healthy adults. However, this review failed to support the ability of probiotics to cause persistent changes in gut microbiota, or improve lipid profile in healthy adults. The feasibility of probiotics consumption to provide benefits in healthy adults requires further investigation.
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http://dx.doi.org/10.1038/s41430-018-0135-9DOI Listing
January 2019

Lifestyle and self-management determinants of hypertension control in a sample of Australian adults.

Expert Rev Cardiovasc Ther 2018 Mar 5;16(3):229-236. Epub 2018 Feb 5.

c Menzies Health Institute Queensland and School of Medicine , Griffith University , Gold Coast , Australia.

Background: Poor hypertension control can increase the risk of cardiovascular, renal and kidney diseases, and increase the social and economic burden of the disease.

Methods: This study aimed to explore the lifestyle and self-management skills (medication adherence, self-monitoring, self-efficacy) determinants of hypertension control in a sample of hypertensive Australians. In a cross-sectional design, a total of 233 hypertensive adults completed a survey. Hypertension control was categorised as good control if hypertensive individuals managed to reduce their blood pressure (BP) < 140/90 mmHg, otherwise it was categorised as poor control. Data were analysed using bivariate analysis and hierarchical logistic regression.

Results: 55% of the participants had poor BP control. A significantly higher frequency of poor BP self-monitoring was observed in individuals with poor control compared to their counterparts. Poor self-monitoring and a sedentary lifestyle were associated with higher odds of poor control (OR: 5.33, 95% CI: 1.78 - 15.93; p < 0.01, and OR: 4.69, 95% CI: 1.00 - 22.25; p < 0.05, respectively). No significant association was observed between other variables and hypertension control.

Conclusion: Successful BP control for hypertensive individuals may require interventions and strategies that assist with improving BP self-monitoring skills and increasing physical activity.
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http://dx.doi.org/10.1080/14779072.2018.1435272DOI Listing
March 2018

Effect of probiotics and synbiotics consumption on serum concentrations of liver function test enzymes: a systematic review and meta-analysis.

Eur J Nutr 2018 Sep 8;57(6):2037-2053. Epub 2017 Nov 8.

Menzies Health Institute Queensland and School of Allied Health Sciences, Griffith University, Gold Coast, Australia.

Purpose: The gut-liver interaction suggests that modification of gut bacterial flora using probiotics and synbiotics may improve liver function. This systematic review and meta-analysis aimed to clarify the effect of probiotics and synbiotics consumption on the serum concentration of liver function enzymes.

Methods: PubMed (MEDLINE), Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library (Central) were searched from 1980 to August 2017 for studies where adults consumed probiotics and/or synbiotics in controlled trials and changes in liver function enzymes were examined.

Results: A total of 17 studies (19 trials) were included in the meta-analysis. Random effects meta-analyses were applied. Probiotics and synbiotics significantly reduced serum alanine aminotransferase [- 8.05 IU/L, 95% confidence interval (CI) - 13.07 to - 3.04; p = 0.002]; aspartate aminotransferase (- 7.79 IU/L, 95% CI: - 13.93 to - 1.65; p = 0.02) and gamma-glutamyl transpeptidase (- 8.40 IU/L, 95% CI - 12.61 to - 4.20; p < 0.001). Changes in the serum concentration of alkaline phosphatase and albumin did not reach a statistically significant level. Changes to bilirubin levels were in favour of the control group (0.95 μmol/L, 95% CI 0.48-1.42; p < 0.001). Subgroup analysis suggested the existence of liver disease at baseline, synbiotics supplementation and duration of supplementation ≥ 8 weeks resulted in more pronounced improvement in liver function enzymes than their counterparts.

Conclusions: Probiotics and synbiotics may be suggested as supplements to improve serum concentration of liver enzymes, especially when synbiotics administered for a period ≥ 8 weeks and in individuals with liver disease.
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http://dx.doi.org/10.1007/s00394-017-1568-yDOI Listing
September 2018

The effect of lipophilicity and dose on the frequency of statin-associated muscle symptoms: A systematic review and meta-analysis.

Pharmacol Res 2018 02 21;128:264-273. Epub 2017 Sep 21.

School of Health, Medical and Applied Sciences, Central Queensland University, Bruce Highway, North Rockhampton, Queensland, 4702, Australia.

Addressing the factors which lead to the development of statin-associated muscle symptoms (SAMS) is vital for maintaining patient compliance with these pharmaceuticals, and thus improving patient outcomes. This study aimed to clarify the relationship between statin lipophilicity, or dose, and the frequency of adverse muscle symptoms using a systematic review of randomised controlled trials (RCTs). RCTs, including statin monotherapy and placebo groups, which reported data on muscle adverse events were identified through the PubMed and Scopus databases. Risk ratios (RRs) and 95% confidence intervals (CI) were pooled using a random-effects meta-analysis. A total of 135 RCTs were included in this review. Statin therapy was associated with a significant, but modest, increase in the risk of adverse muscle symptoms compared to placebo (RR=1.050; 95% CI=1.014-1.089; P=0.007; I=3.291%). This significant association was primarily due to the inclusion of RCTs recruiting participants with a history of statin intolerance. Lipophilic statins had no appreciable impact on the development of SAMS compared to hydrophilic formulations. A univariate meta-regression of dose (standardised to atorvastatin dose equivalents) and the risk of musculoskeletal complaints also showed no significant association. The results obtained from this meta-analysis indicate that there is a slight increase in the risk of SAMS, especially in individuals with a history of statin intolerance. There is limited evidence to suggest that the risk of SAMS would differ between the use of lipophilic and hydrophilic statins, or high- and low-dose therapy.
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http://dx.doi.org/10.1016/j.phrs.2017.09.013DOI Listing
February 2018

Dietary Patterns, Nutrition Knowledge, Lifestyle, and Health-Related Quality of Life: Associations with Anti-Hypertension Medication Adherence in a Sample of Australian Adults.

High Blood Press Cardiovasc Prev 2017 Dec 7;24(4):453-462. Epub 2017 Sep 7.

Menzies Health Institute Queensland and School of Medicine, Griffith University, Gold Coast, Australia.

Introduction: Poor anti-hypertension medication (AHT) adherence can increase disease costs and adverse outcomes. Hypertensive individuals who have a better nutrition knowledge may lead a healthier lifestyle, have a better health-related quality of life (HRQoL) and greater confidence to change behaviour. On this basis, they may have better treatment adherence.

Aim: To explore the association between the above-mentioned variables and AHT adherence in a group of Australian adults with high blood pressure (BP) in a cross-sectional clinical and community-based study.

Methods: Adults with high BP (n = 270) completed a questionnaire including: food frequency questionnaire (FFQ), nutrition knowledge, HRQoL, self-efficacy of diet and exercise, lifestyle and AHT adherence sections. Bivariate analysis and hierarchical logistic regression were used to explore the data.

Results: Three dietary patterns were identified from the FFQ, using factor and cluster analyses (Western, Snack and Alcohol, and Balanced). We observed that following a Western dietary pattern, having lower exercise self-efficacy and shorter sleep duration were more dominant in the poor AHT adherence individuals compared to their counterparts. A positive association was observed between self-efficacy and sleep duration with AHT adherence. A Western dietary pattern was prevalent in high BP participants which slightly reduced the likelihood of good adherence.

Conclusion: A healthier dietary pattern, better exercise self-efficacy and adequate sleep (more than six hours a night) may increase the likelihood of AHT adherence in individuals with high BP. Interventions focusing on improving these variables are required to confirm the findings of this study.
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http://dx.doi.org/10.1007/s40292-017-0229-9DOI Listing
December 2017