Publications by authors named "Seyed Ali Keshavarz"

59 Publications

Dietary diversity modifies the association between FTO polymorphisms and obesity phenotypes.

Int J Food Sci Nutr 2021 Feb 24:1-11. Epub 2021 Feb 24.

Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

The current study aimed to evaluate the interaction of the dietary diversity score (DDS) and FTO polymorphisms concerning obesity phenotypes. The 4480 subjects of this cohort study were selected. The polymorphisms rs1121980, rs14211085 and rs8050136 were selected and genotyped. The weighted method was used to calculate the genetic risk score (GRS). Obesity marker changes were calculated. Those with minor allele carriers of rs1121980 had lower body mass index changes Q1: 1.58 ± 0.60 vs. Q4: 0.13 ± 0.59) and visceral adiposity index (VAI) (Q1: -0.00 ± 0.02 vs. Q4: -0.04 ± 0.02) when they had higher DDS (P interaction = 0.05). Carriers of the minor allele of rs8050136 had significant VAI change across DDS quartiles (Q1: -0.01 ± 0.02 vs. Q4: -0.02 ± 0.02, P interaction = 0.05). No significant interaction was found between the GRS and DDS on general obesity. The pattern of dietary diversity may have a mediatory role in improving obesity markers in subjects with a more genetic predisposition to adiposity.
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http://dx.doi.org/10.1080/09637486.2021.1890698DOI Listing
February 2021

Variants in Circadian Rhythm Gene Interacts with Healthy Dietary Pattern for Serum Leptin Levels: a Cross-sectional Study.

Clin Nutr Res 2021 Jan 28;10(1):48-58. Epub 2021 Jan 28.

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran 14155-6117, Iran.

Circadian disruption causes obesity and other metabolic disorders. There is no research considering the role of Cryptochromes (Cry) 1 body clock gene and major dietary patterns on serum leptin level and obesity. We aimed to investigate the interaction between circadian gene polymorphisms and major dietary patterns on leptin and obesity related measurements. This study was performed on 377 overweight and obese women. Mean age and body mass index (BMI) of study subjects were 36.64 ± 9.02 years and 30.81 ± 3.8 kg/m, respectively. Dietary assessment was done using a validated 147-item food frequency questionnaire. rs2287161 were genotyped using polymerase chain reaction-restriction fragment length polymorphism. Generalized linear models were used for interaction analysis. Healthy and unhealthy dietary pattern (HDP and UDP, respectively) were extracted using factor analysis (principal component analysis). Our study revealed a significant higher weight (p = 0.003) and BMI (p = 0.042) in women carrying CC homozygote compared with G allele carriers. Moreover, our findings showed a significant gene-diet interaction between HDP and rs2287161 on BMI (p = 0.034) and serum leptin level (p = 0.056) in which, BMI and serum leptin level were lower in subjects with CC genotype than in those with GG genotype while following HDP. This study suggests a significant interaction between rs2287161 polymorphisms and HDP on BMI and serum leptin and the lowering effects were apparent among C allele carriers compared to G allele ones. This data highlights the role of dietary pattern in relation of gene and obesity.
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http://dx.doi.org/10.7762/cnr.2021.10.1.48DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7850819PMC
January 2021

The effects of Chlorella supplementation on glycemic control, lipid profile and anthropometric measures on patients with type 2 diabetes mellitus.

Eur J Nutr 2021 Feb 2. Epub 2021 Feb 2.

Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.

Background: Diabetes is a chronic disease and the prevalence of it is rapidly increasing. Recently, the use of natural products in chronic diseases such as diabetes has gained more attention. Chlorella, a single-celled green alga, is one of them. There have been some studies on the effects of chlorella supplementation in chronic diseases such as NAFLD, prediabetes, and diabetic mice, but none of them examined the effects of chlorella in patients with T2DM. The present study was designed to evaluate the effects of chlorella supplementation on glycemic control, lipid profile, and anthropometric indices in type 2 diabetic patients.

Methods: This study is a double-blind, randomized controlled trial. 84 patients with T2DM assigned into two groups, receiving 1500 mg/day C. vulgaris or placebo for 8 weeks. Anthropometric information, blood pressure, 24-h food intake recall, and blood samples were collected at the beginning and end of the study to determine the changes of FBS, HbA1c, insulin concentration, insulin resistance, and lipid profile.

Results: None of the variables investigated in this study showed a significant change after 8 weeks of intervention with C. vulgaris.

Conclusion: According to the findings of this study, supplementation with C. vulgaris with a dosage of 1500 mg/day for 8 weeks, does not improve the anthropometric measurements, glycemic status, and lipid profile as well. Thus, it cannot be considered as a complementary therapeutic approach to common medications at this dosage and duration. However, future studies with a higher dosage of C. vulgaris and more prolonged than 8 weeks are needed to be done.
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http://dx.doi.org/10.1007/s00394-021-02492-5DOI Listing
February 2021

Short-term effectiveness of a theory-based intervention to promote diabetes management behaviours among adults with type 2 diabetes in Iran: A randomised control trial.

Int J Clin Pract 2021 Jan 6:e13994. Epub 2021 Jan 6.

Department of Clinical Nutrition, Tehran University of Medical Sciences, Tehran, Iran.

Background: Diet and physical activity are recommended for diabetes management. Evidence suggests theory-based interventions are more efficacious than non-theory approaches. This study aimed to test the short-term effectiveness of an integrated theoretical model-based intervention to encourage compliance for low-fat food consumption, carbohydrate counting and physical activity in adults with type 2 diabetes.

Methods: A 4-week parallel randomised control trial was conducted in Iran. Data were collected using a self-report questionnaire at baseline and 8-weeks post-intervention. This survey assessed the theory of planned behaviour (TPB) constructs of attitude, subjective norm (others' approval) and perceived behavioural control (PBC). We also assessed risk perceptions (motivational) and planning (volitional) from the health action process approach (HAPA). Furthermore, weight, body mass index, triglyceride (TG) and LDL-cholesterol were measured, with a sub-sample of participants providing haemoglobin A1c (HbA1c) assessments.

Results: For both low-fat food consumption and physical activity, only planning revealed a significant improvement over time for intervention rather than control participants (F = 8.78, P ≤ .001 for low-fat vs F = 11.26, P ≤ .001 for physical activity). For carbohydrate counting, significant effects were found for behaviour (F = 4.37, P = .03), intention (F = 8.14, P ≤ .001), PBC (F = 7.52, P ≤ .001) and planning (F = 4.54, P = .03), reflecting improvements over time in the intervention participants compared to controls. Furthermore, the effects of the intervention on behaviour were partially mediated via participants' degree of planning (B = 0.10, SE = 0.06, CI = 0.01 to 0.26). The serum TG level was significantly reduced from pre to post-intervention for intervention rather than for control participants (F = 18.69, P ≤ .001) as did Hb1Ac in a sub-sample of study participants.

Conclusions: This intervention showed promising short-term effects for carbohydrate counting but did not show improvements for low-fat diet nor physical activity. Given the improvement in psychological measures and self-reported behaviour for carbohydrate counting, coupled with the findings for TG, future research is needed to demonstrate longer-term improvements.
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http://dx.doi.org/10.1111/ijcp.13994DOI Listing
January 2021

Associations of dietary inflammatory index, serum levels of MCP-1 and body composition in Iranian overweight and obese women: a cross-sectional study.

BMC Res Notes 2020 Nov 23;13(1):544. Epub 2020 Nov 23.

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box: 14155-6117, Tehran, Iran.

Objective: Although, several studies have illustrated that there is a relation between dietary inflammatory index (DII) with obesity-related parameters, and inflammation, their results were controversial. This study aimed to investigate this relationship among Iranian women.

Results: Multivariable linear regression showed that fat mass was 0.14 kg lower in the anti-inflammatory diet group, with respect to the pro-inflammatory group, after adjusting covariates such as age, physical activity, economic and job status (β = - 0.142, 95% CI - 4.44, - 1.71, P = 0.03). Fat-free mass (FFM) was 1.5 kg more in the anti-inflammatory diet group, compared to the pro-inflammatory diet group, after adjusting for potentials cofounders (β = 1.50, 95% CI 0, 3.01, p = 0.05). Furthermore, after adjusting for potentials cofounders, it was revealed that the subjects with lower DII had lower monocyte chemoattractant protein-1 (MCP-1) levels in serum (β = - 18.81, 95% CI - 35.84, - 1.79, p = 0.03). These findings suggest an inverse and significant relationship between DII and FFM and also DII is directly related to Fat mass and the level of MCP-1. This finding can be used for developing interventions that aim to promote healthy eating to prevent inflammation and non-communicable disease development among obese females.
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http://dx.doi.org/10.1186/s13104-020-05390-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7684955PMC
November 2020

Effects of soy milk consumption on gut microbiota, inflammatory markers, and disease severity in patients with ulcerative colitis: a study protocol for a randomized clinical trial.

Trials 2020 Jun 23;21(1):565. Epub 2020 Jun 23.

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran.

Background: Several strategies are recommended to alleviate clinical symptoms of ulcerative colitis (UC). Soy milk may affect UC through its anti-inflammatory properties. However, no study has examined the effects of soy milk consumption on gut microbiota and inflammatory biomarkers in patients with UC. The current study will be done to examine the effects of soy milk consumption on UC symptoms, inflammation, and gut microbiota in patients with UC.

Methods: This study is a randomized clinical trial, in which thirty patients with mild to moderate severity of UC will be randomly allocated to receive either 250 mL/day soy milk plus routine treatments (n = 15) or only routine treatments (n = 15) for 4 weeks. Assessment of anthropometric measures and biochemical indicators including serum concentrations of high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interferon gamma (IFN-γ) will be done at the study baseline and end of trial. In addition, the quantity of butyrate-producing bacteria including Clostridium cluster IV, Faecalibacterium prausnitzii, and Roseburia spp.; prebiotic bacteria including Lactobacillus spp. and Bifidobacteria spp.; and mucus-degrading bacteria including Akkermansia muciniphila, Bacteroides fragilis, and Ruminococcus spp., as well as calprotectin and lactoferrin levels, will be explored in fecal samples. Also, the Firmicutes to Bacteroidetes ratio which is of significant relevance in human gut microbiota composition will be assessed.

Discussion: Altered gut microbiota has been reported as an important contributing factor to inflammation in patients with inflammatory bowel disease (IBD). Soy milk contains several components such as phytoestrogens with potential anti-inflammatory properties. This product might affect gut microbiota through its protein and fiber content. Therefore, soy milk might beneficially affect systemic inflammation, gut microbiota, and then clinical symptoms in patients with UC.

Trial Registration: Iranian Registry of Clinical Trials (www.irct.ir) IRCT20181205041859N1. Registered on 27 January 2019.
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http://dx.doi.org/10.1186/s13063-020-04523-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7310397PMC
June 2020

Dietary total antioxidant capacity and its association with sleep, stress, anxiety, and depression score: A cross-sectional study among diabetic women.

Clin Nutr ESPEN 2020 06 19;37:187-194. Epub 2020 Mar 19.

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran; Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Background: Diabetes as a common chronic disease leads to several serious disabilities and complications. Patients with type 2 diabetes are involved with psychological and sleep disorders which diet can be effective in the management of these problems. The present study aimed to investigate the association of Dietary Total Antioxidant Capacity (DTAC) and sleep, stress, anxiety, and depression among diabetic women.

Methods: This cross-sectional study conducted on 265 women with type 2 diabetes. A validated food frequency questionnaire was filled to evaluate dietary intakes. We calculated DTAC based on amounts of antioxidant in each dietary item using the ferric reducing ability of plasma (FRAP) and oxygen radical absorbance capacity (ORAC) databases. Pittsburgh Sleep Quality Index was used to assess sleep quality. Moreover, 21 items Depression, Anxiety, and Stress Scale was used to assess mental disorders.

Results: Subjects in the highest tertile of FRAP and ORAC score compared to those in the lowest tertile of these scores had 94% and 87% lower risk of poor sleep, respectively. The odds of depression were negatively related to the highest tertile of FRAP and ORAC score (OR: 0.21, 95%CI: 0.09-0.50 and OR: 0.21, 95%CI: 0.10-0.48, respectively). Participants with the highest tertile of FRAP compared to those within the lowest tertile of FRAP score had a 59% lower risk of anxiety. The odds of stress were negatively related to the highest tertile of FRAP and ORAC score (OR: 0.10, 95%CI: 0.04-0.23 and OR: 0.13, 95%CI: 0.06-0.29, respectively).

Conclusion: There is a significant association between DTAC, sleep status and psychological disorders. However, prospective studies in both genders should be conducted to confirm the actual relationship.
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http://dx.doi.org/10.1016/j.clnesp.2020.03.002DOI Listing
June 2020

A randomized controlled trial investigating the effect of a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols on the intestinal microbiome and inflammation in patients with ulcerative colitis: study protocol for a randomized controlled trial.

Trials 2020 Feb 18;21(1):201. Epub 2020 Feb 18.

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, PO Box 81745, Tehran, Iran.

Background: No conclusive treatment is available for irritable bowel disease (IBD). Adherence to a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) might alleviate clinical symptoms of IBD. However, no study has investigated the effect of low FODMAPs diet on the intestinal microbiota and inflammatory biomarkers in patients with IBD. The aim of current study is to examine the effect a low FODMAP diet on IBD symptoms, inflammation, and the intestinal microbiota in patients with ulcerative colitis.

Methods And Analysis: This study is a randomized clinical trial. Thirty patients with mild to moderate ulcerative colitis will be randomly allocated to receive a low FODMAP diet (n = 15) or to continue their usual diet as control (n = 15), for 4 weeks. The quantity of intestinal microbiota including Clostridium cluster IV, Faecalibacterium prausnitzii, Rosburia spp., Lactobacillus spp., Bifidobacteria spp., Akkermansia muciniphila, Bacteroides fragilis, and Ruminococcus spp., and the Firmicutes to Bacteroidetes ratio and calprotectin and lactoferrin levels will be explored in fecal samples from patients. In addition, anthropometric measures and biochemical assessments including serum concentrations of highly sensitive-C reactive protein (hs-CRP), tumour necrosis factor-α (TNF-α) and IL-1β will be taken from patients at baseline and end of the study. The study has been registered in IRCT (IRCT20181126041763N1; registration date: 2019-01-18).

Discussion: Consumption of a low-FODMAP diet might decrease systemic and intestinal inflammation, change the bacterial population in the gut, and modulate clinical symptoms in patients with ulcerative colitis. Further studies investigating the effect of such a diet on other variables, including other bacterial species and inflammatory cytokines, are required to confirm future findings of this trial.
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http://dx.doi.org/10.1186/s13063-020-4108-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7029518PMC
February 2020

Association between a low-carbohydrate diet and sleep status, depression, anxiety, and stress score.

J Sci Food Agric 2020 May 24;100(7):2946-2952. Epub 2020 Feb 24.

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.

Background: Dietary intakes, especially carbohydrates, play an important role in blood glucose control in patients with diabetes. It is suggested that carbohydrate amounts may be effective in diabetes complications. This study aimed to reveal the association of low-carbohydrate diet (LCD) and sleep and mental status among patients with diabetes.

Methods: This cross-sectional study was conducted among 265 women with type 2 diabetes. Anthropometric measures, as well as biochemical tests, were recorded. Dietary intakes were recorded using a validated food-frequency-questionnaire to calculate LCD score. To assess mental disorders and sleep quality, the Depression, Anxiety and Stress Scale and the Pittsburgh Sleep Quality Index were used respectively.

Results: Patients in the highest LCD quartile were the ones with the lowest carbohydrate consumption. There was no significant association between cardiovascular risk factors and LCD score even after controlling confounder variables (P > 0.05). Subjects in the highest quartile of LCD score compared with those within the lowest quartile had a 69% lower risk of poor sleep after adjusting confounders. The odds of depressive symptoms were negatively related to the highest quartile of LCD score in the crude model and even after full-adjusted model (odds ratio: 0.42; 95% confidence interval: 0.17-1.01). Participants in the highest quartile of LCD score compared with those in the lowest quartile had a 73% lower risk of anxiety.

Conclusion: It seems that patients who consumed lower carbohydrate have better sleep status and are less involved with mental disorders. However, regarding the nature of the present study, well-designed cohort studies are suggested to be conducted in the future. © 2020 Society of Chemical Industry.
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http://dx.doi.org/10.1002/jsfa.10322DOI Listing
May 2020

Association of dietary acid load and plant-based diet index with sleep, stress, anxiety and depression in diabetic women.

Br J Nutr 2020 04 6;123(8):901-912. Epub 2019 Dec 6.

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.

Diabetes is a common chronic disease with various complications. The present study was conducted to determine the association of plant-based diet index (PDI) and dietary acid load (DAL) with sleep status as well as mental health in type 2 diabetic women. In this cross-sectional study, a validated FFQ was used to assess dietary intakes of 230 diabetic patients. We created a whole PDI, healthful PDI (hPDI) and unhealthful PDI (uPDI). DAL was calculated based on potential renal acid load and net endogenous acid production method. The Pittsburgh Sleep Quality Index and twenty-one-item Depression, Anxiety and Stress Scale were used to assess sleep and mental health disorders, respectively. Participants in the top group of uPDI had greater risk of poor sleep (OR 6·47, 95 % CI 2·75, 15·24). However, patients who were in the top group of hPDI had a lower risk of sleep problems (OR 0·28, 95 % CI 0·13, 0·62). Participants in the top group of uPDI had greater risk of depression, anxiety and stress (OR 9·35, 95 % CI 3·96, 22·07; OR 4·74, 95 % CI 2·28, 9·85; OR 4·24, 95 % CI 2·14, 8·38, respectively). In conclusion, participants with higher DAL scores and patients who adhered to animal-based diets rather than plant-based diets were more likely to be poor sleepers and have mental health disorders.
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http://dx.doi.org/10.1017/S0007114519003179DOI Listing
April 2020

A placebo controlled randomized clinical trial of Crocus sativus L. (saffron) on depression and food craving among overweight women with mild to moderate depression.

J Clin Pharm Ther 2020 Feb 10;45(1):134-143. Epub 2019 Oct 10.

Department of Biostatistics and Epidemiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

What Is Known And Objective: Crocus sativus L., commonly known as saffron, has known anti-depressive properties. However, its effects on food craving and body weight in depressed patients are unknown. Hence, we aimed to evaluate the effects of saffron capsules on food craving, body weight and depression among overweight women with mild and moderate depression compared to the placebo.

Methods: Seventy-three women with BMI ≥ 25 comorbid with mild-to-moderate depression were recruited in this 12-week double-blind, placebo-controlled randomized clinical trial. Participants were randomly assigned into one of the two groups receiving daily either 30 mg of Crocus sativus capsules (15 mg twice/day) or placebo capsules (twice/day). We performed body composition assessments, and beck depression inventory-II at the baseline, and then 2, 4, 8 and 12 weeks later. One month after the participants stopped taking the capsules, weight differences were measured and compared between groups.

Results And Discussion: Fifty-two patients finished the study. The demographic and clinical variables at baseline were the same in two groups. Mean depression scores in the saffron group significantly decreased compared to placebo (mean ± SD: -8.4 score ± 5.9 vs -3.9 ± 5.5; t[50] = 2; P = .007; 95% CI: 1.3-7.7). There was not a significant effect of saffron on food craving using repeated-measures ANOVA, F(1, 29) = 0.38, P = .54. Patients in the saffron group showed fewer side effects.

What Is New And Conclusion: Saffron capsules were not effective in reducing food craving, but as a safe over-the-counter supplement, it may help reduce the symptoms of depression in patients who experience mild or moderate depression and are overweight.
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http://dx.doi.org/10.1111/jcpt.13040DOI Listing
February 2020

Effects of l-carnitine supplementation on cardiovascular and bone turnover markers in patients with pemphigus vulgaris under corticosteroids treatment: A randomized, double-blind, controlled trial.

Dermatol Ther 2019 09 28;32(5):e13049. Epub 2019 Aug 28.

Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.

Pemphigus vulgaris (PV) is a severe, bullous, autoimmune disease of the skin and mucous membranes. Corticosteroids are usually the main core treatment for controlling PV, which could lead to several side effects such as insulin resistance, osteoporosis, and cardiovascular disorders. The aim of this study is to evaluate the protective effects of l-carnitine (LC) supplementation in PV patients under corticosteroid treatment. In this randomized, double-blind, placebo-controlled clinical trial, 48 patients with PV were divided randomly into two groups to receive 2 g LC (n = 24) or a placebo (n = 24) for 8 weeks, respectively. Serum levels of osteopontin (OPN), bone morphogenic protein 4 (BMP4), cystatin C, systolic and diastolic blood pressure, 25 hydroxyvitamin D3, and LC were evaluated at the beginning and at the end of the study. LC supplementation demonstrated a significant increase in serum carnitine (p < .001). In addition, at the end of the trial, LC supplementation significantly decreased serum BMP4 (p = .003), OPN (p = .03), and cystatin C (p = .001) levels. There was no significant effect on blood pressure in comparison with the placebo. During study, no harmful side effects were reported by patients. These findings indicate that LC supplementation significantly leads to favorable changes in OPN, BMP4, and cystatin C in PV patients under corticosteroid therapy. However, further investigations are required to confirm these results.
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http://dx.doi.org/10.1111/dth.13049DOI Listing
September 2019

The association between dietary antioxidants and adipokines level among obese women.

Diabetes Metab Syndr 2019 Mar - Apr;13(2):1369-1373. Epub 2019 Feb 13.

Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.

Aim: Adipokines are associated with several oxidative stress-related diseases and pathologic conditions. We aimed to assess the association between antioxidants and adipokines in obese adults.

Methods And Materials: In this cross-sectional study, a total of 160 obese women were included. Body composition and anthropometric characteristics were measured. Dietary intakes were assessed by 3-day, 24-h dietary recall. Blood samples were obtained following an overnight fasting. Serum concentrations of adipokines including progranulin, retinol binding protein 4 (RBP4) and Angiopoietin-related growth factor 6 (ANGPTL6) was measured using an enzyme-linked immunosorbent assay. ANCOVA and the linear regression model analysis was performed to assess the relationship between Progranulin, RBP4, AnGPTL6, and antioxidants.

Results: Mean age of included women was 39.31 ± 12.10. Mean and standard deviation for BMI was 35.05 ± 4.26 in this obese population. There was a positive significant association between ANGPTL6 and vitamin D intake (p < 0.001). Also, there was a marginal association between RBP4 and vitamin A (p = 0.063) intake, but after adjustment age, and fat mass, we found a significant association (p = 0.008). However, the associations between dietary antioxidants, progranulin, and ANGPTL6 were not statistically significant.

Conclusions: ANGPTL6 and RBP4 levels directly associated with dietary vitamins D and A intake, respectively. But, according to the results, the association between ANGPTL6 and vitamin D was bidirectional. The suggested associations probably can be useful in the development of interventional studies for management of chronic diseases.
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http://dx.doi.org/10.1016/j.dsx.2019.02.022DOI Listing
December 2019

Effects of ginger supplementation on anthropometric, glycemic and metabolic parameters in subjects with metabolic syndrome: A randomized, double-blind, placebo-controlled study.

J Diabetes Metab Disord 2019 Jun 22;18(1):119-125. Epub 2019 Mar 22.

3Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Science, No. 7, West Arghavan St., Farahzadi Blvd., Zip Code: 1981619573, P.O.Box: 19395-4741, Tehran, Iran.

Background: Metabolic syndrome (MetS) is one of the worldwide most chronic endocrine disorders. The disease can also lead to several other chronic disorders such as type 2 diabetes mellitus, cardiovascular diseases, renal diseases and cancers. This study aimed to evaluate the safety and efficacy of ginger powder on biochemical and anthropometric parameters in patients with MetS.

Methods: This randomized controlled clinical trial was conducted on 37 patients with MetS. We supplemented the individuals with MetS with either 2 g per day ginger powder or placebo for 12 weeks. Biochemical and anthropometric parameters before and after the intervention were compared between the two groups.

Results: After 12 weeks of treatment, the levels of triglyceride (TG), FBS, and insulin resistance were significantly improved in the patients receiving ginger in compare to the placebo group ( < 0·05). Moreover, significant changes were observed in terms of weight, waist circumference, LDL, HDL, total cholesterol, systolic and diastolic blood pressure and energy intake between the groups.

Conclusion: In general, our findings demonstrated that the ginger supplementation offers beneficial effects on patients with MetS, at least, in part due to the modulatory effects on TG, FBS, and insulin resistance.
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http://dx.doi.org/10.1007/s40200-019-00397-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6582048PMC
June 2019

Green cardamom supplementation improves serum irisin, glucose indices, and lipid profiles in overweight or obese non-alcoholic fatty liver disease patients: a double-blind randomized placebo-controlled clinical trial.

BMC Complement Altern Med 2019 Mar 12;19(1):59. Epub 2019 Mar 12.

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.

Background: Despite the reported health effects of cardamom on dyslipidemia, hepatomegaly, and fasting hyperglycemia, no human research has studied its potency in non-alcoholic fatty liver disease (NAFLD) as the hepatic part of metabolic syndrome. Our aim was determining the effects of green cardamom (GC) on serum glucose indices, lipids, and irisin level among overweight or obese NAFLD patients.

Methods: The place of participant recruitment was the polyclinic of the National Iranian Oil Company (NIOC) central hospital in Tehran. Based on the ultrasonography and eligibility criteria, 87 participants were randomly divided into two groups as cardamom (n = 43) or placebo (n = 44). The supplementation was two 500 mg capsules 3 times/day with meals for 3 months. Serum irisin, fasting blood sugar (FBS), insulin (FBI), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-c), and high-density lipoprotein cholesterol (HDL-c) were measured. Quantitative insulin sensitivity check index (QUICKI) and homeostasis model assessment-insulin resistance (HOMA-IR) were also calculated.

Results: In comparison with placebo, GC significantly increased irisin, HDL-c, and QUICKI and decreased FBI, TG, LDL-c, HOMA-IR, and the grade of fatty liver (P < 0.05). After adjustment for confounders, the changes were similar (P < 0.05) with an exception for LDL-c which had a trend (P = 0.07). The differences in FBS, TC, and body mass index (BMI) were not significant (P > 0.05).

Conclusion: GC supplement improved the grade of fatty liver, serum glucose indices, lipids, and irisin level among overweight or obese NAFLD patients. The changes in these biomarkers may yield beneficial effects on NAFLD. Further trials on the efficacy of GC for clinical practice are suggested.

Trial Registration: Iranian Registry of Clinical Trials, IRCT2015121317254N4 . Registered 27/12/2015.
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http://dx.doi.org/10.1186/s12906-019-2465-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419418PMC
March 2019

Vitamin D3 supplementation improves serum SFRP5 and Wnt5a levels in patients with type 2 diabetes: A randomized, double-blind, placebo-controlled trial.

Int J Vitam Nutr Res 2018 Feb 10;88(1-2):73-79. Epub 2019 Apr 10.

1 Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, International Campus, Tehran University of Medical Sciences, Tehran, Iran.

To explore the effect of vitamin D3 on novel serum adipokines, secreted frizzled-related protein 5 (SFRP5) and Wingless-Type MMTV Integration Site Family Member 5a (Wnt5a) levels in Type 2 Diabetes Mellitus (T2DM) patients. Forty patients (16 women and 24 men) with type 2 diabetes participated in this double-blind, randomized, placebo-controlled clinical trial study. Participants were randomly assigned to receive 4000 IU vitamin D (n = 20) or placebo (n = 20) daily for 2 months. Anthropometric indices, fasting blood glucose (FBS), hemoglobin A1c (HbA1c), insulin, serum tumor necrosis factor (TNF)-α, Wnt5a, SFRP5, physical activity, lipid profile, dietary intake, and serum calcidiol were assessed at the baseline and after 8 weeks. In the group receiving Vitamin D, a significant increase in Calicidiol (15.03 ± 10.44 vs. 27.33 ± 11.2 ng/dl; P = < 0.001), SFRP5 (3.6 ± 0.46 vs. 3.98 ± 0.59 ng/ml; P = 0.01), and Wnt5a (0.33 ± 0.129 vs. 0.29 ± 0.047; P = 0.03) was observed. After two months supplementation, there were significant between-group differences in Calicidiol (27.33 ± 11.2 vs. 17.9 ± 12.95 ng/dl; P = 0.01), TNF-α (89.22 ± 34.28 vs. 164.93 ± 120.45 ng/ml; P = 0.006), Wnt5a (0.29 ± 0.047 vs. 0.33 ± 0.09; P = 0.04), and HbA1c (6.6 ± 0.96 % vs. 7.64 ± 1.15 %; = 0.002). Moreover, the net changes (end - baseline) of Calicidiol (P = < 0.001), SFRP5 (P = 0.04), Wnt5a (P = 0.005), TNF-α (P = 0.01), insulin (P = 0.03), and QUICKI (P = 0.01) was significant between the groups. There were no significant effects on FBS and homeostasis model of assessment-estimated insulin resistance (HOMA-IR). 8 weeks of vitamin D3 supplementation for patients with type 2 diabetes may increase serum anti-inflammatory adipokine SFRP5 but decrease serum pro-inflammatory Wnt5a and TNF-α.
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http://dx.doi.org/10.1024/0300-9831/a000509DOI Listing
February 2018

The Effect of Omega-3 Fatty Acids on Serum Apelin Levels in Cardiovascular Disease: A Randomized, Double-Blind, Placebo-Controlled Trial.

Rep Biochem Mol Biol 2018 Oct;7(1):59-66

Department of cellular and molecular nutrition, School of nutritional sciences and dietetics, International Campus, Tehran University of Medical Sciences, Tehran, Iran.

Background: Cardiovascular disease (CVD) is the leading cause of mortality worldwide. Omega-3 fatty acids have been shown to have both anti-atherogenic and anti-inflammatory effects through inducing the expression and production of adipokines. Adipokines such as apelin, have been observed to play a protective role in the incidence and progression of CVD. The aim of this study was to assess the influence of omega-3 fatty acids supplementation on the serum apelin levels in patients with cardiovascular disease.

Methods: Forty-six male patients with CVD participated in the study. Patients were randomly allocated into two groups receiving either omega-3 fatty acids or a placebo. Participants received 4 g of omega-3 fatty acids (EPA: 720 mg, DHA: 480 mg) or a placebo (edible paraffin) for 8 weeks. Serum apelin levels, high sensitive C-reactive protein (hs-CRP), and lipid profiles were measured. Dietary intake, anthropometric parameters, body composition, systolic and diastolic blood pressure were evaluated before and after the 8 weeks of intervention. Statistical analyses were performed using SPSS version 22.

Results: Two participants from the placebo group withdrew from the study. Prior to the intervention, no significant differences were present between the two groups in age, body mass index, body composition, dietary intakes, lipid profiles and blood pressure. Compared to placebo, the intake of omega-3 fatty acids increased serum apelin levels (p= 0.018), decreased the levels of LDL cholesterol, and decreased serum hs-CRP concentrations (p= 0.007, p= 0.011 respectively). Additionally, the concentrations of VLDL, TG and hs-CRP (p= 0.037, p= 0.037 and p= 0.016 respectively) declined compared to baseline and final values in the omega-3 fatty acids group.

Conclusion: Omega-3 fatty acid supplementation increases serum apelin and HDL concentrations, while decreasing serum LDL-C and hs-CRP levels.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6175591PMC
October 2018

Green cardamom increases Sirtuin-1 and reduces inflammation in overweight or obese patients with non-alcoholic fatty liver disease: a double-blind randomized placebo-controlled clinical trial.

Nutr Metab (Lond) 2018 25;15:63. Epub 2018 Sep 25.

1Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, No.44, Hojjatdoust Alley, Naderi Ave, Keshavarz Blvd, Tehran, 1416643931 Iran.

Background: Non-alcoholic fatty liver disease (NAFLD) is the hepatic component of metabolic syndrome. Despite the beneficial health effects of cardamom on dyslipidemia, hepatomegaly, and fasting hyperglycemia, no previous human study has been conducted on the efficacy of cardamom in NAFLD. The aim of this study was to assess the effects of green cardamom (GC) on serum Sirtuin-1 (Sirt1), inflammatory factors, and liver enzymes in overweight or obese NAFLD patients.

Methods: The recruitment of subjects was conducted at the polyclinic of the central hospital of National Iranian Oil Company (NIOC), Tehran. Eighty-seven patients who participated were divided randomly into two groups according to the ultrasonography and eligibility criteria as cardamom ( = 43) or placebo ( = 44). The intervention involves taking two 500 mg capsules three times per day with meals for 3 months. General characteristics, dietary intake and physical activity status, weight and height were determined. In addition, serum Sirt1, tumor necrosis factor-alpha (TNF-α), high sensitive c-reactive protein (hs-CRP), interleukin-6 (IL-6), alanine transaminase (ALT), and aspartate transaminase (AST) were measured. The degree of fatty liver was determined at beginning and end of the study.

Results: In comparison with placebo, GC significantly increased Sirt1 and decreased hs-CRP, TNF-α, IL-6, ALT, and the degree of fatty liver ( < 0.05). The differences in weight, BMI, and AST were not significant ( > 0.05).

Conclusion: GC supplementation could improve some biomarkers related to fatty liver including inflammation, ALT, and Sirt1 in overweight/obese NAFLD patients. Further trials on cardamom's potential are suggested.

Trial Registration: Iranian Registry of Clinical Trials, IRCT2015121317254N4. Registered 27/12/2015.
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http://dx.doi.org/10.1186/s12986-018-0297-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6156864PMC
September 2018

A comparison of the sensitivity and specificity of anthropometric measurements to predict unhealthy metabolic phenotype in overweight and obese women.

Diabetes Metab Syndr 2018 Nov 8;12(6):1147-1153. Epub 2018 Jul 8.

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran. Electronic address:

Aim: Metabolically Healthy Obese (MHO) is called to obese people that their insulin sensitivity, lipid profiles and inflammatory profiles are favorable, and there are no signs of hypertension and cardio-metabolic diseases. The metabolically unhealthy obese (MUHO) is the opposite. A Body Shape Index (ABSI) is a marker to identifying abdominal obesity that is derived from weight, height and waist circumference (WC). Several studies have reported ABSI is associated with diabetes, metabolic syndrome, hypertension and higher mortality rate.

Materials And Methods: A total of 305 overweight and obese women were included in the current comparative cross-sectional study. Body composition was measured using body composition analyzer. Blood samples were obtained. The usual food intake of evaluated through the use of a semi-quantitative food frequency questionnaire.

Results: The results of this study revealed that there is a significant relationship between ABSI and MHO and MUHO (p = 0.04) and area under the ROC curve was 0.60. Also there is a significant relationship between BMI, fat mass index (FMI), free fat mass index (FFMI), neck circumference (NC), WC, fat mass (FM) and metabolic healthy status (MHS). The largest area under the ROC curve belonged to NC, WC, FM and BMI (0.66).

Conclusion: The findings of this study suggest that there is a significant relationship between ABSI, BMI, FMI, FFMI, NC, WC, FM and MHS. The largest area under the ROC curve was related to the NC, WC, FM and BMI not ABSI, that means NC, WC, FM and BMI have maximum sensitivity and specificity.
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http://dx.doi.org/10.1016/j.dsx.2018.06.023DOI Listing
November 2018

Peroxisome proliferator-activated receptor gamma coactivator 1α variation: a closer look at obesity onset age and its related metabolic status and body composition.

Appl Physiol Nutr Metab 2018 Dec 7;43(12):1321-1325. Epub 2018 Jun 7.

d Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.

There is a lack of knowledge regarding the effect of polymorphisms of the peroxisome proliferator-activated receptor gamma coactivator 1α (PGC-1α) gene on the age of obesity onset. Hence, 3 polymorphisms of the PGC-1α gene (PGC-1α rs17574213, rs8192678, and rs3755863) were examined in association with obesity onset age. Also, obesity onset age-related metabolic status and body composition were evaluated. This cross-sectional study was conducted with a total of 321 obese participants. Anthropometric and biochemical information, body composition, and PGC-1α gene sequences were analyzed. The rs17574213 polymorphism was associated with obesity onset in children aged <1 years and 10-18 years. The rs8192678 polymorphism was associated with obesity onset in adulthood. Body mass index, body fat percent, and trunk fat were higher in groups whose obesity began at age <1 year or 10-18 years than in other groups. Serum levels of high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and total cholesterol were lowest in the group with obesity onset between the ages of 10 and 18 years. Visceral fat and fasting blood glucose were highest in those whose obesity began in adulthood. In conclusion, 2 polymorphisms of the PGC-1α gene were associated with obesity onset age.
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http://dx.doi.org/10.1139/apnm-2018-0190DOI Listing
December 2018

Assessment of the Efficacy of Physical Activity Level and Lifestyle Behavior Interventions Applying Social Cognitive Theory for Overweight and Obese Girl Adolescents.

J Res Health Sci 2018 Apr 7;18(2):e00409. Epub 2018 Apr 7.

Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.

Background: Childhood obesity has become a global epidemic and physical inactivity and considered as one of the most important contributing factors. We aimed to evaluate a school-based physical activity intervention using social cognitive theory (SCT) to increase physical activity behavior in order to prevent obesity among overweight and obese adolescent girls.

Study Design: Randomized controlled trial study.

Methods: A seven-month randomized controlled trial based on SCT was implemented with 172 overweight and obese girl students (87 in intervention and 85 in control group), with the presence of their parents and teachers. Activities of the trial included: Sports workshops, physical-activity consulting private sessions, free practical and competitive sports sessions, family exercise sessions, text messages, and newsletters. Body Mass Index (BMI) and Waist Circumference (WC) were measured and questionnaires about duration of physical activity, duration of screen time (watching television and playing computer games) and psychological variables regarding the SCT constructs were obtained.

Results: Duration of physical activity (in minutes) and most of psychological variables (self-efficacy, social support, and intention) significantly increased at post-intervention, while hours of watching television and playing computer were significantly decreased (P<0.001). The subjects' mean BMI and WC reduced in the intervention group from 29.47 (4.05) kg/m2 to 28.5 (4.35) kg/m2 and 89.65 (8.15) cm to 86.54 (9.76) cm, although they were not statistically significant compared with the control group (P=0.127 and P=0.504, respectively).

Conclusions: School-based intervention using SCT led to an increase in the duration of physical activity and reduction in the duration of screen time in overweight and obese adolescent girls.
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April 2018

Omega-3 supplementation effects on body weight and depression among dieter women with co-morbidity of depression and obesity compared with the placebo: A randomized clinical trial.

Clin Nutr ESPEN 2018 06 17;25:37-43. Epub 2018 Mar 17.

School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.

Purpose: We aimed to evaluate the effects of the omega-3 supplementation on body weight and depression among women with co-morbidity of depression and obesity seeking weight reduction compared with the placebo.

Methods: Sixty five patients with co-morbidity of depression and overweight/obesity (BMI ≥ 25) signed the informed consent form and enrolled into this 12-week double-blind, placebo-controlled randomized clinical Trial. Subsequently, participants randomly assigned into one of the two groups receiving daily 6 capsules of omega-3 (each capsule containing 180 mg EPA, and 120 mg DHA) or 6 capsules of placebo (two with each meal). We performed body composition assessments and Beck depression inventory at the baseline, and weeks 2, 4, 8, and 12 after the start of the study. One month after stopping the capsules at the follow-up visit, weight was measured to compare weight relapse between the two groups.

Results: Forty five patients finished the study. No significant differences were seen between groups regarding demographic and clinical variables at baseline. Using repeated measures ANOVA, omega-3 significantly reduced depression compared with the placebo (P = 0.05). Mean ± SD weight reduction in omega-3 group 3.07 ± 3.4 kg and in the placebo group was 1.16 ± 2.7 kg and the difference between groups was significant using independent sample t-test (p = 0.049). Patients in the omega-3 group did not show significantly more side effects compared to the placebo but they were not successful in preventing weight regain one month after the end of the study.

Conclusion: Based on our findings omega-3 capsule as a safe over-the-counter supplement might be helpful in reducing the signs of depression and also body weight in patients with co-morbidity of depression and obesity.
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http://dx.doi.org/10.1016/j.clnesp.2018.03.001DOI Listing
June 2018

Variants in the PPARGC1A Gene may Influence the Effect of Fat Intake on Resting Metabolic Rate in Obese Women.

Lipids 2018 03 16;53(3):291-300. Epub 2018 Apr 16.

Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.

Recent studies have shown that dietary intake and genetic variants play a decisive role in the risk of obesity. Therefore, this study was designed to examine the interaction between dietary fat and PPARGC1A polymorphisms on the level of resting metabolic rate (RMR). We enrolled 288 Iranian overweight and obese women in this cross-sectional study. We sequenced the 648 b.p. DNA in Exon 8 of PPARGC1A gene. We analyzed the two single-nucleotide polymorphisms, namely rs11290186 and rs2970847, in this region. All participants were assessed for RMR, dietary intake, and body composition. This study demonstrated that total cholesterol and insulin levels were positively associated with T allele carriers of rs2970847. Moreover, the A-deletion allele carrier of the rs11290186 genotype had higher triacylglycerol and insulin concentrations. The current study revealed that, after adjustment for energy intake, the AA genotype of PPARGC1A (rs11290186) had a direct association with polyunsaturated fatty acids and linoleic acid intakes. Another important finding in our study was that there was an interaction seen between fat and saturated fatty acids intake with the PPARGC1A genotypes. Women with fat intakes of more than 30% of calorie intake per day and the A-deletion genotype had a lower RMR and RMR/fat free mass (FFM). It seems that the PPARGC1A polymorphisms lead to the downregulation of insulin signaling and subsequently insulin resistance. In addition, the interactions between the PPARGC1A polymorphisms (rs11290186) and the level of dietary fat intake probably can have an effect on RMR and RMR/FFM in obese women.
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http://dx.doi.org/10.1002/lipd.12024DOI Listing
March 2018

The Effect of Omega-3 Fatty Acids, EPA, and/or DHA on Male Infertility: A Systematic Review and Meta-analysis.

J Diet Suppl 2019 16;16(2):245-256. Epub 2018 Feb 16.

d Research Center for Biochemistry and Nutrition in Metabolic Diseases , Kashan University of Medical Sciences , Kashan , IR , Iran.

The objective was to evaluate the effect of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) on sperm parameters including total sperm concentration, sperm motility, sperm DHA, and seminal plasma DHA concentration in infertile men. The literature search was conducted in PubMed, Google Scholar, and Scopus from January 1, 1990 to December 20, 2017. The systematic review and meta-analysis were based on randomized controlled trials in infertile men with DHA or EPA treatments, either alone or in combination with other micronutrients. Three studies met the inclusion criteria: 147 patients in the intervention group and 143 patients in the control group. The analysis showed that omega-3 treatments significantly increased the sperm motility (RR 5.82, 95% CI [2.91, 8.72], p <. 0001, I = 76%) and seminal DHA concentration (RR 1.61, 95% CI [0.15, 3.07], p =. 03, I = 98%). Compared with the controls, the interventions did not affect the sperm concentration (RR 0.31, 95% CI [-8.13, 8.76], p =. 94, I = 95%) or sperm DHA (RR 0.50, 95% CI [-4.17, 5.16], p =. 83, I = 99%). The observed heterogeneity may be due to administration period and dosage of omega-3 fatty acids across the studies. Funnel plot shows no evidence of publication bias. This meta-analysis indicates that supplementing infertile men with omega-3 fatty acids resulted in a significant improvement in sperm motility and concentration of DHA in seminal plasma.
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http://dx.doi.org/10.1080/19390211.2018.1431753DOI Listing
June 2019

Dietary fat intake associated with bone mineral density among visfatin genotype in obese people.

Br J Nutr 2018 01;119(1):3-11

3Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics,Tehran University of Medical Sciences (TUMS),PO Box 14155-6117,Tehran,Iran.

Osteoporosis and adipose tissue are closely related with many contradictions. Visfatin is an adipokine that is related to osteoporosis and adiposity. This nutrigenomics study examined the interaction between visfatin genotypes and dietary fat intake, with regard to bone mineral density (BMD) among an obese population. In this cross-sectional study, 336 subjects were enrolled; the mean age was 38·25 (sd 11·69) years and the mean BMI was 31·79 (sd 4·77) kg/m2. Laboratory measurements were lipid profile, insulin and fasting blood sugar. Bone density measurements were assessed by dual-energy X-ray absorptiometry. Dietary data were collected through a 3-d 24-h dietary recall. Genotyping for visfatin gene SNP (rs2110385) was performed by the PCR-restriction fragment length polymorphism method. The frequency of GG, GT and TT genotypes were 33·92 48·51 and 17·54 %, respectively, and 86·6 % of participants were women. The results showed that subjects with TT genotypes had significantly higher lumbar BMD, T score and z score (P<0·0001). After categorisation by percentage of fat intake (30 % of total energy content as a cut-off point), no interaction was found, but when categorised by fat types, we found an interaction between visfatin genotypes and dietary PUFA intake in terms of the hip T score and z score (P=0·043, B= -0·08; P=0·04, B= -0·078, respectively). There was a significant relationship between high PUFA intake and lower energy and protein intake. When participants were categorised by median PUFA intake (22·8 g), it was concluded that subjects with GG genotype who had high PUFA-intake diets had lower hip z scores and T scores, unlike the other genotypes.
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http://dx.doi.org/10.1017/S000711451700304XDOI Listing
January 2018

School-Based Nutrition Education Intervention Using Social Cognitive Theory for Overweight and Obese Iranian Adolescent Girls: A Cluster Randomized Controlled Trial.

Int Q Community Health Educ 2017 Oct 3;38(1):37-45. Epub 2018 Jan 3.

2 Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Iran.

Background Nowadays childhood obesity has become one the most challenging issue which is considered as a principle public health problem all around the world. This study was conducted with the aim of evaluating the impact of a 7-month school-based nutrition education intervention using social cognitive theory (SCT) to prevent obesity among overweight and obese adolescent girls. Method In this cluster randomized community trial after choosing schools, a total of 172 overweight and obese girl students participated in the study (87 in the intervention and 85 in the control group). A 7-month intervention based on SCT for students, their parents, and teachers was conducted. At baseline and end of the study, body mass index (BMI), waist circumstances (WCs), dietary intake, and psychological questionnaires regarding the SCT constructs were obtained. Results After 7 months, the mean of BMI and WCs reduced in the intervention group from 29.47 (4.05) to 28.5 (4.35) and from 89.65 (8.15) to 86.54 (9.76), respectively, but in comparison to the control group, they were not statistically significant ( p values .127 and .504, respectively). In the intervention group, nutritional behaviors and most of the psychological variables (self-efficacy, social support, intention, and situation) were improved in favor of the study and they were significant in comparison to the control group ( p < .05). Conclusion Although school-based nutrition education intervention using SCT did not change significantly BMI and WCs among the targeted population in this study, dietary habits as well as psychological factors improved significantly in the intervention group. This trial was registered in Iranian Registry of Clinical Trials, www.irct.ir (IRCT2013103115211N1).
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http://dx.doi.org/10.1177/0272684X17749566DOI Listing
October 2017

Obesity intervention programs among adolescents using social cognitive theory: a systematic literature review.

Health Educ Res 2018 02;33(1):26-39

Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad 91779-48564, Iran.

Social cognitive theory (SCT) is a well-known theory for designing nutrition education and physical activity programs for adolescents. This systematic review aimed to evaluate the efficacy of intervention studies based on SCT in reducing or preventing overweight and obesity in adolescents. An electronic literature search in PubMed-Medline, Web of Science and Scopus was performed to identify intervention studies based on SCT aiming at preventing or reducing obesity in adolescents. All the articles published up to July 2016 were included. Only studies reporting body mass index (BMI) or its variant as one of the outcome measures were included. From 240 initially identified studies, 12 met the eligibility criteria. Seven had moderate or strong study quality. Two of the eight randomized controlled trials (RCT) and two of the four quasi-experimental studies showed significant reduction in BMI among intervened participants compared to control. Impacts on diet and physical activity were mixed, but were mostly not significant. The current systematic review found only weak evidence for the efficacy of SCT-based interventions in treating and preventing obesity in adolescents. Further studies systematically using effective behavior change strategies or techniques, larger population sizes, better measurement tools and more robust designs are warranted for a conclusive judgment.
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http://dx.doi.org/10.1093/her/cyx079DOI Listing
February 2018

Vitamin D Status and Resting Metabolic Rate May Modify through Expression of Vitamin D Receptor and Peroxisome Proliferator-Activated Receptor Gamma Coactivator-1 Alpha Gene in Overweight and Obese Adults.

Ann Nutr Metab 2018 19;72(1):43-49. Epub 2017 Dec 19.

Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.

Background: Resting metabolic rate (RMR) used to prognosticate and measure the amount of energy required. Vitamin D is known as a new predictor of RMR. The aim of this study is to investigate the relationship between vitamin D effects on RMR in connection with the vitamin D receptor (VDR) and peroxisome proliferator-activated receptor gamma coactivator-1 alpha (PGC-1α) gene expression.

Methods: We enrolled 298 overweight and obese adults in this cross-sectional study. Body mass index (BMI), fat mass, fat-free mass, insulin level, visceral fat, and vitamin D status were assessed. RMR was measured by means of indirect calorimetry. The real-time polymerase chain reaction using specific primer pairs for VDR and PGC-1α was performed.

Results: There were significant differences in terms of fat free mass, fat percentage, insulin levels, RMR/kg body weight, and RMR/BMI, VDR, and PGC-1α among participants were categorized based on the vitamin D status. But after using general linear model for adjusting, all significant results missed their effectiveness except RMR/kg body weight and VDR. Linear regression analysis used to show the mediatory role of VDR and PGC-1α on the RMR/kg body weight and vitamin D status relationship. Our results showed that VDR had a mediatory effect on the relationship between RMR/kg body weight and vitamin D status (β = 0.38, 95% CI -0.48 to 1.60; β = -1.24, 95% CI -5.36 to 1.70). However, PGC-1α did not affect the relationship between RMR/kg body weight and vitamin D status (β = 0.50, 95% CI = -0.02 to 3.42; β = 0.59, 95% CI 0.14-3.90).

Conclusion: Our study showed the mediatory effect of VDR gene expression in the association of 25(OH)2D plasma levels and resting metabolic rate among obese individuals.
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http://dx.doi.org/10.1159/000485662DOI Listing
August 2019

Metabolically healthy/unhealthy components may modify bone mineral density in obese people.

Arch Osteoporos 2017 Oct 29;12(1):95. Epub 2017 Oct 29.

Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.

Link between obesity and bone health is controversial. It seems that maybe the difference in metabolic status leads to this difference. We studied relation between metabolically healthy/unhealthy components with bone mineral density. Results showed metabolically unhealthy obesity (MUHO) phenotypes have better bone status at hip site than metabolically healthy obesity (MHO). Also, component metabolic can effect on BMD in different sites.

Purpose/introduction: This cross-sectional study aimed to compare total BMD and L-L4 BMD in MHO and MUHO base on Karelis criteria.

Methods: We enrolled 272 Iranian obese women and men (BMI ≥ 30). According to Karelis criteria, the participants were grouped base to MHO and MUHO. The body composition and BMD were assessed for all cases. Serum HDL-C, LDL-C, total cholesterol, triglyceride (TG), fasting blood glucose, homeostatic model assessment-insulin resistance (HOMA-IR), and hypersensitive C-reactive protein (hs-CRP) levels were quantified by ELISA method.

Results: Our results demonstrate MUHO phenotype have high total BMD more than MHO (P = 0.01, CI = 0.12 to 0.21). Also, the results of logistic regression analysis showed MUHO have strongly associated with total BMD (β = -0.42, CI = - 0.31 to - 0.04, P = 0.009), but did not affected L2-L4 BMD (β = - 0.09, CI = - 0.14 to 0.08, P = 0.578); this represents that there was discordance in MUHO subjects. Our evidence implicated that HOMA-IR, high level serum TG, hs-CRP, and low level serum HDL had mediatory effect on relationship between obesity and high BMD at the hip region in MUHO subjects (P < 0.05).

Conclusion: Present evidence indicates that, could be a novel link between difference in MUH phenotype and MH phenotype with bone status. Also, component metabolic can effect on BMD in different sites.
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http://dx.doi.org/10.1007/s11657-017-0381-9DOI Listing
October 2017

Vitamin D Receptor Gene Variation, Dietary Intake and Bone Mineral Density in Obese Women: A Cross Sectional Study.

J Nutr Sci Vitaminol (Tokyo) 2017 ;63(4):228-236

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS).

Osteoporosis and fragility fractures have been regarded as important public health concerns. We investigated their possible association with vitamin D receptor (VDR) FOK1 polymorphisms (rs10735810) and dietary parameters such as calcium and vitamin D intake. A total of 264 Iranian obese women (BMI>30 kg/m) were categorized based on the FOK1 genotype and divided into two groups: group one with the FF genotype (n=184) and the f allele carrier group with the Ff or ff genotype (n=80). The body composition, dietary intake and bone mineral density were assessed for all cases. The frequency of the F and f alleles for FOK1 in the study were 71.5% and 28.5%, respectively. Women with the f allele had a higher BMI (p=0.05), as well as parathyroid hormone (PTH) and tumor necrosis factor alpha (TNF-α) concentration (p=0.05, p=0.01, respectively). Participants with calcium intakes of more than 1,000 mg/d and the ff genotype had a higher L2_L4 Z-score. Moreover, women with vitamin D intakes of less than 600 IU/d and the ff genotype had a higher total T-score and total Z-score. Although women whose dietary intake of vitamin D was higher than the recommended dietary allowance (RDA>600 IU/d) and had the FF genotype had a higher total T-score and total Z-score, as well. Our findings suggest that interactions between FOK1 polymorphisms in Iranian obese women and dietary intake of calcium and vitamin D may play a decisive role in bone mineral density and osteoporosis among these women.
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http://dx.doi.org/10.3177/jnsv.63.228DOI Listing
July 2018