The Effect of Walnut (Juglans regia) Leaf Extract on Glycemic Control and Lipid Profile in Patients With Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Mirzababaei Atieh,Daneshvar Mojtaba,Abaj Faezeh,Daneshzad Elnaz,Hosseininasab Dorsa,Clark Cain C. T.,Mirzaei Khadijeh 한국임상영양학회 2022 Clinical Nutrition Research Vol.11 No.2

Numerous clinical trials have examined the beneficial effects of Juglans regia leaf extract (JRLE) in patients with type 2 diabetes mellitus (T2DM); however, the results of these studies are inconsistent. Therefore, we conducted the current systematic review and meta-analysis to evaluate the effect of JRLE on glycemic control and lipid profile in T2DM patients. We searched online databases including PubMed, Scopus, EMBASE, and Web of Science for randomized controlled clinical trials that examined the effect of JRLE on glycemic and lipid indices in T2DM patients. Data were pooled using both fixed and random-effect models and weighted mean difference (WMD) was considered as the overall effect size. Of the total records, 4 eligible studies, with a total sample size of 195 subjects, were included. The meta-analysis revealed that JRLE supplementation significantly reduces fasting blood glucose (WMD, −18.04; 95% confidence interval [CI], −32.88 mg/dL, −3.21 mg/dL; p = 0.017) and significantly increases fasting insulin level (WMD, 1.93; 95% CI, 0.40 U/L, 3.45 U/L; p = 0.014). Although the overall effect of JRLE supplementation on hemoglobin A1c was not significant, a significant reduction was seen in studies with an intervention duration of > 8 weeks (WMD, −0.64; 95% CI, −1.16%, −0.11%; p = 0.018). Moreover, we also found no significant change in lipid parameters. Our findings revealed a beneficial effect of JRLE supplementation on glycemic indices in T2DM patients, but no significant improvement was found for lipid profile parameters.

The effect of psyllium supplementation on blood pressure: a systematic review and meta-analysis of randomized controlled trials

Cain C. T. Clark,Mina Salek,Elahe Aghabagheri,Sadegh Jafarnejad 대한내과학회 2020 The Korean Journal of Internal Medicine Vol.35 No.6

Background/Aims: Global incidence of hypertension is estimated to be, in excess of, one billion people, and given the efficacy of soluble dietary fibers, in particular, Psyllium, to positively impact blood pressure in patients with hypertension, it is of clinical importance that consensus on its supplementation be established. Therefore, the aim of the study was systematically review and meta-analyze the effect of psyllium supplementation on blood pressure of hypertensive patients in randomized controlled trials. Methods: We searched six universal databases including; Pubmed/Medline, Ovid, Cochrane Library, Google Scholar, Embase, and Scopus until November 2018. Both combined and stratified analyzes were conducted. A fixed-effects or random- effects model was used to assess the mean effect sizes. Results: An eventual 11 trials with 592 participants were considered as eligible for inclusion in the present meta-analysis. The meta-analysis revealed a significant reduction of 2.04 mmHg in systolic blood pressure (weighted mean difference, –2.04; 95% confidence interval, –2.82 to –1.63; p < 0.001). Whilst meta-regression highlighted that the hypotensive effect of psyllium was stronger in subjects with higher baseline blood pressure. Conclusions: Given the overarching benefits and lack of reported side effects, particularly for hypertensive patients, health care providers and clinicians should consider the use of psyllium supplementation for the treatment or abatement of hypertension, or hypertensive symptoms.

Breakfast-Based Dietary Patterns and Obesity in Tehranian Adults

Zahra Akbarzade,Saba Mohammadpour,Kurosh Djafarian,Cain C. T. Clark,Parivash Ghorbaninejad,Maryam Mohtashami,Sakineh Shab-Bidar 대한비만학회 2020 The Korean journal of obesity Vol.29 No.3

Background: Breakfast is an important meal of the day that contributes to an overall healthy dietary pattern, better nutrient intake, and diet quality. This study sought to investigate the relationship between breakfast patterns and general and central obesity among middle-aged adults. Methods: In this cross-sectional study of 840 apparently healthy women and men, aged 20–59 years, we assessed usual dietary intake by means of three 24-hour dietary recalls and we took anthropometric measurements. Dietary patterns were subsequently identified by factor analysis. To assess the association between breakfast composition and central and general obesity, logistic regression analysis was performed. Results: We identified three major dietary patterns by factor analysis: the “bread and grains, meat products, and coffee” dietary pattern, the “sweets, tea and coffee” dietary pattern, and the “fruits, vegetables, and eggs” dietary pattern. Those people in the third tertile of the “sweets, tea and coffee” dietary category had a greater chance of having central obesity (odds ratio, 1.80; 95% confidence interval, 1.25–2.59; P=0.001). Moreover, higher adherence to the “bread and grains, meat products, and coffee” pattern increased the chance of central obesity (odds ratio, 1.67; 95% confidence interval, 1.47–1.97; P=0.03). Conclusion: Overall, our results suggest that specific breakfast dietary patterns are associated with increased odds of central obesity in Iranian adults.

The Association Between Dietary Energy Density and Musculoskeletal Pain in Adult Men and Women

Bahrampour Niki,Rasaei Niloufar,Gholami Fatemeh,Clark Cain C. T. 한국임상영양학회 2022 Clinical Nutrition Research Vol.11 No.2

Musculoskeletal pains (MPs), defined as persistent or recurrent pain, is a complex health problem. High overall calorie and fat intake have been related to obesity and MPs. Dietary energy density (DED), defined as energy content of food and beverages (in kcal) per unit total weight, has been associated with chronic muscle, cartilage, bone damage and pain. Thus, the purpose of this study is to investigate the association between DED and MPs in adult men and women. A total of 175 men and women (> 18 years) with MP participated in the study. A validated short form physical activity (PA) questionnaire, demographic, and McGill Pain Questionnaire were used. Anthropometric measurements were evaluated via standard protocols. Furthermore, a seven-day 24-hour recall of diet was used to determine the dietary intake. Total DED was calculated and divided into quartiles. Linear regression was used to discern the association between DED and MPs in adults. Participants assigned in the highest category of DED were characterized by lower intake of potassium, magnesium, vitamin C, folate, and fiber. However, results showed displayed higher intake of sodium, vitamin E, vitamin B3, fat, protein, cholesterol, saturated fatty acids, monounsaturated fatty acids, and polyunsaturated fatty acids (p < 0.001). Finally, after adjustment for confounders such as age, gender, PA, body mass index, waist circumference, education, job, marital status, history of some chronic diseases and vitamin C supplementation, a significant positive association was detected between DED and pain intensity. There was no significant association between DED and pain frequency in all models.

The Association between Dietary Antioxidant Quality Score and Cardiorespiratory Fitness in Iranian Adults: a Cross-Sectional Study

( Hossein Shahinfar ),( Mahshid Shahavandi ),( Aliyu Tijani Jibril ),( Kurosh Djafarian ),( Cain C. T. Clark ),( Sakineh Shab-bidar ) 한국임상영양학회 2020 Clinical Nutrition Research Vol.9 No.3

The association between dietary antioxidant quality score (DAQS) and cardiovascular risk factors such as low cardiovascular fitness (CRF) and elevated blood pressure (BP) has rarely been investigated. To investigate the association between DAQS, CRF, and BP. This cross-sectional study was conducted on 270 adult subjects living in Tehran, Iran. Dietary intake was evaluated using a validated food frequency questionnaire. The DAQS was calculated using antioxidant-nutrient intake. Socio-economic status, anthropometric measures, and BP were recorded by a trained interviewer, using standard methods. A significant increase was found in maximal oxygen uptake (p value = 0.01) across tertiles of DAQS. After adjusting for confounders, the association remained unchanged (p value = 0.02). Participants in the highest tertile of DAQS had higher systolic BP (SBP) (p value = 0.01) and diastolic BP (DBP) (p value = 0.03), although adjustment for confounding factors attenuated the results (p value = 0.3 for DBP and p value = 0.6 for SBP). Our results revealed that higher DAQS is associated with better CRF in Iranian adults. Further studies are needed to establish the veracity of our results.

Association of Nutrient Patterns with Metabolic Syndrome and Its Components in Iranian Adults

( Zahra Akbarzade ),( Mohammad Reza Amini ),( Farhang Djafari ),( Habib Yarizadeh ),( Fatemeh Mohtashaminia ),( Maryam Majdi ),( Elham Bazshahi ),( Kurosh Djafarian ),( Cain C. T. Clark ),( Sakineh Sh 한국임상영양학회 2020 Clinical Nutrition Research Vol.9 No.4

We aimed to examine the association between nutrient patterns and metabolic syndrome (MetS) in Iranian adults. In a cross-sectional study of 850 self-certified healthy women and men aged 20-59 years old, dietary data were assessed using three 24-hour recall. Anthropometric measures were done and blood samples were collected to measure serum fasting serum glucose and lipid profile. The MetS was defined using the International Diabetes Federation. Major nutrient patterns were identified using principle competent analysis. In the first nutrient pattern, the individuals in the fifth quintile had a higher intake of vitamins B1, B2, B3, B5, B6, B12, zinc, iron, saturated fatty acids (SFAs), and protein. In the second nutrient pattern, individuals in the first quintile had lower consumption of zinc, SFAs, vitamin E, α-tocopherol, oleic acid, polyunsaturated fatty acids, β-carotene, linolenic acid, and monounsaturated fatty acids, compared to the fifth quintile. Furthermore, in the third nutrient pattern, the individuals in the fifth quintile had a higher intake of potassium, magnesium, phosphorous, calcium, protein, carbohydrate, vitamin C, and folate compared to other quintiles. We identified the second pattern had an indirect association with systolic and diastolic blood pressure, triglycerides, fasting blood sugar (p < 0.001 for all), and total cholesterol (p = 0.04) when it was controlled for body weight. Our findings showed that nutrient patterns may have an association with MetS components with mediating body weight.

Association of Dietary Patterns with Visceral Adiposity, Lipid Accumulation Product, and Triglyceride-Glucose Index in Iranian Adults

( Mohammad Reza Amini ),( Hossein Shahinfar ),( Nadia Babaei ),( Samira Davarzani ),( Mojdeh Ebaditabar ),( Kurosh Djafarian ),( Cain C. T. Clark ),( Sakineh Shab-bidar ) 한국임상영양학회 2020 Clinical Nutrition Research Vol.9 No.2

In the present study, we sought to examine the association between dietary patterns (DPs) and visceral adiposity, lipid accumulation product (LAP), and triglyceride-glucose index. This cross-sectional study was conducted on adults aged between 18-45 years old who lived in Tehran, Iran, between February 2017 and December 2018 (n = 270). DPs were derived using principal component analysis. We used analysis of variance to examine differences in continues variables across tertiles of major DPs. Subsequently, for the modeling of these relationships, and also considering the possible effect of the confounding factors, multivariate regression was used. Three DPs were identified: healthy pattern, mixed pattern, and western pattern, respectively. Compared with individuals in the lowest category of mixed pattern, those in the highest category had lower fasting blood sugar (96.26 ± 11.57 vs. 101 ± 28.66, p = 0.01). A significant association was found between healthy pattern, after adjustment for potential confounders, and odds of LAP; such that individuals in the top category of healthy pattern score were 71% less likely to have a high LAP compared with those in the lowest category (odds ratio, 0.29; 95% confidence interval, 0.10-0.81). We found that adherence to a healthy DP was associated with decreased LAP. To confirm the veracity of these findings, more studies should be conducted.