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There are some indications of regional differences in the association between fish consumption and clinical outcomes. We aimed to test the linear and potential non-linear dose-response relationships between fish consumption and risk of all-cause and cardiovascular (CVD) mortality, and possible confounding by region. Systematic review and dose-response meta-analysis. Systematic search using PubMed and Scopus, from inception up to September 2016. Prospective observational studies reporting the estimates of all-cause and CVD mortality in relation to three or more categories of fish intake were included. Random-effects dose-response meta-analysis was conducted. Fourteen prospective cohort studies (ten publications) with 911 348 participants and 75 451 incident deaths were included. A 20 g/d increment in fish consumption was significantly and inversely associated with the risk of CVD mortality (relative risk=0·96; 95 % CI 0·94, 0·98; I 2=0 %, n 8) and marginally and inversely associated with the risk of all-cause mortality (relative risk=0·98; 95 % CI 0·97, 1·00; I 2=81·9 %, n 14). Subgroup analysis resulted in a significant association only in the subgroup of Asian studies, compared with Western studies, in both analyses. Analysis of Western studies suggested a nearly U-shaped association, with a nadir at fish consumption of ~20 g/d in analysis of both outcomes. Meanwhile, the associations appeared to be linear in Asian studies. There was potential evidence of regional differences in the association between fish consumption and mortality. It may be helpful to examine the associations by considering types of fish consumed and methods of fish preparation.

Background Self-rated health (SRH) has been identified in many studies as a valid predictor of mortality and healthcare utilization. There is limited research on SRH and dietary intake. This study aimed to investigate the association between healthy eating index (HEI) and SRH in adults living in Tehran. Methods This cross-sectional study was carried out among 850 adult men and women aged 20–59 years who visited health centers in Tehran from 2021 to 2022. Dietary intake was assessed using a validated and reliable semiquantitative food frequency questionnaire with 168 food items, and SRH was assessed with one question: “In general, how do you rate your health?“. We categorized SRH into excellent/very good, good, and fair/poor. In the descriptive statistics part, we used mean ± standard deviation or number (ratio) for quantitative and qualitative variables, respectively. The chi-squared test and one-way analysis of variance were used to calculate the percentage and mean for demographic characteristics across tertiles of SRH. An analysis of covariance was used to compare the means of energy, macronutrients, the HEI, and its component variables across the tertiles of SRH. Results The final sample included 795 participants (68.2% female; mean ± standard deviation age: 44.81 ± 10.62 years) whose 40% reported excellent/very good SRH, and 30% reported good and fair/poor SRH separately. There was no association between body mass index, physical activity, education, health status, smoking, and sleep duration with SRH. After adjustment, the total HEI score and its component scores did not differ across the tertiles of SRH status. However, participants with good SRH had a higher intake of total energy (mean difference (MD): 180.33 Kcal, P value < 0.001), total fat (MD: 8.15 gr, P value = 0.002), and total carbohydrates (MD: 20.18 gr, P value = 0.004) than those with fair/poor SRH. Conclusion According to our findings, fair/poor SRH was associated with a lower consumption of total energy, total fat, and total carbohydrates in Iranian adults. Additional observational studies would be necessary to clarify these findings.

Accumulating evidence suggests positive effects of branched-chain amino acids (BCAAs) on moderate muscle damage. However, findings vary substantially across studies. The aim of this review was to examine the effect of BCAAs on recovery following exercise-induced muscle damage. Controlled trials were identified through a computerized literature search and tracking of citations performed up to November 2015. To pool data, either a fixed-effects or a random-effects model was used; for assessing heterogeneity, Cochran's Q and I2 tests were used. Eight trials met the inclusion criteria. Pooled data from the eight studies showed that BCAAs significantly reduced creatine kinase at two follow-up times (<24 and 24 h) in comparison with placebo recovery (<24 h: mean difference, –71.55 U/L, 95% confidence interval, –93.49 to –49.60, P < 0.000, n = 5 trials; 24 h: mean difference, –145.04 U/L, 95% confidence interval, –253.66 to –36.43, P = 0.009, n = 8 trials). In contrast, effects were not significant in any of the follow-up times for muscle soreness or lactate dehydrogenase. The current evidence-based information indicates that use of BCAAs is better than passive recovery or rest after various forms of exhaustive and damaging exercise. The advantages relate to a reduction in muscle soreness and ameliorated muscle function because of an attenuation of muscle strength and muscle power loss after exercise. •Branched-chain amino acids (BCAAs) significantly reduced creatine kinase for up to 24 h.•BCAAs demonstrated no beneficial effects in any of the follow-up times for muscle soreness and lactate dehydrogenase.•BCAA is better than passive recovery or rest after various forms of exhaustive and damaging exercise.

Alzheimer’s disease (AD) is a neurodegenerative condition characterized by cognitive decline and associated metabolic disturbances, including altered amino acid profiles. This study investigated the effects of probiotic supplementation with Lactobacillus rhamnosus HA-114 and Bifidobacterium longum R0175 on serum amino acid levels in adults with mild to moderate AD. In a 12-week, randomized, double-blind, placebo-controlled trial, 60 participants (aged 50–90 years) were assigned to three groups: L. rhamnosus ( n  = 20), B. longum ( n  = 20), or placebo ( n  = 20). Serum amino acids were analyzed using High-Performance Liquid Chromatography (LC). Changes in total amino acids, Branched Chain Amino Acids (BCAAs), and aromatic amino acids (AAAs) were assessed as the primary outcomes. A significant interaction effect was found between time and group for serum amino acids. Compared to placebo, the B. longum group showed a significant increase in total amino acids (difference: 2132.67 µmol/L, 95% CI: 464.06–3801.28; p  = 0.01), BCAAs (difference: 255.15 µmol/L, 95% CI: 53.01–457.30; p  = 0.01), and AAAs (difference: 374.34 ng/ml, 95% CI: 57.45–691.23; p  = 0.02). The L. rhamnosus group also showed a significant increase in BCAAs compared to placebo (difference: 206.08 µmol/L, 95% CI: 3.94–408.23; p  = 0.04). The greatest improvements were consistently observed in the B. longum group across all primary outcome measures. Probiotic supplementation, particularly with B. longum , significantly improved serum amino acid profiles in patients with mild to moderate Alzheimer’s disease. These findings support the potential of specific probiotic strains to address metabolic imbalances in AD through gut-brain axis modulation. Trial Registration : IRCT number: 20210513051277N1 (2021-05-27).

Diet and lifestyle as modifiable factors play an effective role in muscle strength and muscle endurance. In addition, inflammatory reactions may have an association with the etiology of a a lower muscle strength and muscle endurance. We aimed to investigate the association of dietary and lifestyle inflammation scores (DLIS) with muscle strength and muscle endurance in a sample of Iranian adults. In this cross-sectional study, 270 adults aged 20 to 59 years (55.9% female) were selected. The dietary intakes were collected using a 168-item semi-quantitative food frequency questionnaire. The DLIS was calculated using the dietary inflammatory score (DIS), and lifestyle inflammatory score (LIS). Muscle endurance and muscle strength were measured by a digital-handgrip-dynamometer. Multivariate adjusted means for muscle strength and endurance across quartiles of the DIS, LIS, and DLIS were determined by the ANCOVA test. Multiple linear regression analysis was used to evaluate the association between inflammation scores (i.e., DIS, LIS, and DLIS), and muscle strength, muscle endurance. The DLIS ranged between −2.94 and 3.09. The adjusted P-value of muscle strength of the right hand (MSR) along quartiles of DIS was significantly lower (P = 0.024). MSR (β: −1.19; P-value: 0.020) and mean muscle strength (MMS) (β: −0.95; P-value: 0.047) had significant association with DIS. MSR (β: −0.85; P-value: 0.050) had a marginally significant association with DLIS. Overall, we found that a high adherence to a pro-inflammatory diet might be associated to a lower muscle strength. However, a lifestyle with greater inflammatory potential was not related to any components of muscle endurance. Further studies with prospective designs are needed to confirm the present findings in further details.

Results of studies on the effect of chromium supplementation on blood pressure (BP) are contradictory. The purpose of the current study was to carry out a meta-analysis on the effects of chromium supplementation on systolic blood pressure (SBP) and diastolic blood pressure (DBP). We conducted a systematic literature search of PubMed, SCOPUS, Cochrane Library, Web of Science, and Embase databases from inception up to July 2020 for randomized controlled trials (RCTs) that evaluate the impacts of chromium on SBP and DBP. A random-effects model was used to compute weighted mean differences (WMDs) with 95% confidence intervals (CIs). Heterogeneity was determined by I2 statistics and the Cochrane Q test. Sensitivity analysis was performed by eliminating each study one by one and recalculating the pooled effect. Ten studies comprising a total of 624 subjects were included in our meta-analysis. Chromium supplementation did not significantly change SBP (WMD: −0.642: 95% CI: (−2.15, 1.30) mmHg; p = 0.312; I2 = 12.7%) and DBP (WMD: −0.10; 95% CI: (−1.39, 1.18) mmHg; p = 0.070; I2 = 37.6%). Subgroup analysis based on dose and duration of chromium supplementation also did not significantly change the mean of SBP and DBP. The present meta-analysis of RCTs did not show the beneficial effects of chromium supplementation on BP in adults.

Rheumatoid arthritis (RA) is a chronic inflammatory disorder affecting postmenopausal women. This study investigated the effects of intermittent fasting (IF) on antioxidant and inflammatory markers and liver enzymes in postmenopausal, overweight and obese women with RA. This 8-week randomized controlled trial included 44 postmenopausal women with RA divided into an intervention group following a 16:8 IF diet and a control group maintaining their usual diet and received recommendations for healthy eating. Inflammatory indices, oxidative stress markers, and liver enzymes were measured at baseline and post intervention. The IF group showed significant decreases in serum malondialdehyde (MDA) levels ( P  = 0.02) and neutrophil-to-lymphocyte ratio ( P  = 0.018) and increased catalase levels ( P  = 0.004) compared to the control group. Liver enzymes aspartate transaminase (AST) and alanine transaminase (ALT) also decreased significantly in the IF group ( P  = 0.02 and P  = 0.03, respectively). No significant differences were observed in the other measured parameters between groups. In conclusion, the 16:8 IF diet demonstrated beneficial effects on some oxidative stress markers, inflammatory indices, and liver enzymes in postmenopausal, overweight, and obese women with RA. These findings suggest that IF may be an effective non-pharmacological intervention for managing RA in this population, potentially addressing both primary disease symptoms and associated metabolic complications. Further research is needed to elucidate the long-term effects and mechanisms of IF in the management of RA.

The development of Alzheimer's disease (AD) has been strongly linked to the apolipoprotein E (APOE) polymorphism. A number studies have reported that the APOE ε4 allele is a genetic risk factor for developing AD, whereas the APOE ε2 and APOE ε3 alleles are considered to be neutral or even protective; however, there are conflicting data about these relationships in certain ethnic populations. Several meta-analyses have been performed to reduce the heterogeneity of results from different studies and estimate the real association in specific ethnicities. The aim of this study was to investigate the association between the APOE polymorphism and AD in an Iranian population. Our results showed a higher incidence of AD among individuals carrying the APOE ε4 allele (OR = 4.81, 95% CI: 3.28–7.05), more notably in those with the APOE ε4/e4 genotype (OR = 7.47, 95% CI: 2.35–23.73), while carrying the APOE ε3 allele was demonstrated to have a protective effect (OR = 0.40, 95% CI: 0.30–0.54). The association between the APOE ε2 allele and AD was not statically significant. However, further studies focusing on other parameters such as age, sex and environmental conditions are needed to reveal the true association between the APOE polymorphism and AD.

Background It has been recently reported that lipoprotein-associated phospholipase A2 (Lp-PLA2) may predict the risk of cardiovascular disease. The effect of multi-strain probiotics on Lp-PLA2 in patients with type 2 diabetes is still not clear. Aims This study aimed to determine the effect of multi-strain probiotic supplementation on lipoprotein-associated phospholipase A2, and glycemic status, lipid profile, and body composition in patients with type 2 diabetes. Methods In this randomized double-blind placebo-controlled clinical trial, 68 participants with type 2 diabetes, in the age group of 50–65 years, were recruited and randomly allocated to take either probiotic (n = 34) or placebo (n = 34) for 12 weeks. The primary outcome was lipoprotein-associated phospholipase A2, and secondary outcomes were glycemic parameters, lipid profile, anthropometric characters, and body composition (fat mass and fat-free mass). Results There was a significant reduction in serum lipoprotein-associated phospholipase A2, in the probiotic group, it dropped by 6.4 units at the end of the study ( p  < 0.001) compared to the placebo group. Probiotic supplementation also resulted in a significant improvement in the hemoglobin A1c and high-density lipoprotein cholesterol 1.5% ( p  < 0.001) and 6 mg/dl ( p 0.005 ), respectively. There were no significant changes in other outcomes. Conclusion Probiotic supplementation was beneficial for reducing Lp-PLA2 and hemoglobin-A1c and improving high-density lipoprotein cholesterol, which may suggest an improvement in the prognosis in patients with type 2 diabetes.