Dietary Choline and Betaine Intakes and Risk of Cardiovascular Diseases: Review of Epidemiological Evidence

<p><strong>BACKGROUND</strong>: Cardiovascular diseases (CVD) are the most important causes of human</p>mortality in the world. Higher intakes of choline and betaine have been shown to be associated<br />with lower plasma homocysteine levels (the putative CVD risk factor). This study aimed to<br />review the evidence on the association between dietary intakes of choline and betaine and<br />traditional/novel CVD risk factors.<br /><strong>METHODS</strong>: We searched in PubMed website from 1990 to 2009, with the use of following<br />keywords: "dietary choline and betaine, cardiovascular diseases, metabolic syndrome,<br />inflammation". The cross-sectional and prospective studies as well as the clinical trials were<br />recruited in this investigation.<br /><strong>RESULTS</strong>: Dietary intakes of &ldquo;choline&rdquo;/&ldquo;choline and betaine&rdquo; were not significantly associated<br />with CVD risk; however, the higher intakes of choline and betaine were associated with higher<br />serum concentrations of CRP, IL-6 and TNF-5. Individuals with high plasma choline levels were<br />obese and had elevated plasma triglycerides, HDL and non-HDL cholesterol levels; whereas<br />high plasma betaine levels were inversely associated with these biochemical markers. Both<br />choline and betaine supplementation resulted in increased blood lipid profiles.<br /><strong>CONCLUSION</strong>: Although dietary intakes of choline and betaine were not significantly<br />associated with CVD incidence, the long-term consumption of these nutrients have been shown<br />to prevent CVD mortality by decreasing inflammation and other risk factors.<br /><strong>Keywords</strong>: Choline, Betaine, Cardiovascular Diseases, Metabolic Syndrome, Inflammatio

Immunomodulatory Effects of Flavonoids: Possible Induction of T CD4+ Regulatory Cells Through Suppression of mTOR Pathway Signaling Activity

The increasing rate of autoimmune disorders and cancer in recent years has been a controversial issue in all aspects of prevention, diagnosis, prognosis and treatment. Among dietary factors, flavonoids have specific immunomodulatory effects that might be of importance to several cancers. Over different types of immune cells, T lymphocytes play a critical role in protecting the immune system as well as in the pathogenesis of specific autoimmune diseases. One of the important mediators of metabolism and immune system is mTOR, especially in T lymphocytes. In the current review, we assessed the effects of flavonoids on the immune system and then their impact on the mTOR pathway. Flavonoids can suppress mTOR activity and are consequently able to induce the T regulatory subset

The contribution of dietary and non-dietary factors to socioeconomic inequality in childhood anemia in Ethiopia:a regression-based decomposition analysis

OBJECTIVE: There is a scarcity of evidence on socioeconomic inequalities of childhood anemia in Ethiopia. We determined the magnitude of socioeconomic inequality in anemia and the contribution of dietary and non-dietary factors to the observed inequality, using a nationally representative data of 2902 children included in the 2016 Ethiopian demographic and health survey. The data were collected following a multistage, stratified cluster sampling strategy. We followed the Blinder-Oaxaca regression-based approach to decompose the inequality and determine the relative contribution (%) of the dietary and non-dietary factors to the observed inequality. RESULT: We found a significant pro-poor socioeconomic inequality in childhood anemia in Ethiopia. A third (~ 33%) of the inequality was attributable to compositional differences in the dietary determinants of anemia (dietary diversity, meal frequency, and breastfeeding factors). Non-dietary factors like residence place, maternal education, and birth weight) jointly explained ~ 36% of the inequality. Maternal education was the single most important factor, accounting alone for ~ 28% the inequality, followed by rural residence (~ 17%) and dietary diversity (~ 16%). Efforts to narrow socioeconomic gaps and/or designing equity sensitive interventions by prioritizing the poor in health/nutrition interventions stands worth of consideration to reduce the burden of childhood anemia in Ethiopia and beyond

Comparison the effect of low glycemic index diet with healthy nutritional recommendations based diet on obese adolescent girls

زمینه و هدف: هر چند مطالعات بسیاری به ارزیابی تأثیر نمایه گلیسمی بر چربی خون در بزرگسالان پرداخته اند، اما اطلاعات در این زمینه برای کودکان و نوجوانان محدود است. هدف این تحقیق مقایسه اثرات رژیم غذایی با نمایه گلیسمی پایین (LGI) با رژیم غذایی مبتنی بر توصیه های تغذیه سالم (HNR) بر سطح فراسنج های لیپیدی و آپولیپوپروتئین ها در نوجوانان دختر مبتلا به اضافه وزن و چاقی بود. روش بررسی: در این مطالعه کارآزمایی بالینی تصادفی شده پنجاه دختر سالم چاق یا دارای اضافه وزن و با وضعیت بلوغ یکسان بطور تصادفی در یکی از دو گروه رژیم غذایی LGI و رژیم غذایی مبتنی بر HNR قرار گرفتند. افراد هر دو گروه، رژیم غذایی با ترکیب مشابهی از درشت مغذی ها (56-53 کربوهیدرات، 18-16 پروتئین و 30-27 چربی) دریافت و مصرف نمودند. ارزیابی های بیوشیمیایی شامل تری گلیسیرید (TG)، کلسترول تام (TC)، لیپوپروتئین با دانسیته پایین (LDL)، لیپوپروتئین با دانسیته بالا (HDL)، آپولیپوپروتئین های A (Apo A) و B (Apo B) و لیپوپروتئین (a) (Lpa) یک بار در ابتدا و یک بار در انتهای مطالعه انجام شد. مقایسه مقادیر قبل و بعد در هر گروه با آزمون t زوجی و مقایسه تغییرات مشاهده شده در دو گروه با آزمون t مستقل در نرم افزار SPSS انجام شد. یافته ها: نمایه گلیسمی در گروه رژیم غذایی LGI کمتر از 50 بود (67/1 ± 67/42). میانگین نمایه توده بدنی در گروه LGI برابر 55/0 ± 97/27 متر بر مجذور قد و در گروه HNR برابر 01/1 ± 82/28 متر بر مجذور قد بود. میانگین سن در افراد گروه HNR از افراد گروه LGI به طور معنی داری بالاتر بود (27/0 ± 98/13 در مقابل 21/0 ± 18/13، 031/0=P). مقادیر متغیرهای بیوشیمیایی در ابتدا و انتهای مطالعه در بین دو گروه با یکدیگر تفاوتی نداشت. درصد تغییرات شاخص های چربی خون در بین گروه LGI و HNR نشان دهنده عدم وجود تفاوت معنی دار در تغییرات TG (به ترتیب 20/17± 90/27 و 53/10 ± 15/6؛ 274/0=P)، TC (به ترتیب 49/4 ± 58/5 و 63/3 ± 65/0-، 283/0=P)، HDL (به ترتیب 05/4 ± 20/1 و 07/3 ± 77/1-، 556/0=P)، LDL (به ترتیب 52/4 ± 35/4 و 32/3 ± 24/2-، 225/0=P)، Apo A (به ترتیب 73/5 ± 18/0- و 19/5 ± 37/9-؛ 242/0=P)، Apo B (به ترتیب 22/7±24/10 و 40/7±73/6؛ 738/0=P) و Lpa (به ترتیب 13/40 ±71/57 و 24/47 ± 18/97، 676/0=P) در بین دو گروه بود. نتیجه گیری: رژیم غذایی با نمایه گلیسمی پایین در مقایسه با رژیم غذایی مبتنی بر توصیه های تغذیه سالم تاثیر مفیدی در چربی خون ندارد

The effect of apple cider vinegar on lipid profiles and glycemic parameters:a systematic review and meta-analysis of randomized clinical trials

Abstract Background Elevated lipid profiles and impaired glucose homeostasis are risk factors for several cardiovascular diseases (CVDs), which, subsequently, represent a leading cause of early mortality, worldwide. The aim of the current study was to conduct a systematic review and meta-analysis of the effect of apple cider vinegar (ACV) on lipid profiles and glycemic parameters in adults. Methods A systematic search was conducted in electronic databases, including Medline, Scopus, Cochrane Library, and Web of Knowledge, from database inception to January 2020. All clinical trials which investigated the effect of ACV on lipid profiles and glycemic indicators were included. Studies were excluded if ACV was used in combination with other interventions or when the duration of intervention was  8-weeks, respectively. Furthermore, ACV consumption significantly decreased FPG levels in a subgroup of studies that administered ACV for > 8-weeks. Further, ACV intake appeared to elicit an increase in FPG and HDL-C concentrations in apparently healthy participants. Conclusion We found a significant favorable effect of ACV consumption on FPG and blood lipid levels

The state of child nutrition in Ethiopia:an umbrella review of systematic review and meta-analysis reports

BACKGROUND: Malnutrition remains to be a major public health problem in developing countries, particularly among children under-5 years of age children who are more vulnerable to both macro and micro-nutrient deficiencies. Various systematic review and meta-analysis (SRM) studies were done on nutritional statuses of children in Ethiopia, but no summary of the findings was done on the topic. Thus, this umbrella review was done to summarize the evidence from SRM studies on the magnitude and determinants of malnutrition and poor feeding practices among under-5 children in Ethiopia. METHODS: PubMed, Embase, Scopus, Web of Sciences, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, and Google Scholar were searched for SRM studies on magnitude and risk factors of malnutrition and child feeding practice indicators in Ethiopia. The methodological quality of the included studies was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR) tool. The estimates of the included SRM studies on the prevalence and determinants of stunting, wasting, underweight, and poor child feeding practices were pooled and summarized with random-effects meta-analysis models. RESULT: We included nine SRM studies, containing a total of 214,458 under-5 children from 255 observation studies. The summary estimates of prevalence of stunting, underweight, and wasting were 42% (95%CI = 37-46%), 33% (95%CI = 27-39%), and 15% (95%CI = 12-19%), respectively. The proportion of children who met the recommendations for timely initiation of breastfeeding, exclusive breastfeeding during the first 6 months, and timely initiation of complementary feeding were 65, 60, and 62%, respectively. The proportion of children who met the recommendations for dietary diversity and meal frequency were 20, and 56%, respectively. Only 10% of children fulfilled the minimum criteria of acceptable diet. There was a strong relationship between poor feeding practices and the state of malnutrition, and both conditions were related to various health, socio-economic, and environmental factors. CONCLUSION: Child malnutrition and poor feeding practices are highly prevalent and of significant public health concern in Ethiopia. Only a few children are getting proper complementary feeding. Multi-sectoral efforts are needed to improve children's feeding practices and reduce the high burden of malnutrition in the country

The effect of synbiotic supplementation on body composition and lipid profile in patients with NAFLD: A randomized, double blind, placebo-controlled clinical trial study

Background: Regarding the growing prevalence of non-alcoholic fatty liver disease, concentrating on various strategies for its prevention and management seems necessary. Objectives: This study aimed to assess the effects of synbiotic administration on body composition and lipid profile in patients with NAFLD. Methods: Eighty patients with NAFLD participated in this randomized, double-blind, placebo-controlled clinical trial (from March to July 2014) in Iran. Based on AST and ALT as main variables of the study, 34 patients were required in each group (power 80% and α = 5%). Considering a 20% sample loss, 80 patients were enrolled. Synbiotic supplement in form of a 500 mg capsule (containing 7 species of probiotic bacteria and Fructooligosaccharides) was administrated to patients in the intervention group and those in the placebo group received 1 placebo capsule daily for 8 weeks. At the baseline and the end of the study, body composition and lipid profile were evaluated. Results: A significant reduction was observed in weight (P = 0.001), body fat (P = 0.02), and total cholesterol (P = 0.04) within the synbiotic group. Onthe other hand,WC(P = 0.02), total cholesterol, and LDL-c (P = 0.04 and P = 0.001, respectively) were significantly increased in the placebo group. TG, HDL-c, and FBG levels remained statistically unchanged in both groups. Significance betweengroup differences were seen in total cholesterol (P = 0.01), LDL (P = 0.01), weight, WC, and body fat after adjustment for energy intake (P = 0.05). Conclusions: Synbiotic supplementation may improve lipid profile and body composition in patients with NAFLD and might be useful in prevention of the disease progression

The Association between Hypertriglyceridemic Waist Phenotype, Menopause, and Cardiovascular Risk Factors

Background: The incidence of cardiovascular disease (CVD) and its risk factors increase after menopause, thus realizing that the effect of menopause on women's health is becoming ever more vital. Objective: The aim of this study was to investigate the menopausal effect on cardiovascular risk factors in elevated triglycerides (TG) and waist circumference (WC) phenotype, and to compare this phenotype among pre- and postmenopausal women. Method: A total of 4146 women were randomly selected for this study from three districts of Isfahan, Arak, and Najafabad in Isfahan Healthy Heart Program (IHHP). Anthropometric, physical, and biochemical factors were assessed using standard methods. All variables were studied based on the menopause status and the levels of TG and WC. Results: Twenty-five point three percent of the postmenopausal women and 9.5% of the pre-menopausal women were hyper-TG/WC phenotype; however, the highest percent (77.1%) belonged to high-WC women in the postmenopausal group. In comparison with the postmenopausal women, the premenopausal women were more physically active, with higher education level, but lower BMI, WC, waist to hip ratio, and less likely to be smoker. In postmenopausal women, biochemical factors including fasting blood sugar and lipid profiles were significantly higher than the premenopausal women. There was no significant difference for multivariate-adjusted means of cardiovascular risk factors for menopause in different phenotypes of the WC and TG groups after adjustment for age and BMI. Conclusion: Hyper- TG/WC phenotype was more prevalent in postmenopausal women and menopause is not independently associated with CVD risk factors

The relationship between residential altitude and stunting:evidence from &gt;26,000 children living in highlands and lowlands of Ethiopia

Little information is known about the influence of altitude on child growth in Ethiopia, where most people live in highlands. We investigated the relation of residential altitude with growth faltering (stunting) of infants and young children in Ethiopia. We also examined whether the altitude-growth relationship was independent of the influence of the dietary and non-dietary determinants of growth. We used the data of 26 976 under-5-year-old children included in the Ethiopian Demographic and Health Surveys, conducted from 2005 to 2016. The samples were recruited following a two-stage cluster sampling strategy. Stunting was defined by height-for-age <-2 z-scores. The relationship between residential altitude and stunting was examined by running multiple logistic regression analysis, controlling the effect of covariate dietary and non-dietary variables. The residential altitude of the study participants ranged from-116 to 4500 m above sea level (masl). There was a significant and progressive increase in the prevalence and odds of stunting with increasing altitude (P < 0·001), irrespective of the dietary and non-dietary predictors of stunting. The prevalence of stunting was lowest in lowlands (39 %) and highest in highlands (47 %). Compared with altitude <1000 masl, the odds of stunting was 1·41 times higher at altitude ≥2500 masl (OR 1·41, 95 % CI 1·16, 1·71) and 1·29 times higher at altitude 2000-2499 masl (OR 1·29, 95 % CI 1·11, 1·49). Children living in highlands might be at a higher risk of poor growth. Further studies are warranted to understand the mechanism behind the observed altitude-stunting link and identify strategies to compensate for the growth-faltering effect of living in highlands

Dietary sodium and potassium intake and their association with blood pressure in a non-hypertensive Iranian adult population: Isfahan salt study

Aim: The association of sodium (Na) and potassium (K) intake with blood pressure (BP) is an ongoing debate, especially in central Iran. We aimed to examine the mean Na and K intake, major sources of Na and the relationship between BP and dietary and urinary Na and K. Methods: This cross-sectional study was performed in central Iran in 2013-2014. A total of 796 non-hypertensive adults aged >18years were randomly recruited. The semi-quantitative food frequency questionnaire was used to assess dietary Na and K intake. Moreover, 24-hour urine samples were collected to measure 24-hour urinary Na (UNa) and K (UK) as biomarkers. BP was measured twice on each arm using a standard protocol. Results: The mean Na and K intake were 4309.6±1344.4 and 2732.7±1050.5mg/day, respectively. Table and cooking salt were the main sources of Na. Odds ratio (OR) (95% confidence interval (CI)) of the crude model in the highest quartile of UNa indicated a significant association with the higher risk of prehypertension (OR (95% CI): 2.09 (1.09-4.05); P for trend=0.007). After adjustment for potential confounders, prehypertension was significantly associated with increasing dietary Na/K ratio (OR (95% CI): 1.28 (1.01-1.57); P for trend=0.046) and UNa/UK ratio (OR (95% CI): 2.15(1.08-4.55); P for trend=0.029). Conclusions: Increasing dietary and urinary Na/K ratios and UNa were associated with elevated BP and prehypertension occurrence. These findings support the necessity of developing a salt reduction programme in our country. © 2016 Dietitians Association of Australia