Effects of green coffee aqueous extract supplementation on glycemic indices, lipid profile, CRP, and malondialdehyde in patients with type 2 diabetes: a randomized, double-blind, placebo-controlled trial

Background/objectivesStudies have reported the health benefits of green coffee extract (GCE) in experimental models. In the current study, we aimed to determine whether supplementation with GCE improves glycemic indices, inflammation, and oxidative stress in patients with type 2 diabetes (T2D).Methods and study designThis randomized, double-blind, placebo-controlled trial included 44 patients (26 male and 18 female) with T2D and overweight/obesity. After blocked randomization, patients received either capsules containing 400 mg GCE twice per day (n = 22) or a placebo (n = 22) and were followed for 10 weeks. In this study, glycemic indices, lipid profiles, anthropometric examinations, blood pressure, high-sensitivity C-reactive protein (hs-CRP), and malondialdehyde (MDA) were measured twice; at baseline and at the end of the study.ResultsAfter 10 weeks of supplementation, GCE supplementation significantly reduced body weight (p = 0.04) and body mass index (BMI) (p = 0.03) compared to the placebo. The intention-to-treat (ITT) analysis indicated patients in the GCE group had a lower fasting blood glucose (FBG) concentration compared to the placebo group; however, this decreasing was marginally significant (8.48 ± 8.41 vs. 1.70 ± 5.82 mg/dL, p = 0.05). There was no significant difference in insulin levels and HOMA-IR between the groups. At the end of the study, significant changes in systolic blood pressure (SBP) (p = 0.01), triglyceride (TG) level (p = 0.02), high-density lipoprotein (HDL) (p = 0.001), and TG-to-HDL ratio (p = 0.001) were found between the intervention and placebo groups. Our trial indicated GCE supplementation had no effect on diastolic blood pressure (DBP), low-density lipoprotein (LDL), or total cholesterol. During the supplementation period, the hs-CRP level significantly decreased in the GCE group compared to the placebo group (p = 0.02). No significant changes were observed in the MDA level between the two groups at the end of the study (p = 0.54).ConclusionOur findings showed beneficial effects of GCE on SBP, TG, hs-CRP, and HDL levels in patients with T2D and overweight/obesity over a 10-week period of supplementation.Clinical trial registration:https://en.irct.ir/trial/48549, identifier [IRCT20090203001640N18]

Perspective: The Application of A Priori Diet Quality Scores to Cardiovascular Disease Risk-A Critical Evaluation of Current Scoring Systems.

Healthy dietary habits are the cornerstone of cardiovascular disease (CVD) prevention. Numerous researchers have developed diet quality indices to help evaluate and compare diet quality across and within various populations. The availability of these new indices raises questions regarding the best selection relevant to a given population. In this perspective, we critically evaluate a priori-defined dietary indices commonly applied in epidemiological studies of CVD risk and mortality. A systematic literature search identified 59 observational studies that applied a priori-defined diet quality indices to CVD risk factors and/or CVD incidence and/or CVD mortality. Among 31 different indices, these scores were categorized as follows: 1) those based on country-specific dietary patterns, 2) those adapted from distinct dietary guidelines, and 3) novel scores specific to key diet-related factors associated with CVD risk. The strengths and limitations of these indices are described according to index components, calculation methods, and the application of these indices to different population groups. Also, the importance of identifying methodological challenges faced by researchers when applying an index are considered, such as selection and weighting of food groups within a score, since food groups are not necessarily equivalent in their associations with CVD. The lack of absolute cutoff values, emphasis on increasing healthy food without limiting unhealthy food intake, and absence of validation of scores with biomarkers or other objective diet assessment methods further complicate decisions regarding the best indices to use. Future research should address these limitations, consider cross-cultural and other differences between population groups, and identify translational challenges inherent in attempting to apply a relevant diet quality index for use in CVD prevention at a population level

Iron, Iodine and Vitamin A in the Middle East; A Systematic Review of Deficiency and Food Fortification

Background: Micronutrient deficiency is one of the major public health problems in the Middle East affecting economic, political and social development of countries. The three commonest micronutrient deficiencies belong to iron, iodine and vitamin A. Methods: we conducted a systematic review of published English articles in the Middle East countries using databases from PubMed, World Health Organization and Food and Agriculture Organization from 1985 onward. A total of 6050 articles were identified and after evaluation based on eligibility criteria, 81 articles included in this systematic review.Results: Despite implementation of flour fortification other control strategies, the prevalence of iron deficiency is moderate to severe in the Middle Eastern countries, because of ineffective iron fortification program, food interaction and hemoglobin application as anemia indictors in these countries. Mild to severe iodine deficiency disorders exist in many countries of the Middle East, due to lack of effective iodine supplementation program. The prevalence of vitamin A deficiency is mild to severe and there is lack of vitamin A fortification program in many countries in this region.Conclusion: Despite unharmonized efforts to control malnutrition of micronutrients, iron, iodine and vitamin A deficiencies are still exist in some countries of the Middle East. Effective, well controlled and harmonized programs for elimination of micronutrient deficiencies need to be initiated for governments and supported by international organizations in this region

Association between some dietary factors and risk of hypertension: Tehran lipid and glucose study (2008-11)

Background and Objective: Hypertension in long time can cause cardiovascular disorders and increase chance of stroke. This study was done to determine the association between some dietary factors and risk of hypertension. Methods: This cross-sectional study was conducted on the fourth phase (2008-11) of Tehran lipid and glucose study (TLGS). In this study 6089 subjects (2807 males and 3282 females), aged 19-70 years, were participated and dietary, demographic, anthropometric and blood pressure of each subject were collected. Dietary intake was assessed using a validated and reliable food frequency questionnaire with 147-items. Odds ratio for hypertension according to quartiles of dietary factors was determined using logistic regression with adjustment for confounder variables. Results: The rate of hypertension was 29.8%. Mean of weight, body mass index, waist circumference, prevalence of abdominal obesity and alliteration in the hypertensive subjects were significantly higher than normotensive subjects (P<0.05). There was a non significant direct relationship between energy density, total fat and saturated fat. Higher consumption of fiber was associated with lower risk of hypertension (OR: 0.62, 95% CI: 0.37-0.97). The risk of hypertension increased in the highest quartiles of dietary protein (OR: 1.20, 95% CI: 1.02-1.43). Odds ratio for hypertension was higher among subjects whom consumed lower fruits and nuts than those subjects with higher fruits consumption (OR: 1.33, 95% CI: 1.15-1.85) and nuts (OR: 1.21, 95% CI: 1.02-1.42). Conclusion: High consumption of fiber could protect against hypertension while some dietary factors such as high consumption of protein could increase risk of hypertension

Association between dietary phytochemical index and 3-year changes in weight, waist circumference and body adiposity index in adults: Tehran Lipid and Glucose study

<p>Abstract</p> <p>Background</p> <p>High intakes of phytochemical-rich foods have favorable effects on the prevention of chronic diseases. In this study we assessed the dietary phytochemical index (PI) in relation to 3-year change in weight, waist circumference (WC), body adiposity index (BAI) among Tehranian adults.</p> <p>Methods</p> <p>This longitudinal study was conducted in the framework of Tehran Lipid and Glucose Study, between 2006–2008 and 2009–2011, on 1938 adults, aged 19–70 y. The usual intake of participants was measured at baseline using a validated semi-quantitative food frequency questionnaire and dietary PI was calculated. Anthropometric measures were assessed both at baseline and 3 years later. Multiple regression models were used to estimate mean difference changes in anthropometrics associated with various dietary PI.</p> <p>Results</p> <p>The mean age of participants was 40.4 ± 13.0 y, at baseline, respectively. Mean weight gain was 1.49 ± 5.06 kg (1.65 ± 5.3 kg in men and 1.34 ± 4.9 kg in women) during 3-year period. After adjustment for potential confounding variables including age at baseline, sex, BMI, educational levels, smoking, physical activity, total energy intake, dietary intake of carbohydrate, fat and protein, dietary intakes of whole grains in the highest quartile category of PI were inversely associated with 3-year changes in weight and WC (<it>P for trend <0.05</it>). Dietary intake of fruits in the highest quartile was also associated with lower weight gain during the study period (<it>P for trend <0.05</it>). There was significant inverse association between the highest quartile category of dietary PI with the 3-year changes in weight and BAI (<it>P for trend <0.05</it>).</p> <p>Conclusion</p> <p>Higher dietary PI could have favorable effects on prevention of weight gain and reduction of body adiposity in adults.</p

Dietary phytochemical index and subsequent changes of lipid profile: A 3-year follow-up in Tehran Lipid and Glucose Study in Iran

BACKGROUND: High intakes of phytochemical-rich foods have beneficial effects on lipid profiles and cardiovascular disease (CVD). In this study, we assessed the association between the dietary phytochemical index (PI) and changes in lipid profile after 3-year follow-up among Iranian adults. METHODS: This longitudinal study was conducted in 1983 subjects, aged 19-70 years, selected among participants of the Tehran Lipid and Glucose Study. Dietary data were collected by using a validated semi-quantitative food frequency questionnaire with 168 food items at baseline. PI was calculated based on daily energy derived from [(phytochemical-rich foods kcal/total daily energy intake kcal) &times; 100]. Lipid profile was measured at baseline and after 3 years and changes in serum lipid profiles were assessed during 3-year follow-up. RESULTS: The mean age of participants was 40.4 &plusmn; 13.0 years; participants in the highest PI quartile category were more likely to be older. After 3 years of follow-up, total cholesterol was significantly lower in the highest quartile compared with lower quartile of PI in men (181 &plusmn; 3 vs. 189 &plusmn; 3, P for trend &lt;0.05). There were significant inverse association between dietary PI and 3 years changes of total cholesterol [&beta;: &minus;5.6, 95% confidence interval (CI) = &minus;9.3, &minus;1.8], triglycerides (&beta; = &minus;13.7, 95% CI = &minus;24.6, &minus;2.8), and non-high-density lipoprotein cholesterol (HDL-C) (&beta; = &minus;6.2, 95% CI = &minus;10.8, &minus;1.5), in highest quartile of PI in men. Lipid profiles showed no significant changes over the study period in women. CONCLUSION: Higher dietary PI is associated with 3 years improvement of total cholesterol, triglycerides, and non-HDL-C. Higher consumption of phytochemical-rich foods is recommended to prevent CVD. &nbsp; Keywords: Phytochemical, Triglyceride, Cholesterol, Fruit and vegetables, Whole Grains&nbsp;</p