Effect of conjugated linoleic acid and vitamin E on glycemic control, body composition, and inflammatory markers in overweight type2 diabetics

BACKGROUND: The healthy properties of conjugated linoleic acid (CLA) such as weight loss, reducing cardiovascular risk factors and inflammation have been reported. The trans-10, cis-12 CLA isomer is related to increasing insulin resistance, but the effects of cis-9, trans-11 isomer is not clear. The aim of this study was to investigate the effects of CLA with and without Vitamin E on body weight, body composition, glycemic index, inflammatory and coagulation factors, lipid profile, serum leptin and adiponectin, malondialdehyde (MDA), and blood pressure in type2 diabetes. METHODS: 56 patients with type2 diabetes were included in 8 week double-blind control trial that used metformin. They randomly divided into three groups: CLA + VitE, CLA + VitE placebo, CLA placebo + VitE placebo. All variables, anthropometric measurements, and body composition were evaluated at the beginning and the end of study. Statistical analysis and analysis of dietary data were performed using SPSS and nutritionist IV software, respectively. RESULTS: There were not any significant differences in variable changes among three groups. However, there was a trend to increase in MDA and decrease in apoB100 among CLA consumers. CONCLUSION: The results of this study showed that administration of CLA supplementation for 8 weeks does not affect any indicators of metabolic control in overweight type2 diabetic patients

Bushehr Elderly Health (BEH) programme: study protocol and design of musculoskeletal system and cognitive function (stage II).

Abstract INTRODUCTION: Musculoskeletal disorders and cognitive diseases are prevalent, and they are significant determinants of morbidity and mortality in older adults. The aim of this study is to investigate the prevalence of musculoskeletal and cognitive diseases and their risk factors and also to assess their associations during future follow-ups. METHODS AND ANALYSIS: Bushehr Elderly Health (BEH) programme is a population-based prospective cohort study being conducted in Bushehr, a southern province of Iran. A total of 3000 older people aged ≥60 years participated in the first stage from which 2772 were eligible to participate in the second stage, which started after 2.5 years. Data including demographic status, lifestyle factors, general healthandmedical history, and mentalandfunctional health are collected through a questionnaire. Anthropometric measures, performance testsandmuscle strength, blood pressure and and body composition measurements are done. A total 25 cc venous blood is taken, and sera are stored at -80°C for possible future analyses. ETHICS AND DISSEMINATION: The study protocol was approved by the ethics committee of Endocrinology and Metabolism Research Institute, affiliated to Tehran University of Medical Science as well as the Research Ethics Committee of Bushehr University of Medical Sciences. A written informed consent was signed by all the participants. The study findings will show the prevalence of musculoskeletal disease, cognitive impairment and their risk factors in an elderly population. The participants will be followed during the study to measure the occurrence outcomes.This study will also have the potential to inform the development of beneficial interventions to improve the management of musculoskeletal and cognitive impairment in Iran and other countries in the Middle East.Our findings will be disseminated via scientific publication as well as presentation to stakeholders, including the patients, clinicians, the public and policymakers, via appropriate avenue

A review of Ramadan fasting and diabetes mellitus: Controversies regarding the effects of Ramadan fasting on diabetic patients

Although several studies have investigated the effects of Ramadan fasting on diabetic patients, the exact impacts on diabetes control have not been well elucidated yet. There are neither precise quantitative criteria nor clear guidelines regarding Ramadan fasting for diabetic patients. This review aimed to discuss the results of previous studies. The neglected points in performed studies should be considered in the design and interpretation of future research related to Ramadan fasting in diabetic patients. A thorough research was carried out on the internet, using the following keywords: “Ramadan”, “Ramadan fasting”, “Islamic fasting”, “fasting in Ramadan”, and “fasting”, in combination with words such as “diabetes mellitus”, “hyperglycemia”, “hypoglycemia”, and “diabetic ketoacidosis”. Databases including PubMed, Google Scholar, and some regional databases were searched in order to find related articles (cross-sectional, descriptive-analytical, cohort, clinical trial, and review studies), published during 1957-2013. The obtained data showed that Ramadan fasting could be non-risky for partially controlled diabetic patients. However, the safety of Ramadan fasting for diabetic patients with different blood glucose levels and complications is not yet determined. Many deficiencies and limitations are observed in the related studies such as the heterogeneity of participants including differences in lifestyle and circadian rhythm changes. Therefore, well controlled studies need to be performed to evaluate factors affecting blood glucose level during Ramadan fasting.

Ramadan fasting, pregnancy and lactation

Background: Fasting and malnutrition during pregnancy is associated with deleterious consequences such as hypoglycemia, ketonemia, impaired fetal IQ, low birth weight and even abortion. Comparison of pregnancy length and year duration shows that about 75% of pregnancies coincided with Ramadan. Also, fasting during Ramadan is not equivalent to hunger and malnutrition, however, knowledge of the effects of Ramadan fasting on pregnancy outcome is important. In this review, the results of all studies related to the possible effects of Ramadan fasting in pregnancy and lactation have been collected. Material and Methods: Keywords such as "Ramadan", "Ramadan Fasting", "Islamic Fasting", "Fasting in Ramadan "and Fasting with words Pregnancy, Birth Weight, Lactation, Preterm, Milk Composition, Breast Milk were searched in PubMed Database, SID (Scientific Information Database), and some regional journals and 40 related articles (descriptive cross - sectional, cohort, clinical trial and review articles) from 1968 to 2010 were studied. Results: Based on available information, if the maternal nutrition during Ramadan is good, the normal process of pregnancy will be maintained and Ramadan fasting would not have deleterious effects on fetal physical and mental growth. Conclusion: Considering nutritional tips, nursing mothers could also fast during Ramadan

Ramadan fasting, mental health and sleep-wake pattern

Background: Life style Changes during Ramadan month could possibly affect sleep-related behaviors such as total daily sleep time, sleep and wake up time and brain waves. In addition, Spirituality and religiosity have a marvelous influence on mental health and effective solutions against stress are being religious and believe in God. This review discusses the results of all related studies about possible effects of Ramadan fasting on various aspects of sleep pattern and mental health. Methods: Keywords such as ‘Ramadan’, ‘Ramadan Fasting’, ‘Islamic Fasting’, ‘Fasting in Ramadan’ and Fasting along Sleep, Chronotype, Sleep Latency, REM, NREM, Brain Wave, Psychology, Mental health, Religion, Mood, Depression, Social interaction, Depressive illness, Psychomotor performances, Bipolar disorders, Accident, Mania, Anxiety and Stress were searched via PubMed database, Scientific Information Datebas (SID) and also some local journals, hence, 103 related articles from 1972 until 2010 were studied. Results: The results of studies about the effects of Ramadan fasting on sleep pattern is not similar and these differences could be due to cultural and life style discrepancy in several countries. Fasting during Ramadan could lead to delay in sleep-wake cycle, decrease in deep sleep and lack of awareness during the day. Conclusion: There are various reasons such as dietary pattern, hormonal changes and also stress which could alter the quantity and quality of sleep during Ramadan. Also, according to the available information, there is a relationship between fasting and mental health

Recommended guideline for designing and interpreting of Ramadan fasting studies in medical research

Ramadan fasting is specific intermittent fasting comprising significant changes in routine lifestyle pattern and may affect body homeostasis and metabolism. In spite of several studies conducted on the effects of Ramadan fasting on various aspects of health and disease, because of heterogeneity in methodology and procedures (sometimes inevitable), a comprehensive concluding for reliable results as in most conditions is impossible. Based on basic studies and those have been conducted in this field, this paper suggests a checklist contains, as far as possible, important factors to be considered in designing, interpreting and comparing the results of Ramadan fasting studies. Accordingly, circadian rhythm, season/latitude sensitivity, serum osmolarity and, lifestyle changes (including dietary intakes, physical activity, sleep quality and duration, smoking and, etc.) may be of great importance. Also, a close definition of the number of fasting days and it consecutively or alternatively must be presented with reference to sex. Appropriate time points for blood/urine sampling would be varied case by case

Ramadan major nutrient patterns are associated with anthropometric measurements and physical activity in Tehran, Iran

During Ramadan fasting quantity and quality of dietary intake may change. There was no data on nutrient patterns in Ramadan fasting. The purpose of this study was to identify Ramadan major nutrient patterns among those who fast in Tehran, Iran. 510 fasting people aged 18-65 years and BMI 18.5-40 Kg/m2 were recruited in our study by 2-stage cluster sampling method in June-July 2014. Data on the socio-demographic and physical activity level were collected by questionnaire. Usual diet during Ramadan was estimated by valid and reliable food frequency questionnaire. BMI was calculated based on measured height and weight. Three nutrient patterns derived by conducting principal component factor analysis on 30 major nutrients. Micronutrient and fiber pattern which characterized by high intake of vitamin K, total fiber, iron, manganese, magnesium, β-carotene, folate, vitamin B12, potassium and calcium was adversely associated with weight (b=-0.16, P= 0.004). High protein pattern had great loadings on protein, riboflavin, phosphorous and zinc which physical activity level was decreased by tertiles of this pattern (b=0.13, P=0.02). High carbohydrate pattern which presented high positive loadings on carbohydrate and thiamin and negative loading on total fat, poly unsaturated fatty acids and monounsaturated fatty acids was positively associated with BMI (b= 0.12, P=0.03). Adherence to different Ramadan nutrient patterns is associated with weight, BMI and physical activity level. People on high in carbohydrate may have a higher BMI and low micronutrient density diet that should be considered in Ramadan fasting nutrition educational programs

The Association of Bread and Rice with Metabolic Factors in Type 2 Diabetic Patients.

Carbohydrates are shown to have an important role in blood glucose control, type 2 diabetes and cardiovascular diseases risk. This is even more challenging when considering populations consuming refined grains diets. Bread and rice are staple foods which supply main proportion of Iranian calorie intake. This study was designed to investigate the effect of bread and rice intake on blood glucose control, lipid profile and anthropometric measurements in Iranian type 2 diabetic patients.426 patients with type 2 diabetes were included in this study. Anthropometric measurements were done using standard methods. Dietary information was assessed by a valid and reliable food frequency questionnaire (FFQ). Fasting blood glucose (FBG), glycated hemoglobin (HbA1c), serum triglycride (TG), total cholesterol (TC), low density lipoprotein (LDL) and high density lipoprotein (HDL) cholesterol were examined after 12-hour fasting.The results represented that people in the highest tertile compared to the lowest tertile of calorie adjusted total bread intake have higher FBG. FBG in the highest tertile of calorie adjusted total bread-rice intake was also significantly higher than the lowest. The association remained significant after adjusting for potential confounders. Rice intake showed no association with cardio-metabolic risk factors.We founded that higher total bread intake and total bread-rice intake were associated with FBG in type 2 diabetic patients whereas rice intake was not associated with glucose and lipid profile. This result should be confirmed in prospective studies, considering varieties, glycemic index (GI), glycemic load (GL) and cooking method of bread and rice

Appendicular Skeletal Muscle Mass Reference Values and the Peak Muscle Mass to Identify Sarcopenia among Iranian Healthy Population

Background: Sacopenia is a common problem in elderly with the adverse outcomes. The objective of this study was to estimate the peak appendicular skeletal muscle mass (ASM) and age of its attainment by sex among the Iranian population. Methods: A total of 691 men and women aged 18–94 years participated in this cross-sectional, population-based study in Bushehr, Iran. ASM was measured by dual X-ray absorptiometry. Cutoff points for men and women were established considering two standard deviations (SDs) below the mean values of the skeletal muscle index (SMI) for young reference groups. The relationship between ASM and age was described by the second-degree regression models. Two SDs below the mean SMIs of reference groups were as cutoff values of low muscle mass in Iranian population. Results: The peak ASM values were 21.35 ± 0.12 Kg and 13.68 ± 0.10 Kg, and the age at peak ASM were 26 (24–28) years and 34 (33–35) years for men and women, respectively. Mean and SD of SMI in those ages were 7.01 ± 0.02 Kg/m2 and 5.44 ± 0.02 Kg/m2 among men and women, respectively. Calculated cutoff values of low muscle mass among the Iranian population were 7.0 Kg/m2 and 5.4 Kg/m2 among men and women, respectively. Conclusions: Iranian reference values of SMI for both genders were similar to Asia Working Group for Sarcopenia recommendation and lower than the United States and European values. Further studies from different nations and the Middle East countries are needed to obtain reference values for populations, enabling the researchers for comparison and also more valid reports on sarcopenia prevalence