Saman Khalesi

Effect of Probiotics on Blood Pressure A Systematic Review and Meta-Analysis of Randomized, Controlled Trials

Previous human clinical trials have shown that probiotic consumption may improve blood pressure (BP) control. The aim of the present systematic review was to clarify the effects of probiotics on BP using a meta-analysis of randomized, controlled trials. PubMed, Scopus, Cochrane Library (Central), Physiotherapy Evidence Database, and Clinicaltrial.gov databases were searched until January 2014 to identify eligible articles. Meta-analysis using a random-effects model was chosen to analyze the impact of combined trials. Nine trials were included. Probiotic consumption significantly changed systolic BP by −3.56 mm Hg (95% confidence interval, −6.46 to −0.66) and diastolic BP by −2.38 mm Hg (95% confidence interval, −2.38 to −0.93) compared with control groups. A greater reduction was found with multiple as compared with single species of probiotics, for both systolic and diastolic BP. Subgroup analysis of trials with baseline BP ≥130/85 mm Hg compared with <130/85 mm Hg found a more significant improvement in diastolic BP. Duration of intervention <8 weeks did not result in a significant reduction in systolic or diastolic BP. Furthermore, subgroup analysis of trials with daily dose of probiotics <1011 colony-forming units did not result in a significant meta-analysis effect. The present meta-analysis suggests that consuming probiotics may improve BP by a modest degree, with a potentially greater effect when baseline BP is elevated, multiple species of probiotics are consumed, the duration of intervention is ≥8 weeks, or daily consumption dose is ≥1011 colony-forming units. # Novelty and Significance {#article-title-52}Previous human clinical trials have shown that probiotic consumption may improve blood pressure (BP) control. The aim of the present systematic review was to clarify the effects of probiotics on BP using a meta-analysis of randomized, controlled trials. PubMed, Scopus, Cochrane Library (Central), Physiotherapy Evidence Database, and Clinicaltrial.gov databases were searched until January 2014 to identify eligible articles. Meta-analysis using a random-effects model was chosen to analyze the impact of combined trials. Nine trials were included. Probiotic consumption significantly changed systolic BP by −3.56 mm Hg (95% confidence interval, −6.46 to −0.66) and diastolic BP by −2.38 mm Hg (95% confidence interval, −2.38 to −0.93) compared with control groups. A greater reduction was found with multiple as compared with single species of probiotics, for both systolic and diastolic BP. Subgroup analysis of trials with baseline BP ≥130/85 mm Hg compared with <130/85 mm Hg found a more significant improvement in diastolic BP. Duration of intervention <8 weeks did not result in a significant reduction in systolic or diastolic BP. Furthermore, subgroup analysis of trials with daily dose of probiotics <1011 colony-forming units did not result in a significant meta-analysis effect. The present meta-analysis suggests that consuming probiotics may improve BP by a modest degree, with a potentially greater effect when baseline BP is elevated, multiple species of probiotics are consumed, the duration of intervention is ≥8 weeks, or daily consumption dose is ≥1011 colony-forming units.

Effect of Probiotics on Blood Pressure

Previous human clinical trials have shown that probiotic consumption may improve blood pressure (BP) control. The aim of the present systematic review was to clarify the effects of probiotics on BP using a meta-analysis of randomized, controlled trials. PubMed, Scopus, Cochrane Library (Central), Physiotherapy Evidence Database, and Clinicaltrial.gov databases were searched until January 2014 to identify eligible articles. Meta-analysis using a random-effects model was chosen to analyze the impact of combined trials. Nine trials were included. Probiotic consumption significantly changed systolic BP by −3.56 mm Hg (95% confidence interval, −6.46 to −0.66) and diastolic BP by −2.38 mm Hg (95% confidence interval, −2.38 to −0.93) compared with control groups. A greater reduction was found with multiple as compared with single species of probiotics, for both systolic and diastolic BP. Subgroup analysis of trials with baseline BP ≥130/85 mm Hg compared with <130/85 mm Hg found a more significant improvement in diastolic BP. Duration of intervention <8 weeks did not result in a significant reduction in systolic or diastolic BP. Furthermore, subgroup analysis of trials with daily dose of probiotics <1011 colony-forming units did not result in a significant meta-analysis effect. The present meta-analysis suggests that consuming probiotics may improve BP by a modest degree, with a potentially greater effect when baseline BP is elevated, multiple species of probiotics are consumed, the duration of intervention is ≥8 weeks, or daily consumption dose is ≥1011 colony-forming units. # Novelty and Significance {#article-title-52}Previous human clinical trials have shown that probiotic consumption may improve blood pressure (BP) control. The aim of the present systematic review was to clarify the effects of probiotics on BP using a meta-analysis of randomized, controlled trials. PubMed, Scopus, Cochrane Library (Central), Physiotherapy Evidence Database, and Clinicaltrial.gov databases were searched until January 2014 to identify eligible articles. Meta-analysis using a random-effects model was chosen to analyze the impact of combined trials. Nine trials were included. Probiotic consumption significantly changed systolic BP by −3.56 mm Hg (95% confidence interval, −6.46 to −0.66) and diastolic BP by −2.38 mm Hg (95% confidence interval, −2.38 to −0.93) compared with control groups. A greater reduction was found with multiple as compared with single species of probiotics, for both systolic and diastolic BP. Subgroup analysis of trials with baseline BP ≥130/85 mm Hg compared with <130/85 mm Hg found a more significant improvement in diastolic BP. Duration of intervention <8 weeks did not result in a significant reduction in systolic or diastolic BP. Furthermore, subgroup analysis of trials with daily dose of probiotics <1011 colony-forming units did not result in a significant meta-analysis effect. The present meta-analysis suggests that consuming probiotics may improve BP by a modest degree, with a potentially greater effect when baseline BP is elevated, multiple species of probiotics are consumed, the duration of intervention is ≥8 weeks, or daily consumption dose is ≥1011 colony-forming units.

Flaxseed Consumption May Reduce Blood Pressure: A Systematic Review and Meta-Analysis of Controlled Trials

BACKGROUND High blood pressure is a major health burden positively associated with the risk of cardiovascular disease and other chronic diseases. Flaxseed is a rich dietary source of α-linolenic acid, lignans, and fiber, with a number of positive health benefits on blood pressure. OBJECTIVE The purpose of this study was to clarify the effect of flaxseed consumption on blood pressure. Further, the influence of baseline blood pressure, type of flaxseed supplementation, and duration of flaxseed supplementation on blood pressure was explored. METHOD PubMed (MEDLINE), Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library (Central) were searched through July 2014 for studies in which humans supplemented their habitual diet with flaxseed or its extracts (i.e., oil, lignans, fiber) for ≥2 wk. RESULTS A total of 11 studies (14 trials) were included in the analysis. Random-effects meta-analyses were conducted for the mean difference in blood pressure. Results indicated that flaxseed supplementation reduced systolic blood pressure (-1.77 mm Hg; 95% CI: -3.45, -0.09 mm Hg; P = 0.04) and diastolic blood pressure (-1.58 mm Hg; 95% CI: -2.64, -0.52 mm Hg; P = 0.003). These results were not influenced by categorization of participants into higher baseline blood pressure (≥130 mm Hg). An improvement in diastolic blood pressure was observed in subgroup analysis for consuming whole flaxseed (-1.93 mm Hg; 95% CI: -3.65, -0.21 mm Hg; P < 0.05) and duration of consumption ≥12 wk (-2.17 mm Hg; 95% CI: -3.44, -0.89 mm Hg; P < 0.05). CONCLUSION The present meta-analysis suggests that consumption of flaxseed may lower blood pressure slightly. The beneficial potential of flaxseed to reduce blood pressure (especially diastolic blood pressure) may be greater when it is consumed as a whole seed and for a duration of >12 wk.

Cheese consumption in relation to cardiovascular risk factors among Iranian adults- IHHP Study

BACKGROUND/OBJECTIVE It is expected that dairy products such as cheeses, which are the main source of cholesterol and saturated fat, may lead to the development or increase the risk of cardiovascular and metabolic diseases; however, the results of different studies are inconsistent. This study was conducted to assess the association between cheese consumption and cardiovascular risk factors in an Iranian adult population. SUBJECTS/METHODS Information from the Isfahan Healthy Heart Program (IHHP) was used for this cross-sectional study with a total of 1,752 participants (782 men and 970 women). Weight, height, waist and hip circumference measurement, as well as fasting blood samples were gathered and biochemical assessments were done. To evaluate the dietary intakes of participants a validated food frequency questionnaire, consists of 49 items, was completed by expert technicians. Consumption of cheese was classified as less than 7 times per week and 7-14 times per week. RESULTS Higher consumption of cheese was associated with higher C-Reactive Protein (CRP), apolipoprotein A and high density lipoprotein cholesterol (HDL-C) level but not with fasting blood sugar (FBS), total cholesterol, low density lipoprotein cholesterol (LDL-C), triglyceride (TG) and apolipoprotein B. Higher consumption of cheese was positively associated with consumption of liquid and solid oil, grain, pulses, fruit, vegetable, meat and dairy, and negatively associated with Global Dietary Index. After control for other potential confounders the association between cheese intake and metabolic syndrome (OR: 0.81; 96%CI: 0.71-0.94), low HDL-C level (OR: 0.87; 96%CI: 0.79-0.96) and dyslipidemia (OR: 0.88; 96%CI: 0.79-0.98) became negatively significant. CONCLUSION This study found an inverse association between the frequency of cheese intake and cardiovascular risk factors; however, further prospective studies are required to confirm the present results and to illustrate its mechanisms.

Reduction of aflatoxin level in aflatoxin-induced rats by the activity of probiotic Lactobacillus casei strain Shirota

Aflatoxin B1 (AFB1) is considered as the most toxic food contaminant, and microorganisms, especially bacteria, have been studied for their potential to reduce the bioavailability of mycotoxins including aflatoxins. Therefore, this research investigated the efficacy of oral administration of Lactobacillus casei Shirota (LcS) in aflatoxin‐induced rats.

Dietary patterns, nutrition knowledge and lifestyle: associations with blood pressure in a sample of Australian adults (the Food BP study)

This study examined the association between dietary patterns, nutrition knowledge and lifestyle with blood pressure (BP) in a sample of Australian adults. Adults with normal and high BP were included in a cross-sectional study. Dietary intake data was collected using a Food Frequency Questionnaire. Nutrition knowledge and lifestyle surveys were included in the questionnaire. Dietary patterns were extracted using factor analysis followed by cluster analysis. Associations were analysed using logistic regression. Four hundred and seven participants were included. Three dietary patterns were identified: Western; Snack and alcohol; and Balanced. Participants with high BP had a higher intake of Western and a lower intake of Balanced dietary pattern. A significant and higher frequency of discretionary foods and oils consumption, as well as lower nutrition knowledge score and activity frequency, were observed in the high BP group. Regression analysis indicated that the intake of Western and Snack and alcohol dietary patterns increases the likelihood of having high BP by 2.40 (95% confidence interval (CI): 1.28–4.49) and 2.76 (95% CI: 1.52–5.00), respectively, when nutrition knowledge and lifestyle were controlled for as moderator variables. The likelihood of high BP was not associated with nutrition knowledge, but increased with physical inactivity. This study indicates that poor dietary patterns and inactivity are associated with increases in the likelihood of high BP, and the association is not influenced by nutrition knowledge. These findings indicate the importance of developing public health strategies with an emphasis on improving the dietary patterns of individuals to prevent and control high BP in Australian adults.

Validation of a short food frequency questionnaire in Australian adults

Abstract The aim of this article is to report on the validity and internal consistency of a short food frequency questionnaire (FFQ) to measure dietary intake in Australian adults. A total of 407 individuals completed the short FFQ. The Cronbach’s alpha of 0.66 indicated acceptable internal consistency for the FFQ. Content validity was measured using factor analysis showed that 35% of total variance was explained by factor analysis. The FFQ was also validated against 31 3-day food records (FR). No significant difference between average intake of energy, most macronutrients, and some micronutrients between two instruments was identified. An acceptable levels of correlation (0.39–0.69) was observed between the two instruments. Bland and Altman’s plots showed relative agreement in both instruments with potential bias in measuring iron and iodine. The current FFQ can be an acceptable tool to quickly measuring dietary intake in Australian adults.

Can sesame consumption improve blood pressure? A systematic review and meta‐analysis of controlled trials

Hypertension is a major risk factor for cardiovascular disease, myocardial infarction, stroke and renal failure. Sesame consumption may benefit blood pressure (BP) owing to its high polyunsaturated fatty acid, fibre, phytosterol and lignan contents. To clarify this, a systematic review and meta-analysis of controlled trials was conducted. The PubMed (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Cochrane Library (Central) databases were systematically searched until August 2016. Eight controlled trials with a total of 843 participants met the eligibility criteria. A random effect meta-analysis showed that sesame consumption can reduce systolic BP (-7.83 mmHg, 95% CI: -14.12, -1.54; P < 0.05, I2  = 99%) and diastolic BP (-5.83 mmHg, 95% CI: -9.58, -2.08; P < 0.01, I2  = 98%). To reduce the heterogeneity, the meta-analysis was limited to high methodology quality trials (n = 4), which resulted in a significant reduction in systolic BP (-3.23 mmHg, 95% CI: -5.67, -0.79; I2  = 33%) and a non-significant reduction in diastolic BP (-2.08 mmHg, 95% CI: -4.85, 0.69; I2  = 62%). This study concluded that sesame consumption can reduce systolic and diastolic BP. However, further investigations with larger sample sizes and better methodology quality are required to confirm the BP-lowering effect of sesame consumption.

The effect of lipophilicity and dose on the frequency of statin-associated muscle symptoms: A systematic review and meta-analysis

&NA; Addressing the factors which lead to the development of statin‐associated muscle symptoms (SAMS) is vital for maintaining patient compliance with these pharmaceuticals, and thus improving patient outcomes. This study aimed to clarify the relationship between statin lipophilicity, or dose, and the frequency of adverse muscle symptoms using a systematic review of randomised controlled trials (RCTs). RCTs, including statin monotherapy and placebo groups, which reported data on muscle adverse events were identified through the PubMed and Scopus databases. Risk ratios (RRs) and 95% confidence intervals (CI) were pooled using a random‐effects meta‐analysis. A total of 135 RCTs were included in this review. Statin therapy was associated with a significant, but modest, increase in the risk of adverse muscle symptoms compared to placebo (RR = 1.050; 95% CI = 1.014–1.089; P = 0.007; I2 = 3.291%). This significant association was primarily due to the inclusion of RCTs recruiting participants with a history of statin intolerance. Lipophilic statins had no appreciable impact on the development of SAMS compared to hydrophilic formulations. A univariate meta‐regression of dose (standardised to atorvastatin dose equivalents) and the risk of musculoskeletal complaints also showed no significant association. The results obtained from this meta‐analysis indicate that there is a slight increase in the risk of SAMS, especially in individuals with a history of statin intolerance. There is limited evidence to suggest that the risk of SAMS would differ between the use of lipophilic and hydrophilic statins, or high‐ and low‐dose therapy.

Sesame fractions and lipid profiles: a systematic review and meta-analysis of controlled trials.

Increased plasma lipid profiles are among the most important risk factors of CHD and stroke. Sesame contains considerable amounts of vitamin E, MUFA, fibre and lignans, which are thought to be associated with its plasma lipid-lowering properties. This study aimed to systematically review the evidence and identify the effects of sesame consumption on blood lipid profiles using a meta-analysis of controlled trials. PubMed, CINAHL and Cochrane Library databases were searched (from 1960 to May 2015). A total of ten controlled trials were identified based on the eligibility criteria. Both the Cochrane Collaboration tool and the Rosendal scale were used to assess the risk of bias of the included studies. The meta-analysis results showed that consumption of sesame did not significantly change the concentrations of total blood cholesterol (-0·32 mmol/l; 95% CI -0·75, 0·11; P=0·14, I(2)=96%), LDL-cholesterol (-0·15 mmol/l; 95% CI -0·50, 0·19; P=0·39, I(2)=96%) or HDL-cholesterol (0·01 mmol/l; 95% CI -0·00, 0·02; P=0·16, I(2)=0%). However, a significant reduction was observed in serum TAG levels (-0·24 mmol/l; 95% CI -0·32, -0·15; P<0·001, I(2)=84%) after consumption of sesame. It was concluded that sesame consumption can significantly reduce blood TAG levels but there is insufficient evidence to support its hypocholesterolaemic effects. Further studies are required to determine the potential effect of sesame consumption on lipid profiles and cardiovascular risk factors.