This systematic review was conducted to summarize and clarify the evidence on the association between 25-hydroxyvitamin-D [25(OH)D] concentrations and coronavirus disease 2019 (COVID-19) risk and outcomes. PubMed, Scopus, and Web of Science databases and Google Scholar were searched up to 26 November 2020. All retrospective and prospective cohort, cross-sectional, case-control, and randomized controlled trial studies that investigated the relation between 25(OH)D and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and COVID-19 severity were included. Thirty-nine studies were included in the current systematic review. In studies that were adjusted (OR: 1.77; 95% CI: 1.24, 2.53; I2: 44.2%) and nonadjusted for confounders (OR: 1.75; 95% CI: 1.44, 2.13; I2: 33.0%) there was a higher risk of SARS-CoV-2 infection in the vitamin D deficiency (VDD) group. Fifteen studies evaluated associations between VDD and composite severity. In the studies that were adjusted (OR: 2.57; 95% CI: 1.65, 4.01; I2 = 0.0%) and nonadjusted for confounders (OR: 10.61; 95% CI: 2.07, 54.23; I2 = 90.8%) there was a higher severity in the VDD group. Analysis of studies with crude OR (OR: 2.62; 95% CI: 1.13, 6.05; I2: 47.9%), and adjusted studies that used the Cox survival method (HR: 2.35; 95% CI: 1.22, 4.52; I2: 84%) indicated a significant association of VDD with mortality, while in adjusted studies that used logistic regression, no relation was observed (OR: 1.05; 95% CI: 0.63, 1.75; I2: 76.6%). The results of studies that examined relations between VDD and intensive care unit (ICU) admission, pulmonary complications, hospitalization, and inflammation were inconsistent. In conclusion, although studies were heterogeneous in methodological and statistical approach, most of them indicated a significant relation between 25(OH)D and SARS-CoV-2 infection, COVID-19 composite severity, and mortality. With regard to infection, caution should be taken in interpreting the results, due to inherent study limitations. For ICU admission, inflammation, hospitalization, and pulmonary involvement, the evidence is currently inconsistent and insufficient.

Study design: A randomized, double-blind, placebo-controlled clinical trial. Objective: To assess the effect of alpha-lipoic acid (ALA) supplementation on IL-6, hs-CRP, FBS, anthropometric indices, food intake and blood pressure in male patients with chronic spinal cord injury (SCI). Setting: Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Methods: Fifty-eight men with chronic SCI participated in the study. Participants were divided in two groups: one group received 600 mg of supplemental ALA (n = 28) and the other group received placebo (n = 30) for 12 weeks. At the beginning and end of the study, biochemical parameters, anthropometric indices, blood pressure and dietary intakes were measured. Dietary intake was measured using N4 software, and statistical analyses were carried out using SPSS16. Results: No significant reduction was found in IL-6 (P = 0.97) and hs-CRP levels (P = 0.23). There was significant reduction in fasting blood sugar (P = 0.001), body weight (P = 0.001), BMI (P = 0.001), waist circumference (P = 0.001) and blood pressure (P = 0.001). Dietary intake was significantly reduced, including fat (P = 0.001), carbohydrate (P = 0.001), protein (P = 0.002) and energy intakes (P = 0.001). Conclusion: Lipoic acid supplementation had no significant effect on the measured inflammatory markers but it reduces fasting blood sugar, anthropometric parameters, food intake and blood pressure in men with chronic SCI. Spinal Cord (2015) 53, 621-624; doi:10.1038/sc.2015.35; published online 10 March 2015 INTRODUCTION Alpha-lipoic acid (ALA) or thiocitic acid is an eight-carbon, sulfurcontaining compound. It functions as a cofactor in the multienzyme complexes that catalyze the oxidative decarboxylation of α-keto acids. 1 There is general agreement about the antioxidant properties of ALA, which is thought to work by scavenging free radicals directly, chelating metallic ions, increasing intracellular glutathione and activating endogenous antioxidant systems. 2,3 ALA's antioxidant properties are thought to inhibit the deleterious mechanisms associated with inflammation; however, a number of studies suggest contradictory effects for ALA on inflammatory markers such as IL-6 and C-reactive protein (CRP). [4][5][6] Apart from the antioxidant properties of ALA, it is found to increase nitric oxide synthesis through which endothelial function is probably improved. 7 In addition, ALA reduces body weight and changes other anthropometric indices by suppressing appetite and increasing metabolism. [8][9][10][11][12] Spinal cord injury (SCI) is a devastating condition and entails considerable burden on the individual and society. 13,14 Persons with chronic SCI are at increased risk for obesity, cardiovascular disease, hypertension, diabetes, dyslipidemia and systemic inflammation [15][16][17][18][19] because of changes in their lifestyle, body composition and fat mass. 20 However, these complications may be preventable and treatable. 21 Studying the effect of ALA on cardiovascular risk factors and ...

Background:Regarding to the growing prevalence of nonalcoholic fatty liver disease (NAFLD), concentrating on various strategies to its prevention and management seems necessary. The aim of this study was to determine the effects of symbiotic on C-reactive protein (CRP), liver enzymes, and ultrasound findings in patients with NAFLD.Methods:Eighty NAFLD patients were enrolled in this randomized, double-blind, placebo-controlled clinical trial. Participants received symbiotic in form of a 500 mg capsule (containing seven species of probiotic bacteria and fructooligosaccharides) or a placebo capsule daily for 8 weeks. Ultrasound grading, CRP, and liver enzymes were evaluated at the baseline and the end of the study.Results:In the symbiotic group, ultrasound grade decreased significantly compared to baseline (P < 0.005) but symbiotic supplementation was not associated with changes in alanine aminotransferase (ALT) and aspartate transaminase (AST) levels. In the placebo group, there was no significant change in steatosis grade whereas ALT and AST levels were significantly increased (P = 0.002, P = 0.02, respectively). CRP values remained static in either group.Conclusions:Symbiotic supplementation improved steatosis in NAFLD patients and might be useful in the management of NAFLD or protective against its progression.

Background: Based on the results of many studies on the relationship between nutritional status and clinical implications in dialysis patients, malnutrition is one of the most important factors associated with mortality in these patients. The current study examined the effect of nutritional education based on Health Belief Model (HBM) on nutritional knowledge, HBM constructs, and dietary intake in Hemodialysis (HD) patients. Materials and Methods: One-hundred chronic HD patients entered to this randomized clinical trial in 2017 in Iran; 41 in control group and 45 in intervention group completed the study. Demographic data and four 24-h recalls were collected. To evaluate the nutritional knowledge and HBM constructs, a researcher-made questionnaire was used. Patients were evaluated before, immediately after, and 3 months after intervention. Eight 1-h education sessions in 4 weeks were considered for intervention group. Independent samples t -test, Chi-square test, and repeated measures ANOVA were used to analyze the data. Results: Repeated measures ANOVA test showed significant increases in scores of the nutritional knowledge test, perceived susceptibility, perceived severity, perceived barriers ( p = < 0.001), perceived benefits ( p = 0.010), and self-efficacy ( p = 0.019) after the study in the intervention group. There were no significant differences between two groups in energy, protein, High Biologic Value (HBV) protein, carbohydrate, fat, cholesterol, fiber, vitamin B2, B3, B6, B12, E, calcium, phosphorus, and potassium intake. Conclusions: It seems that education based on HBM can improve nutritional knowledge but in order to influence on dietary intake, longer interventions that are more comprehensive are needed.

Background:Stroke as a devastating condition is one of the major causes of death worldwide. It is accountable for long time disability with high personal and social cost in adults. There are several risk factors for stroke such as diabetes and hypertension. Alpha-lipoic acid (ALA) as an antioxidant can be a risk modifier in these patients. We designed this trial to scrutinize the possible effects of ALA consumption on some cardiovascular risk factors in patients experienced stroke.Methods:In this randomized, double-blind, placebo-controlled clinical trial, 67 patients experienced stroke were randomly allocated into two groups (taking a 600 mg ALA supplement or placebo daily for 12 weeks). Fasting blood sugar (FBS), fasting insulin and systolic (SBP), and diastolic blood pressure (DBP) were measured before and after intervention in this study. Statistical analyses were performed using SPSS version 16 (SPSS Inc., Chicago, IL, USA) software.Results:Primary features were similar in the intervention and placebo groups (P > 0.05). After the intervention period, SBP (P < 0.001), DBP (P < 0.001) and FBS (P < 0.001) reduced in ALA group compared with placebo group, significantly. No significant change was seen in insulin level (P = 0.82).Conclusions:Results of this trial indicated that 12 weeks supplementation with 600 mg ALA has beneficial effects on SBP, DBP, and FBS but has no effect on insulin level.