The Effect of Sumac Fruit on Serum Lipids and Body Mass Index in Hemodialysis Patients

Abstract

Background. Sumac fruit is an antioxidant and reduces serum triglyceride (TG) and cholesterol (CHOL) levels. Therefore, this study aimed to investigate the effect of sumac fruit on serum lipids and body mass index (BMI) of hemodialysis (HD) patients. Materials and Methods. This triple-blind randomized clinical trial study was conducted for 12 weeks on HD patients. Participants were randomly divided into three groups of 2-gram sumac (N = 40), 3-gram sumac (N = 40), and placebo (N = 40) by nonprobability consecutive sampling and stratified block randomization method based on inclusion criteria. Serum lipids and BMI were measured at the beginning of the study and also at the end of the sixth and the twelfth weeks. The physical activity and 24-hour dietary recall questionnaires were used to collect data. Results. No significant difference was found between the level of nutrient and micronutrient intake ( P > 0.05 ), physical activity ( P = 0.159 ), and BMI ( P = 0.718 ) of patients in the three groups before and after the intervention. However, the difference in serum low-density lipoprotein (LDL) levels in each studied group was significant over time ( P < 0.001 ). The difference was not statistically significant between the groups before the intervention, 6 and 12 weeks after the intervention (group effect), and between the study groups over time (time-group interaction). No statistically significant difference was observed between the mean levels of TG ( P = 0.875 ), CHOL level ( P = 0.969 ), LDL level ( P = 0.998 ), high-density lipoprotein (HDL) level ( P = 0.136 ), and BMI ( P = 0.608 ) in the groups over time. Conclusion. Consumption of sumac fruit significantly changed the LDL level over time. Although BMI and serum lipids changed in HD patients, these changes were not significant. Future studies are needed to determine the effective dose of sumac and any dose increase should take toxicity into account and consider a larger sample size and longer intervention and follow-up times.

Effects of sumac supplementation on lipid profile: A systematic review and meta‐analysis of randomized controlled trials

“…The general risk of bias for all studies was low except for one study (Rouhi‐Boroujeni et al, 2016). Four of the included studies were double‐blind (Afandak et al, 2023; Ehsani et al, 2022; Hajmohammadi et al, 2018; Rouhi‐Boroujeni et al, 2016) and three studies were triple‐blind (Alahnoori et al, 2022a, 2022b; Asgary et al, 2018; Sabzghabaee et al, 2014). Some of the included studies were characterized by a lack of information about allocation concealment (Rouhi‐Boroujeni et al, 2016; Sabzghabaee et al, 2014).…”

“…Ultimately by including seven articles that were published between 2014 and 2023 with 570 participants, this meta-analysis was performed. The qualified studies enrolled subjects including patients with hyperlipidemia (Asgary et al, 2018;Hajmohammadi et al, 2018), overweight or obese subjects with dyslipidemia (Sabzghabaee et al, 2014), patients with hypercholesterolemia (Rouhi-Boroujeni et al, 2016), polycystic ovary syndrome (PCOS; Afandak et al, 2023), non-alcoholic fatty liver disease (Ehsani et al, 2022), and hemodialysis patients (Alahnoori et al, 2022a(Alahnoori et al, , 2022b. The dose of sumac intake varied from 1 to 3 g/day, and the intervention duration of all included trials was from 4 to 12 weeks.…”

“…In 2018, a systematic review that studied the effect of R. coriaria on blood lipids showed no significant differences in blood lipids between the intervention and control groups (Akbari-Fakhrabadi et al, 2018). As some clinical trials have been published after 2018 (Afandak et al, 2023;Alahnoori et al, 2022aAlahnoori et al, , 2022bEhsani et al, 2022) and according to this study's limitations, such as lack of sufficient clinical trials and variable inconsistency, we conducted an updated meta-analysis. Hence, to fill the knowledge gap, this study is designed to investigate the effects of sumac supplementation on lipid profiles.…”

Interventions to increase physical activity level in patients with whole spectrum chronic kidney disease: a systematic review and meta-analysis

“…When data was missing or unclear [ 27–32 ], we emailed the original authors ( Supporting Information Table S5 ). Studies without sufficient primary data (e.g., data reported in the literature for which means and standard deviations of physical activity could not be calculated) were excluded from the meta-analysis, but qualitative summaries were performed.…”

“…Studies without sufficient primary data (e.g., data reported in the literature for which means and standard deviations of physical activity could not be calculated) were excluded from the meta-analysis, but qualitative summaries were performed. Two authors responded with data from their studies [ 27 , 30 ], but Alahnoori et al. [ 27 ] reported categorical data and were excluded from the meta-analysis.…”