Nutritional advice

Objectives:
Chemotherapy-induced peripheral neuropathy (CIPN) is a common symptom, but prophylactic measures cannot still be carried out effectively. In addition, the efficacy of vitamin E in preventing peripheral neurotoxicity caused by chemotherapy is inconclusive. Therefore, this review article has been conducted.

Does vitamin E supplementation decrease risk of chemotherapy-induced peripheral neuropathy?

Study design:
This review article included 8 RCTs with a total of 488 patients.
The number of participants in each arm ranged from 13 to 96.
The experimental intervention was vitamin E supplementation as an adjuvant to cisplatin, paclitaxel and other chemotherapies.
There was no publication bias.

Results and conclusions:
The investigators found patients who received vitamin E supplementation of 600 mg/day had a significantly lower incidence of chemotherapy-induced peripheral neuropathy of 69% [risk ratio = 0.31, 95% CI = 0.14 to 0.65, p = 0.002, I2 = 0%] than the placebo group (group without vitamin E).

The investigators found patients in the cisplatin chemotherapy group who received vitamin E supplementation had a significantly lower incidence of chemotherapy-induced peripheral neuropathy of 72% [risk ratio = 0.28, 95% CI = 0.14 to 0.54, p = 0.0001, I2 = 0%]  than the placebo group.

The investigators found, moreover, vitamin E supplementation significantly decreased patients’ sural amplitude after 3 rounds of chemotherapy [MD = -2.66, 95% CI = -5.09 to -0.24, p = 0.03, I2 = 0%] in contrast with that of placebo supplementation, while no significant difference was observed when patients were treated with vitamin E after 6 rounds of chemotherapy [MD = -1.28, 95% CI = -3.11 to 0.54, p = 0.17, I2 = 40%].

The investigators found, in addition, the vitamin E-supplemented group had better improvement in the neurotoxicity score and lower incidence of reflexes and distal paraesthesias than the control group.

The investigators concluded that vitamin E supplementation of 600 mg/day decreases risk of chemotherapy-induced peripheral neuropathy, particularly in the cisplatin chemotherapy group. More high-quality trials with standardized reporting of clinical outcomes about peripheral neuropathy are needed to explore the exact role of vitamin E in the prevention of chemotherapy-induced peripheral neuropathy.

Original title:
Protective Effects of Vitamin E on Chemotherapy-Induced Peripheral Neuropathy: A Meta-Analysis of Randomized Controlled Trials by Miao H, Li R [...], Wen Z.

Link:
https://www.karger.com/Article/FullText/515620

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Objectives:
The efficacy of dendritic cell vaccine for newly diagnosed glioblastoma remains controversial. Therefore, this review article has been conducted.

Does dendritic cell vaccine provide benefits for the newly diagnosed glioblastoma?

Study design:
This review article included 3 randomized controlled trials (RCTs).

Results and conclusions:
The investigators found overall, compared with control group for newly diagnosed glioblastoma, dendritic cell vaccine showed no substantial effect on:
-median overall survival [SMD = 0.11, 95% CI = -0.18 to 0.41, p = 0.45];
-median progression-free survival [SMD = 0.12, 95% CI = -0.24 to 0.48, p = 0.50];
-progression-free survival rate [risk ratio = 1.29, 95% CI = 0.82 to 2.04, p = 0.27];
-overall survival rate [risk ratio = 1.29, 95% CI = 0.61 to 2.72, p = 0.50] or;
-nervous system disorders [risk ratio = 0.80, 95% CI= 0.59 to 1.08, p = 0.14].

The investigators concluded dendritic cell vaccine provides no obvious benefits for the newly diagnosed glioblastoma.

Original title:
The Efficacy of Dendritic Cell Vaccine for Newly Diagnosed Glioblastoma: A Meta-analysis of Randomized Controlled Studies by Tan L, Peng J, […], Wu Q.

Link:
https://pubmed.ncbi.nlm.nih.gov/34767325/

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Dendritic cells (DCs) are professional antigen-presenting cells that link innate and adaptive immunity and are critical for the induction of protective immune responses against pathogens.

Glioblastoma is an aggressive type of cancer that can occur in the brain or spinal cord.

Objectives:
Since WHO recommended introduction of at least a single dose of inactivated poliovirus vaccine (IPV) in routine immunisation schedules, there have been global IPV shortages. Fractional-dose IPV (fIPV) administration is one of the strategies to ensure IPV availability. Therefore, this review article has been conducted.

Is there a difference in seroconversion and antibodies response between fractional-dose IPV (fIPV) and full-dose IPV?

Study design:
This review article included 14 articles: 2 ongoing trials and 12 articles reporting on 10 completed studies.

The seroconversion meta-analysis for the three-dose comparison was homogeneous [p = 0.45, I2 = 0%], whereas heterogeneity was observed in the two-dose [p 0.00001, I2 = 88%] and one-dose [p = 0.0004, I2 = 74%] comparisons.
Heterogeneity was observed in meta-analyses of GMTs for one-dose [p 0.00001, I2 = 92%, two-dose [p = 0.002, I2 = 80%] and three-dose [p 0.00001, I2 = 93%] comparisons. Findings for types 1 and 3 were similar to those for type 2.
The certainty of the evidence was high for the three-dose comparisons and moderate for the rest of the comparisons.

Results and conclusions:
The investigators found for poliovirus type 2, there were no significant differences in the proportions of seroconversions between fractional and full doses of IPV for 2 or 3 doses: the risk ratio for serconversion at 1 dose was 0.61 [95% CI = 0.51 to 0.72], at 2 doses was 0.90 [95% CI = 0.82 to 1.00] and at 3 doses was 0.95 [95% CI = 0.91 to 1.00].

The investigators found geometric mean titres (GMTs) for poliovirus type 2 were lower for fIPV than for full-dose IPV [-0.51, 95% CI = -0.87 to -0.14] at 1 dose [-0.49, 95% CI = -0.70 to -0.28] at 2 doses and [-0.98, 95% CI = -1.46 to -0.51] at 3 doses.

The investigators concluded that there is no substantial difference in seroconversion between 3 doses of fractional-dose IPV (fIPV) and 3 doses of full-dose poliovirus vaccine (IPV), although the full dose gives higher titres of antibodies for poliovirus type 1, 2 and 3. Use of fractional IPV instead of the full dose can stretch supplies and possibly lower the cost of vaccination.

Original title:
Fractional dose compared with standard dose inactivated poliovirus vaccine in children: a systematic review and meta-analysis by Mashunye TR, Ndwandwe DE, [...], Wiysonge CS.

Link:
https://pubmed.ncbi.nlm.nih.gov/33939958/

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Objectives:
It has been theorized that folic acid supplementation improves inflammation. However, its proven effects on inflammatory markers are unclear as clinical studies on this topic have produced inconsistent results. Therefore, this review article has been conducted.

Have folic acid supplements positive effects on inflammatory markers, like CRP, IL-6 and TNF-α?

Study design:
This review article included 12 RCTs with a total of 1,392 participants.
The studies were conducted between 2003 and 2018 and their sample size varied from 19 to 530 participants.
The mean age of the participants ranged from 24.1 to 68.1 years old.
The supplementation period ranged from 2 to 52 weeks.
The daily mentioned dosage of folic acid varied between 0.8 mg and 10 mg/d.

There was no publication bias.

Results and conclusions:
The investigators found a significant effect of folic acid supplementation on serum concentrations of CRP [WMD = -0.59 mg/L, 95% CI = -0.85 to -0.32, p 0.001, I2 = 91.3%, p 0.001].
This significantly reduced effect was also found in the subgroup and sensitivity analysis.
Subgroup analysis showed that baseline serum concentrations of CRP, duration of intervention, dosage and the participants’ age and gender explained this heterogeneity.

The investigators concluded that 0.8-10 mg/d folic acid supplements decrease serum concentrations of CRP.

Original title:
Effects of Folic Acid Supplementation on Inflammatory Markers: A Grade-Assessed Systematic Review and Dose-Response Meta-Analysis of Randomized Controlled Trials by Asbaghi O, Ashtary-Larky D, […], Naeini AA.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8308638/

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Objectives:
Does breastfeeding reduce risk of ovarian cancer in women with BRCA1 mutation or BRCA2 mutation?

Study design:
This review article included 1 cohort study and 4 case-control studies with a total of 14,601 women with a BRCA1 or BRCA2 mutation.

There was no publication bias.

Results and conclusions:
The investigators found ever having performed breastfeeding significantly reduced risk of ovarian cancer with 23.3% [pooled OR = 0.767, 95% CI = 0.688 to 0.856, I2 = 0%] in women with BRCA1 mutation.

The investigators found ever having performed breastfeeding non-significantly reduced risk of ovarian cancer with 18.3% [pooled OR = 0.817, 95% CI = 0.650 to1.028, I2 = 0%] in women with BRCA2 mutation.

The investigators found breastfeeding for >1 year significantly reduced risk of ovarian cancer with 21.3% [pooled OR = 0.787, 95% CI = 0.682 to 0.907, I2 = 0%] in women with BRCA1 mutation.

The investigators found breastfeeding for >1 year significantly reduced risk of ovarian cancer with 43.3% [pooled OR = 0.567, 95% CI = 0.400 to 0.802, I2 = 0%] in women with BRCA2 mutation.

The investigators concluded that ever having performed breastfeeding reduces risk of ovarian cancer in women with BRCA1 mutation and breastfeeding for >1 year reduces risk of ovarian cancer in women with BRCA2 mutation.

Original title:
The preventive effect of breastfeeding against ovarian cancer in BRCA1 and BRCA2 mutation carriers: A systematic review and meta-analysis by Eoh KJ, Park EY, […], Lim MC.

Link:
https://pubmed.ncbi.nlm.nih.gov/34304906/

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Objectives:
The association between serum 25-hydroxyvitamin D 25(OH)D level (vitamin D level in blood) and asthma occurrence in children was controversial. Therefore, this review article has been conducted.

Does a low vitamin D level increase risk of asthma occurrence in children?

Study design:
This review article included 35 studies with 5,711 children with asthma and 21,561 children without asthma. Among them, 24 studies were included for analyzing the association between 25(OH)D level and asthma and 12 studies evaluated the treatment effect of vitamin D.

Results and conclusions:
The investigators found that the children with asthma had significant lower 25(OH)D level than children without asthma [21.7 ng/mL versus 26.5 ng/mL, SMD = -1.36, 95% CI = -2.40 to -0.32, p = 0.010].

The investigators found, besides, children with asthma treated with vitamin D supplement had a significantly lower recurrence rate of 65% than the placebo group [18.4% versus 35.9%, RR = 0.35, 95% CI = 0.35 to 0.79, p = 0.002].

The investigators concluded that children with asthma have a lower 25(OH)D level than healthy children. Vitamin D supplement could decrease the asthma recurrence rate in the follow-up years.

Original title:
Vitamin D and asthma occurrence in children: A systematic review and meta-analysis by Wang Q, Ying Q, [...], Chen J.

Link:
https://pubmed.ncbi.nlm.nih.gov/34366195/

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Objectives:
Vitamin D deficiency is frequently associated with several medical conditions. However, a comprehensive meta-analysis assessing the association between vitamin D level and acne is lacking. Therefore, this review article (meta-analysis) has been conducted.

Does a low vitamin D level (expressed as circulating 25(OH)D levels) increase risk of both acne and acne severity?

Study design:
This review article included 13 articles with a total of 1,362 acne patients and 1,081 healthy controls (persons without acne).

Results and conclusions:
The investigators found that the circulating 25(OH)D levels were significantly lower in patients with acne than in healthy controls [pooled MD = -9.02 ng/mL, 95% CI = -13.22 to -4.81, p 0.0001].

The investigators found that vitamin D deficiency was more prevalent in acne patients than in healthy controls [pooled OR = 2.97, 95% CI = 1.68 to 5.23, I2 = 72%].

The investigators found that vitamin D levels were negatively correlated with acne severity.

The investigators concluded that the vitamin D levels are low in acne patients. Also, there is evidence of an inverse association between vitamin D levels and acne severity. Therefore, vitamin D might be involved in the pathogenesis (the manner of development of a disease) of acne.

Original title:
Association between Vitamin D Level and Acne, and Correlation with Disease Severity: A Meta-Analysis by Hasamoh Y, Thadanipon K, […], Juntongjin P.

Link:
https://pubmed.ncbi.nlm.nih.gov/34348293/

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Objectives:
Selenium (Se) is a trace element having significant effects on human metabolism. Recent studies suggest that selenium supplementation have a pivotal effect on the inflammatory markers. Therefore, this review article has been conducted.

Does selenium supplementation reduce plasma inflammatory markers including C-reactive protein (CRP) and high-sensitivity C-reactive protein (hs-CRP) and nitric oxide (NO) as a stress oxidative index, among patients with metabolic diseases?

Study design:
This review article included 7 RCTs.

Results and conclusions:
The investigators found subgroup analysis of CRP type showed that selenium supplementation significantly decreased hs-CRP level [pooled SMD = -0.44, 95% CI = -0.67 to -0.21] among patients with metabolic diseases.

The investigators concluded that selenium supplementation decreases hs-CRP level among patients with metabolic diseases.

Original title:
The effects of dietary selenium supplementation on inflammatory markers among patients with metabolic diseases: a systematic review and meta-analysis of randomized controlled trials by Djalalinia S, Hasani M, […], Qorbani M.

Link:
https://pubmed.ncbi.nlm.nih.gov/34222098/

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Objectives:
Previous studies have provided limited evidence for the effect of carrot intake on bladder cancer incidence. Therefore, this review article has been conducted.

Is there a relationship between dietary carrot intake and bladder cancer incidence?

Study design:
This review article included 3 cohort studies.

Results and conclusions:
The investigators found in a meta-analyse of 3 cohort studies no significant association between dietary carrot intake and bladder cancer risk [summary HR = 1.02, 95% CI = 0.95 to 1.10, I2 = 0.0%, p = 0.859].

The investigators concluded that there is no association between dietary consumption of carrot and the risk of bladder cancer.

Original title:
Association of Dietary Carrot Intake With Bladder Cancer Risk in a Prospective Cohort of 99,650 Individuals With 12.5 Years of Follow-Up by Xu X, Zhu Y, […], Xia D.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8349976/

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Objectives:
Whether N-acetylcysteine (NAC) therapy can promote the improvement of clinical symptoms and lung function in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has not been verified by large-scale randomized controlled trials, only a few small sample studies. Therefore, this review article has been conducted.

Does n-acetylcysteine (NAC) supplementation improve clinical symptoms and lung function in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD)?

Study design:
This review article included 12 retrospective analyses and 3 randomized controlled trials (RCTs) with 1,605 patients.
The 15 included studies were small sample studies, with sample sizes ranging from 72 to 146.

9 studies had a Jadad score of 3-5 points and 6 studies had a Jadad score of 1-2 points.

Results and conclusions:
The investigators found the meta-analysis results of 10 studies (525 cases in the n-acetylcysteine group and 524 cases in the control group) showed that the forced expiratory volume in the first second (FEV1) of the n-acetylcysteine group was markedly higher than that of the control group; the mean difference was 30.63 [95% CI = 25.48 to 35.78, I2 = 92%] and the difference was statistically significant [z = 11.65 and p 0.0001].

The investigators found the meta-analysis results of 6 studies (347 cases in the n-acetylcysteine group and 350 cases in the control group) showed that forced expiratory volume in the first second/forced vital capacity (FEV1/FVC) of the n-acetylcysteine group was markedly higher than that of the control group; the mean difference was 30.42 [95% CI = 24.00 to 36.85, I2 = 93%] and the difference was statistically significant [z = 9.28 and p 0.0001].

The investigators found the meta-analysis results of 6 studies (323 cases in the n-acetylcysteine group and 322 cases in the control group) showed that the glutathione sulfur transferase (GSH-ST) activity of the n-acetylcysteine group was notably greater than that of the control group; the mean difference was 3.10 [95% CI = 1.38 to 4.82, I2 = 91%] and the difference was statistically significant [z = 3.63, p = 0.0004].

The investigators found the meta-analysis results of 4 studies (224 cases in the n-acetylcysteine group and 227 cases in the control group) showed that the ability of the n-acetylcysteine group to inhibit hydroxyl free radicals was higher than that of the control group; the mean difference was 77.52 [95% CI = 61.01 to 94.03, I2 = 44%] and the difference was statistically significant [z = 9.20 and p 0.0001]. 

The investigators found the meta-analysis results of 4 studies (224 cases in the n-acetylcysteine group and 227 cases in the control group) showed that the superoxide anion radical resistance ability of the n-acetylcysteine group was greater than the ability of the control group; the mean difference was 47.75 [95% CI = 36.26 to 59.25, I2 = 35%] and the difference was statistically significant [z = 8.14 and p 0.0001]. 

The investigators concluded n-acetylcysteine (NAC) supplementation could promote the symptom improvement rate of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), improve lung function in FEV1 and FEV1/FVC and enhance the body’s antioxidant capacity. Could because the sample size of the literature included in this review article was small. The sample size should be expanded in future randomized controlled trials to verify these findings. All in all, the results of this review article can provide a reliable theoretical basis for the clinical treatment of AECOPD, so that patients can benefit from NAC treatment.

Original title:
Systematic review and meta-analysis of the efficacy of N-acetylcysteine in the treatment of acute exacerbation of chronic obstructive pulmonary disease by Jiang C, Zou J, [...], Yang Y.

Link:
https://apm.amegroups.com/article/view/72787/html

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An acute exacerbation of chronic obstructive pulmonary disease is a sudden worsening of chronic obstructive pulmonary disease (COPD) symptoms including shortness of breath, quantity and color of phlegm that typically lasts for several days.
 

Objectives:
Zinc in one of the most abundant trace minerals in human body which is involved in numerous biological pathways and has variety of roles in the nervous system. It has been assumed that zinc exerts its role in nervous system through increasing brain derived neurotrophic factor (BDNF) concentrations. Therefore, this review article has been conducted.

Does zinc supplementation increase brain derived neurotrophic factor (BDNF) levels?

Study design:
This review article included 5 studies with 238 participants. These studies enrolled subjects with premenstrual syndrome, diabetic retinopathy, major depression disorder, overweight/obese and obese with mild to moderate depressive disorders.

Funnel plot did not suggest publication bias.

Results and conclusions:
The investigators found zinc supplementation failed to increase blood brain derived neurotrophic factor concentrations with effect size of 0.30 [95% CI = -0.08 to 0.67, p = 0.119].

The investigators concluded zinc supplementation does not increase brain derived neurotrophic factor (BDNF) levels. However, the small number of included articles and significant heterogeneity between them can increase the risk of a false negative result; therefore, the results should be interpreted with caution.

Original title:
The effect of zinc supplementation on brain derived neurotrophic factor: A meta-analysis by Jafari F, Mohammadi H and Amani R.

Link:
https://pubmed.ncbi.nlm.nih.gov/33831797/

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Brain Derived Neurotrophic Factor (BDNF) plays an important role in neuronal survival and growth, serves as a neurotransmitter modulator and participates in neuronal plasticity, which is essential for learning and memory.
Decreased levels of BDNF are associated with neurodegenerative diseases with neuronal loss, such as Parkinson's disease, Alzheimer's disease, multiple sclerosis and Huntington's disease.
 

Objectives:
Omega-3 polyunsaturated fatty acid (PUFA) supplementation has been proposed as a potential therapy for cancer-related malnutrition, which affects up to 70% of patients with cancer. Therefore, this review article has been conducted.

Do patients with cancer benefit from oral omega-3 PUFA supplements?

Study design:
This review article included 31 RCTs.
Trials supplementing ≥600 mg/d omega-3 PUFA (oral capsules, pure fish oil or oral nutritional supplements) compared with a control intervention for ≥3 weeks.

The Cochrane risk of bias tool graded most trials as “unclear” or “high” risk of bias.

Results and conclusions:
The investigators found meta-analyses showed no significant difference between omega-3 PUFA supplements and control intervention on muscle mass, quality of life and body weight.

The investigators found oral omega-3 PUFA supplements significantly reduced the likelihood of developing chemotherapy-induced peripheral neuropathy with 80% [OR = 0.20, 95% CI = 0.10 to 0.40, p 0.001, I2 = 0%].  

The investigators concluded that oral omega-3 PUFA supplementation may reduce the incidence of chemotherapy-induced peripheral neuropathy in patients with cancer. May reduce because most trials were graded as “unclear” or “high” risk of bias.

Original title:
The effect of oral omega-3 polyunsaturated fatty acid supplementation on muscle maintenance and quality of life in patients with cancer: A systematic review and meta-analysis by Lam CN, Watt AE, [...], van der Meij BS.

Link:
https://pubmed.ncbi.nlm.nih.gov/34130028/

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Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most frequent side effects caused by antineoplastic agents. Antineoplastic drugs are medications used to treat cancer. Antineoplastic drugs are also called anticancer, chemotherapy, chemo, cytotoxic or hazardous drugs.

Objectives:
Do patients with knee osteoarthritis benefit from vitamin D supplementation?

Study design:
This review article included 6 articles with a total of 1,599 patients with osteoarthritis of the knee.

Results and conclusions:
The investigators found, the results of the meta-analysis showed that vitamin D supplementation statistically significantly improved WOMAC score [SMD = -0.67, 95% CI = -1.23 to -0.12) in patients with knee osteoarthritis, including WOMAC pain score [SMD = -0.32, 95% CI = -0.63 to -0.02], function score [SMD = -0.34, 95% CI = -0.60 to -0.08] and stiffness score [SMD = -0.13, 95% CI = -0.26 to -0.01].

The investigators found, in subgroup analysis, vitamin D supplementation less than 2000 IU (50 mcg) was statistically significant for the reduction of stiffness score [SMD = -0.22, 95% CI = -0.40 to -0.04].

The investigators found vitamin D supplements significantly reduced synovial fluid volume progression in patients with knee osteoarthritis [SMD = -0.20, 95% CI -0.39 to -0.02].

The investigators concluded vitamin D supplements improve WOMAC pain and function in patients with knee osteoarthritis.

Original title:
Does vitamin D improve symptomatic and structural outcomes in knee osteoarthritis? A systematic review and meta-analysis by Zhao ZX, He Y, […], Chen J.

Link:
https://pubmed.ncbi.nlm.nih.gov/33783714/

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The WOMAC is a validated patient-administered questionnaire that assesses 3 components: pain, stiffness and function, with the score range of 0-20 for pain, 0-8 for stiffness and 0-68 for physical function.
 

Objectives:
There appears to be a sex-specific association between obesity and colorectal neoplasia in patients with Lynch Syndrome (LS). Therefore, this review article has been conducted.

Does obesity (BMI>30) increase colorectal cancer in patients with Lynch Syndrome?

Study design:
This review article included 3 prospective cohort studies with 2,463 subjects (persons), of which 735 subjects with colorectal cancer.

All studies with a prospective study design (cohort studies) expressed the association between obesity and colorectal cancer in terms of adjusted HR (95% CI).

There was no publication bias.

Results and conclusions:
The investigators found a twofold risk of colorectal cancer in obese men with Lynch Syndrome compared to nonobese men with Lynch Syndrome [SRR = 2.09, 95% CI = 1.23 to 3.55, I2 = 33%].  
No significantly increased risk due to obesity was found for women [SRR = 1.41, 95% CI = 0.46 to 4.27, I2 = 68%].  

The investigators found a significantly 49% increased colorectal cancer risk for obesity (BMI>30) for subjects with an MLH1 mutation [SRR = 1.49, 95% CI = 1.11 to 1.99, I2 = 0%].

The investigators concluded that obesity (BMI>30) increases colorectal cancer in men with Lynch Syndrome, particularly with an MLH1 mutation.

Original title:
A Meta-Analysis of Obesity and Risk of Colorectal Cancer in Patients with Lynch Syndrome: The Impact of Sex and Genetics by Lazzeroni M, Bellerba F, […], Gandini S.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8160758

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Lynch syndrome, also known as hereditary non-polyposis colorectal cancer (HNPCC), is an autosomal dominantly inherited disease. People with Lynch syndrome have about a 40% to 80% chance of getting colorectal cancer by age 70. They’re also at risk for cancer of the uterus, ovaries or stomach. And they tend to get cancer at younger ages than other people, often in their 30s and 40s.

An error or mutation, in one copy of the MLH1 gene is one of the causes of Lynch syndrome. Men and women with a mutation in MLH1 have a 52-82% lifetime risk (up to age 70) to develop colon or rectal cancer.
 

Objectives:
Do critically ill patients benefit of thiamine (vitamin B1) supplementation?

Study design:
This review article included 8 RCTs and 10 cohort studies.

Results and conclusions:
The investigators found in the analysis of RCTs, that thiamine supplementation showed a significantly 42% lower odds of developing ICU delirium [OR = 0.58, 95% CI = 0.34 to 0.98].

The investigators found a reduction in mortaliy was observed on performing fixed effect model analysis. However, a level of statistical significance could not be reached on performing randon effect model analysis [OR = 0.78, 95% CI = 0.59 to 1.04].

The investigators found in subgroup analysis of 13 studies in patients with sepsis, there was no difference in mortality between the 2 groups [OR = 0.83, 95% CI = 0.63 to 1.09].

The investigators concluded thiamine (vitamin B1) supplementation in critically ill patients shows a reduction in the incidence of ICU delirium among RCTs. However, there is no significant benefit in terms of overall mortality and mortality in patients with sepsis. Further, large scale randomized prospective studies are warranted to investigate the role of thiamine supplementation in critically ill patients.

Original title:
Effect of thiamine supplementation in critically ill patients: A systematic review and meta-analysis by Sedhai YR, Shrestha DB, […], Kashiouris MG.

Link:
https://pubmed.ncbi.nlm.nih.gov/34118501/

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Intensive Care Unit (ICU) delirium is a nonspecific, potentially preventable and often reversible disorder of impaired cognition, which results from various causes in ICU patients. The term “delirium”is derived from the Latin word “delirare” which literally means “to go out of the furrow” or figuratively “crazy or deranged”.
 

Objectives:
Does calcium reduce the risk of incidence and recurrence of colorectal adenomas and advanced adenomas?

Study design:
This review article included 37 relevant clinical trials and observational studies involving over 10,964 cases.

Results and conclusions:
The investigators found that calcium consumption significantly reduced the risk of colorectal adenomas incidence by 8% [RR = 0.92, 95% CI = 0.89 to 0.96].

The investigators found that calcium intake as a food significantly reduced the risk of colorectal adenomas incidence by 21% [RR = 0.79, 95% CI = 0.72 to 0.86].

The investigators found that calcium intake as dairy product significantly reduced the risk of colorectal adenomas incidence by 12% [RR = 0.88, 95% CI = 0.78 to 0.98].

The investigators found, however, calcium supplements did not show a significant effect on colorectal adenomas incidence [RR = 0.97, 95% CI = 0.89 to 1.05].

The investigators found that total calcium intake significantly reduced the risk of advanced colorectal adenomas incidence by 21% [RR = 0.79, 95% CI = 0.73 to 0.85].

The investigators found that total calcium intake significantly reduced the risk of recurrence of adenomas by 12% [RR = 0.88, 95% CI = 0.84 to 0.93].

The investigators concluded that natural sources of calcium such as dairy products and foods have more effective role than supplementary calcium in terms of reducing the risk of incidence and recurrence of colorectal adenomas and advanced adenomas.

Original title:
Calcium and dairy products in the chemoprevention of colorectal adenomas: a systematic review and meta-analysis by Emami MH, Salehi M, […], Maghool F.

Link:
https://pubmed.ncbi.nlm.nih.gov/33951958/

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The colorectal adenoma is a benign glandular tumor of the colon and the rectum. It is a precursor lesion of the colorectal adenocarcinoma (colon cancer).

Objectives:
Apart from ruminant fat, trans fatty acids are produced during the partial hydrogenation of vegetable oils, (eg, in the production of ultraprocessed foods). Harmful cardiovascular effects of trans fatty acids are already proven, but the link with cancer risk has not yet been summarized. Therefore, this review article has been conducted.

Does high consumption of dietary trans fat increase risk of cancer?

Study design:
This review article included 17 cohort and case-control studies on breast cancer, 11 cohort and case-control studies on prostate cancer and 9 cohort and case-control studies on colorectal cancer.

Results and conclusions:
The investigators found that high consumption of dietary total trans fat significantly increased prostate cancer with 49% [OR = 1.49, 95% CI = 1.13 to 1.95].
Significantly means that there is an association with a 95% confidence.

The investigators found that high consumption of dietary total trans fat significantly increased colorectal cancer with 26% [OR = 1.26, 95% CI = 1.08 to 1.46].
Significant because OR of 1 was not found in the 95% CI of 1.08 to 1.46. OR of 1 means no risk/association.

The investigators found no association between high consumption of dietary total trans fat and the risk of breast cancer [OR = 1.12, 95% CI = 0.99 to 1.26].
No association ant because OR of 1 was found in the 95% CI of 0.99 to 1.26. OR of 1 means no risk/association.

The investigators found results were dependent on the fatty acid subtype, with even cancer-protective associations for some partially hydrogenated vegetable oils.

The investigators found enhancing moderators in the positive transfat-cancer relation were gender (direction was cancer-site specific), European ancestry, menopause, older age and overweight.

The investigators concluded that high consumption of dietary total trans fat increases prostate cancer and colorectal cancer. Future studies need methodological improvements (eg, using long-term follow-up cancer data and intake biomarkers). Owing to the lack of studies testing trans-fatty acid subtypes in standardized ways, it is not clear which subtypes (eg, ruminant sources) are more carcinogenic.

Original title:
Dietary trans-fatty acid intake in relation to cancer risk: a systematic review and meta-analysis by Michels N, Specht IO and Huybrechts I.

Link:
https://pubmed.ncbi.nlm.nih.gov/34104953/

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A diet high in trans fat is a diet with more than 1 En% trans fat.

Trans fat can be found in doughnuts, cakes, pie crusts, biscuits, frozen pizza, cookies, crackers and stick margarines and other spreads.

Objectives:
The efficacy of soy diet for nonalcoholic fatty liver disease remains controversial. Therefore, this review article has been conducted.

Does soy supplementation have positive effects on nonalcoholic fatty liver disease?

Study design:
This review article included 5 RCTs.
All of 5 RCTs have a relatively small sample size (n 100).

Jadad scores of the 5 included studies vary from 3 to 5 and all 5 studies were considered to be high-quality ones according to quality assessment.

Results and conclusions:
The investigators found, overall, compared with control group for nonalcoholic fatty liver disease, soy supplementation is associated with significantly reduced HOMA-IR [SMD = -0.42, 95% CI = -0.76 to -0.08, p = 0.01], increased insulin [SMD = -0.64, 95% CI = -0.98 to -0.30, p = 0.0002] and decreased malondialdehyde [SMD = -0.43, 95% CI = -0.74 to -0.13, p = 0.005].

The investigators found, however, compared with control group for nonalcoholic fatty liver disease, soy supplementation demonstrated no substantial impact on body mass index [SMD = 0.17, 95% CI = -0.20 to 0.53, p = 0.37), alanine aminotransferase [SMD = -0.01, 95% CI = -0.61 to 0.60, p = 0.98), aspartate-aminotransferase [SMD = 0.01, 95% CI = -0.47 to 0.49, p = 0.97], total cholesterol [SMD = 0.05, 95% CI = -0.25 to 0.35, p = 0.73] or low density lipoprotein cholesterol (bad cholesterol) [SMD = 0, 95% CI = -0.30 to 0.30, p = 0.99].

The investigators concluded that soy supplementation improves insulin resistance for nonalcoholic fatty liver disease.

Original title:
Soy diet for nonalcoholic fatty liver disease: A meta-analysis of randomized controlled trials by Xiong P and Zhu YF.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8183754/

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Nonalcoholic fatty liver disease (NAFLD) is an umbrella term for a range of liver conditions affecting people who drink little to no alcohol. Non-alcoholic fatty liver disease is a disorder, caused by a build-up of fat in the liver.
 

Objectives:
Despite the widespread increase in the incidence of early-onset colorectal cancer (EoCRC), the reasons for this increase remain unclear. Therefore, this review article has been conducted.

What are the risk factors of early-onset colorectal cancer?

Study design:
This review article included 20 studies.

With the exception of alcohol consumption, there was considerable heterogeneity among studies [I2 > 60%].

Results and conclusions:
The investigators found colorectal cancer history in a first-degree relative was significantly associated with a 4.21-fold enhanced risk of early-onset colorectal cancer [RR = 4.21, 95% CI = 2.61 to 6.79].

The investigators found hyperlipidemia significantly increased risk of early-onset colorectal cancer with 62% [RR = 1.62, 95% CI = 1.22 to 2.13].

The investigators found obesity (BMI>30) significantly increased risk of of early-onset colorectal cancer with 54% [RR = 1.54, 95% CI = 1.01 to 2.35].

The investigators found compared to non-drinkers, high alcohol consumption significantly increased risk of of early-onset colorectal cancer with 71% [RR = 1.71, 95% CI = 1.62 to 1.80].

The investigators concluded that colorectal cancer history in a first-degree relative, hyperlipidemia (a high level of lipids (fats, cholesterol and triglycerides) circulating in the blood), obesity and high alcohol consumption are risk factors of early-onset colorectal cancer. High-quality studies conducted on generalizable populations and that comprehensively examine risk factors for early-onset colorectal cancer are required to inform primary and secondary prevention strategies.

Original title:
Risk Factors for Early-Onset Colorectal Cancer: A Systematic Review and Meta-analysis by O'Sullivan DE, Sutherland RL, […], Brenner DR.

Link:
https://pubmed.ncbi.nlm.nih.gov/33524598/

Additional information of El Mondo:
Find more information/studies on obesity, alcohol consumption and colorectal cancer right here.

Early-onset colorectal cancer is colorectal cancer diagnosed in a patient younger than age 50.

 

Objectives:
Is hypertension a risk factor in adults with cerebral palsy?

Study design:
This review article included data from 11 international cohort studies representing 444 adults with cerebral palsy [median (IQR) age of the sample was 29.0 (23.0-38.0), 51% men, 89% spastic type, Gross Motor Function Classification System levels I-V].

Results and conclusions:
The investigators found overall mean systolic blood pressure was 124.9 mmHg [95% CI = 121.7 to 128.1] and overall mean diastolic blood pressure was 79.9 mmHg [95% CI = 77.2 to 82.5].

The investigators found overall prevalence of hypertension was 28.7% [95% CI = 18.8 to 39.8%].

The investigators found subgroup analysis indicated higher blood pressure levels or higher prevalence of hypertension in adults with cerebral palsy above 40 years of age, men, those with spastic cerebral palsy or those who lived in Africa.

The investigators concluded that the findings in this review article underscore the importance of clinical screening for blood pressure in individuals with cerebral palsy beginning in young adulthood.

Original title:
Blood pressure in adults with cerebral palsy: a systematic review and meta-analysis of individual participant data by Noten S, van den Berg-Emons RJG, [...], Van Der Slot WMA.

Link:
https://pubmed.ncbi.nlm.nih.gov/34102658/

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Find more information/studies on lowering blood pressure and cardiovascular disease right here.

Cerebral palsy (CP) is a group of disorders that affect a person's ability to move and maintain balance and posture. Cerebral palsy is the most common motor disability in children.
 

Objectives:
Does guarana supplementation reduce cancer-related fatigue?

Study design:
This review article included 7 RCTs with a total of 427 cancer patients.
Some studies presented a low risk of bias for all the categories.
Meta-analysis was conducted for 3 studies about breast cancer, which presented sufficient data.

The instruments used to analyze fatigue were the Brief Fatigue Inventory (BFI), the Chalder Fatigue Scale, the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-FATIGUE) and the Piper Scale.

Results and conclusions:
The investigators found guarana supplementation did not reduce cancer-related fatigue compared with placebo groups [mean = -0.02, 95% CI = -1.54 to 1.50, p = 0.98] and the quality of evidence according to GRADE was very low.

The investigators concluded that guarana supplementation did not reduce cancer-related fatigue. However, further studies with better methodological quality are needed.

Original title:
The use of guarana (Paullinia cupana) as a dietary supplement for fatigue in cancer patients: a systematic review with a meta-analysis by de Araujo DP, Pereira PTVM, […], Garcia JBS.

Link:
https://pubmed.ncbi.nlm.nih.gov/34146166/

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Objectives:
Systemic inflammation and oxidative stress (OS) are associated with breast cancer. Coenzyme Q10 (CoQ10) as an adjuvant treatment with conventional anti-cancer chemotherapy has been demonstrated to help in the inflammatory process and oxidative stress. Therefore, this review article has been conducted.

Does coenzyme Q10 supplementation reduce levels of inflammatory markers, oxidative stress parameters and matrix metalloproteinases/tissue inhibitor of metalloproteinases (MMPs/TIMPs) in patients with breast cancer?

Study design:
This review article included 9 RCTs.

Results and conclusions:
The investigators found that coenzyme Q10 supplementation (100 mg/day for 45-90 days) significantly decreased the levels of
-vascular endothelial growth factor (VEGF) [SMD = -1.88, 95% CI = -2. 62 to -1.13, I2 = 93.1%, p 0.001];
-IL-8 [SMD = -2.24, 95% CI = -2.68 to -1.8, I2 = 79.6%, p = 0.001];
-matrix metalloproteinase-2 (MMP-2) [SMD = -1.49, 95% CI = -1.85 to -1.14, I2 = 76.3%, p = 0.005] and
-matrix metalloproteinase-9 (MMP-9) [SMD = -1.58, 95% CI = -1.97 to -1.19, I2 = 79.6%, p = 0.002].

The investigators concluded that 100 mg/day coenzyme Q10 supplementation for 45-90 days reduces some of the important markers of inflammation and matrix metalloproteinases in patients with breast cancer. However, further studies with controlled trials for other types of cancer are needed to better understand and confirm the effect of coenzyme Q10 on tumor therapy.

Original title:
Effects of coenzyme Q10 supplementation on inflammation, angiogenesis, and oxidative stress in breast cancer patients: a systematic review and meta-analysis of randomized controlled trials by Alimohammadi M, Rahimi A, […], Rafiei A.

Link:
https://pubmed.ncbi.nlm.nih.gov/34008150/

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Vascular endothelial growth factor (VEGF) plays a central role in promoting angiogenesis and is over-expressed in breast cancer.

IL-8 is a marker of ER-negative and/or HER2-positive breast cancer.

Matrix metalloproteinases (MMPs) are a group of zinc-containing, calcium dependent endopeptidases which play a substantial role in breast carcinogenesis through several mechanisms. These mechanisms include remodeling of extracellular matrix (ECM), cell proliferation and angiogenesis which promote metastasis and result in tumor progression.

Objectives:
Catechins are a part of the chemical family of flavonoids, a naturally occurring antioxidant, and a secondary metabolite in certain plants. Green tea catechins are well recognized for their essential anti-inflammatory, photo-protective, antioxidant and chemo-preventive functions. Ultraviolet radiation is a principal cause of damage to the skin. Studies observed that regular intake of green tea catechins increased the minimal dose of radiation required to induce erythema. However, there is a gap in knowledge regarding the impact of oral supplementation with green tea catechins on ultraviolet radiation-induced skin inflammation in human subjects. Therefore, this review article has been conducted.

Is green tea catechin supplementation associated with protection against UV-induced damage due to erythema inflammation in humans?

Study design:
This review article included 6 randomized controlled studies with a total of 100 healthy volunteers. The intervention duration of administrated green tea catechins orally varied from 6 to 12 weeks.

All studies included in this systematic review and meta-analysis measured the erythema index using solar simulator techniques, wherein the blue-light (mimicking sunlight) solar simulator was used to irradiate the skin and skin color was evaluated by chromameter before and 24 h after irradiation at baseline and post-supplementation of green tea catechins.

Results and conclusions:
The investigators found meta-analysis results confirmed oral supplementation of green tea catechins was highly effective at low-intensity ultraviolet radiation-induced erythema response [MED range = 1.25 to 1.30] compared to placebo, showing a significant pooling difference in erythema index [SMD = -0.35, 95% CI = -0.57 to -0.13, p = 0.002, I2 = 4%, p = 0.40] in the random-effects model.

The investigators concluded that regular green tea catechin supplementation (as low as 540 mg of green tea catechins per day) is associated with protection against UV-induced damage due to erythema inflammation in humans, wherein green tea catechin metabolites are bioavailable at the dermis and epidermis levels of the skin and thus increase the minimal dose of radiation (MED) required to induce erythema. This in turn suggests that green tea catechins can strengthen the skin’s tolerance to ultraviolet radiation-induced skin damage from radiation through the prevention of the ultraviolet radiation-induced perturbation of epidermal barrier functions.

Original title:
Green Tea Catechin Association with Ultraviolet Radiation-Induced Erythema: A Systematic Review and Meta-Analysis by Kapoor MP, Sugita M, [...], Okubo T.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8233826/

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Sunburn, also called UV-induced or solar erythema, is characterized by painful blistering and sometimes second degree burn.

Objectives:
Which disease-modifying osteoarthritis drugs improve knee and hip osteoarthritis among adults?

Study design:
This review article included 28 randomized controlled trials (RCTs) with 11,890 patients.

Results and conclusions:
The investigators found glucosamine supplements significantly improved both structure [minimum joint width or cartilage volume: network results: SMD = 0.16, 95% CI = 0.04 to 0.28] and symptoms [pain = -0.15, 95% CI = -0.25 to -0.05 and function = -0.17, 95% CI = -0.28 to -0.07] of knee and hip osteoarthritis among adults.

The investigators found chondroitin supplements significantly improved both structure [minimum joint width or cartilage volume: network results: SMD = 0.21, 95% CI = 0.10 to 0.32] and symptoms [pain = -0.06, 95% CI = -0.15 to -0.03 and function = -0.15, 95% CI = -0.26 to -0.03] of knee and hip osteoarthritis among adults.

The investigators found strontium supplements significantly improved structure [minimum joint width or cartilage volume: SMD = 0.20, 95% CI = 0.20 to 0.38] of knee and hip osteoarthritis among adults.

The investigators found vitamin D supplements significantly improved symptoms [pain = -0.15, 95% CI = -0.27 to -0.03 and function = -0.18, 95% CI = -0.31 to -0.06] of knee and hip osteoarthritis among adults.  

The investigators found, although doxycycline also demonstrated a favorable efficacy ranking, its safety profile was poor [withdrawal: network relative risk = 1.69, 95% CI = 1.03 to 2.75].

The investigators concluded glucosamine and chondroitin supplements yield statistically significant but clinically questionable long-term benefit on structure and symptoms of knee and hip osteoarthritis among adults, though both have favorable safety profiles.
Strontium supplements improve structure and vitamin D supplements improve symptoms of knee and hip osteoarthritis among adults. Although doxycycline has a favorable efficacy ranking, its safety profile is poor.
None of the 12 classes of drugs appears to have long-term clinically significant benefit.

Original title:
The Efficacy and Safety of Disease-Modifying Osteoarthritis Drugs for Knee and Hip Osteoarthritis-a Systematic Review and Network Meta-Analysis by Yang W, Sun C, […], Zhuo Q.

Link:
https://pubmed.ncbi.nlm.nih.gov/33846938/

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Objectives:
Patients with kidney failure often present with reduced cardiovascular functional reserve and exercise tolerance. Previous studies on cardiorespiratory fitness examined with cardiopulmonary-exercise-testing (CPET) in kidney-transplant-recipients (KTR) had variable results. Therefore, this review article has been conducted.

Does cardiovascular functional reserve improve after kidney-transplantation?

Study design:
This review article included 8 studies with 461 participants.

Results and conclusions:
The investigators found kidney-transplant-recipients had significantly higher oxygen consumption at peak/max exercise (VO2 peak/VO2 max) compared to patients with kidney failure [SMD = 0.70, 95% CI = 0.31 to 1.10, I2 = 70%, p = 0.002]. 

The investigators found, in subgroup analyses, similar differences were evident among 7 studies comparing kidney-transplant-recipients and hemodialysis patients [SMD = 0.64, 95% CI = 0.16 to 1.12, I2 = 65%, p = 0.009] and 2 studies comparing kidney-transplant-recipients with peritoneal dialysis subjects [SMD = 1.14, 95% CI = 0.19 to 2.09, I2 = 50%, p = 0.16]. 

The investigators found across 4 studies with relevant data, oxygen consumption during peak/max exercise showed significant improvement after kidney-transplantation compared to pre-transplantation values [WMD = 2.43, 95% CI = 0.01 to 4.85, I2 = 68%, p = 0.02].

The investigators concluded kidney-transplant-recipients exhibit higher cardiovascular functional reserve during cardiopulmonary-exercise-testing compared to patients with kidney failure. Cardiovascular reserve is also improved after kidney-transplantation in relation to pre-surgery levels.

Original title:
Cardiorespiratory fitness in kidney transplant recipients compared to patients with kidney failure: a systematic review and meta-analysis by Theodorakopoulou MP, Boutou AK, […], Sarafidis P.

Link:
https://pubmed.ncbi.nlm.nih.gov/34170572/

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Cardiac reserve or cardiovascular reserve refers to the difference between the rate at which the heart pumps blood and its maximum capacity for pumping blood at any given time. A measurement of the cardiovascular reserve may be a health indicator for some medical conditions, like patients with kidney failure.