Nutritional advice

Objectives:
The association between coffee consumption and the circulating level of adiponectin and leptin has been evaluated in several epidemiological studies with conflicting results. Therefore, this review article has been conducted.

Is there an association between coffee consumption and the circulating level of adiponectin and leptin in humans?

Study design:
This review article included 12 cross-sectional studies.

Results and conclusions:
The investigators found when compared the highest versus the lowest coffee intake category, coffee consumption was associated with a higher circulating adiponectin level [SMD = 0.11, 95% CI = 0.06 to 0.17, p 0.001].

The investigators found in subgroup analysis when compared the highest versus the lowest coffee intake category, coffee consumption was associated with a higher circulating adiponectin level in women [SMD = 0.11, 95% CI = 0.02 to 0.20, p = 0.01], but not in men [SMD = 0.03, 95% CI = -0.08 to 0.14, p = 0.59].

The investigators found when compared the highest versus the lowest coffee intake category, coffee consumption was associated with a lower circulating leptin level [SMD = -0.19, 95% CI = -0.28 to -0.10, p 0.001].

The investigators concluded that coffee consumption is associated with a higher circulating level of adiponectin in women and a lower circulating level of leptin. However, more well-designed prospective cohort studies and randomised controlled trials are needed to further elaborate the concerned issues.

Original title:
Associations of coffee consumption with circulating level of adiponectin and leptin. A meta-analysis of observational studies by Zhang Y and Zhang DZ.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29513118

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Find more information/studies on coffee consumption, diabetes and overweight right here.

Adiponectin is a unique adipokine, which is specifically and abundantly expressed in adipose tissues and improves insulin resistance. Having insulin resistance may increase the risk of type 2 diabetes and metabolic syndrome.

Objectives:
Many studies were conducted to explore the relationship between dietary protein intake and risk of prostate cancer, obtaining inconsistent results. Therefore, this review article has been conducted.

Does dietary protein intake increase risk of prostate cancer?

Study design:
This review article included a total of 8 cohort studies, 5 case-control studies and 1 RCT, comprising 13,483 prostate cancer cases among 286,245 participants.

Begg’s funnel plots and Egger’s test [p = 0.296] indicated that no publication bias was found in overall analysis.

Results and conclusions:
The investigators found in the overall analysis there was no association with prostate cancer risk when comparing the highest protein intake with the lowest protein intake [summary RR = 0.993, 95% CI = 0.930-1.061, I2 = 0.0%, p = 0.656].
The sensitivity analysis showed that there is no single study that had potential effects on the overall result while removing a study at a time.

The investigators found in the stratified analysis by protein type, the association was non-significant on prostate cancer risk in both animal protein intake [RR = 1.001, 95% CI = 0.917-1.092] and vegetable protein intake [RR = 0.986, 95% CI = 0.904-1.076].
Non-significant because RR of 1 was found in the 95% CI of 0.917 to 1.092. RR of 1 means no risk/association.

The investigators found there was also no significant association in cohort studies [RR = 1.080, 95% CI = 0.964-1.209] and in case-control studies [RR = 0.960, 95% CI = 0.874-1.055].

The investigators found there was no association with prostate cancer localized-stage disease risk when comparing the highest protein intake with the lowest protein intake [summary RR = 1.263, 95% CI = 0.953-1.674].

The investigators found there was no association with prostate cancer advanced-stage disease risk when comparing the highest protein intake with the lowest protein intake [summary RR = 0.973, 95% CI = 0.745-1.272].

The investigators concluded that there is no effect on prostate cancer with high-protein intake. Since some limitations exited in this review article, future studies are wanted to confirm the result.

Original title:
Association between dietary protein intake and prostate cancer risk: evidence from a meta-analysis by Ye M, Yan T and Jing D.

Link:
https://wjso.biomedcentral.com/articles/10.1186/s12957-018-1452-0

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Find more information/studies on protein and cancer right here.

Objectives:
There has been accumulating evidence that several micronutrients may play a protective role in the risk of solid cancers. However, their role in hematological malignancies remains to be elucidated. Therefore, this review article has been conducted.

Is there a relationship between vitamin intake and risk of non-Hodgkin lymphoma?

Study design:
This review article included a total of 12 cohort studies.

Results and conclusions:
The investigators found null associations regarding
-supplemented vitamin A [pooled RR = 0.92, 95% CI = 0.80-1.07];
-supplemented vitamin C [pooled RR = 1.00, 95% CI = 0.90-1.12];
-total vitamin D [pooled RR = 1.05, 95% CI = 0.91-1.20];
-supplemented vitamin E [pooled RR = 0.98, 95% CI = 0.88-1.10] and;
-dietary lycopene intake [pooled RR = 1.00, 95% CI = 0.86-1.16] and risk of non-Hodgkin lymphoma.

The investigators found no summary estimates were provided for other hematological malignancies due to the limited number of studies.

The investigators concluded there is no association between vitamin A, C, D, E and lycopene and risk of non-Hodgkin lymphoma.

Original title:
Micronutrient Intake and Risk of Hematological Malignancies in Adults: A Systematic Review and Meta-analysis of Cohort Studies by Psaltopoulou T, Ntanasis-Stathopoulos I, […], Sergentanis TN.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30288994

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Objectives:
There were inconsistent results with respect to the correlation between consumption of wine and the development of colorectal cancer (CRC). Therefore, this review article has been conducted.

Does consumption of wine increase colorectal cancer risk?

Study design:
This review article included a total of 8 case-control studies and 9 cohort studies, involving 12,110 colorectal cancer cases.

Results and conclusions:
The investigators found that wine drinking was not associated with any greater risk for colorectal cancer [SRR = 0.99, 95% CI = 0.89-1.10, p-heterogeneity 0.001] compared with nondrinkers.

The investigators found subgroup analyses (to get more information) indicated that null associations were observed in men and women for colon and rectal cancer.

The investigators found subgroup analyses showed neither light to moderate [2 drinks/day: SRR = 0.93, 95% CI = 0.80-1.08, I2 = 69.2%] nor heavy [≥2 drinks/day: SRR = 1.00, 95% CI = 0.86-1.16, I2 = 39.9%] consumption of wine was associated statistically with colorectal cancer risk.

The investigators concluded that wine consumption is not associated with the risk of colorectal cancer. Furthermore, null associations are found in men and women for colon and rectal cancer.

Original title:
Wine consumption and colorectal cancer risk: a meta-analysis of observational studies by Xu W, Fan H, [...], Ge Z.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30247171

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Find more information/studies on review article/significant/heterogeneity, colorectal cancer and wine consumption right here.

Objectives:
Does dietary carrot intake reduce breast cancer risk?

Study design:
This review article included a total of 10 articles involving 13,747 cases (women with breast cancer).

A significant heterogeneity was observed among studies.

Results and conclusions:
The investigators found for the highest compared with the lowest dietary carrot intake a significantly reduced risk of 21% for breast cancer [OR = 0.79, 95% CI = 0.68 to 0.90]. Omission of any single study (=sensitivity analysis) had little effect on the combined risk estimate.

The investigators found in the subgroup analyses separated by study design, the inverse associations were more pronounced in the case-control studies than in the cohort studies, while the associations did not significantly differ by geographical region, study quality, exposure assessment.

The investigators concluded that high intake of dietary carrot reduces breast cancer risk.

Original title:
Association between dietary carrot intake and breast cancer: A meta-analysis by Chen H, Shao F, […], Miao Q.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30212943

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Find more information/studies on review article/significant/heterogeneity, breast cancer and carrot consumption right here.

Objectives:
Inflammation is associated with an increased risk of a range of chronic diseases. A diet high in fruit and vegetables may help to reduce inflammation, as fruit and vegetables are rich sources of antioxidants and other biologically active substances, which may improve immune function. Therefore, this meta-analysis (systematic review) has been conducted.

Does fruit or vegetables intake reduce inflammation and improve immune function?

Study design:
This review article included 71 clinical trials and 12 were observational studies (n = 10 cross-sectional studies and n = 2 cohort studies).

Results and conclusions:
The investigators found among observational studies (n = 10 studies) an inverse association between intakes of fruit or vegetables and inflammatory biomarkers.

The investigators found the majority of the intervention studies (n = 48 studies) reported beneficial effects of fruit or vegetable intake on ≥1 biomarker of systemic or airway inflammation.

The investigators found a meta-analysis of included studies showed that fruit or vegetable intake significantly decreased circulating levels of C-reactive protein and tumor necrosis factor-α [p 0.05] and significantly increased the γδ-T cell population [p 0.05].

The investigators concluded that higher intakes of fruit and vegetables lead to both a reduction in proinflammatory mediators and an enhanced immune cell profile.

Original title:
Effects of fruit and vegetable consumption on inflammatory biomarkers and immune cell populations: a systematic literature review and meta-analysis by Hosseini B, Berthon BS, […], Wood LG.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29931038

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The level of C-reactive protein (CRP), which can be measured in your blood, increases when there's inflammation in your body.

Tumour necrosis factor-alpha (TNF-alpha) is recognized as an important mediator in many cytokine-dependent inflammatory events.

 

Objectives:
Do dietary flavonoid intake reduce colorectal cancer risk?

Study design:
This review article included 5 prospective cohort and 7 case-control studies with a tolal of 17,481 cases (persons with colorectal cancer) and 740,859 controls (persons without colorectal cancer).

All studies were adjusted for a wide range of potential confounders of colorectal cancer, such as age, gender, BMI, physical activity, family history of colorectal cancer, education, energy intake, alcohol, fiber intake, red and processed meat intake, tobacco, aspirin and non-steroidal anti-inflammatory drug.

There was no publication bias.

Results and conclusions:
The investigators found that there was no significant association between colorectal cancer risk and total flavonoid intake, with a pooled OR from the combination of the included studies of 0.73 [95% CI = 0.48-1.10] for the highest category of intake vs. the lowest category. Similarly, no association between the intake of flavanones or flavan-3-ols and the risk of colorectal cancer was observed.

The investigators found in subgroup analysis of both cohort and case-control studies that when compared with the lowest, the highest intake of dietary flavonols significanty reduced risk of colorectal cancer with 30% [OR = 0.70, 95% CI = 0.54-0.90]. Nevertheless, substantial heterogeneities existed across the studies.
However, this reduced risk was not significant in cohort studies [pooled RR = 1.00, 95% CI = 0.92-1.08].

The investigators found in subgroup analysis of both cohort and case-control studies that when compared with the lowest, the highest intake of dietary flavones significanty reduced risk of colorectal cancer with 21% [OR = 0.79, 95% CI = 0.83-0.99]. Nevertheless, substantial heterogeneities existed across the studies.
However, this reduced risk was not significant in cohort studies [pooled RR = 1.02, 95% CI = 0.94-1.11].

The investigators found in subgroup analysis of both cohort and case-control studies that when compared with the lowest, the highest intake of dietary anthocyanidins significanty reduced risk of colorectal cancer with 22% [OR = 0.78, 95% CI = 0.64-0.95]. Nevertheless, substantial heterogeneities existed across the studies. 
However, this reduced risk was not significant in cohort studies [pooled RR = 1.00, 95% CI = 0.91-1.10].

The investigators found dose-response meta-analysis indicated that an increment of dietary flavones intake of 1 mg per day significantly reduced risk of colorectal cancer with 9% [pooled OR = 0.91, 95% CI = 0.84-0.99].

The investigators found dose-response meta-analysis indicated that an increment of dietary flavonols intake of 10 mg per day significantly reduced risk of colorectal cancer with 14% [pooled OR = 0.86, 95% CI = 0.76-0.97].

The investigators found that high intake of flavonols significantly decreased risk of colon cancer with 20% [OR = 0.80, 95% CI = 0.68-0.94].
Significantly means that there is an association with a 95% confidence.

The investigators found that high intake of flavones significantly decreased risk of rectal cancer with 18% [OR = 0.82, 95% CI = 0.70-0.97].
Significantly because OR of 1 was not found in the 95% CI of 0.70 to 0.97. OR of 1 means no risk/association.

The investigators concluded that high intake of dietary flavonols, flavones and anthocyanidins may decrease the risk of colorectal cancer. May decrease because substantial heterogeneities existed across the studies and the reduced risk was not significant in cohort studies.

Original title:
Dietary Flavonoids and the Risk of Colorectal Cancer: An Updated Meta-Analysis of Epidemiological Studies by Chang H, Lin Lei L, […], Guohua Zhao G.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6073812/

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Find more information/studies on review article/significant/publication bias, colorectal cancer and flavonoids right here.

The results of a review article are only reliable when they are also found in cohort studies. Thus, the significantly reduced risk must be found in both patient-control studies (more sensitive to errors) and cohort studies (less susceptible to errors).

Objectives:
Controversial results have been reported concerning the influence of calcium intake on prostate cancer risk. Therefore, this review article has been conducted.

Does calcium intake increase prostate cancer risk?

Study design:
This review article included 11 cohort studies and 1 case control study.

The average age of majority was between 50-70 years and also about 83%of articles had been performed in the USA.

Begg’s test showed the effect of publication bias was significant for relationship between calcium intake and total prostate cancer [p = 0.02] and the relationship between total calcium and localized prostate cancer [p = 0.03].

Results and conclusions:
The investigators found that total calcium intake significantly increased the total prostate cancer risk with 15% [overall RR = 1.15, 95% CI = 1.04-1.27, I2 = 59.7%, p = 0.006].
Sensitivity analysis by removing one study at the same time indicated that the overall RR was robust.

The investigators found in studies with follow-up more than 10 years a significantly increased risk of 22% [RR = 1.22, 95% CI = 1.07-1.38] for total prostate for total calcium intake.

The investigators found in 9 studies a significantly increased risk of 9% [RR = 1.09, 95% CI = 1.01-1.18] for total prostate cancer for 750 mg calcium intake per day.

The investigators found in 8 cohort studies, no association between total calcium intake and localized prostate cancer [RR = 1.05, 95% CI = 0.96-1.14].

The investigators found in 7 cohort studies, no association between total calcium intake and advance prostate cancer [RR = 1.15, 95% CI = 0.89-1.50].

The investigators concluded that calcium intake of 750 mg per day could be considered as a risk factor for total prostate cancer. Could be because there was publication bias.

Original title:
Total Calcium (Dietary and Supplementary) Intake and Prostate Cancer: a Systematic Review and Meta-Analysis by Rahmati S, Azami M, […], Sayehmiri K.

Link:
http://journal.waocp.org/?sid=Entrez:PubMed&id=pmid:29936714&key=2018.19.6.1449

Additional information of El Mondo:
Find more information/studies on cancer and calcium right here.

Objectives:
Although glucosamine and chondroitin sulfate have showed beneficial effects on joint tissues in osteoarthritis (OA), their therapeutic use in the clinical setting is still debatable. Therefore, this meta-analysis (systematic review) has been conducted.

Do glucosamine and chondroitin sulfate supplements relieve pain of knee osteoarthritis?

Study design:
This review article included RCTs.

The pain of knee osteoarthritis was measured using the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) and/or the Visual Analog Scale (VAS).

Results and conclusions:
The investigators found that glucosamine supplements significantly reduced pain of knee osteoarthritis (expressed as Visual Analog Scale (VAS) [WMD = - 7.41 mm, 95% CI = - 14.31 to - 0.51, p = 0.04].
Significant means that there is an association with a 95% confidence.

The investigators found that chondroitin supplements significantly reduced pain of knee osteoarthritis (expressed as Visual Analog Scale (VAS) [WMD = - 8.35 mm, 95% CI = - 11.84 to - 4.85, p  0.00001].
Significant because the found p-value of 0.00001 is less than 0.05.

The investigators found that the combination of glucosamine and chondroitin supplements non-significantly reduced pain of knee osteoarthritis (expressed as Visual Analog Scale (VAS) [WMD = - 0.28 mm, 95% CI = - 8.87 to 8.32, p = 0.95].
Non-significantly because the found p-value of 0.95 is greater than 0.05.

The investigators found that none of the glucosamine, chondroitin supplements or their combination had a significant positive effect on the total WOMAC index and its subscores.

The investigators concluded that oral supplementation with glucosamine or chondroitin sulfate reduces pain in knee osteoarthritis. However, there is no additional effect using both therapeutic agents in combination for the management of symptomatic knee osteoarthritis.

Original title:
Effect of glucosamine and chondroitin sulfate in symptomatic knee osteoarthritis: a systematic review and meta-analysis of randomized placebo-controlled trials by Simental-Mendía M, Sánchez-García A, […], Simental-Mendía LE.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29947998

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Objectives:
Prostate cancer (PCa) is one of the leading cause cancer among men worldwide. Many epidemiologic studies have reported an association between carbohydrate intake and prostate cancer. However, the evidence from epidemiologic studies is inconsistent. Therefore, this review article has been conducted.

Does carbodydrate intake increase prostate cancer risk?

Study design:
This review article included 21 studies published from 1980 to 2018, including 98,739 participants and 11,573 cases (persons with prostate cancer).

Multivariate-adjusted odds ratios (ORs) were pooled using random-effect models.

Results and conclusions:
The investigators found no association between higher carbohydrate intake and prostate cancer risk [OR =1.11, 95% CI = 0.98-1.26, I2 = 62.7%].
No association because OR of 1 was found in the 95% CI of 0.98 to 1.26. RR of 1 means no risk/association.

The investigators found no association between higher carbohydrate intake and advanced prostate cancer risk [OR = 0.95, 95% CI = 0.78-1.16, I2 = 14.1%].

The investigators found no association between higher carbohydrate intake and non-advanced prostate cancer risk [OR = 1.01, 95% CI = 0.79-1.29, I2 = 64.4%].

The investigators found there was not a significant dose-response association observed for carbohydrate intake with prostate cancer risk and advanced prostate cancer risk.

The investigators concluded that there is no association between carbohydrate intake and prostate cancer risk. Nor is association detected about carbohydrate intake with advanced or non-advanced prostate cancer risk. More studies are needed for a further dose-response meta-analysis.

Original title:
Carbohydrate intake and the risk of prostate cancer by Fan LL, Su HX, […], Nan CJ.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29778541

Additional information of El Mondo:
Find more information/studies on cancer and carbohydrate right here.

Objectives:
Several epidemiological studies have assessed the ability of vitamin B2 to prevent colorectal cancer (CRC), but the results are controversial. Therefore, this review article has been conducted.

Does vitamin B2 intake reduce colorectal cancer risk?

Study design:
This review article included a total of 14 studies reporting vitamin B2 intake and 2 studies reporting blood vitamin B2 concentration, comprising 14,934 cases (persons with colorectal cancer) and 1,593 cases (persons with colorectal cancer), respectively.

Results and conclusions:
The investigators found in pooled analysis a significantly reduced risk of 13% [RR = 0.87, 95% CI = 0.81-0.93] for colorectal cancer for vitamin B2 intake.
Significant means that there is an association with a 95% confidence.

The investigators found in subgroup analysis a significantly reduced risk of 14% [RR = 0.86, 95% CI = 0.78-0.94] for colorectal cancer for vitamin B2 intake from diet and supplements.

The investigators found in subgroup analysis a significantly reduced risk of 11% [RR = 0.89, 95% CI = 0.82-0.98] for colorectal cancer for dietary vitamin B2 intake.

The investigators found the dose-response model indicated a non-linear trend and colorectal cancer risk was reduced by 10% when vitamin B2 intake increased to 5 mg/day.

The investigators found that high blood concentrations of vitamin B2 significantly reduced the colorectal cancer risk with 26% [RR = 0.74, 95% CI = 0.59-0.92].

The investigators concluded that both higher vitamin B2 intake (5 mg per dag) and higher blood vitamin B2 concentration reduce colorectal cancer risk. These results suggest the importance of vitamin B2 intake in the prevention of colorectal cancer.

Original title:
Vitamin B2 intake reduces the risk for colorectal cancer: a dose-response analysis by Ben S, Du M, [...], Wang M.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29744609

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Find more information/studies on vitamin B2 and colorectal cancer right here.

Objectives:
In the past, some observational studies have been carried out on the relationship between milk and dairy intake and risk of acne occurrence. However, their results were conflicting. Therefore, this meta-analysis (systematic review) has been conducted.

Does milk and dairy intake increase risk of acne?

Study design:
This review article included observational studies.

Results and conclusions:
The investigators found for highest compared with lowest category of dairy intake a significantly increased risk of 161% for acne [OR = 2.61, 95% CI = 1.20 to 5.67].

Significant means that there is an association with a 95% confidence.

The investigators found for highest compared with lowest category of total milk intake a significantly increased risk of 48% for acne [OR = 1.48, 95% CI = 1.31 to 1.66].
Significantly means it can be said with a 95% confidence that a high total milk intake really increased the risk of getting acne with 48%. 

The investigators found for highest compared with lowest category of low-fat milk intake a significantly increased risk of 25% for acne [OR = 1.25, 95% CI = 1.10 to 1.43].
Significant because OR of 1 was not found in the 95% CI of 1.10 to 1.43. RR of 1 means no risk/association.

The investigators found for highest compared with lowest category of skim milk intake a significantly increased risk of 82% for acne [OR = 1.82, 95% CI = 1.34 to 2.47].

The investigators found results of dose-response analysis revealed a significant linear relationship between dairy, whole milk and skim milk and risk of acne and a nonlinear association between dairy, milk, low-fat milk and skim milk intake and acne.

The investigators concluded there is a positive relationship between dairy, total milk, whole milk, low-fat and skim milk consumption and acne occurrence. In contrary, there is no significant association between yogurt/cheese and acne development.

Original title:
Dairy intake and acne development: A meta-analysis of observational studies by Aghasi M, Golzarand M, […], Taheri F.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29778512

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Objectives:
Is there an association between wine consumption and prostate cancer risk?

Study design:
This review article included 6 cohort and 8 case-control studies with a total of 455,413 subjects regarding moderate wine consumption and risk of prostate cancer.

There was no evidence of publication bias.

Results and conclusions:
The investigators found in pooled analysis of cohort studies (438,302 subjects from which 19,238 developed prostate cancer during observation/follow-up) no association between moderate wine consumption and prostate cancer risk [pooled RR = 1.06, 95% CI = 0.96-1.15, p = 0.22, I2 = 0%]. 

The investigators found in multivariable analysis that moderate red wine consumption was associated with a significantly decreased risk of 12% for prostate cancer [pooled RR = 0.88, 95% CI = 0.78-0.999, p = 0.047, I2 = 0%]. 

The investigators found in multivariable analysis that moderate white wine consumption increased significantly the risk of prostate cancer with 26% [pooled RR = 1.26, 95% CI = 1.10-1.43, p = 0.001, I2 = 34.4%].

The investigators concluded that moderate consumption of white wine increases the risk of prostate cancer, whereas moderate consumption of red wine has a protective role. This hypothesis-generating data should serve as a rationale for uncovering the molecular underpinnings of this differential effect in order to potentially devise prevention strategies in the at-risk population.

Original title:
The impact of moderate wine consumption on the risk of developing prostate cancer by Vartolomei MD, Kimura S, […], Shariat SF.
 
Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5909789/

Additional information of El Mondo:
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Objectives:
Esophageal cancer (EC) is the eighth most common cancer and the sixth most frequent cause of cancer death in the whole world. Many studies have investigated the association between citrus fruit intake and the risk of esophageal cancer, but the results are inconsistent and not analyzed by category. Therefore, this review article has been conducted.

Does citrus fruit intake reduce esophageal cancer risk?

Study design:
This review article included 20 case-control studies and 5 cohort studies.
The studies were published between 1983 and 2015 with a total of 2,456 esophageal squamous cell carcinoma (ESCC) (range 47-395), 1,284 esophageal adenocarcinoma (EAC) (range 67-282) and 1,990 esophageal cancer (EC) (range 53-1,246).

The Newcastle-Ottawa Quality Assessment Scale (NOS) scores of 25 clinical trials range from 5 to 9, with an average of approximately 7. The median score was 6.75 for case-control studies and 8 for cohort studies.

There was no evidence of publication bias. 

Results and conclusions:
The investigators found in 10 case-control studies and 3 cohort studies a significantly reduced risk of 41% [pooled RR = 0.59, 95% CI = 0.47-0.76, I2 = 60.7%, p  = 0 .002] for esophageal squamous cell carcinoma in the citrus fruit consumption group.
Significant because RR of 1 was not found in the 95% CI of 0.47 to 0.76. RR of 1 means no risk/association.

The investigators found in 5 case-control studies and 3 cohort studies a non-significantly reduced risk of 14% [pooled RR = 0.86, 95% CI = 0.74-1.01, I2 = 0.0%, p = 0.598] for esophageal adenocarcinoma in the citrus fruit consumption group.
Non-significantly because RR of 1 was found in the 95% CI of 0.74 to 1.01. RR of 1 means no risk/association.

The investigators found in 20 case-control studies and 5 cohort studies a significantly reduced risk of 35% [pooled RR = 0.65, 95% CI = 0.56-0.75, I2 = 51.1%, p = 0.001] for esophageal cancer in the citrus fruit consumption group.

The investigators found in subgroup analysis significant inverse associations between citrus fruit intake and the risk of esophageal squamous cell carcinoma in cohort studies [OR  =  0.66, 95% CI = 0.49-0.88] and hospital-based cohort studies [OR  =  0.82, 95% CI = 0.33-0.75], but not in population-based cohort studies [OR  =  0.82, 95% CI = 0.62-1.09].

The investigators found in subgroup analysis significant inverse associations between citrus fruit intake and the risk of esophageal squamous cell carcinoma in >7 scores studies [OR =  0.56, 95% CI = 0.43-0.72].

The investigators concluded that citrus fruit intake reduces risk of esophageal cancer, particularly esophageal squamous cell carcinoma. However, further studies are warranted to find which constituents in citrus fruit prevent esophageal cancer and its mechanism.

Original title:
Intakes of citrus fruit and risk of esophageal cancer: A meta-analysis by Zhao W, Liu L and Xu S.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5895383/

Additional information of El Mondo:
Find more information/studies on fruit consumption and cancer right here.

Objectives:
The relationship between vitamin intake and pancreatic cancer (PC) risk is disputed. Therefore, this review article has been conducted.

Is there a relationship between dietary vitamin intake and pancreatic cancer risk?

Study design:
This review article included 25 observational studies with a total of 1,214,995 individuals, of which 8,000 pancreatic cancer cases.

In the identified studies, 10 were population-based case-control studies, 4 were hospital-based case-control studies, 2 were RCTs, 9 were cohort studies, 11 were prospective studies and 14 were retrospective studies.
The number of participants ranged from 305 to 537,218 and pancreatic cancer cases ranged from 79 to 2,383.
Quality scores of included case-control and cohort studies ranged from 7 to 9 with an average score of about 8.

Results and conclusions:
The investigators found in prospective cohort studies a significantly reduced risk of 10% [multivariable-adjusted RR = 0.90, 95% CI = 0.83-0.98, I2 = 11%] for pancreatic cancer when comparing the highest dietary vitamin intake with the lowest, particularly for 10 μg/d dietary intake of vitamin D [multivariable-adjusted RR = 0.75, 95% BI = 0.60-0.93, I2  =  59%].

The investigators concluded that a high dietary vitamin intake decreases the risk of pancreatic cancer, particularly for 10 μg/d dietary intake of vitamin D.

Original title:
Vitamin intake and pancreatic cancer risk reduction: A meta-analysis of observational studies by Liu Y, Wang X, [...], Liu S.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5895396/

Additional information of El Mondo:
Find more information/studies on vitamin D and cancer right here.

A review article (a collection of scientific studies on a specific topic) of cohort studies or case-control studies will answer the following question:
"Should I change my diet?".

Objectives:
The evidence is mixed on the use of long chain omega 3 fatty acids in the prevention and management of childhood asthma. Therefore, this meta-analysis (systematic review) has been conducted.

Does fish consumption reduce risk of childhood asthma?

Study design:
This review article included 23 observational studies on fish intake in association with childhood asthma.

Results and conclusions:
The investigators found in 15/23 studies early introduction of fish (6-9 months) and regular consumption (at least once a week) improved asthma symptoms and reduced risk in children 0-14 years as compared to no fish consumption; 6/23 showed no effect and 2/23 studies suggested adverse effects.

The investigators found a significantly reduced risk of 25% [OR = 0.75, 95% CI = 0.60-0.95] for all fish intake on current asthma in children up to 4.5 years old. 

The investigators found a significantly reduced risk of 38% [OR = 0.62, 95% CI = 0.48-0.80] for all fish intake on current wheeze in children up to 4.5 years old.

The investigators found as compared to no fish intake, a significantly reduced risk of 65% [OR = 0.35, 95% CI = 0.18-0.67] for fatty fish intake on asthma in children 8-14 years old. 

The investigators concluded that introduction of fish early in life (6-9 months) and regular consumption of all fish (at least once a week) reduces asthma and wheeze in children up to 4.5 years old, while fatty fish intake has beneficial effects in older children (8-14 years). Future well-designed clinical trials are recommended to confirm the promising findings documented in this literature analysis.

Original title:
The role of fish intake on asthma in children: A meta-analysis of observational studies by Papamichael MM, Shrestha SK, [...], Erbas B.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29524247

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Objectives:
Breast cancer is the most common cancer in women worldwide. The association between body mass index (BMI) and breast cancer risk has been paid more attention in the past few years, but the findings are still controversial. Therefore, this review article has been conducted.

Is there a relationship between BMI and breast cancer risk among women?

Study design:
This review article included 12 prospective cohort studies comprising 22,728,674 women.

All studies were published from 2004 to 2014, with the mean duration of follow-up varying from 4.29 to 10.8 years.
The sample size of included studies ranged from 15,054 to 1,222,630 women.
The Newcastle-Ottawa scale was applied to assess the quality of the included studies and the results showed all studies were of high quality, with a Newcastle-Ottawa scale score of ≥7.
There was no evidence of publication bias with Egger’s test [p = 0.74] and the funnel plot showed no sign of asymmetry by visual inspection.

Results and conclusions:
The investigators found overall results showed a weak positive association between a 5-unit increase in BMI and breast cancer risk, indicating that a 5 kg/m2 increase in BMI corresponded to a 2% increase in breast cancer risk [SRR = 1.02, 95% CI = 1.01-1.04, p 0.001, I2 = 74.2%, p = 0.00]. The results were statistically robust in sensitivity analyses.

The investigators found in subgroup analysis that higher BMI significantly reduced breast cancer risk with 2% among premenopausal women [SRR = 0.98, 95% CI = 0.96-0.99, p 0.001].

The investigators found there was evidence of a linear association between BMI and breast cancer risk in both premenopausal and postmenopausal women [p nonlinearity = 0.892 and p nonlinearity = 0.630, respectively].

The investigators concluded that every 5 kg/m² increase in BMI corresponds to a 2% increase in breast cancer risk in women. However, higher BMI is a protective factor of breast cancer risk for premenopausal women. Further studies are necessary to verify these findings and elucidate the pathogenic mechanisms.

Original title:
Association between body mass index and breast cancer risk: evidence based on a dose-response meta-analysis by Liu K, Zhang W, [...], Dai Z.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5783020/

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Objectives:
Lung cancer is the most common cause of cancer death. Fruits and vegetables containing carotenoids and other antioxidants have been hypothesized to decrease lung cancer risk. Therefore, this meta-analysis (systematic review) has been conducted.

Do fruits and vegetables reduce lung cancer risk?

Study design:
This review article included prospective cohort studies up to December 2014.

Results and conclusions:
The investigators found in 18 studies, when comparing the highest fruits and vegetables with the lowest intakes, a significantly reduced risk of 14% for lung cancer [summary RR = 0.86 [95% CI = 0.78-0.94].

The investigators found in 25 studies, when comparing the highest vegetables with the lowest intakes, a significantly reduced risk of 8% for lung cancer [summary RR = 0.92 [95% CI = 0.87-0.97].

The investigators found in 29 studies, when comparing the highest fruits with the lowest intakes, a significantly reduced risk of 18% for lung cancer [summary RR = 0.82, 95% CI = 0.76-0.89].

The investigators found the association with fruit and vegetable intake was marginally significant in current smokers and inverse but not significant in former or never smokers.

The investigators found in 4 studies for each 100 g/day increase of fruits and vegetables, a significantly reduced risk of 4% for lung cancer [RR = 0.96, 95% CI = 0.94-0.98, I2 = 64%, n (cases) = 9,609].

The investigators found in 20 studies for each 100 g/day increase of vegetables, a significantly reduced risk of 6% for lung cancer [RR = 0.94, 95% CI = 0.89-0.98, I2 = 48%, n (cases) = 12,563].

The investigators found in 23 studies for each 100 g/day increase of fruits, a significantly reduced risk of 8% for lung cancer [RR = 0.92, 95% CI = 0.89-0.95, I2 = 57%, n (cases) = 14,506].

The investigators found the results were consistent among the different types of fruits and vegetables. However, the strength of the association differed across locations.

The investigators found evidence of a non-linear relationship [p 0.01] between fruit and vegetable intake and lung cancer risk showing that no further benefit is obtained when increasing consumption above ∼400g per day.

The investigators concluded fruits and/or vegetables intakes reduce risk of lung cancer with no further benefit when increasing consumption of fruits and vegetables above ∼400g per day.

Original title:
Fruits, vegetables and lung cancer risk: a systematic review and meta-analysis by Vieira AR, Abar L, […], Norat T.

Link:
http://www.ncbi.nlm.nih.gov/pubmed/26371287

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Objectives:
Multiple epidemiologic studies have evaluated the relationship between dietary cholesterol and lung cancer risk, but the association is controversial and inconclusive. Therefore, this review article has been conducted.

Does consumption of dietary cholesterol increase risk of lung cancer?

Study design:
This review article included 10 case-control studies (6,894 lung cancer cases and 29,736 controls/persons with no lung cancer) and 6 cohort studies (1,769 lung cancer cases among 241,920 participants).

The Newcastle-Ottawa Scale scores for the included studies ranged from 6 to 9 and all studies were deemed to be of high quality (≥6).

There was no evidence of publication bias observed. Case-control studies: Egger’s test, p = 0.737, Begg’s test, p = 0.213 and cohort studies: Egger’s test, p = 0.459, Begg’s test, p = 1.000.

Results and conclusions:
The investigators found in case-control studies that a high dietary cholesterol intake significantly increased lung cancer risk with 70% [OR = 1.70, 95% CI = 1.43-2.03, I2 = 42.3%, p = 0.067]. No significant change in the result was found in the sensitivity analysis.

The investigators found in cohort studies no association between a high dietary cholesterol intake and lung cancer risk [RR = 1.08, 95% CI = 0.94-1.25, I2 = 0.0%, p = 0.833]. No significant change in the result was found in the sensitivity analysis.

The investigators found in 6 case-control studies that a high dietary total fat intake significantly increased lung cancer risk with 64% [OR = 1.64, 95% BI = 1.16-2.33, I2 = 68.7%, p = 0.004]. No significant change in the result was found in the sensitivity analysis.

The investigators concluded that a high dietary cholesterol intake might increase lung cancer risk. Might increase because the increased risk was not significant in cohort studies. Therefore, carefully designed and well-conducted cohort studies are needed to identify the association between dietary cholesterol and lung cancer risk.

Original title:
Dietary Cholesterol Intake and Risk of Lung Cancer: A Meta-Analysis by Lin X, Liu L, […], Lian X.

Link:
http://www.mdpi.com/2072-6643/10/2/185/htm

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A high dietary cholesterol intake is an intake of more than 200-300 mg cholesterol per day.

The result of a review article is only reliable when the result is also significant in cohort studies (thus not only significant in case-control studies).
 

Objectives:
Does the consumption of various types of tomato products reduce prostate cancer risk and is there a potential dose-response relationship?

Study design:
This review article included 30 studies, which summarized data from 24,222 cases (subjects with prostate cancer) among 260,461 participants.

Results and conclusions:
The investigators found that higher total tomato consumption was associated with a reduced risk of 19% for prostate cancer [RR = 0.81, 95% CI = 0.71 to 0.92, p = 0.001].

The investigators found in subgroup analysis that higher tomato foods consumption was associated with a reduced risk of 16% for prostate cancer [RR = 0.84, 95% CI = 0.72 to 0.98, p = 0.030].

The investigators found in subgroup analysis that higher cooked tomatoes and sauces consumption was associated with a reduced risk of 16% for prostate cancer [RR = 0.84, 95% CI = 0.73 to 0.98, p = 0.029]. 

The investigators found in subgroup analysis, however, no association between higher raw tomatoes consumption and prostate cancer risk [RR = 0.96, 95% CI = 0.84 to 1.09, p = 0.487].

The investigators found there was a significant dose-response association for total tomato consumption [p = 0.040], cooked tomatoes and sauces [p  0.001] and raw tomatoes [p = 0.037], but there was not a significant association with tomato foods [p-linear = 0.511, p-nonlinear = 0.289].

The investigators concluded that increased tomato consumption, particularly cooked tomatoes and sauces reduces prostate cancer risk. Furthermore, there are dose-response relationships for total tomato consumption and for cooked tomatoes and sauces. Further studies are required to determine the underlying mechanisms of these associations.

Original title:
Processed and raw tomato consumption and risk of prostate cancer: a systematic review and dose-response meta-analysis by Rowles JL, Ranard KM, […], Erdman JW Jr.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29317772

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Objectives:
Zinc is an essential trace element for living organisms and their biological processes. Zinc plays a key role in more than 300 enzymes and it is involved in cell communication, proliferation, differentiation and survival. Zinc also plays a role in regulating the immune system with implications in pathologies where zinc deficiency and inflammation are observed. Therefore, this meta-analysis (systematic review) has been conducted.

Do zinc deficiency increase risk of autoimmune disorders?

Study design:
This review article included 62 case-control studies.

The manner of collecting and investigating zinc samples was very heterogeneous.

Results and conclusions:
The investigators found in fixed model that serum zinc concentration of autoimmune disease patients was significantly lower than in controls [mean effect = -1.19, 95% CI = -1.26 to -1.11].

The investigators found in fixed model that plasma zinc concentration of autoimmune disease patients was significantly lower than in controls [mean effect = -3.97, 95% CI = -4.08 to -3.87].

The investigators concluded that a deficiency of zinc in serum and plasma increases risk of autoimmune disorders in humans.

Original title:
Zinc Status and Autoimmunity: A Systematic Review and Meta-Analysis by Sanna A, Firinu D, […], Valera P.

Link:
http://www.mdpi.com/2072-6643/10/1/68/htm

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An autoimmune disease is a condition in which your immune system mistakenly attacks your body. These are the most common autoimmune diseases:  

1. Addison’s disease: Caused by an adrenal hormone insufficiency. Addison’s disease can lead to muscle weakness and fatigue, nausea, weight loss, irritability, low blood pressure, low blood sugar and depression.
2. Celiac disease (gluten allergy): Celiac disease is a reaction to gluten (found in barley, rye and wheat) that causes damage to the lining of the small intestine.
3. Graves’ disease: Caused by extremely overactive thyroid gland. People who have Graves’ disease may have difficulty sleeping, bulging of the eyes, irritability, brittle hair, unexplained weight loss, sensitivity to heat, muscle weakness, light menstrual periods and shakiness of the hands. On the other hand, some people with Graves’ disease may experience no symptoms at all.
4. Hashimoto’s disease: Caused by inflammation of the thyroid gland. Although sometimes no symptoms occur, Hashimoto’s thyroiditis often results in a goiter (enlargement of the thyroid gland, which may be visible as a bulge in the neck), weight gain, fatigue, muscle weakness, depression, cold sensitivity, dry hair and skin, and constipation.
5. Inflammatory bowel disease: This disease refers to a group of inflammatory diseases of the colon and small intestine.
6. Multiple Sclerosis or MS: This disease affects the brain and spinal cord. People who have MS may experience weakness, trouble with balance and coordination, problems speaking and walking, tremors, paralysis and numbness in the extremities.
7. Psoriasis: This is a skin condition that causes redness and irritation as well as thick, flaky, silver-white patches.
8. Pernicious anemia: Caused by the inability to absorb vitamin B12 leading to a decrease in red blood cells.
9. Reactive arthritis: Caused by inflammation of joints, the urethra and eyes.
10. Raynaud’s phenomenon: People with Raynaud’s have a problem with blood flow, resulting in numbness, tingling of the fingers, discoloration, toes and tip of the nose with exposure to cold temperatures.
11. Rheumatoid arthritis: In rheumatoid arthritis, autoimmunity causes the immune system to attack tissues in the joints. It typically affects the small joints in your hands and feet causing painful swelling, stiffness and loss of movement in the joints that can eventually result in bone erosion and joint deformity.
12. Scleroderma: Scleroderma is a connective tissue disease that causes changes in skin, muscles, blood vessels and internal organs.
13. Sjögren’s syndrome: Caused by destruction of the glands that produce tears and saliva causing dry eyes and mouth.
14. Systemic lupus erythematosus: In lupus, antibodies made by the immune system attack the body. Systemic lupus erythematosus can affect skin, kidneys, joints and brain.
15. Type 1 diabetes: In type 1 diabetes, the immune system attacks cells in the pancreas that produce insulin. When your insulin levels are insufficient, your body cannot control your blood glucose level, which can lead to a number of problems, including kidney failure, stroke, vision loss, circulation problems and heart disease.

Objectives:
Women have a 50% risk of urinary tract infection (UTI) over their lifetime and 20-30% experience a subsequent urinary tract infection recurrence. Cranberry (Vaccinium spp.) has been advocated for treatment of urinary tract infection; however, its efficacy is controversial. Therefore, this review article (meta-analysis) has been conducted.

Does cranberry reduce the risk of urinary tract infection recurrence in healthy women?

Study design:
This review article included 7 RCTs conducted in healthy nonpregnant women aged ≥18 years with a history of urinary tract infection (n = 1498 participants).
Risk of bias indicated that 2 studies had high loss to follow-up or selective outcome reporting. Overall, the studies were relatively small, with only 2 having >300 participants.

Results and conclusions:
The investigators found that cranberry significantly reduced the risk of urinary tract infection by 26% [pooled risk ratio = 0.74, 95% CI = 0.55-0.98, I2 = 54%].

The investigators concluded that cranberry may be effective in preventing urinary tract infection recurrence in generally healthy women. May be effective because the studies were relatively small, with only 2 having >300 participants. Therefore, larger high-quality studies are needed to confirm these findings.

Original title:
Cranberry Reduces the Risk of Urinary Tract Infection Recurrence in Otherwise Healthy Women: A Systematic Review and Meta-Analysis by Zhuxuan Fu, DeAnn Liska, […], Mei Chung.

Link:
http://jn.nutrition.org/content/147/12/2282.abstract

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Objectives:
Epidemiological studies have provided controversial evidence between beverage consumption and the risk of ulcerative colitis (UC). Therefore, this review article (meta-analysis) has been conducted.

Is there a relationship between beverage consumption and risk of ulcerative colitis?

Study design:
This review article included 13 case-control studies and 3 prospective cohort studies, with a total of 3,689 cases (subjects with ulcerative colitis) and 335,339 controls (subjects without ulcerative colitis).

Egger test detected no significant publication bias.

Results and conclusions:
The investigators found high intake of soft drinks versus low intake, significantly increased risk of ulcerative colitis with 69% [pooled RR = 1.69, 95% CI = 1.24-2.30, I2  =  12.9%, p  = 0 .332].
In subgroup analysis, no substantial changes of the primary result were found between subgroups.

The investigators found high tea consumption versus low consumption, significantly decreased risk of ulcerative colitis with 31% [pooled RR = 0.69, 95% CI = 0.58-0.83, I2  =  0.0%, p  = 0 .697].
In subgroup analysis, no substantial changes of the primary result were found between subgroups.

The investigators found no significant association between alcohol [pooled RR = 1.08, 95% CI = 0.66-1.51] or coffee consumption [pooled RR = 0.58, 95% CI = 0.33-1.05, I2  =  87.5%, p    0.001] and risk of ulcerative colitis. No significant association because RR of 1 was found in the 95% CI of 0.66 to 1.51. RR of 1 means no risk/association.

The investigators concluded high consumption of soft drinks increases the risk of ulcerative colitis, while high tea consumption decreases the risk.

Original title:
Beverage consumption and risk of ulcerative colitis. Systematic review and meta-analysis of epidemiological studies by Nie JY and Zhao Q.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5728934/

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Objectives:
The role of omega-3 polyunsaturated fatty acids (omega-3 or n-3 PUFAs) in the pathogenesis and treatment of children and adolescents with attention deficit hyperactivity disorder (ADHD) is unclear. Therefore, this review article (meta-analysis) has been conducted.

Do children and adolescents with attention deficit hyperactivity disorder (ADHD) benefit from n-3 PUFA supplementation?

Study design:
This review article included 7 RCTs and 7 case-control studies.

Results and conclusions:
The investigators found in 7 RCTs (n = 534 randomised youth with ADHD) n-3 PUFAs supplementation significantly improved ADHD clinical symptom scores [g = 0.38, p 0.0001].

The investigators found in 3 RCTs (n = 214 randomised youth with ADHD) n-3 PUFAs supplementation significantly improved cognitive measures associated with attention [g = 1.09, p = 0.001].

The investigators found children and adolescents with ADHD had lower levels of DHA [7 case-control studies, n = 412, g = -0.76, p = 0.0002], EPA (7 case-control studies, n = 468, g = -0.38, p = 0.0008] and total n-3 PUFAs [6 case-control studies, n = 396, g = -0.58, p = 0.0001].

The investigators concluded there is evidence that n-3 PUFAs supplementation monotherapy improves clinical symptoms and cognitive performances in children and adolescents with ADHD and that these youth have a deficiency in n-3 PUFAs levels. These findings provide further support to the rationale for using n-3 PUFAs as a treatment option for ADHD.

Original title:
Omega-3 Polyunsaturated Fatty Acids in Youths with Attention Deficit Hyperactivity Disorder (ADHD): A Systematic Review and Meta-Analysis of Clinical Trials and Biological Studies by Chang JC, Su KP, [...], Pariante CM.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28741625

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EPA and DHA are n-3 PUFA.

Objectives:
What is the relationship between dietary intake of 12 major food groups, including whole grains, refined grains, vegetables, fruit, nuts, legumes, eggs, dairy, fish, red meat, processed meat and sugar-sweetened beverages and colorectal cancer (CRC) risk?

Study design:
This review article included cohort studies.

Results and conclusions:
The investigators found in the linear dose-response meta-analysis, that every 30 g/d whole grains significantly reduced risk of colorectal cancer with 5% [RR = 0.95, 95% CI = 0.93 to 0.97, n = 9 cohort studies].

The investigators found in the linear dose-response meta-analysis, that every 100 g/d vegetables significantly reduced risk of colorectal cancer with 3% [RR = 0.97, 95% CI = 0.96 to 0.98, n = 15 cohort studies].

The investigators found in the linear dose-response meta-analysis, that every 100 g/d fruit significantly reduced risk of colorectal cancer with 3% [RR = 0.97, 95% CI = 0.95 to 0.99, n = 16 cohort studies]. 

The investigators found in the linear dose-response meta-analysis, that every 200 g/d dairy products significantly reduced risk of colorectal cancer with 7% [RR = 0.93, 95% CI = 0.91 to 0.94, n = 15 cohort studies]. 

The investigators found in the linear dose-response meta-analysis, that every 100 g/d red meat significantly increased risk of colorectal cancer with 12% [RR = 1.12, 95% CI = 1.06 to 1.19, n = 21 cohort studies].

The investigators found in the linear dose-response meta-analysis, that every 50 g/d processed meat significantly increased risk of colorectal cancer with 17% [RR = 1.17, 95% CI = 1.10 to 1.23, n = 16 cohort studies].

The investigators found some evidence for a nonlinear relationship between dietary intake of vegetables, fruit and dairy products and risk of colorectal cancer.

The investigators concluded that daily dietary intake of 30g whole grains, 100g vegetables,100g fruit and 200g dairy products reduce risk of colorectal cancer, while daily dietary intake of 100g red meat and 50g processed meat increase risk of colorectal cancer.

Original title:
Food groups and risk of colorectal cancer by Schwingshackl L, Schwedhelm C, [...], Schlesinger S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29210053

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