Nutritional advice

Objectives:
Malaria causes a reduction in haemoglobin that is compounded by primaquine, particularly in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency.

The aim of this review article is to determine the relative contributions to red cell loss of malaria and primaquine in patients with uncomplicated Plasmodium vivax.

Study design:
This review article included 29 studies with a total of 3,421 patients (1,692 (49.5%) with normal glucose-6-phosphate dehydrogenase status, 1,701 (49.7%) with unknown status and 28 (0.8%) deficient or borderline individuals).

Patients were followed for 28 days in 14 studies (n = 1,841), 29 to 42 days in 7 studies (n = 388) and more than 42 days in 8 studies (n = 1,192).

The majority of patients were male (64.6%, 2,211/3,421).
The median age of patients was 19 years (inter-quartile range (IQR) 9-32), with 1,314 (38.4%) patients younger than 15 years.

Results and conclusions:
The investigators found of 1,975 patients treated with chloroquine alone, the mean haemoglobin fell from 12.22 g/dL [95% CI = 11.93 to 12.50] on day 0 to a nadir of 11.64 g/dL [95% CI = 11.36 to 11.93] on day 2, before rising to 12.88 g/dL [95% CI = 12.60 to 13.17] on day 42.

The investigators found in comparison to chloroquine alone, the mean haemoglobin in 1,446 patients treated with chloroquine plus primaquine was -0.13 g/dL [95% CI = - 0.27 to 0.01] lower at day of nadir [p = 0.072], but 0.49 g/dL [95% CI = 0.28 to 0.69] higher by day 42 [p  0.001].

The investigators found on day 42, patients with recurrent parasitaemia had a mean haemoglobin concentration -0.72 g/dL [95% CI = -0.90 to -0.54] lower than patients without recurrence [p  0.001].

The investigators found 7 days after starting primaquine, G6PD normal patients had a 0.3% (1/389) risk of clinically significant haemolysis [fall in haemoglobin > 25% to  7 g/dL] and a 1% (4/389) risk of a fall in haemoglobin > 5 g/dL.

The investigators concluded primaquine has the potential to reduce malaria-related anaemia at day 42 and beyond by preventing recurrent parasitaemia. Its widespread implementation will require accurate diagnosis of glucose-6-phosphate dehydrogenase deficiency to reduce the risk of drug-induced haemolysis in vulnerable individuals.

Original title:
The haematological consequences of Plasmodium vivax malaria after chloroquine treatment with and without primaquine: a WorldWide Antimalarial Resistance Network systematic review and individual patient data meta-analysis by Commons RJ, Simpson JA, […], Price RN.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6670141/

Additional information of El Mondo:
Find more information/studies on malaria and food fortification/malnutrition right here.

Objectives:
Does green coffee bean extract (GCBE) supplementation reduce blood pressure?

Study design:
This review article included 9 RCTs.

Results and conclusions:
The investigators found a significant reduction in systolic blood pressure (SBP) [WMD = -3.093 mmHg, 95% CI = -3.914 to -2.273, I2 = 0.0%] and diastolic blood pressure (DBP) [WMD = -2.170 mmHg, 95% CI = -2.749 to -1.590, I2 = 46.5%] after green coffee supplementation with low heterogeneity among the studies.

The investigators found in subgroup analysis, a significant reduction in systolic blood pressure and diastolic blood pressure in studies with hypertensive patients, green coffee dosage 400 mg per day and administered for 4 weeks.

The investigators concluded 400 mg coffee bean extract supplementation per day during 4 weeks reduces systolic blood pressure and diastolic blood pressure in hypertensive patients.

Original title:
The effect of green coffee extract supplementation on blood pressure: A systematic review and meta-analysis of randomized controlled trials by Han B, Nazary-Vannani A, […], Kord-Varkaneh H.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31429515

Additional information of El Mondo:
Find more information/studies on coffee and reducing blood pressure right here.
 

Objectives:
The lipid distribution in people who are overweight and obese is directly related to metabolic diseases. Quercetin supplementation may be an appropriate approach for reducing the risk factors of metabolic diseases in people who are obese. Therefore, this review article has been conducted.

Does quercetin supplementation reduce risk factors of metabolic diseases in people who are obese?

Study design:
This review article included 5 RCTs.

Results and conclusions:
The investigators found ≥150 mg/day quercetin supplementation during >6 weeks significantly reduced LDL-cholesterol (bad cholesterol) levels in people who are obese [SMD = -0.8, 95% CI = -1.21 to -0.39, p 0.00001].

The investigators concluded ≥150 mg/day quercetin supplementation during >6 weeks reduces LDL-cholesterol levels in people who are obese.

Original title:
Quercetin Actions on Lipid Profiles in Overweight and Obese Individuals: A Systematic Review and Meta-analysis by Guo W, Gong X and Li M.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31465275

Additional information of El Mondo:
Find more information/studies on quercetin, cholesterol and obesity/overweight right here.

Objectives:
Measles is an important cause of death in children, despite the availability of safe and cost-saving measles-containing vaccines (MCVs). The first MCV dose (MCV1) is recommended at 9 months of age in countries with ongoing measles transmission and at 12 months in countries with low risk of measles.

The aim of this review article is to assess the benefits and risks of MCV1 in infants younger than 9 months.

Study design:
This review article included 56 studies (randomised and quasi-randomised controlled trials, outbreak investigations cohort and case-control studies).

No differences in the risk of adverse events after MCV1 administration were found between infants younger than 9 months and those aged 9 months of older.

Overall, the quality of evidence ranged from moderate to very low.

Results and conclusions:
The investigators found the proportion of infants who seroconverted increased from 50% [95% CI = 29-71] for those vaccinated with MCV1 at 4 months of age to 85% [95% CI = 69-97] for those were vaccinated at 8 months.

The investigators found the pooled geometric mean titre ratio for infants aged 4-8 months vaccinated with MCV1 compared with infants vaccinated with MCV1 at age 9 months or older was 0.46 [95% CI = 0.33-0.66, I2 = 99.9%, p 0.0001].

The investigators found only one study reported on avidity and suggested that there was lower avidity and a shorter duration of immunity following MCV1 administration at 6 months of age than at 9 months of age [p = 0.0016] or 12 months of age [p 0.001].
No effect of age at MCV1 administration on cellular immunity was found.

The investigators found one study reported that vaccine efficacy against laboratory-confirmed measles virus infection was 94% [95% CI = 74-98] in infants vaccinated with MCV1 at 4.5 months of age.

The investigators found the pooled vaccine effectiveness of MCV1 in infants younger than 9 months against measles was 58% [95% CI = 9-80, I2 = 84.9%, p 0.0001].

The investigators found the pooled vaccine effectiveness estimate from within-study comparisons of infants younger than 9 months vaccinated with MCV1 were 51% [95% CI = 44 to 83, I2 = 92.3%, p 0.0001] and for those aged 9 months and older at vaccination it was 83% [95% CI = 76-88, I2 = 93.8%, p 0.0001].  

The investigators concluded MCV1 administered to infants younger than 9 months induces a good immune response, whereby the proportion of infants seroconverted increases with increased age at vaccination. A large proportion of infants receiving MCV1 before 9 months of age are protected and the vaccine is safe, although higher antibody titres and vaccine effectiveness are found when MCV1 is administered at older ages. Recommending MCV1 administration to infants younger than 9 months for those at high risk of measles is an important step towards reducing measles-related mortality and morbidity.

Original title:
Immunogenicity, effectiveness, and safety of measles vaccination in infants younger than 9 months: a systematic review and meta-analysis by Nic Lochlainn LM, de Gier B, [...], Hahné SJM.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31548079

Additional information of El Mondo:
Find more information/studies on vaccination and food fortification/malnutrition right here.

Objectives:
Maternal folic acid supplementation is considered mandatory in almost every country in the world to prevent congenital malformations. However, little is known about the association of maternal folic acid intake with the occurrence of childhood cancer. Therefore, this review article has been conducted.

Does maternal folic acid supplementation during pregnancy reduce risk of childhood cancer?

Study design:
This review article included 17 case-control studies.

Results and conclusions:
The investigators found in random-effects model, maternal folic acid supplementation during pregnancy significantly reduced risk of childhood acute lymphoblastic leukaemia with 25% [OR = 0.75, 95% CI = 0.66 to 0.86].
Significantly because OR of 1 was not found in the 95% CI of 0.66 to 0.86. OR of 1 means no risk/association.

The investigators found in random-effects model, there was no significant association between maternal folic acid supplementation during pregnancy and acute myeloid leukaemia [OR = 0.70, 95% CI = 0.46 to 1.06] or childhood brain tumours [OR = 1.02, 95% CI = 0.88 to 1.19].
No significant because OR of 1 was found in the 95% CI of 0.88 to 1.19. OR of 1 means no risk/association.

The investigators concluded maternal folic acid supplementation during pregnancy reduces risk of childhood acute lymphoblastic leukaemia. Thus, healthcare professionals are recommended to provide regular health education and health promotion to the community on the benefits of folic acid supplementation during pregnancy.

Original title:
The Protective Effect of Maternal Folic Acid Supplementation on Childhood Cancer: A Systematic Review and Meta-analysis of Case-control Studies by Wan Ismail WR, Abdul Rahman R, […],Nawi AM.

Link:
https://www.jpmph.org/journal/view.php?doi=10.3961/jpmph.19.020

Additional information of El Mondo:
Find more information/studies on folic acid and pregnancy right here.
 

Objectives:
Vaccinating infants with a first dose of measles-containing vaccine (MCV1) before 9 months of age in high-risk settings has the potential to reduce measles-related morbidity and mortality. However, there is concern that early vaccination might blunt the immune response to subsequent measles vaccine doses. Therefore, this review article (meta-analysis) has been conducted. 

Does measles-containing vaccine (MCV1) administration to infants younger than 9 months reduce immune responses to subsequent MCV doses?

Study design:
This review article included 13 studies.

Overall, the quality of evidence was moderate to very low.

Results and conclusions:
The investigators found from 13 studies, the pooled proportion of infants seropositive after two measles-containing vaccine doses, with MCV1 administered before 9 months of age, was 98% [95% CI = 96-99, I2 = 79.8%, p 0.0001], which was not significantly different from seropositivity after a two-dose MCV schedule starting later [p = 0.087].

The investigators found only 1 of 4 studies found geometric mean titres after MCV2 administration to be significantly lower when MCV1 was administered before 9 months of age than at 9 months of age or later.

The investigators found there was insufficient evidence to determine an effect of age at MCV1 administration on antibody avidity.

The investigators found the pooled vaccine effectiveness estimate derived from 2 studies of a two-dose MCV schedule with MCV1 vaccination before 9 months of age was 95% [95% CI = 89-100, I2 = 12.6%, p = 0.29].

The investigators found 7 studies reporting on measles virus-specific cellular immune responses found that T-cell responses and T-cell memory were sustained, irrespective of the age of MCV1 administration.

The investigators concluded administering MCV1 to infants younger than 9 months followed by additional MCV doses results in high seropositivity, vaccine effectiveness and T-cell responses, which are independent of the age at MCV1, supporting the vaccination of very young infants in high-risk settings. However, there is some evidence that MCV1 administered to infants younger than 9 months results in lower antibody titres after one or two subsequent doses of MCV than when measles vaccination is started at age 9 months or older. Therefore, the clinical and public-health relevance of this immunity blunting effect are uncertain.

Original title:
Effect of measles vaccination in infants younger than 9 months on the immune response to subsequent measles vaccine doses: a systematic review and meta-analysis by Nic Lochlainn LM, de Gier B, [...], Hahné SJM.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31548081

Additional information of El Mondo:
Find more information/studies on vaccination and food fortification/malnutrition right here.

Objectives:
Environmental risk factors regrading rheumatoid arthritis (RA) have not been explored extensively. Selenium (Se), zinc (Zn) and copper (Cu) nutrients were reported to associate with rheumatoid arthritis, but the results were inconsistent. Therefore, this review article has been conducted.

Is there a relationship between serum selenium, zinc and copper levels and rheumatoid arthritis risk?

Study design:
This review article included 41 studies.

Results and conclusions:
The investigators found meta-analysis of 16 studies involving 806 rheumatoid arthritis patients and 959 health controls showed that serum selenium levels [SMD = -1.04, 95% CI = -1.58 to -0.50] were significantly decreased in rheumatoid arthritis patients.

The investigators found meta-analysis of 23 studies involving 1,398 rheumatoid arthritis patients and 1,299 health controls showed that serum zinc levels [SMD = -1.20, 95% CI = -1.74 to -0.67] were significantly decreased in rheumatoid arthritis patients.

The investigators found meta-analysis of 26 studies involving 1,723 rheumatoid arthritis patients and 1,451 health controls showed that serum copper levels [SMD = 1.26, 95% CI = 0.63 to 1.89] were significantly increased in rheumatoid arthritis patients.

The investigators found meta-regression reported that steroid use was positively related to serum level of selenium in rheumatoid arthritis [β = 0.041, 95% CI = 0.002 to 0.079].

The investigators found differences in serum selenium, zinc and copper between rheumatoid arthritis patients and controls were all related with the geographical distribution.

The investigators concluded patients with rheumatoid arthritis have significant decreased serum selenium and zinc levels and increased serum copper levels than health controls, suggesting potential roles of selenium, zinc and copper in the pathogenesis of rheumatoid arthritis. Patients and rheumatologist should give enough attention to the monitor of these elements during follow up.

Original title:
Common trace metals in rheumatoid arthritis: A systematic review and meta-analysis by Ma Y, Zhang X, […], Pan F.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31442958

Additional information of El Mondo:
Find here more information/studies about selenium, zinc and copper and chronic disease.


 

Objectives:
L-carnitine plays a fundamental biological role in the metabolism of lipids and may positively affect blood pressure by decreasing insulin resistance, although the latter remains less clear. Therefore, this review article has been conducted.

Does L-carnitine supplementation reduce blood pressure?

Study design:
This review article included 10 RCTs using a random-effects model to estimate the pooled effect sizes of L-carnitine supplementation on systolic (SBP) and diastolic blood pressure (DBP).

Results were expressed as weighted mean difference (WMD) and 95% confidence intervals (CI).

No evidence of publication bias was observed about the effects of L-carnitine supplementation on systolic blood pressure [p = 0.307] and diastolic blood pressure [p = 0.729], as evidenced by the results of the Egger's test.

Results and conclusions:
The investigators found L-carnitine supplementation decreased diastolic blood pressure [WMD = -1.162 mmHg, 95% CI = -2.020 to -0.303, p = 0.008] without changing systolic blood pressure levels [WMD = -0.085 mmHg, 95% CI = -1.455 to 1.285, p = 0.903].

The investigators found results of subgroup analyses revealed L-carnitine supplementation decreased diastolic blood pressure levels in participants with overweight and obesity [WMD = -1.232 mmHg, 95% CI = -2.297 to -0.167, p = 0.023] and with doses of 2 g/d [WMD = -1.639 mmHg, 95% CI = -3.038 to -0.240, p = 0.022].

The investigators concluded that 2 g/d L-carnitine supplementation decreases diastolic blood pressure in participants with overweight and obesity. However, more research is required to determine the molecular mechanism underlying the relationship between of L-carnitine on blood pressure.

Original title:
Effects of L-carnitine supplementation on blood pressure: a systematic review and meta-analysis of randomized controlled trials by Askarpour M, Hadi A, […], Ghaedi E.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31481697

Additional information of El Mondo:
Find more information/studies on L-carnitine and cardiovascular diseases right here.
 

Objectives:
Numerous observational studies have also documented lower serum vitamin D levels among tuberculosis patients compared to healthy controls and prior meta-analyses investigating the association between vitamin D and tuberculosis have concluded that low vitamin D increases tuberculosis disease risk. However, most studies were cross-sectional studies and assessed vitamin D status after the diagnosis of active tuberculosis disease, rather than the impact of preexisting vitamin D levels on the risk of progression to tuberculosis disease. Given tuberculosis disease can induce profound metabolic abnormalities, it is unclear whether vitamin D deficiency increases tuberculosis disease risk or whether underlying tuberculosis infection or disease leads to decreased serum 25-(OH)D levels. Therefore, this review article (meta-analysis) has been conducted. 

Does vitamin D deficiency increase risk of tuberculosis?

Study design:
This review article included 7 studies (3 prospective cohort studies, 2 nested case-control studies and 2 prospective case-cohort studies) with a total of 456 tuberculosis cases among 3,544 participants from 13 countries: Brazil, The Gambia, Haiti, India, Malawi, Pakistan, Peru, South Africa, Spain, Tanzania, Thailand, US and Zimbabwe.
The median time to tuberculosis diagnosis from enrolment was 151.0 days (IQR 44.0-342.0 days).
The majority of the participants (86.5%) were over 15 years of age.

Results and conclusions:
The investigators found in the pooled analysis, vitamin D deficiency (serum 25-(OH)D levels 50 nmol/L) significantly increased risk of tuberculosis with 48% [age, gender, BMI and HIV status adjusted OR = 1.48, 95% CI = 1.04-2.10, p = 0.03].

The investigators found in the pooled analysis, severe vitamin D deficiency (serum 25-(OH)D levels 25 nmol/L) non-significantly increased risk of tuberculosis with 105% [OR = 2.05, 95% CI = 0.87-4.87, p trend for decreasing 25-(OH)D levels from sufficient vitamin D to severe deficiency = 0.02].

The investigators found among 1,576 HIV-positive patients, vitamin D deficiency conferred a 2-fold [age, gender, BMI and HIV status adjusted OR = 2.18, 95% CI = 1.22-3.90, p = 0.01] increased risk of tuberculosis and the age, gender, BMI and HIV status adjusted OR for severe vitamin D deficiency compared to sufficient vitamin D was 4.28 [95% CI = 0.85-21.45, p = 0.08].

The investigators concluded low serum 25-(OH)D levels were associated with increased risk of future progression to tuberculosis disease in a dose-dependent manner and that the risk of tuberculosis disease is highest among HIV-positive individuals with severe vitamin D deficiency. Randomized control trials are needed to evaluate the possible role of vitamin D supplementation on reducing tuberculosis disease risk.

Original title:
Vitamin D status and risk of incident tuberculosis disease: A nested case-control study, systematic review, and individual-participant data meta-analysis by Aibana O, Huang CC, […], Murray MB.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6738590/

Additional information of El Mondo:
Find more information/studies on meta-analyse/adjusted OR, food fortification/malnutrition and vitamin D right here.

Objectives:
Epidemiological investigations evaluating the association of dietary calcium intake with metabolic syndrome (MetS) risk have yielded controversial results. Therefore, this review article has been conducted.

Does dietary calcium intake reduce risk of metabolic syndrome?

Study design:
This review article included a total 15 cross-sectional studies for dietary calcium intake.

Results and conclusions:
The investigators found for the highest versus lowest category of dietary calcium intake, a significantly reduced risk of 20% [combined OR = 0.80, 95% CI = 0.70 to 0.91] for metabolic syndrome.

The investigators found in dose-response analysis, a non-linear relationship between dietary intake of calcium and risk of metabolic syndrome [p non-linearity > 0.001].

The investigators found 280 mg/d dietary calcium intake significantly reduced risk of metabolic syndrome with 13% [OR = 0.87, 95% CI = 0.82 to 0.93].

The investigators concluded 280 mg/d dietary calcium intake may reduce risk of metabolic syndrome. May reduce because this review article only included cross-sectional studies and no cohort studies. Therefore, these findings should need to be further confirmed by larger prospective cohort studies.

Original title:
Dietary calcium intake and the risk of metabolic syndrome: evidence from observational studies by Cheng L, Hu D and Jiang W.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30846011

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

Objectives:
Systematic inflammation plays a major role in all stages of chronic diseases. Recent evidence suggests that coenzyme Q10 (CoQ10), as an anti-inflammatory agent, has shown beneficial effects on the inflammatory process of various human diseases. However, several trials have examined the effects of coenzyme Q10 on pro-inflammatory cytokines with contrasting results. Therefore, this review article has been conducted.

Does coenzyme Q10 supplementation reduce inflammation in humans?

Study design:
This review article included 9 RCTs with a total of 509 patients (269 in the coenzyme Q10 arm and 240 in the control arm).

Results and conclusions:
The investigators found that oral coenzyme Q10 supplementation (60-500 mg/day for 8-12 weeks) resulted in significant reduction of TNF-α [SMD = -0.44, 95% CI = -0.81 to -0.07 mg/dL, I2 = 66.1%, p  = 0.00] and IL-6 levels [SMD = -0.37, 95% CI = -0.65 to -0.09, I2 = 57.2%, p  = 0.01], respectively.

The investigators found subgroup analyses represented a significant reduction of TNF-α and IL-6 levels in patients with BMI  26.
Due to the small number of studies and patients included in each subgroup, these subgroup analyses need to be interpreted cautiously.

The investigators concluded there is a significant effect of 60-500 mg/day coenzyme Q10 supplements for 8-12 weeks on some of the inflammatory markers among patients with chronic diseases which could attenuate the inflammatory state. However, well-designed studies with a larger sample size are required. Note that the results should be interpreted with caution because of the evidence of heterogeneity and limited number of studies.

Original title:
Can coenzyme Q10 supplementation effectively reduce human tumor necrosis factor-α and interleukin-6 levels in chronic inflammatory diseases? A systematic review and meta-analysis of randomized controlled trials by Vafa M.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31185284

Additional information of El Mondo:
Find here more information/studies about chronic disease and coenzyme Q10.

Objectives:
The eradication of wild and vaccine-derived poliovirus requires the global withdrawal of oral poliovirus vaccines (OPVs) and replacement with inactivated poliovirus vaccines (IPVs). The first phase of this effort was the withdrawal of the serotype 2 vaccine in April 2016, with a switch from trivalent OPVs to bivalent OPVs. Therefore, this review article (meta-analysis) has been conducted.

The aim of this review article is to produce comparative estimates of humoral and intestinal mucosal immunity associated with different routine immunisation schedules.

Study design:
This review article included 17 trials with a maximum of 8,279 evaluable infants were eligible for assessment of humoral immunity and 8 trials with 4,254 infants were eligible for intestinal immunity.

Only trials done outside western Europe or North America and without variation in age schedules (ie, age at administration of the vaccine) between study groups were included in this review article, because trials in high-income settings differ in vaccine immunogenicity and schedules from other settings and to ensure consistency within the network of trials.

Results and conclusions:
The investigators found for serotype 2 the risk ratio of seroconversion after 3 doses of bivalent oral poliovirus vaccines was 0.14 [95% CrI = 0.11-0.17, τ = 0.05, 95% CrI = 0.009-0.15] compared with 3 doses of trivalent oral poliovirus vaccines.

The investigators found for serotype 2 the addition of 1 or 2 full doses of an IPV after a bivalent OPV schedule increased the RR to 0.85 [95% CrI = 0.75-1.0] and 1.1 [95% CrI = 0.98-1.4], respectively.
However, the addition of an IPV to bivalent OPV schedules did not significantly increase intestinal immunity [RR = 0.33, 95% CrI = 0.18-0.61), compared with trivalent OPVs alone.

The investigators found for serotypes 1 and 3, there was susbstantial inconsistency and between-trial heterogeneity between direct and indirect effects. Therefore, only present pooled estmates on seroconversion were performed, which were at least 80% for serotype 1 and at least 88% for serotype 3 for all vaccine schedules.

The investigators concluded for WHO's polio eradication programme, the addition of one IPV dose for all birth cohorts should be prioritised to protect against paralysis caused by type 2 poliovirus. However, this inclusion will not prevent transmission or circulation in areas with faecal-oral transmission.

Original title:
Vaccine schedules and the effect on humoral and intestinal immunity against poliovirus: a systematic review and network meta-analysis by Macklin GR, Grassly NC, […], O'Reilly KM.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31350192

Additional information of El Mondo:
Find more information/studies on food fortification/malnutrition and vaccination right here.

Objectives:
Do dietary intakes of soy, soy isoflavones and soy protein reduce risk of mortality from all causes, cancers and cardiovascular diseases?

Study design:
This review article included 23 prospective cohort studies with an overall sample size of 330,826 participants.

Results and conclusions:
The investigators found soy/soy products consumption significantly reduced risk of mortality from cancers with 12% [pooled relative risk = 0.88, 95% CI = 0.79 to 0.99, p = 0.03, I2 = 47.1%].

The investigators found soy/soy products consumption significantly reduced risk of mortality from cardiovascular diseases with 15% [pooled effect size = 0.85, 95% CI = 0.72 to 0.99, p = 0.04, I2 = 50.0%].

The investigators found such significant associations were also observed for all-cause mortality in some subgroups of the included studies, particularly those with higher quality.

The investigators found in addition, higher dietary intake of soy was associated with decreased risk of mortality from gastric, colorectal and lung cancers as well as ischemic cardiovascular diseases.

The investigators found participants in the highest category of dietary soy isoflavones intake had a 10% lower risk of all-cause mortality compared with those in the lowest category.

The investigators found that a 10-mg/day increase in dietary intake of soy isoflavones was associated with 7% and 9% decreased risk of mortality from all cancers and breast cancer, respectively.

The investigators found for each 5-g/day increase in consumption of soy protein a 12% reduction in breast cancer death.

The investigators found, however, dietary intake of soy protein was not significantly associated with all-cause and cardiovascular diseases mortality.

The investigators concluded that soy and its isoflavones consumption favorably influence risk of mortality. In addition, soy protein dietary intake is associated with a decreased risk in the mortality of breast cancer. These findings support the current recommendations to increase intake of soy for greater longevity.

Original title:
Soy, Soy Isoflavones, and Protein Intake in Relation to Mortality from All Causes, Cancers, and Cardiovascular Diseases: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies by Nachvak SM, Moradi S, […], Sadeghi O.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31278047

Additional information of El Mondo:
Find more information/studies on soy consumption, cardiovascular diseases and breast cancer right here.

 

Objectives:
There is little evidence whether eggs affect inflammation. Therefore, this review article has been conducted.

Does egg consumption increase risk of inflammation?

Study design:
This review article included 8 RCTs assessed high sensitivity c-reactive protein (hs-CRP), 4 RCTs assessed interleukin-6 (IL-6) and 5 RCTs assessed tumor necrosis factor alpha (TNF-α).

Results and conclusions:
The investigators found egg consumption did not affect hs-CRP [WMD = 0.24 mg/L, 95% CI = -0.43 to 0.90, I2 = 53.8%, p = 0.48], IL-6 [WMD = 0.20 pg/mL, 95% CI =  -0.71 to 1.11, I2 = 69.3%, p = 0.50] and TNF-α [WMD = -0.38 pg/mL, 95% CI = -0.87 to 0.10, I2 = 0.00%, p = 0.12] relative to controls.

The investigators concluded that egg consumption has no effect on serum biomarkers of inflammation in adults.

Original title:
Effect of Egg Consumption on Inflammatory Markers: A Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials by Sajadi Hezaveh Z, Khalighi Sikaroudi M, […], Soltani S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31259415

Additional information of El Mondo:
Find more information/studies on egg consumption and chronic disease right here.

Inflammation in human body can be measured by means of biomarkers. These biomarkers are hs-CRP, IL-6 and TNF-α.
 

Objectives:
The distribution of goiter among children and its risk factors are not well investigated in Ethiopia. Therefore, this review article (meta-analysis) has been conducted.

The aim of this review article is to provide pooled prevalence of goiter and its associated factors among children in Ethiopia.

Study design:
This review article included 19 cross-sectional studies with a total sample of 10,253 children (aged 6-18 years).
All studies used palpation as the assessment method to diagnose goiter using the WHO/UNICEF/ICIDD criteria.
All studies reported high response rates (> 90%).
The quality score of included studies ranged from 6 to 7 with a mean score of 6.67 (SD = 0.42).

Both funnel plots of precision asymmetry and the Egger’s test of the intercept indicated the absence of publication bias in the included studies. Visual examination of the funnel plot showed a symmetric distribution of studies. Additionally, Egger’s test of the intercept was -0.004 [95% CI = - 0.3 to 0.3, p > 0.05], suggesting that publication bias estimates were not statistically significant.

Results and conclusions:
The investigators found pooled estimate of goiter among children in Ethiopia was 40.50% [95% CI = 33.6-47.40].
The regional distribution of goiter ranged from 44.22 [95% CI = 17.44-71] in Southern Nations Nationalities and Peoples' Region, to 32.79% [95% CI = 19.86-45.73] in Benishangul Gumez region.
No single study significantly affected the overall pooled estimate of goiter in the sensitivity analyses.

The investigators found the prevalence of goiter among female children (44.34%) was higher than among male (32.88%) children.

The investigators found goiter prevalence was also significantly higher among children who consumed vegetables 3 or more times per week OR = 1.3 [95% CI = 1.02-1.66]; those who had family history of goiter, OR = 2.38 [95% CI = 1.9-2.99] and those whose family stored salt near to fires, OR = 1.41 [95% CI = 1.1-1.79].

The investigators concluded that the prevalence of goiter among children in Ethiopia (aged 6-18 years) is high and that goiter may be endemic in the country according to WHO criteria. Goiter among children is significantly associated with consuming vegetables 3 or more times per week, the presence of family history of goiter and storing salt near a fire. These findings suggest that more attention should be given to strengthening the government’s national salt iodization program. Future research should investigate household-level factors that contribute to high goiter prevalence even when there is high coverage of adequately iodized salt. In particular, additional research on appropriate salt storage and the risks of consuming goitrogenic foods require more robust investigation.

Original title:
Prevalence of goiter among children in Ethiopia and associated factors: a systematic review and meta-analysis by Dessie G, Amare D, […], Burrowes S.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6716873/

Additional information of El Mondo:
Find more information/studies on food fortification/malnutrition and iodine right here.

Iodine deficiency is the most common cause of thyroid enlargement and goiter. A goiter (GOI-tur) is an abnormal enlargement of the thyroid gland.

Objectives:
Observational studies have reported controversial evidence of the association between dietary fat intake and ovarian cancer. Therefore, this review article has been conducted.
Does dietary fat intake increase risk of ovarian cancer among women?

Study design:
This review article included 21 observational studies involved approximately 900,000 women.

Results and conclusions:
The investigators found a significant nonlinear association between dietary total fat intake with the risk of ovarian cancer, with a relatively steep slope at dietary total fat intake higher than 30 g/day [p non-linearity 0.01].

The investigators found, moreover, the risk of ovarian cancer was increased in non-linear form for both saturated and monounsaturated fat from 25 g/day [p non-linearity 0.05].

The investigators found in linear meta-analysis a 2% greater risk of ovarian cancer per 10 g/day increase in total dietary fat intake.

The investigators found in linear meta-analysis a 2% greater risk of ovarian cancer per 0.5 g/day increase in dietary trans fat intake.

The investigators found in linear meta-analysis a 1% greater risk of ovarian cancer per 2.5 g/day increase in dietary monounsaturated fat intake.
However, this association for monounsaturated fat was marginally significant [p = 0.052].

The investigators found in linear meta-analysis a 1% greater risk of ovarian cancer per 50 mg/day increase in dietary cholesterol intake.

The investigators concluded that dietary total, trans, saturated and partially monounsaturated fat as well as cholesterol intake increase risk of ovarian cancer among women.

Original title:
Dietary Fat Intake and Risk of Ovarian Cancer: A Systematic Review and Dose-Response Meta-Analysis of Observational Studies by Sadeghi A, Shab-Bidar S, […], Djafarian K.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31058552

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

Objectives:
Does a high blood homocysteine level increase risk of cognitive impairment, like Alzheimer's disease and vascular dementia?

Study design:
This review article included 28 prospective cohort studies with 2,557 cases (1,035 all-cause dementia, 530 Alzheimer's disease, 92 vascular dementia and >900 cognitive impairment without dementia (CIND)) among 28,257 participants.
 
The average follow-up period ranged from 2.7 to 35 years.

There was no clear evidence of publication bias with Begg's and Egger's tests for Alzheimer dementia [p = 0.806, 0.084, respectively].

Results and conclusions:
The investigators found there was a clear linear dose-response relationship between blood homocysteine concentration and risk of Alzheimer-type dementia [p > 0.05 for non-linearity].

The investigators found for every 5 μmol/L increase in blood homocysteine a significantly increased risk of 15% [pooled RR = 1.15, 95% CI = 1.04 to 1.26, I2 = 56.6%, n = 5] for Alzheimer-type dementia.
Sensitivity analysis showed similar results.

The investigators found due to the presence of publication bias and low statistical power, elevated levels of blood homocysteine were not appreciably associated with risk of all-cause, vascular dementia and cognitive impairment without dementia.

The investigators concluded every 5 μmol/L increase in blood homocysteine is linearly associated with a 15% increase in relative risk of Alzheimer-type dementia.

Original title:
Hyperhomocysteinemia and risk of incident cognitive outcomes: An updated dose-response meta-analysis of prospective cohort studies by Zhou F and Chen S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30826501

Additional information of El Mondo:
Find more information/studies on Alzheimer disease.
 

Objectives:
HIV-infected children are at a higher risk of invasive pneumococcal disease (IPD) and its mortality, even in the era of antiretroviral therapy. Thus, an effective vaccination strategy would be beneficial. Therefore, this review article (meta-analysis) has been conducted.

The aim of this review article is to provide a summary of evidence about effectiveness and efficacy of at least one dose of pneumococcal conjugate vaccination (PCV) among children with and without HIV considering subgroups of pneumococcal serotypes.

Study design:
This review article included 10 studies on 7 years old or older children. Out of these, 1 was conducted in the USA and 9 studies in the South Africa. No cohort study was identified.
The analyzed data included 1,332 children with HIV-infection (HI) and 3,462 children without HIV-infection (HUI) children in 3 case-control studies, 2,577 HI and 37,259 HUI children in 3 randomized trials and 48,550 HI and 2,272,443 HUI children in four pre-post studies.

The heterogeneity of individual studies was high, especially in pre-post studies.
There was no evidence of influential study and/or publication bias based on the sensitivity analysis and Egger’s test for publication bias.

Results and conclusions:
The investigators found based on case-control studies, the overall effectiveness of pneumococcal conjugate vaccination against any invasive pneumococcal disease was estimated as -6.2% [95% CI = - 67.6 to 32.7] and 65.1% [95% CI = 47.3 to 76.9] among HI and HUI children, respectively.
Based on randomized trials, the overall efficacy among HI and HUI children was estimated 45.0% [95% CI = 31.2 to 56.1] and 52.6% [95% CI = 25.7 to 69.8], respectively.

The investigators found effectiveness of pneumococcal conjugate vaccination among HIV-infected children for IPDs caused by vaccine serotypes was estimated as 7.7 [95% CI = - 66.7 to 48.9] and for IPDs caused by non-vaccine serotypes was estimated as - 402.8 [95% CI = - 1856 to - 29.2].

The investigators concluded the overall effectiveness (efficacy in the real situation) of pneumococcal conjugate vaccination (PCV) in preventing of invasive pneumococcal disease (IPD) (including both of vaccine or non-vaccine serotype IPDs) among HIV-infection (HI) children is significantly lower than without HIV-infection (HUI) children [- 6.2% vs. 65.1%].

Original title:
Effectiveness of pneumococcal conjugate vaccination against invasive pneumococcal disease among children with and those without HIV infection: a systematic review and meta-analysis by Vardanjani HM, Borna H and Ahmadi A.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683423/

Additional information of El Mondo:
Find more information/studies on food fortification/malnutrition and vaccination right here.

Objectives:
The prevalence of overweight/obesity in adults is raised to 39%, which is nearly tripled more than 1975. The alteration of the gut microbiome has been widely accepted as one of the main causal factors. Therefore, this review article has been conducted.

Does probiotics supplementation prevent overweight/obesity in adults?

Study design:
This review article included 12 RCTs (11 randomized, double-blinded, controlled trials and 1 randomized, single-blinded, controlled trial) with a total of 821 participants (416 participants were given placebo and 405 participants were given probiotics).

7 RCTs included participants who consumed two or multiple strains of probiotics and 5 RCTs included participants who consumed a single strain of probiotics.
7 RCTs investigated a high dosage of probiotics (>1010 CFU) and 5 RCTs investigated lower dosage of probiotics (1010 CFU).
Probiotics were administered in different forms, including sachet, capsule, powder, kefir, yogurt and fermented milk.
Duration of the probiotics supplementation ranged from 8 to 24 weeks.

There was no significant publication bias.

Results and conclusions:
The investigators found compared with control groups, probiotics supplementation resulted in a significantly reduction in body weight [WMD = -0.55, 95% CI = -0.91 to -0.19 kg, I2 = 64%, p = 0.003].
Subgroup analyses stratified by probiotics dosage, the number of probiotics strains or forms of probiotics showed the effects of probiotics supplementation on body weight were significantly reduced in trials with high dose of probiotics [WMD = -0.58, 95% CI = -0.92 to 0.23 kg], a single strain of probiotics [WMD = -0.49, 95% CI = -0.92 to -0.07 kg] and the capsule or powder of probiotics [WMD = -0.55, 95% CI = -0.84 to -0.26 kg].
Sensitivity analyses revealed that no particular studies significantly affected the summary effects of body weight.

The investigators found compared with control groups, probiotics supplementation resulted in a significantly reduction in BMI [WMD = -0.30, 95% CI = -0.43 to -0.18 kg/m², I2 = 59%, p = 0.006].
Subgroup analyses stratified by probiotics dosage, the number of probiotics strains or forms of probiotics showed the effects of probiotics supplementation on BMI were significantly reduced with the high dose [WMD = -0.29, 95% CI = -0.46 to -0.12 kg/m²] and single strain of probiotics [WMD = -0.36, 95% CI = -0.52 to -0.20 kg/m²].
Sensitivity analyses revealed that no particular studies significantly affected the summary effects of BMI.

The investigators found compared with control groups, probiotics supplementation resulted in a significantly reduction in waist circumference [WMD = -1.20, 95% CI = -2.21 to -0.19 cm, p = 0.02, I2 = 90%, p 0.00001].
Subgroup analyses stratified by probiotics dosage, the number of probiotics strains or forms of probiotics indicated the effects of probiotics supplementation on waist circumference were significantly reduced in trials with high dose of probiotics [WMD = -1.53, 95% CI = -2.64 to -0.41 cm], a single strain of probiotics [WMD = -1.69, 95% CI = -3.04 to -0.33 cm] and the food form of probiotics [WMD = -1.11, 95% CI = -1.64 to -0.59 cm].
Sensitivity analyses revealed that no particular studies significantly affected the summary effects of waist circumference.

The investigators found compared with control groups, probiotics supplementation resulted in a significantly reduction in fat mass [WMD = -0.91, 95% CI = -1.19 to -0.63 kg, p 0.00001, I2 = 43%, p = 0.08] and fat percentage [WMD = -0.92, 95% CI = -1.27 to -0.56%, p 0.00001, I2 = 57%, p = 0.04].
Subgroup analyses stratified by probiotics dosage, the number of probiotics strains and forms of probiotics indicated that the effect of probiotics supplementation on fat mass was significantly reduced, showing a greater decrease in fat mass with high dosage probiotics WMD -1.08, 95% CI = -1.21 to -0.95 kg] compared to low dosage probiotics [WMD = -1.00, 95% CI = -1.59 to -0.42 kg], a greater decrease with single strain probiotics [WMD = -1.15, 95% CI = -1.28 to -1.02 kg] compared to multiple strain probiotics [WMD = -0.60, 95% CI = -0.94 to -0.26] kg] and a greater decrease with administration probiotics in the form of food [WMD = -1.13, 95% CI = -1.58 to -0.67 kg] compared to in the forms of capsule or powder [WMD = -1.07, 95% CI = -1.20 to -0.94 kg].
No particular study significantly affected the pooled effect of probiotics on fat mass and fat percentage by sensitivity analyses.

The investigators found compared with control groups, probiotics supplementation significantly improved total cholesterol levels [SMD = -0.43, 95% CI = -0.80 to -0.07, p = 0.02, I2 = 73%, p = 0.001].
Subgroup analyses only stratified by probiotics dosage and the number of probiotics strains indicated the effects of probiotics supplementation on total cholesterol were significantly reduced in trials with single strain probiotics [WMD = -0.61, 95% CI = -1.54 to -0.32], compared to multiple strain probiotics [WMD = -0.39, 95% CI = -0.66 to -0.13].
Sensitivity analyses revealed that no particular studies significantly affected the summary effects of total cholesterol.

The investigators found compared with control groups, probiotics supplementation significantly improved LDL-cholesterol levels [SMD = -0.41, 95% CI = -0.77 to -0.04, p = 0.03, I2 = 73%, p = 0.001].
Subgroup analyses stratified by probiotics dosage and the number of probiotics strains indicated the effects of probiotics supplementation on LDL-cholesterol were significantly reduced in trials with multiple strain probiotics [WMD = -0.33, 95% CI = -0.57 to -0.09]. Sensitivity analyses revealed that no particular studies significantly affected the summary effects of LDL-cholesterol.

The investigators found compared with control groups, probiotics supplementation significantly improved fasting plasma glucose (FPG) [SMD = -0.35, 95% CI = -0.67 to -0.02, p = 0.04, I2 = 64%, p = 0.02].

The investigators found compared with control groups, probiotics supplementation significantly improved insulin [SMD = -0.44, 95% CI = -0.84 to -0.03, p = 0.03, I2 = 76%, p = 0.0008].

The investigators found compared with control groups, probiotics supplementation significantly improved HOMA-IR [SMD = -0.51, 95% CI = -0.96 to -0.05, p = 0.03, I2 = 76%, p = 0.003].

The investigators concluded probiotics supplementation during 8 to 24 weeks reduces the body weight and fat mass and improves some of the lipid and glucose metabolism parameters, although some of the effects were small. Probiotics may become a new potential strategy for the prevention and treatment of overweight/obesity in adult individuals.

Original title:
The Potential Role of Probiotics in Controlling Overweight/Obesity and Associated Metabolic Parameters in Adults: A Systematic Review and Meta-Analysis by Wang ZB, Xin SS, [...], Zhang XD.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6500612/

Additional information of El Mondo:
Find more information/studies on probiotics, cholesterol, diabetes and obesity/overweight right here.

Objectives:
Malaria transmission through blood transfusion is an accidental but preventable cause of malaria infection and is increasingly becoming a matter of concern for blood transfusion services. Therefore, this review article (meta-analysis) has been conducted.

The aim of this review article is to provide a summary of evidence about the prevalence of Plasmodium infection in asymptomatic blood donors and the effectiveness of screening methods used based on the available literature.

Study design:
This review article included 71 studies from 21 countries and 5 continents.

3 types of diagnostic methods were used to detect the prevalence of malaria in the included studies: microscopy (n = 51), RDT (n = 25) and molecular techniques (n = 14).

A total of 984,975 blood samples were examined for malaria infection in all studies: 374,919 samples by microscopy, 604,693 by RDT including immunochromatographic test and 5,363 by molecular techniques (PCR, real-time PCR, PCR-restriction fragment length polymorphism (RFLP) and nested PCR).

Results and conclusions:
The investigators found the median prevalence of malaria parasitemia among 984,975 asymptomatic healthy blood donors was 10.54% [95% CI = 8.44%-12.84%], 5.36% [95% CI = 2.25%-9.70%] and 0.38% [95% CI = 0.25%-0.54%] by microscopy, molecular methods (polymerase chain reaction) and rapid diagnostic tests, respectively.
The most commonly detected Plasmodium species was P. falciparum.

The investigators found the pooled prevalence of malaria infection in asymptomatic blood donors was 7.14% [95% CI = 3.61%-11.74%] among studies conducted before 2010 vs 13.61% [95% CI = 9.33%-18.55%] among those conducted after 2010. However, this difference in prevalence was not statistically significant [p = 0.1872].

The investigators found the highest prevalence of malaria infection among blood donors was observed in Africa; 21% [95% CI = 14%-29%] of blood donors had a positive malaria test detected by microscopy.
By RDT, the highest prevalence was observed in Africa [7.4%, 95% CI = 3%-12%] and no parasitemia was detected in other continents.
Molecular methods (PCR) have indicated a higher prevalence of malaria infection in the blood donor population in Africa [36%, 95% CI = 11%-72%].
However, using a molecular technique did not impact the observed prevalence in other continents: Asia 4% [95% CI = 1%-13%], Americas 2% [95% CI = 1%-7%] and Europe 1% [95% CI = 0%-3%].

The investigators found according to the multivariate analysis, a positive association was observed between malaria infection and female sex, commercial donor type and blood group A [p 0.005].
Those individuals residing in rural areas and with no history of previous transfusion had a higher prevalence of infection; however, this was not statistically significant.

The investigators concluded that transfusion-transmitted malaria is one of the most significant transfusion-associated infections, especially in Sub-Saharan Africa, compared with other transfusion-linked infections. World Health Organization guidelines for screening and deferral need to be reinforced in each country and tailored to the local context. Future work must aim to understand the clinical significance of transfusion-transmitted malaria in malaria-endemic settings.

Original title:
Transfusion-Transmitted Malaria: A Systematic Review and Meta-analysis by Ahmadpour E, Foroutan-Rad M, […], Cevik M.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6634438/

Additional information of El Mondo:
Find more information/studies on food fortification/malnutrition and malaria right here.

Objectives:
Previous studies reported that magnesium deficiency was associated with vascular calcifications, atherosclerosis and cardiovascular disease, which might play an independent pathogenic role in chronic kidney disease (CKD) and end-stage renal disease (ESRD) patients. However, the results of these studies were somewhat underpowered and inconclusive. Therefore, this review article has been conducted.

Does hypomagnesemia (a low blood magnesium concentration) increase risk of mortality in patients with chronic kidney disease and end-stage renal disease?

Study design:
This review article included 20 studies involving 200,934 participants.

Results and conclusions:
The investigators found hypomagnesemia significantly increased risk of all-cause mortality in patients with chronic kidney disease and end-stage renal disease with 32% [multivariable adjusted HR = 1.32, 95% CI = 1.19-1.47, p 0.00001]. 

The investigators found, on the contrary, hypermagnesemia (a high blood magnesium concentration) significantly decreased risk of all-cause mortality in patients with chronic kidney disease and end-stage renal disease with 14% [HR = 0.86, 95% CI = 0.79-0.94, p = 0.001] (per unit increase).

The investigators found, moreover, hypermagnesemia significantly decreased risk of cardiovascular mortality in patients with chronic kidney disease and end-stage renal disease with 29% [adjusted HR = 0.71, 95% CI = 0.53-0.97, p = 0.03]. 

The investigators found subgroup analysis showed that hypomagnesemia significantly increased all-cause mortality in hemodialysis patients with 29% [HR = 1.29, 95% CI = 1.12-1.50, p = 0.0005].

The investigators concluded hypomagnesemia (a low blood magnesium concentration) increases cardiovascular and all-cause mortality in patients with chronic kidney disease and end-stage renal disease. Further studies evaluating benefits of magnesium correction in chronic kidney disease and dialysis patients with hypomagnesemia should be performed.

Original title:
Serum magnesium, mortality, and cardiovascular disease in chronic kidney disease and end-stage renal disease patients: a systematic review and meta-analysis by Xiong J, He T, […], Zhao J.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30888644

Additional information of El Mondo:
Find here more information/studies about chronic disease, magnesium and kidney diseases.

Normal values of serum magnesium are considered those between 0.7 and 1.0 mmol/L.
Hypomagnesemia has a serum magnesium concentration of 0.7 mmol/L.
Blood magnesium concentration can be increased by eating magnesium-rich foods and/or taking magnesium supplements.

Objectives:
Although intake of fruits and vegetables seemed to have a protective effect on bone metabolism, its effect on fractures remains uncertain. Therefore, this review article has been conducted.

Does intake of fruits and vegetables reduce risk of fractures?

Study design:
This review article included 6 cohort studies and 4 RCTs.
6 cohort studies included 225,062 participants (134,365 women and 90,697 men) aged 50 years or older. The participants’ follow-up time ranged from 2.8 years to 20 years.

Validated food frequency questionnaires (FFQs), 24-hour food recall (24h-R) and 7-day food record were used to evaluate fruit and vegetable intake.

Results and conclusions:
The investigators found in 5 cohort studies that intake of at least one serving of fruits and vegetables per day significantly reduced risk of hip fractures with 8% [pooled HR = 0.92, 95% CI = 0.87 to 0.98, I2 = 55.7%, p = 0.060] among participants aged 50 years or older.

The investigators found in 2 cohort studies that intake of at least one serving of fruits and vegetables per day significantly reduced risk of any fractures with 10% [pooled HR = 0.90, 95% CI = 0.86 to 0.96, I2 = 24.9%, p = 0.249] among participants aged 50 years or older.

The investigators found no association between the bone resorption marker CTx and 3 months of fruit and vegetable intake evaluated by 4 RCTs.

The investigators concluded that at least one serving of fruits and vegetables per day is associated with a lower risk of fractures among participants aged 50 years or older.

Original title:
Fruit and vegetable intake and bones: A systematic review and meta-analysis by Brondani JE, Comim FV, […], Premaor MO.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6544223/

Additional information of El Mondo:
Find more information/studies on fruits and vegetables consumption and elderly.
 

Objectives:
Insulin resistance, dyslipidemia and increased systemic inflammation are important risk factors for chronic kidney disease (CKD). Hence, vitamin D administration might be an appropriate approach to decrease the complications of chronic kidney disease. Therefore, this review article has been conducted.

Have vitamin D supplements beneficial effects on people with chronic kidney disease?

Study design:
This review article included 17 RCTs.

Results and conclusions:
The investigators found pooling findings from 5 RCTs revealed a significant reduction in fasting glucose among people with chronic kidney disease [WMD = -18.87, 95% CI = -23.16 to -14.58] following the administration of vitamin D.

The investigators found pooling findings from 3 RCTs revealed a significant reduction in homeostatic model assessment of insulin resistance (HOMA-IR) among people with chronic kidney disease [WMD = -2.30, 95% CI = -2.88 to -1.72] following the administration of vitamin D.

The investigators found pooling findings from 6 RCTs revealed a significant reduction in triglycerides among people with chronic kidney disease [WMD = -32.52, 95% CI = -57.57 to -7.47] following the administration of vitamin D or treatment.

The investigators found pooling findings from 5 RCTs revealed a significant reduction in total cholesterol concentrations among people with chronic kidney disease [WMD = -7.93, 95% CI = -13.03 to -2.83] following the administration of vitamin D or treatment.

The investigators found there was no effect on insulin, HbA1c, LDL and HDL cholesterol and CRP levels among people with chronic kidney disease following the administration of vitamin D or treatment.

The investigators concluded there are beneficial effects of vitamin D supplementation or treatment on improving fasting glucose, HOMA-IR, triglycerides and total cholesterol levels among patients with chronic kidney disease.

Original title:
The effects of vitamin D treatment on glycemic control, serum lipid profiles, and C-reactive protein in patients with chronic kidney disease: a systematic review and meta-analysis of randomized controlled trials by Milajerdi A, Ostadmohammadi V, […], Asemi Z.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31338797

Additional information of El Mondo:
Find here more information/studies about chronic disease, cholesterol, vitamin D and kidney diseases.

Objectives:
Does a dietary low-ratio n-6/n-3 PUFA supplementation improve risk factors (such as fasting blood glucose, HbA1c) of diabetes?

Study design:
This review article included 11 RCTs.

No significant publication bias was observed for all blood glucose and other related indicators as suggested by Begg's test and Egger's test.

Results and conclusions:
The investigators found no significant effect of dietary low-ratio n-6/n-3 PUFA supplementation on:
-fasting blood glucose [WMD = 0.057 mmol/L, 95% CI = -0.090 to 0.204 mmol/L];
-insulin [WMD = -0.757 mIU/L, 95% CI = -2.419 to 0.904 mIU/L];
-insulin resistance index [WMD = -0.201, 95% CI = -0.566 to 0.165] and;
-glycosylated hemoglobin [WMD = -0.063%, 95% CI = -0.061 to 0.186%].

The investigators found subgroup analysis showed that the effect of dietary low-ratio n-6/n-3 PUFA on the reduction of the plasma insulin level in North America [WMD = -3.473 mIU/L, 95% CI = -5.760 to -1.185 mIU/L] was more obvious than that in Asian countries [WMD = -0.797 mIU/L, 95% CI = -2.497 to 0.902 mIU/L] and European countries [WMD = -0.063 mIU/L, 95% CI = -0.061 to 0.186 mIU/L].

The investigators found in the subgroup of diabetic subjects, dietary low-ratio n-6/n-3 PUFA supplementation significantly decreased plasma insulin level [WMD = -3.010 mIU/L, 95% CI = -5.371 to -0.648 mIU/L] and insulin resistance index [WMD = -0.460, 95% CI = -0.908 to -0.012].

The investigators found when the intervention period was longer than 8 weeks, dietary low-ratio n-6/n-3 PUFA supplementation significantly decreased the plasma insulin level [WMD = -2.782 mIU/L, 95% CI = -4.946 to -0.618 mIU/L].

The investigators concluded dietary low-ratio n-6/n-3 PUFA supplementation improves the glucose metabolism by reducing the insulin and insulin resistance in the diabetic patients. Dietary low-ratio n-6/n-3 PUFA supplementation also reduces the plasma insulin level when the supplementation duration is longer than 8 weeks.

Original title:
Effect of low-ratio n-6/n-3 PUFA on blood glucose: a meta-analysis by Li N, Yue H, […], Xu T.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31292599

Additional information of El Mondo:
Find more information/studies on diabetes and PUFA right here.

Objectives:
Do dietary intakes or circulating concentration of major dietary antioxidants, like vitamin C, E and beta-carotene reduce risk of total cardiovascular mortality?

Study design:
This review article included a total of 15 prospective cohort studies and 3 prospective evaluations within interventional studies with 320,548 participants and 16,974 deaths from total cardiovascular mortality.

Results and conclusions:
The investigators found compared to the lowest category, the highest category of dietary vitamin C intake significantly reduced risk of total cardiovascular mortality with 21% [relative risk = 0.79, 95% CI = 0.68 to 0.89, I2 = 46%, n = 10].

The investigators found compared to the lowest category, the highest category of circulating concentration of vitamin C significantly reduced risk of total cardiovascular mortality with 40% [relative risk = 0.60, 95% CI = 0.42 to 0.78, I2 = 65%, n = 6].

The investigators found compared to the lowest category, the highest category of circulating concentration of vitamin E (α-tocopherol) significantly reduced risk of total cardiovascular mortality with 18% [relative risk = 0.82, 95% CI = 0.76 to 0.88, I2 = 0%, n = 5].

The investigators found compared to the lowest category, the highest category of circulating concentration of β-carotene significantly reduced risk of total cardiovascular mortality with 32% [relative risks = 0.68, 95% CI = 0.52 to 0.83, I2 = 50%, n = 6].

The investigators found dose-response meta-analyses demonstrated that the circulating biomarkers of antioxidants were more strongly associated with risk of total cardiovascular mortality than dietary intakes.

The investigators concluded that higher dietary vitamin C intakes and higher circulating concentrations of vitamin C, vitamin E and β-carotene are associated with a lower risk of total cardiovascular mortality.

Original title:
Dietary and circulating vitamin C, vitamin E, β-carotene and risk of total cardiovascular mortality: a systematic review and dose-response meta-analysis of prospective observational studies by Jayedi A, Rashidy-Pour A, […], Shab-Bidar S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30630552

Additional information of El Mondo:
Find more information/studies on antioxidants, vitamin C, E, β-carotene and cardiovascular diseases right here.

Circulating concentration of vitamin C in blood can be increased by eating foods that are high in vitamin C and/or taking vitamin C supplements.