Nutritional Advice El Mondo

Nutritional advice

Cardiovascular diseases

Scientific studies (review articles) on the relationship between diet/nutrients and cardiovascular diseases:
One swallow does not make a summer. A famous Dutch saying that could not be any more obvious. Just because one single scientific study about a certain topic makes certain claims, it does not necessarily mean it is true. On the other hand, a review article (a collection of scientific studies on a certain topic) of randomized, placebo-controlled double blind clinical trials (RCTs) will answer the following question:
"Do taking dietary supplements make sense?" Yes for a positive conclusion and no for a negative conclusion.

One swallow does not make a summer. A famous Dutch saying that could not be any more obvious. Just because one single scientific study about a certain topic makes certain claims, it does not necessarily mean it is true. On the other hand, a review article (a collection of scientific studies on a certain topic) of cohort studies or case-control studies will answer the following question:
"Should I change my diet?".

2023:

  1. 500 mL/d orange juice consumption causally reduce bad cholesterol
  2. 30g/d whole grains consumption reduce all-cause mortality
  3. Dietary intake of 200-700 mg/day calcium reduces stroke among Asians
  4. Green tea may causally improve risk factors of cardiovascular disease
  5. Green tea causally lowers blood pressure in healthy individuals

2022:

  1. 20 g/day olive oil reduce all-cause mortality
  2. 25-200 g/d peanuts may causally reduce total cholesterol levels
  3. Brassica vegetables causally reduce total cholesterol
  4. Higher dietary fiber intake improves causally cardiovascular risk factors
  5. 500 mg/d dietary flavonoid intake reduces cardiovascular disease, diabetes and hypertension
  6. Serum vitamin D concentrations between 40 and 75 nmol/L reduce hypertension in adult
  7. 200 mg/day flavan-3-ols dietary intake reduce stroke
  8. Dietary oat supplementation may improve BMI among obese participants with mild metabolic disturbances

2021:

  1. Purified anthocyanin supplements reduce cardiovascular risk
  2. HDL cholesterol level under 2.33 mmol/L reduces cardiovascular disease mortality
  3. Higher sodium and lower potassium reduce in a dose-response manner cardiovascular risk
  4. 4000 mg inositol supplements reduce blood pressure
  5. 25 mg/d dietary flavonols or 5 mg/d dietary flavones reduce coronary heart disease
  6. Low-carbohydrate diets decrease LDL particle number
  7. Onion causally increases good cholesterol
  8. Dyslipidemia increases severity and mortality of COVID-19
  9. Best cut-off point of homocysteine for predicting acute ischemic stroke is 20.0 μmol/L
  10. Green leafy vegetables reduce cardiovascular disease
  11. Clinical screening for blood pressure in cerebral palsy is needed
  12. White meat reduces all-cause mortality
  13. Obesity increases atrial fibrillation recurrence in patients undergoing catheter ablation
  14. Cardiovascular drugs may not be associated with poor COVID-19 outcomes
  15. Low to moderate alcohol intake decreases venous thromboembolism
  16. Rice bran oil causally decreases cholesterol and triglyceride levels in adults
  17. Most prevalent neurological comorbidity in COVID-19 is cerebrovascular disease
  18. Weekly 175-350 grams oily fish lower cardiovascular disease among patients with vascular disease
  19. Mortality is more frequently in COVID-19 patients with chronic kidney diseases and cardiovascular disease
  20. Soy consumption causally lowers blood pressure in adults
  21. Daily 700-1000 mg dietary calcium intake increases cardiovascular disease in healthy postmenopausal women
  22. High NT-pro BNP and CK-MB levels in COVID-19 patients correlate with worse outcomes
  23. Diet with <30 En% carbohydrates causally increases adiponectin concentration in adults
  24. Omega-3 fatty acids consumption reduce recurrent venous thromboembolism

2020:

  1. 1-mg/day dietary heme iron intake increase cardiovascular disease mortality
  2. <3 cups/d coffee is essential for the prevention of dyslipidemia 
  3. Higher intakes of total protein reduce all-cause mortality
  4. 2-3 servings/week fish reduce all-cause mortality in patients with type 2 diabetes
  5. Every 1 gram sodium increases cardiovascular disease risk by 6%
  6. Most prevalent comorbidities among COVID-19 are hypertension, diabetes, cardiovascular disease, liver disease, lung disease, malignancy, cerebrovascular disease, COPD and asthma
  7. A higher fish consumption reduces coronary heart disease
  8. Dietary intake of vitamin B6 and folate reduces stroke
  9. A high serum vitamin C reduces blood pressure
  10. Male, age, cardiovascular disease, hypertension and diabetes mellitus increase mortality in patients with COVID-19
  11. Green tea reduces blood pressure in subjects with hypertension
  12. Potassium intake from 3,128 mg per day increases blood pressure
  13. Tomato consumption reduces bad cholesterol levels
  14. 200-1500 mg/d dietary calcium intakes do not increase cardiovascular disease
  15. 1-3 eggs/day during 3 to 12 weeks have no effect on blood pressure
  16. 100 mg/day magnesium dietary intake reduce type 2 diabetes
  17. Alzheimer disease increases risk of hemorrhagic stroke
  18. Pneumococcal vaccination may decrease all-cause mortality in patients with cardiovascular disease
  19. 100-g/d fish consumption decreases liver cancer
  20. Yogurt intake is associated with a reduced risk of type 2 diabetes
  21. Daily 1 cup tea decreases all-cause mortality among elderly
  22. Hypertension, diabetes, COPD, cardiovascular disease and cerebrovascular disease are major risk factors for patients with COVID-19
  23. Hypertension, cardiovascular diseases, diabetes mellitus, smoking, COPD, malignancy and chronic kidney disease are risk factors for COVID-19 infection
  24. Flaxseed supplementation decreases plasma lipoprotein(a) levels
  25. Higher linoleic acid blood concentration reduces cancer mortality
  26. Cardiovascular metabolic diseases increase risk of corona virus infection
  27. Vitamin C supplements during ≥6 weeks reduce blood pressure
  28. Quercetin supplements decrease triglycerides levels
  29. Heart failure increases risk of all-cause dementia
  30. Low-carbohydrate diet reduces cardiovascular disease

2019:

  1. Grape products reduce bad cholesterol in adults
  2. <400 mg coffee bean extract supplementation reduces blood pressure in hypertensive patients
  3. Higher circulating concentration of vitamin C, vitamin E and β-carotene reduce cardiovascular mortality
  4. Saturated fat increases Alzheimer disease
  5. Dietary intakes of anthocyanins reduce hypertension
  6. Cashew consumption improves triglyceride levels
  7. Coenzyme Q10 supplements reduce inflammation in patients with coronary artery disease
  8. Kiwifruit does not improve cardiovascular risk factors
  9. Trans fatty acids intake increases cardiovascular disease
  10. Diet with high total antioxidant capacity decreases cancer mortality
  11. Peanut consumption more than 12 weeks increases good cholesterol

2018:

  1. High dietary vitamin E intake reduces risk of stroke
  2. Diet with medium-chain saturated fatty acids leads to higher HDL cholesterol
  3. 150 g/day French-fries consumption increases risk of hypertension
  4. 10,000 steps a day do not decrease blood pressure in healthy adults
  5. Walnut-enriched diet reduces cholesterol and triglyceride levels
  6. Higher sodium intake and higher dietary sodium-to-potassium ratio are associated with a higher risk of stroke
  7. EPA/DHA ratio of < 1 reduces risk of postoperative atrial fibrillation after coronary artery bypass grafting
  8. Coronary heart disease and heart failure increase risk of dementia
  9. Coenzyme Q10 supplementation reduces serum triglycerides levels of patients with metabolic disorders
  10. Olive oil consumption decreases LDL cholesterol and triglyceride less than other plant oils
  11. 1 serving/week poultry intake reduces risk of stroke among US people
  12. Resveratrol supplements do not reduce LDL-cholesterol levels
  13. 20g/d of fish consumption reduce risk of CVD mortality

2017:

  1. Replacing saturated fat with PUFA will lower coronary heart disease events
  2. Omega-3 supplementation decreases risk of cardiac death
  3. 500 mL/d beetroot juice reduces blood pressure
  4. Atrial fibrillation, previous stroke, myocardial infarction, hypertension, diabetes and previous TIA increase risk of post-stroke dementia
  5. Daily dietary intake of 30g whole grains, 100g fruits and 200g dairy products reduce risk of hypertension
  6. At least 28 g/d whole grain intake reduce risk of total, cardiovascular and cancer mortality
  7. Red and processed meat increase risk of stroke
  8. 8.7 g/day viscous soluble fiber during 7 weeks reduces blood pressure
  9. A diet with <10 En% saturated fat reduces cholesterol and blood pressure in children
  10. Consumption of whole grains, fish, vegetables and fruit decrease risk of cardiovascular diseases
  11. Coenzyme Q10 supplements result in lower mortality and improved exercise capacity of patients with heart failure
  12. EPA and DHA supplements reduce risk of cardiovascular diseases
  13. Up to 12g/day nut consumption is associated with reduced all-cause and coronary heart disease mortality
  14. 1-724 mg/day anthocyanin supplementation improve vascular health
  15. Weekly 30-180 gram chocolate consumption reduces risk of coronary heart disease, stroke and diabetes
  16. Resistance training reduces blood pressure in prehypertensive and hypertensive subjects
  17. Perioperative antioxidant vitamin therapy in patients undergoing cardiac surgery reduces the incidence of postoperative atrial fibrillation and duration of hospital stay
  18. No association between dietary choline/betaine with incident cardiovascular disease
  19. 0.1-7 drinks/week reduce risk of heart failure
  20. 100-mg/day flavonoids decrease risk of all-cause and cardiovascular disease mortality
  21. Potassium supplementation for at least 4 weeks reduces blood pressure of patients with essential hypertension
  22. 100 mg/day dietary magnesium intake is associated with lower risk of hypertension
  23. Daily 1 egg increases heart failure risk
  24. A daily dose of ≥200 g yogurt intake decreases cardiovascular disease risk
  25. Sesame consumption reduces systolic blood pressure
  26. Higher lycopene exposure reduces risk of cardiovascular diseases
  27. Abdominal adiposity and higher body fat mass increase risk of atrial fibrillation
  28. Tomatoes reduce cardiovascular risk among adults

2016:

  1. Elevated serum phosphorus concentration increases risk of all-cause mortality among men without chronic kidney disease
  2. Garlic supplementation reduces cardiovascular disease risk

2015:

  1. Vitamin B1 deficiency increases systolic heart failure risk
  2. A high GL diet is a risk factor of stroke events

2014:

  1. Olive oil consumption reduces stroke
  2. Perioperative antioxidant supplementations with NAC, PUFA and vitamin C prevent atrial fibrillation after cardiac surgery

2013:

  1. A reduction of 4.4 g/day salt causes important falls in blood pressure in people with both raised and normal blood pressure

2012:

  1. A low GI diet decreases LDL-cholesterol
  2. Flavonoid supplements show significant improvements in vascular function and blood pressure

2011:

  1. Daily dietary intake of 1.6g potassium decreases risk of stroke

2002:

  1. 240 mg magnesium per day decrease systolic blood pressure

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Cardiovascular disease is a class of diseases that involves the heart or blood vessels (arteries, capillaries and veins). Cardiovascular diseases are TIA, heart attack, stroke and vascular disease of the large vessels, such as claudication. Cardiovascular diseases are currently number 1 cause of death in the Western world.

The main causes of cardiovascular diseases are:

Rules of thumb:

  • % reduction of cholesterol = % risk reduction of cardiovascular disease.
  • Per kg weight loss = 1 mmHg blood pressure reduction. So from 130 to 120 mmHg would practically mean 10 kg weight loss.
  • Each gram of salt above 6 grams of salt per day will increase the blood pressure by 1 mmHg.

Daily intake of 3 grams of plant sterols or stanols during 2-3 weeks reduces the LDL cholesterol level by 11.3%. However, avoiding dietary cholesterol is not the solution to a high cholesterol level.  The solution is to choose products with maximum 30 En% fat, and maximum 7 En% saturated fat.

It is very difficult to decrease the cholesterol level by 15% by diet only.

A cholesterol lowering diet contains:

  • Products with maximum 30 En%
  • Products with maximum 7 En% saturated fat
  • Products with maximum 15 En% protein
  • Up to 200 grams of cholesterol per day
  • Products with at least 1.5 grams of fiber per 100 kcal

Heredity also plays a role in cardiovascular diseases. The inherited forms of cardiovascular disease are:

  • Hypertrophic cardiomyopathy (=a heart disease in which the heart muscle is thickened)
  • Dilated cardiomyopathy (=a heart disease in which the heart muscle is dilated)
  • Long-QT syndrome
  • Catecholaminergic polymorphic ventricular tachycardia (CPVT)
  • Brugada syndrome
  • Arrhythmogenic right ventricular dysplasia (ARVD)
  • Familial hypercholesterolemia (FH)

Symptoms of myocardial infarction in men and women are not the same.

Symptoms of myocardial infarction in men are chest pressure, sweating and pain radiating to the arms and jaw.

Symptoms that may indicate a heart attack in women are:

  • Palpitations (pounding heart)
  • Sudden dizziness, a feeling of weakness
  • Insomnia
  • An uncomfortable feeling in the stomach, possibly with nausea
  • A sudden onset of extreme fatigue
  • Shortness of breath
  • Burning sensation below the sternum
  • Unpleasant clamping or tightness in the chest
  • Unpleasant sensation or pain between the shoulder blades, pain in the neck

Dietary guidelines for cardiovascular disease prevention:

  • Choose products with maximum 30 En% fat, products with maximum 7 En% saturated fat, products with maximum 0.3 gram salt per 100 kcal, products with minimum 1.5 grams of fiber per 100 kcal and for fish which provides at least 1000 mg of EPA and DHA per day or in other words, your daily diet (=all meals/products that you eat on a daily basis on average) should contain maximum 30 En% fat, of which maximum 7 En% saturated fat, maximum 0.3 gram salt per 100 kcal and minimum 1.5 grams of fiber per 100 kcal.
  • Stop smoking because smoking causes atherosclerosis.
  • Aim for a healthy weight. A healthy weight has a BMI of 18.5-25. BMI is weight divided by height squared (weight (kg)/height2 (m)).
  • Spend at least 60-90 minutes of physical exercises per day or at least 10000 steps per day.
  • Eat at least 2 times (100-150 g fish per time) a week oily fish. Oily fishes are sardines, herring, salmon, anchovies, eel and mackerel.
  • Eat 250 mg omega-3 fatty acids per day. Omega-3 fatty acids are alpha-linolenic acid, EPA and DHA.
  • Eat 300 grams of vegetables and five servings of fruit per day or 30 grams of fiber per day.
    30 grams of fiber per dag corresponds to a daily diet of minimum 1.5 grams of fiber per 100 kcal.
    10 to 30 grams of fiber a day decreases the LDL cholesterol levels.
  • Eat plenty of whole grains (brown bread, brown rice and oats) and legumes.
  • Limit alcohol consumption to 2 glasses for men and 1 glass for women per day.
  • Eat no more than 6 grams of salt per day, corresponding to 2400 mg of sodium.
  • Eat no more than 200 grams of cholesterol per day at an elevated LDL-cholesterol level.
  • Eat no more than 19 grams of saturated fat per day at 2500 calories diet and 15 grams of saturated fat at 2000 kcal diet. The WHO advises 2000 kcal per day for women and 2500 kcal for men.
  • Take 500 micrograms of folic acid per day at a high homocysteine ​​level.
  • Do not take antioxidant supplements. They do more harm than good!
    Consult your doctor or a dietician when taking dietary supplements!
Target values ​​for a healthy heart:
MeasurementReference values
Total cholesterol level< 4.5 mmol/l
HDL cholesterol level for men> 0.9 mmol/l
HDL cholesterol level for women > 1.1 mmol/l
LDL cholesterol level< 2.5 mmol/l
Triglycerides (blood fats) level< 2.5 mmol/l
Fasting blood sugar level< 6 mmol/l
HbA1c< 7%
Homocysteine level< 12 micromol/l
Blood pressure120/80 mmHg.
120 is systolic blood pressure &
 80 is diastolic blood pressure
Blood pressure in people over 60 years140/90 mmHg

 

Lifestyle measures for the treatment and prevention of high blood pressure
Lifestyle changesRecommendationReduction of systolic blood pressure
Weight lossA healthy weight has a BMI of 18.5-25 kg/m25-20 mmHg
Salt reductionUp to 6 grams of salt a day or 2400 mg of sodium per day2-8 mmHg
Potassium intakePer every increment of 0.6 gram1 mmHg
Physical activities30-60 minutes of physical activity per day4-9 mmHg
Alcohol consumptionMaximum 2 glasses for  men & 1 glass for women2-4 mmHg
DASH dietNutritional pattern rich in fruits, vegetables and low-fat products8-14 mmHg
This table shows that the best way to prevent high blood pressure is to maintain a healthy weight

Cancer

Scientific studies (review articles) on the relationship between diet/nutrients and cancer prevention:
One swallow does not make a summer. A famous Dutch saying that could not be any more obvious. Just because one single scientific study about a certain topic makes certain claims, it does not necessarily mean it is true. On the other hand, a review article (a collection of scientific studies on a certain topic) of randomized, placebo-controlled double blind clinical trials (RCTs) will answer the following question:
"Do taking dietary supplements make sense?" Yes for a positive conclusion and no for a negative conclusion.

One swallow does not make a summer. A famous Dutch saying that could not be any more obvious. Just because one single scientific study about a certain topic makes certain claims, it does not necessarily mean it is true. On the other hand, a review article (a collection of scientific studies on a certain topic) of cohort studies or case-control studies will answer the following question:
"Should I change my diet?".

 

2024:

  1. Higher carotenoids levels reduce breast cancer

2023:

  1. 10 mg/d isoflavone dietary intake reduce breast cancer
  2. Higher tissue levels of linoleic acid reduce prostate cancer
  3. High blood vitamin B6 levels reduce colorectal cancer
  4. Higher choline dietary intake may reduce breast cancer

2022:

  1. Fruits and vegetables reduce endometrial cancer
  2. Higher blood levels of alpha-linolenic acid reduce colorectal cancer
  3. High folate dietary intake reduces colon cancer in people with medium or high alcohol consumption
  4. Higher dietary intake of processed meat increases hepatocellular carcinoma
  5. Dietary intake of vegetables and vitamin C could reduce renal cell carcinoma
  6. A high olive oil consumption reduces cancer risk
  7. Postoperative coffee or caffeine consumption causally reduces postoperative ileus

2021:

  1. 600 mg/d vitamin E supplementation decreases chemotherapy-induced peripheral neuropathy
  2. Dendritic cell vaccine provides no benefits for newly diagnosed glioblastoma
  3. Breastfeeding reduces ovarian cancer in women with BRCA1 or BRCA2 mutation
  4. No association between consumption of carrot and bladder cancer
  5. Omega-3 PUFA supplementation may reduce chemotherapy-induced peripheral neuropathy
  6. High consumption of cruciferous vegetables, citrus fruits, garlic and tomatoes may reduce colorectal cancer
  7. Obesity increases colorectal cancer in men with Lynch Syndrome
  8. Dietary calcium intake reduces colorectal adenomas
  9. High consumption of dietary trans fat increases prostate cancer and colorectal cancer
  10. Hyperlipidemia, obesity and high alcohol consumption are risk factors of early-onset colorectal cancer
  11. Guarana supplementation does not reduce cancer-related fatigue
  12. CoQ10 supplementation reduces markers of inflammation and MMPs in patients with breast cancer
  13. Obesity is a risk factor for mortality from primary liver cancer
  14. Branched-chain amino acids supplementation during oncological surgical period may reduce post-operative morbidity from infections and ascites
  15. High saturated fat increases liver cancer
  16. Coffee and tea consumption reduce glioma
  17. Higher mushroom consumption reduces breast cancer
  18. 1 cup/d green tea reduces esophageal cancer among women
  19. Malignancy increases severe/critical COVID-19
  20. Anti-cancer therapy have no adverse effects on severity and mortality in cancer patients with COVID-19
  21. No association between potato consumption and cancers
  22. 100 mg/d dietary magnesium intakes reduce cancer mortality
  23. Daily 60 to 80 grams citrus fruit reduce lung cancer
  24. A low selenium level increases breast cancer
  25. No association between fish intake and pancreatic cancer
  26. No association between dietary acrylamide intake and breast, endometrial and ovarian cancer

2020:

  1. Vegetable and fruit consumption reduce biliary cancer
  2. Tree nuts reduce cancer mortality
  3. A high plasma folate level does not reduce breast cancer
  4. Higher intakes of total protein reduce all-cause mortality
  5. Higher vitamin C dietary intake reduces breast cancer
  6. Habitual tea consumption reduces nasopharyngeal cancer
  7. Ovarian cancer survivors should consume 300 g/d vegetables and 300 g/d fruit
  8. Fat, cholesterol and vitamin A increase ovarian cancer
  9. Circulating concentrations of α-carotene, β-carotene and lutein and zeaxanthin reduce bladder cancer
  10. Dietary omega-3 PUFAs intake reduce digestive system cancers
  11. 40 g/day of pickled vegetable increase gastric cancer
  12. Higher vitamin B2 and B6 dietary intake decreases ER-/PR- breast cancer
  13. 30 min/day light-intensity physical activity reduce cancer mortality
  14. 100-g/d fish consumption decreases liver cancer
  15. Dietary intake of vitamin A reduces ovarian cancer among North Americans
  16. Nitrite dietary intake increases non-Hodgkin lymphoma in females
  17. Carbohydrate dietary intake may decrease esophageal cancer
  18. Hepatitis C increases pancreatic cancer
  19. Higher linoleic acid blood concentration reduces cancer mortality
  20. Waist circumference is a significant risk factor of liver cancer
  21. Tea consumption may reduce colorectal cancer in female
  22. Daily 20 grams tree nuts reduces cancer of the digestive system
  23. Green tea reduces stomach cancer
  24. Dietary salt intake increases risk of esophageal cancer
  25. Garlic could reduce risk of colorectal cancer

2019:

  1. Dietary fiber intake reduces endometrial cancer
  2. High β-carotene concentration reduces bladder cancer
  3. High consumption of polyunsaturated fat increases skin cancer
  4. 100g fruit per day decrease lung cancer in former smokers
  5. Carrot consumption decreases the lung cancer adenocarcinoma
  6. 0.5 g/day dietary trans fat intake increases ovarian cancer
  7. High serum iron levels increase breast cancer risk
  8. Egg consumption is not associated with brain cancer risk
  9. Tea reduces brain cancer in American population
  10. Decaffeinated coffee consumption could reduce ovarian cancer
  11. Diet with high total antioxidant capacity decreases cancer mortality
  12. Omega-3 fatty acids in fish consumption reduce breast cancer in Asian patients
  13. Physical activity reduces lung cancer among smokers
  14. Trans fatty acids are not associated with risk of breast cancer
  15. Daily 100 μg dietary folate intake reduce oestrogen-receptor-negative breast cancer
  16. 100-300 g/day fruit or vegetables reduce all-cause mortality

2018:

  1. 10g dietary fiber intake per day may reduce ovarian cancer risk
  2. 1 μg/day dietary B12 intake increases esophageal cancer
  3. Protein intake does not increase prostate cancer
  4. No association between vitamin A, C, D, E and lycopene and risk of non-Hodgkin lymphoma
  5. Wine consumption is not associated with colorectal cancer
  6. Dietary carrot intake reduces breast cancer
  7. High intake of dietary flavonols, flavones and anthocyanidins may decrease colorectal cancer
  8. Calcium intake of <750 mg per day could be a risk factor for prostate cancer
  9. No association between carbohydrate intake and prostate cancer risk
  10. 5 mg/day vitamin B2 intake reduces colorectal cancer risk
  11. Moderate consumption of white wine increases the risk of prostate cancer
  12. Citrus fruit intake reduces risk of esophageal cancer
  13. Daily 10 mcg dietary intake of vitamin D decreases risk of pancreatic cancer
  14. Every 5 kg/m2 increase in BMI corresponds to a 2% increase in breast cancer risk in women
  15. A high dietary cholesterol intake might increase lung cancer risk
  16. Daily higher cooked tomatoes and sauces consumption reduces prostate cancer risk

2017:

  1. Saturated fat increases breast cancer mortality among women
  2. Daily dietary intake of 100g red meat and 50g processed meat increase risk of colorectal cancer
  3. Daily 2-4 g carnitine does not reduce cancer-related fatigue
  4. At least 28 g/d whole grain intake reduce risk of total, cardiovascular and cancer mortality
  5. High intake of cooked carrot might be associated with a low incidence of urothelial cancer
  6. Breastfeeding during 6-9 months reduces risk of endometrial cancer
  7. N-3 PUFA supplementation improves immune function and reduces the level of inflammation in gastrointestinal cancer patients postoperatively
  8. Plant-based dietary patterns decrease cancer risk
  9. Up to 12g/day nut consumption is associated with reduced all-cause and coronary heart disease mortality
  10. A high intake of red meat increases risk of lung cancer among non-smokers
  11. High serum selenium levels reduce risk of cervical cancer among women
  12. Both high vitamin E intake and circulating vitamin E levels could reduce cervical neoplasia risk
  13. High intakes of saturated fat increase risk of lung cancer
  14. Vitamin and antioxidant supplements have no overall preventive effect against bladder cancer
  15. At least 1600 mg/day calcium may reduce the recurrence of colorectal adenomas
  16. High levels of physical activity reduce risk of breast cancer in postmenopausal women with a BMI until 30
  17. Daily 100g processed and red meat intake increase esophageal cancer risk
  18. No more than 175 mg/d dietary DHA intake reduces endometrial cancer
  19. Daily 621 mg dietary calcium has protective effect against esophageal cancer in Asian populations
  20. 1-3 servings/d vegetables may lower risk of renal cell carcinoma
  21. Daily 20 grams legume reduces risk of prostate cancer
  22. Daily 300 mcg dietary iodine may decrease risk of thyroid cancer
  23. Daily 2 mg dietary lycopene consumption reduces prostate cancer risk
  24. At least 7 cups/day green tea intake reduce prostate cancer
  25. 1 mg/day dietary vitamin B2 intake reduces risk of breast cancer
  26. Higher dietary carbohydrate intake increases colorectal cancer risk in men
  27. A high total fat consumption increases non-Hodgkin's lymphoma
  28. Daily 2 mg dietary vitamin E intake reduces lung cancer risk
  29. 20 mg/d isoflavones dieatary intake reduces risk of colorectal neoplasms in Asians
  30. Elevated serum selenium levels may decrease high-grade prostate cancer among current and former smokers

2015:

  1. 100-400g/day fruits and vegetables reduce risk of lung cancer
  2. High garlic and onion consumption are likely to reduce gastric cancer risk
  3. Manganese deficiency may increase breast cancer
  4. High dietary vitamin B9, D, B6 and B2 intake reduces risk of colorectal cancer
  5. Red meat induced colorectal cancer is not modified by NAT2 enzyme activity

2014:

  1. Low-fat diet reduces recurrence of breast cancer
  2. Cruciferous vegetable intake protects against cancer of the colon
  3. Recreational physical activity reduces risk of gastric cancer
  4. Daily 200-320 micrograms dietary folate intake reduce breast cancer risk
  5. 100 g/day red meat intake may increase gastric cancer risk
  6. Red meat consumption increases esophageal cancer risk
  7. White meat and fish consumption reduce risk of hepatocellular carcinoma

2012:

  1. High salt intake increases gastric cancer
  2. High intake of vegetables and fruit decreases risk of esophageal squamous cell carcinoma

2011:

  1. Olive oil consumption probably reduces breast cancer and cancer of the digestive system

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The human body consists of organs like liver, lungs and heart. Organs consist of tissues and tissue consists of cells. Under normal circumstances cells only divide when needed, e.g. at recovery, growth and wound healing. This process is also called controlled cell division. Controlled cell division is necessary and innocent. However, it becomes dangerous when cell division within a particular organ is no longer under control. In that case, is called cancer. Cancer is a disorder, characterized by uncontrolled cell division in a particular organ. Cancer is often deadly when there is metastasis.

The oxidative DNA damage is a major risk factor for developing cancer. Antioxidants can protect the DNA against oxidative damage. Oxidative damages can be caused by free radicals.

The word "cancer" is derived from the Latin word "cancer", which means "lobster". There are several types of cancer.

Cancer mortality can be reduced if cases are detected and treated early. There are 2 components of early detection efforts:

  • early diagnosis
  • screening

Cancer is a leading cause of death worldwide.
The most common in 2020 (in terms of new cases of cancer) were:

  • breast
  • lung
  • colon and rectum
  • prostate
  • skin (non-melanoma)
  • stomach

The most common causes of cancer death in 2020 were:

  • lung
  • colon and rectum
  • liver
  • stomach
  • breast

Between 30 and 50% of cancers can currently be prevented by avoiding risk factors and implementing existing evidence-based prevention strategies.

Dietary guidelines for cancer prevention:

  • 7-points nutritional profile of cancer prevention is a diet with:
    1. maximum 30 En% fat
    2. maximum 7 En% saturated fat
    3. maximum 0.2 grams salt per 100 kcal
    4. minimum 1.5 grams fiber per 100 kcal
    5. maximum 70 En% carbohydrates
    6. maximum 25 En% sugar
    7. maximum 35 En% protein
  • The easiest way to follow this diet is to choose only products/meals with:
    1. maximum 30 En% fat
    2. maximum 7 En% saturated fat
    3. maximum 0.2 grams salt per 100 kcal
    4. minimum 1.5 grams fiber per 100 kcal
    5. maximum 70 En% carbohydrates
    6. maximum 25 En% sugar
    7. maximum 35 En% protein
  • However, the most practical way to follow this diet is, all your daily consumed products/meals should contain on average:
    1. maximum 30 En% fat
    2. maximum 7 En% saturated fat
    3. maximum 0.2 grams salt per 100 kcal
    4. minimum 1.5 grams fiber per 100 kcal
    5. maximum 70 En% carbohydrates
    6. maximum 25 En% sugar
    7. maximum 35 En% protein
  • Use the 7-points nutritional profile app to see if your daily diet contains:
    1. maximum 30 En% fat
    2. maximum 7 En% saturated fat
    3. maximum 0.2 grams salt per 100 kcal
    4. minimum 1.5 grams fiber per 100 kcal
    5. maximum 70 En% carbohydrates
    6. maximum 25 En% sugar
    7. maximum 35 En% protein
  • Eat fish that provides at least 250 mg EPA and DHA per day.
  • Aim for a healthy weight. A healthy weight has a BMI of 18.5-25. BMI is weight divided by height squared (weight (kg)/height2 (m)).
  • Spend at least 60-90 minutes per day on physical exercises or at least 10,000 steps per day.
  • Eat 25-30 grams of vegetables and 2-5 servings of fruit a day or at least 25 grams of fiber per day.
    25grams of fiber per day corresponds to a daily diet of 1.3 grams of fiber per 100 kcal.
  • Eat plenty of whole grains, such as brown bread, oatmeal and legumes.
  • Limit to 2 glasses of alcohol for men and 1 glass for women a day or <20 g alcohol per day.
  • Eat no more than 6 grams of salt per day, corresponding to 2400 mg of sodium.
    6 grams salt per day corresponds to a daily diet of <0.3 g salt per 100 kcal.
  • Do not take antioxidant supplements. They do more harm than good!
  • Eat no more than 500g of red meat per week. Red meat increases the risk of developing colorectal cancer.

Different types of cancer:

Cardiovascular diseases

Cardiovascular disease is a class of diseases that involves the heart or blood vessels (arteries, capillaries and veins). Cardiovascular diseases are TIA, heart attack, stroke and vascular disease of the large vessels, such as claudication. Cardiovascular diseases are currently number 1 cause of death in the Western world.

The main causes of cardiovascular diseases are:

  • Arteriosclerosis (a thickening and hardening of arteries)
  • Type 2 diabetes
  • High blood pressure
  • High cholesterol levels
  • High homocysteine ​​levels
  • Obesity

Rules of thumb:

  • % reduction of cholesterol = % risk reduction of cardiovascular disease.
  • Per kg weight loss = 1 mmHg blood pressure reduction. So from 130 to 120 mmHg would practically mean 10 kg weight loss.
  • Each gram of salt above 6 grams of salt per day will increase the blood pressure by 1 mmHg.

Daily intake of 3 grams of plant sterols or stanols during 2-3 weeks reduces the LDL cholesterol level by 11.3%. However, avoiding dietary cholesterol is not the solution to a high cholesterol level.  The solution is to choose products with maximum 30 En% fat, and maximum 7 En% saturated fat.

It is very difficult to decrease the cholesterol level by 15% by diet only.

A cholesterol lowering diet contains:

  • Products with maximum 30 En% fat
  • Products with maximum 7 En% saturated fat
  • Products with maximum 15 En% protein
  • Up to 200 grams of cholesterol per day
  • Products with at least 1.5 grams of fiber per 100 kcal
     

Heredity also plays a role in cardiovascular diseases. The inherited forms of cardiovascular disease are:

  • Hypertrophic cardiomyopathy (=a heart disease in which the heart muscle is thickened)
  • Dilated cardiomyopathy (=a heart disease in which the heart muscle is dilated)
  • Long-QT syndrome
  • Catecholaminergic polymorphic ventricular tachycardia (CPVT)
  • Brugada syndrome
  • Arrhythmogenic right ventricular dysplasia (ARVD)
  • Familial hypercholesterolemia (FH)

Symptoms of myocardial infarction in men and women are not the same.

Symptoms of myocardial infarction in men are chest pressure, sweating and pain radiating to the arms and jaw.

Symptoms that may indicate a heart attack in women are:

  • Palpitations (pounding heart)
  • Sudden dizziness, a feeling of weakness
  • Insomnia
  • An uncomfortable feeling in the stomach, possibly with nausea
  • A sudden onset of extreme fatigue
  • Shortness of breath
  • Burning sensation below the sternum
  • Unpleasant clamping or tightness in the chest
  • Unpleasant sensation or pain between the shoulder blades, pain in the neck

Dietary guidelines for cardiovascular disease prevention:

  • Choose products with maximum 30-35 En% fat, products with maximum 7-10 En% saturated fat, products with maximum 0.1 gram of sodium per 100 g (100 ml) product, products with minimum 1.5 grams of fiber per 100 kcal and for fish which provides at least 1000 mg of EPA and DHA per day.
  • Stop smoking because smoking causes atherosclerosis.
  • Aim for a healthy weight. A healthy weight has a BMI of 18.5-25. BMI is weight divided by height squared (weight (kg)/height2 (m)).
  • Spend at least 60-90 minutes of physical exercises per day or at least 10000 steps per day.
  • Eat at least 2 times (100-150 g fish per time) a week oily fish. Oily fishes are sardines, herring, salmon, anchovies, eel and mackerel.
  • Eat 250 mg omega-3 fatty acids per day. Omega-3 fatty acids are alpha-linolenic acid, EPA and DHA.
  • Eat 300 grams of vegetables and five servings of fruit per day or 30 grams of fiber per day.
    30 grams of fiber per dag corresponds to a daily diet of minimum 1.5 grams of fiber per 100 kcal.
    10 to 30 grams of fiber a day decreases the LDL cholesterol levels.
  • Eat plenty of whole grains (brown bread, brown rice and oats) and legumes.
  • Limit alcohol consumption to 2 glasses for men and 1 glass for women per day.
  • Eat no more than 6 grams of salt per day, corresponding to 2400 mg of sodium.
  • Eat no more than 200 grams of cholesterol per day at an elevated LDL-cholesterol level.
  • Eat no more than 19 grams of saturated fat per day at 2500 calories diet and 15 grams of saturated fat at 2000 kcal diet. The WHO advises 2000 kcal per day for women and 2500 kcal for men.
  • Take 500 micrograms of folic acid per day at a high homocysteine ​​level.
  • Do not take antioxidant supplements. They do more harm than good!
    Consult your doctor or a dietician when taking dietary supplements!

Target values ​​for a healthy heart:

MeasurementReference values
Total cholesterol level< 4.5 mmol/l
HDL cholesterol level for men> 0.9 mmol/l
HDL cholesterol level for women > 1.1 mmol/l
LDL cholesterol level< 2.5 mmol/l
Triglycerides (blood fats) level< 2.5 mmol/l
Fasting blood sugar level< 6 mmol/l
HbA1c< 7%
Homocysteine level< 12 micromol/l
Blood pressure120/80 mmHg.
120 is systolic blood pressure &
 80 is diastolic blood pressure
Blood pressure in people over 60 years140/90 mmHg

 

Lifestyle measures for the treatment and prevention of high blood pressure

Lifestyle changes

Recommendation

Reduction of systolic blood pressure

Weight lossA healthy weight has a BMI of 18.5-25 kg/m2

5-20 mmHg

Salt reductionUp to 6 grams of salt a day or 2400 mg of sodium per day

2-8 mmHg

Potassium intakePer every increment of 0.6 gram

1 mmHg

Physical activities30-60 minutes of physical activity per day

4-9 mmHg

Alcohol consumptionMaximum 2 glasses for  men & 1 glass for women

2-4 mmHg

DASH dietNutritional pattern rich in fruits, vegetables and low-fat products

8-14 mmHg

This table shows that the best way to prevent high blood pressure is to maintain a healthy weight


Scientific studies on the relationship between diet/nutrients and cardiovascular diseases.
Review articles of randomized, placebo-controlled double-blind clinical trials (RCTs) will answer the following question:
"Is taking dietary supplements make sense?". Yes at a positive conclusion and no at a negative conclusion.

Review articles of cohort studies or case-control studies will answer the following question:
"Should I change my diet?".

2017:

  1. Abdominal adiposity and higher body fat mass increase risk of atrial fibrillation
  2. Tomatoes reduce cardiovascular risk among adults

Cancer

The human body consists of organs like liver, lungs and heart. Organs consists of tissues, and tissue consists of cells. Under normal circumstances cells only divide when needed, e.g. at recovery, growth and wound healing. This process is also called controlled cell division. Controlled cell division is necessary and innocent. However, it becomes dangerous when cell division within a particular organ is no longer under control. In that case, is called cancer. Cancer is a disorder, characterized by uncontrolled cell division in a particular organ. Cancer is often deadly when there is metastasis.

The oxidative DNA damage is a major risk factor for developing cancer. Antioxidants can protect the DNA against oxidative damage. Oxidative damages can be caused by free radicals.

The word "cancer" is derived from the Latin word "cancer", which means "lobster". There are several types of cancer.

Cancer mortality can be reduced if cases are detected and treated early. There are two components of early detection efforts:

  • Early diagnosis
  • Screening

Cancer is a leading cause of death worldwide. The main types of cancer are lung, stomach, liver, colorectal, breast and cervical cancer.
Cancer of the lung is the most common cancer in the world.
Lung, stomach, liver, colon and breast cancer cause the most cancer deaths each year.

35% of cancer cases is due to a wrong diet, such as high fat, high salt and/or less fruit and vegetables diet.

Dietary guidelines for cancer prevention:

  • Choose products with maximum 35 En% fat, products with maximum 10 En% saturated fat, products with maximum 0.5 g of sodium per 100 g (100 ml) product, products with minimum 1.3 grams of fiber per 100 kcal and fish providing at least 250 mg EPA and DHA per day.
  • Aim for a healthy weight. A healthy weight has a BMI of 18.5-25. BMI is weight divided by height squared (weight (kg)/height2 (m)).
  • Spend at least 60-90 minutes per day on physical exercises or at least 10000 steps per day.
  • Eat 25-30 grams of vegetables and 2-5 servings of fruit a day or 25-30 grams of fiber per day.
    30 grams of fiber per dag corresponds to a daily diet of minimum 1.5 grams of fiber per 100 kcal.
  • Eat plenty of whole grains, such as brown bread, oatmeal and legumes.
  • Limit to 2-3 glasses of alcohol for men, and 1-2 glasses for women a day or <30 g alcohol per day.
  • Eat no more than 6 grams of salt per day, corresponding to 2400 mg of sodium.
    6 grams salt per day corresponds to a daily diet of <0.3 g salt per 100 kcal.
  • Do not take antioxidant supplements. They do more harm than good!
  • Eat no more than 500 g of red meat per week. Red meat increases the risk of developing colorectal cancer.

Scientific studies on the relationship between diet/nutrients and cancer.
Review articles of randomized, placebo-controlled double-blind clinical trials (RCTs) will answer the following question:
"Is taking dietary supplements make sense?". Yes at a positive conclusion and no at a negative conclusion.

Review articles of cohort studies or case-control studies will answer the following question:
"Should I change my diet?".

  1. Elevated serum selenium levels may decrease high-grade prostate cancer among current and former smokers

Higher carotenoids levels reduce breast cancer

Objectives:
Carotenoids appear to have anticancer effects. Prospective evidence for the relation between serum carotenoids and breast cancer is controversial. Therefore, this review article has been conducted.

Do higher carotenoids levels (likes, α-carotene, β-carotene, β-cryptoxanthin, lycopene, zeaxanthin and lutein) reduce breast cancer risk among women?

Study design:
This review article included 17 nested case-control studies and 1 cohort study, published between 1984 and 2016 with a total of 20,188 participants. 
Median follow-up ranged from 8 months to 21 years during which 7,608 breast cancer cases were reported. 
All studies assessed circulating carotenoids using high-performance liquid chromatography. The majority of studies carried out on circulating carotenoids and the risk of breast cancer were adjusted for the following variables: BMI (n = 9), dietary variables (n = 8), age (n = 9), alcohol (n = 6), age at menarche (n = 6) and age at first birth (n = 8). 
According to the quality assessment, except for 2 studies, other publications had high quality. 

There was no publication bias. 

Results and conclusions:
The investigators found that the highest levels of total carotenoids compared to the lowest were significantly related to a 24% lower risk of breast cancer [relative risk (RR) = 0.76, 95% CI = 0.62 to 0.93, I2 = 45.6%, p = 0.075]. 
According to the sensitivity analysis, no study affected the overall RR. 

The investigators found according to linear dose-response analysis, the risk of breast cancer decreased by 2% for every 10 μg/dL of total carotenoids [RR = 0.98, 95% CI = 0.97 to 0.99]. A steady drop in the risk of breast cancer was observed for total carotenoid concentrations <1200 μg/dL followed by a plateau. The level of evidence was graded as low.

The investigators found that the highest levels of α-carotene compared to the lowest were significantly related to a 23% lower risk of breast cancer [relative risk (RR) = 0.77, 95% CI = 0.68 to 0.87, I2 = 0.0%, p = 0.48]. 
According to the sensitivity analysis, no study affected the overall RR. 

The investigators found according to linear dose-response analysis, the risk of breast cancer decreased by 22% for every 10 μg/dL of α-carotene [RR = 0.78, 95% CI = 0.66 to 0.93]. 
No evidence for nonlinear association was found. The level of evidence was graded as low. 

The investigators found that the highest levels of β-carotene compared to the lowest were significantly related to a 20% lower risk of breast cancer [relative risk (RR) = 0.80, 95% CI = 0.65 to 0.98, I2 = 56.5%, p = 0.004]. 
According to the sensitivity analysis, no study affected the overall RR. 

The investigators found according to linear dose-response analysis, the risk of breast cancer decreased by 4% for every 10 μg/dL of β-carotene [RR = 0.96, 95% CI = 0.93 to 0.99]. No evidence for nonlinear association was found. The level of evidence was graded as low. 

The investigators found that the highest levels of β-cryptoxanthin compared to the lowest were significantly related to a 15% lower risk of breast cancer [relative risk (RR) = 0.85, 95% CI = 0.74 to 0.96, I2 = 0.0%, p = 0.80]. 
According to the sensitivity analysis, no study affected the overall RR. 

The investigators found according to linear dose-response analysis, the risk of breast cancer decreased by 10% for every 10 μg/dL of β-cryptoxanthin [RR = 0.90, 95% CI = 0.82 to 0.99]. 

The investigators found that the highest levels of lycopene compared to the lowest were significantly related to a 14% lower risk of breast cancer [relative risk (RR) = 0.86, 95% CI = 0.76 to 0.98, I2 = 0.0%, p = 0.46]. 
According to the sensitivity analysis, no study affected the overall RR. 

The investigators found that the highest levels of lutein compared to the lowest were significantly related to a 30% lower risk of breast cancer [relative risk (RR) = 0.70, 95% CI = 0.52 to 0.93, I2 = 17.1%, p = 0.30]. 
According to the sensitivity analysis, no study affected the overall RR. 

The investigators concluded that higher levels of carotenoids, α-carotene, β-carotene, β-cryptoxanthin, lycopene and lutein are related to a decreased risk of breast cancer. Additionally, each 10 μg/dL of total carotenoids, α-carotene, β-carotene and β-cryptoxanthin reduce breast cancer risk with 2%, 22%, 4% and 10%, respectively. 

Original title: 
The Association between Circulating Carotenoids and Risk of Breast Cancer: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies by Dehnavi MK, Ebrahimpour-Koujan S, […], Azadbakht L.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10694674/ 

Additional information of El Mondo:
Find more information/studies on cohort studies/significantly, carotenoids and breast cancer right here. 

10 mg/d isoflavone dietary intake reduce breast cancer

Objectives:
Epidemiological studies that focus on the relationship between dietary isoflavone intake and the risk of breast cancer still lead to inconsistent conclusions. Therefore, this review article has been conducted.

Does a high isoflavone dietary intake reduce risk of breast cancer among women?

Study design:
This review article included 7 cohort studies and 17 case-control studies with a total of 902,438 females.
The verification of breast cancer in these studies was based on either a cancer registry record or a histological diagnosis.
The exposure assessment of all included studies was based on a food frequency questionnaire (FFQ) via either face-to-face interviews or self-administrative questionnaires.

The publication biases were evaluated using Begg’s test and Egger’s test. The shape of the funnel plots showed asymmetry [p = 0.001] and the Egger’s test found virtual publication bias [p 0.001]. However, the trim-and-fill method failed to identify any potentially missing studies, indicating the publication bias did not affect the results.

Results and conclusions:
The investigators found in the meta-analysis a significantly reduced risk of 29% for breast cancer [summary OR = 0.71, 95% CI = 0.72 to 0.81, I2 = 82.6%] when comparing the highest to the lowest isoflavone dietary intake.
The result remained the same in sensitivity analysis.

The investigators found in subgroup analysis a statistically significant protective effect of 38% for isoflavone dietary intake on breast cancer in the case-control studies [OR = 0.62, 95% CI = 0.50 to 0.76], while no such effect was observed in the cohort studies [OR = 0.94, 95% CI = 0.86 to 1.02].

The investigators found in subgroup analysis a statistically significant protective effect of 38% for isoflavone dietary intake on breast cancer in Asian women [OR = 0.62, 95% CI = 0.52 to 0.74], while no such effect was observed in non-Asian women [OR = 0.97, 95% CI = 0.88 to 1.06].

The investigators found when the highest isoflavone dietary intake was lower than 10 mg/d, the negative relationship between isoflavone dietary intake and breast cancer disappeared [OR = 1.01, 95% CI = 0.94 to 1.08], whereas a statistically significant protective effect of 37% [OR = 0.63, 95% CI = 0.53 to 0.75] was found, when the highest isoflavone dietary intake was above 10 mg/d.
However, a statistically significant difference in the protective effect of isoflavone dietary intake on breast cancer was observed regardless of whether the women were pre- or postmenopausal and regardless of whether they were ER positive or negative.

The investigators concluded at least 10 mg/d isoflavone dietary intake is helpful in reducing breast cancer risk, particularly among Asian women.

Original title:
Isoflavone Consumption and Risk of Breast Cancer: An Updated Systematic Review with Meta-Analysis of Observational Studies by Yang J, Shen H,  […], Qin Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10224089/

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

Higher tissue levels of linoleic acid reduce prostate cancer

Objectives:
Findings on the association of dietary intake and tissue biomarkers of linoleic acid (LA) with the risk of prostate cancer are conflicting. Also, no meta-analysis summarized available findings in this regard. Therefore, this review article has been conducted.

Do higher tissue levels or higher dietary intakes of linoleic acid reduce prostate cancer risk in men?

Study design:
This review article included 15 prospective cohort studies with 511,622 participants with an age range of ≥18 years.

During the follow-up periods ranging from 5 to 21 years, 39,993 cases of prostate cancer, 5,929 cases of advanced prostate cancer and 1,661 cases of fatal prostate cancer were detected.

Results and conclusions:
The investigators found higher tissue levels of linoleic acid were significantly associated with a reduced risk of 14% for prostate cancer [RR = 0.86, 95% CI = 0.77 to 0.96].   
However, a significant association was not seen for advanced prostate cancer [RR = 0.86, 95% CI = 0.65 to 1.13].

The investigators found in dose-response analysis, each 5% increase in tissue levels of linoleic acid was significantly associated with a 14% lower risk of prostate cancer.

The investigators found no significant association between dietary intake of linoleic acid and risk of total [RR = 1.00, 95% CI = 0.97 to 1.04], advanced [RR = 0.98, 95% CI = 0.90 to 1.07] and fatal prostate cancer [RR = 0.97, 95% CI = 0.83 to 1.13].
Not significant because RR of 1 was found in the 95% CI of 0.83 to 1.13. RR of 1 means no risk/association.

The investigators concluded higher tissue levels of linoleic acid reduce prostate cancer in men.

Original title:
Dietary intake and biomarkers of linoleic acid and risk of prostate cancer in men: A systematic review and dose-response meta-analysis of prospective cohort studies by Yousefi M, Eshaghian N, […], Sadeghi O.

Link:
https://pubmed.ncbi.nlm.nih.gov/37077161/

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

Tissue levels of linoleic acid can be increased by eating foods that are high in linoleic acid and/or taking linoleic acid supplements.
 

Sunflower oil, corn oil, soybean oil, rice bran oil, canola (rapeseed) oil are high in linoleic acid.

 

 

500 mL/d orange juice consumption causally reduce bad cholesterol

Objectives:
Does orange juice consumption causally improve lipid profile?

Study design:
This review article included 9 RCTs with a total of 386 participants.
The mean age of the participants ranged from 36 to 56 years.
All the RCTs used a parallel study design.
The dosage of orange juice ranged from 250 to 1000 mL/d.
The duration of interventions ranged from 3 to 12 weeks.

Results and conclusions:
The investigators found orange juice consumption significantly reduced LDL cholesterol (bad cholesterol) levels [WMD  = -8.35 mg/dL, 95% CI = -15.43 to 1.26, p = 0.021, I2 = 45.8%, p = 0.055].

The investigators found in subgroup analysis based on the administered dosage, LDL cholesterol levels significantly decreased following the consumption of >500 mL/d orange juice [WMD = -9.85 mg/dL, 95% CI = -18.18 to -1.52, p = 0.02].
Moreover, the subgroup analyses based on the duration of intervention revealed that the effect of orange juice supplementation on LDL cholesterol levels was significantly greater in trials lasting ≤8 weeks [WMD = -7.91 mg/dL, 95% CI = -15.91 to -36, p = 0·04].
Also, studies conducted on both genders were observed to be significantly more likely to reduce blood LDL-C levels [WMD = -12.61 mg/dL, 95% CI = -21.19 to -4.04, p = 0.004].

The investigators concluded that  at least 500 mL/d orange juice consumption causally reduce LDL cholesterol (bad cholesterol) levels.

Original title:
Orange juice intake and lipid profile: a systematic review and meta-analysis of randomised controlled trials by Amini MR, Sheikhhossein F, […], Askarpour M.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10052563/

Additional information of El Mondo:
Find more information/studies on orange juice consumption, cholesterol and cardiovasculair disease right here.
 

High blood vitamin B6 levels reduce colorectal cancer

Objectives:
Does a high dietary intake of vitamin B6 or a high blood PLP levels (vitamin B6 level in blood) reduce the risk of colorectal cancer?

Study design:
This review article included 20 cohort studies and 8 case-control studies.

Results and conclusions:
The investigators found higher dietary intake of vitamin B6 significantly reduced the risk of colorectal cancer with 20% [combined OR = 0.80, 95% CI = 0.68 to 0.94].

The investigators found higher blood PLP level significantly reduced the risk of colorectal cancer with 46% [combined OR = 0.54, 95% CI = 0.35 to 0.84].

The investigators found subgroup analysis revealed that higher dietary intake of vitamin B6 significantly reduced the risk of colorectal cancer in women with 21% [combined OR = 0.79, 95% CI = 0.65 to 0.96].

The investigators found subgroup analysis revealed that higher blood PLP level significantly reduced the risk of colorectal cancer in women with 59% [combined OR = 0.41, 95% CI = 0.30 to 0.57].

The investigators found subgroup analysis revealed that higher dietary intake of vitamin B6 significantly reduced the risk of colon cancer in men and women with 24% [combined OR = 0.76, 95% CI = 0.64 to 0.91].

The investigators found subgroup analysis revealed that higher blood PLP level significantly reduced the risk of colon cancer in men and women with 44% [combined OR = 0.56, 95% CI = 0.42 to 0.73].

The investigators concluded that higher dietary intake of vitamin B6 and higher blood PLP level (vitamin B6 level in blood) reduce colorectal cancer risk, particularly colon cancer.

Original title:
Association Between Vitamin B6 and the Risk of Colorectal Cancer: A Meta-analysis of Observational Studies by Lai J, Guo M, […], Li J.

Link:
https://pubmed.ncbi.nlm.nih.gov/36961108/

Additional information of El Mondo:
Find more information/studies on vitamin B6 and colorectal cancer right here.

Circulating concentration of vitamin B6 in blood can be increased by eating foods that are high in vitamin B6 and/or taking vitamin B6 supplements.
 

30g/d whole grains consumption reduce all-cause mortality

Objectives:
Although relationships between the intake of whole grains and refined grains and the incidence of cardiovascular disease (CVD) events and all-cause mortality have been investigated, the conclusions have been inconclusive. Therefore, this review article has been conducted.

Does consumption of whole grains reduce risk of stroke, coronary heart disease, heart  failure, cardiovascular disease and all-cause mortality?

Study design:
This review article included 68 prospective cohort studies (46 for whole grains and 22 for refined grains) with 1,624,407 participants.

The included studies had follow-up periods between 5.4 y and 26 y, with sample sizes varying from 535 to 461,047 participants.

Based on NOS, the mean score of the included studies was 7.74 for whole grains and 7.45 for refined grains.

Egger’s test and funnel plot did not indicate any publication bias for the relationships between 30g/d increases in whole grain consumption and the risk of stroke [p = 0.481], cardiovascular disease [p= 0.144] or all-cause mortality [p = 0.409].

The quality of meta-evidence for the association between whole grain consumption and risks of stroke, coronary heart disease, heart failure, cardiovascular disease and all-cause mortality was moderate, moderate, low, high and high, respectively.
The quality of evidence for refined grain was low.

Results and conclusions:
The investigators found a significantly reduced risk of 3% for stroke per 30-g increase in daily whole grain consumption [RR = 0.97, 95% CI = 0.96 to 0.99, I2 = 0%].

The investigators found a significantly reduced risk of 6% for coronary heart disease (CHD) per 30-g increase in daily whole grain consumption [RR = 0.94, 95% CI = 0.92 to 0.97, I2 = 54.4%].
Sensitivity analyses indicated that the result was stable.

The investigators found a significantly reduced risk of 8% for cardiovascular disease (CVD) per 30-g increase in daily whole grain consumption [RR = 0.92, 95% CI = 0.88 to 0.96, I2 = 82.9%].
Sensitivity analyses indicated that the result was stable.

The investigators found a significantly reduced risk of 6% for all-cause mortality per 30-g increase in daily whole grain consumption [RR = 0.94, 95% CI = 0.92 to 0.97, I2 = 89.8%].
Sensitivity analyses indicated that the result was stable.

The investigators found whole grain consumption was linearly associated with coronary heart disease [p nonlinearity = 0.231] and nonlinearly associated with cardiovascular disease [p nonlinearity = 0.002] and all-cause mortality [p nonlinearity = 0.001].

The investigators concluded that consumption of at least 30g/d whole grains reduce stroke, coronary heart disease, cardiovascular disease and all-cause mortality.

Original title:
Consumption of whole grains and refined grains and associated risk of cardiovascular disease events and all-cause mortality: a systematic review and dose-response meta-analysis of prospective cohort studies by Hu H, Zhao Y, […], Hu D.

Link:
https://www.sciencedirect.com/science/article/pii/S0002916522105186?via%3Dihub

Additional information of El Mondo:
Find more information/studies on whole grain consumption, cardiovasculair disease and stroke right here.

 

Dietary intake of 200-700 mg/day calcium reduces stroke among Asians

Objectives:
Prospective cohorts are inconsistent regarding the association between dietary calcium intake and the risk of stroke. Therefore, this review article has been conducted.

Does dietary intake of calcium reduce risk of stroke?

Study design:
This review article included 18 prospective cohort studies witth19,557 stroke cases (persons) among 882,181 participants.

Results and conclusions:
The investigators found a nonlinear association between calcium intake and risk of stroke [p nonlinearity 0.003].

The investigators found compared with the lowest value of zero assumed as the reference, dietary intake of 200 mg/day calcium significantly reduced stroke risk with 5% [95% CI = 0.92 to 0.98].
This protective effect was only found in Asian countries.

The investigators found compared with the lowest value of zero assumed as the reference, dietary intake of 300 mg/day calcium significantly reduced stroke risk with 6% [95% CI = 0.90 to 0.98].
This protective effect was only found in Asian countries.

The investigators found compared with the lowest value of zero assumed as the reference, dietary intake of 500 mg/day calcium significantly reduced stroke risk with 5% [95% CI = 0.90 to 0.99].
This protective effect was only found in Asian countries.

The investigators found no protective effect for stroke at dietary intake of 700 mg/day calcium or higher.

The investigators concluded dietary intake of 200-700 mg/day calcium reduces stroke risk among Asians.

Original title:
Dietary calcium intake and the risk of stroke: Meta-analysis of cohort studies by Wang ZM, Bu XX, […], Nie ZL.

Link:
https://pubmed.ncbi.nlm.nih.gov/36958976/

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

 

Higher choline dietary intake may reduce breast cancer

Objectives:
The associations between dietary intakes and circulating blood levels of methionine, choline or betaine and breast cancer risk remain currently unclear. Therefore, this review article has been conducted.

Do higher dietary intakes and circulating blood levels of methionine, choline or betaine reduce breast cancer risk?

Study design:
This review article included 8 prospective cohort studies and 10 case-control studies.

Results and conclusions:
The investigators found in case-control studies that higher dietary choline intake significantly reduced breast cancer risk with 62% [OR = 0.38, 95% CI = 0.16 to 0.86].
However, this reduced risk was not significant in prospective cohort studies [HR = 1.01, 95% CI = 0.92 to 1.12].

The investigators concluded that higher choline dietary intake may reduce breast cancer risk. May reduce because this reduced risk is not found in cohort studies.

Original title:
The association between dietary intakes of methionine, choline and betaine and breast cancer risk: A systematic review and meta-analysis by Van Puyvelde H, Dimou N, […], De Bacquer D.

Link:
https://pubmed.ncbi.nlm.nih.gov/36701983/

Additional information of El Mondo:
Find more information/studies on cohort studies/significantly, choline and breast cancer right here.

Green tea may causally improve risk factors of cardiovascular disease

Objectives:
Is there a causal relationship between drinking green tea and improving risk factors of cardiovascular disease, like cholesterol, fasting blood sugar, blood pressure, HbA1c, HOMA-IR?

Study design:
This review article included 55 RCTs with 63 effect sizes with 2,487 participants in the green tea group and 2,387 in the placebo group (group without green tea).

The participants’ mean age ranged between 18 and 68.7 years and the period of intervention ranged between 2 to 48 weeks.
Some of the studies enrolled only males or females and some of them included both genders.

TC, LDL, HDL, FBS, HbA1c and DBP-related evidence had moderate quality due to the serious inconsistency reasons. Additionally, it was shown that evidence regarding TG, fasting insulin, SBP and CRP had low quality due to serious imprecision and inconsistency reasons. The evidence relating to HOMA-IR was also downgraded to very low quality because of the serious inconsistency, imprecision and publication bias.

Results and conclusions:
The investigators found green tea supplementation significantly reduced total cholesterol levels (TC) [WMD = -7.62, 95% CI = -10.51 to -4.73, p ≤ 0.001, I2 = 90.9%].
This significantly reduced effect was also found if females or both males and females were included, the dosage of supplementation was less than 1,000 mg/d, the baseline BMI was between 25-29.9 kg/m2 and the baseline value of TC was more than 200 mg/dL.

The investigators found green tea supplementation significantly reduced LDL cholesterol levels (LDL-C) [WMD = -5.80, 95% CI = -8.30 to -3.30, p ≤ 0.001, I2 = 90.5%].
This significantly reduced effect was also found if males or both males and females were included, the baseline BMI was between 25-29.9 kg/m2 and participants were not affected by T2DM.

The investigators found green tea supplementation significantly reduced fasting blood sugar levels (FBS) [WMD = -1.67, 95% CI = -2.58 to -0.75, p ≤ 0.001, I2 = 72.2%].

This significantly reduced effect was also found when the baseline BMI of participants was between 25-29.9 kg/m2, female or both male and female were included, the duration of intervention was more than 12 weeks, the dosage of supplementation was less than 1,000 mg/d and baseline values of FBS were less than 100 mg/dL.

The investigators found green tea supplementation significantly reduced HbA1c levels [WMD = -0.15, 95% CI = -0.26 to -0.04, p = 0.008, I2 = 71.3%].
This significantly reduced effect was also found if the duration of intervention was ≤ 12 weeks, the dosage of supplementation was ≥ 1,000 mg/d, baseline values of HbA1c were less than 6.5%, male or both genders were involved and the baseline value of BMI was ≥ 30 kg/m2.

The investigators found green tea supplementation significantly reduced diastolic blood pressure (DBP) [WMD = -0.87, 95% CI = -1.45 to -0.29, p = 0.003, I2 = 92.4%].
This significantly reduced effect was also found if the duration of intervention was ≤ 12 weeks, the dosage of supplementation was less than 1,000 mg/d, baseline values of DBP were more than 80 mmHg and the baseline value of BMI was ≥ 30 kg/m2.

The investigators found green tea supplementation significantly increased HDL cholesterol levels (HDL-C) [WMD = 1.85, 95% CI = 0.87 to 2.84, p = 0.010, I2 = 94.4%].
This significantly increased effect was also found if females were included, the baseline BMI was lower more than 30 kg/m2, there was no past medical history of T2DM, the duration of intervention was more than 12 weeks, the dosage of supplementation was less than 1,000 mg/d and baseline values of HDL were more than 50 mg/dL.

The investigators found sensitivity analysis showed no significant difference in results with removing one single study for all considered cardiovascular risk factors including lipid profiles, glycemic indices, SBP and DBP and CRP.

The investigators concluded drinking ≤1,000 mg/d green tea may causally improve risk factors of cardiovascular disease. May improve because the RCTs are of low quality.

Original title:
The effects of green tea supplementation on cardiovascular risk factors: A systematic review and meta-analysis by Zamani M, Kelishadi MR, […], Asbaghi O.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9871939/

Additional information of El Mondo:
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Green tea causally lowers blood pressure in healthy individuals

Objectives:
Is there a causal relationship between drinking green tea and lowering blood pressure in healthy individuals?

Study design:
This review article included 9 RCTs with 345 healty individuals in the intervention group (group with green tea) and 335 healthy individuals in the control group (group without green tea).

The mean age of the individuals in the intervention group was 35.89 ± 8.52, while the mean age of the control group was 36.48 ± 7.68.
All studies clearly described allocation randomization, none had incomplete outcome data, and all used appropriate statistical analysis.
The completion rate of the consumption of green tea ranged from 85-100%.
No publication bias was observed in the studies.

Results and conclusions:
The investigators found combined results of the studies showed that green tea was effective in lowering systolic blood pressure in healthy individuals [MD = -2.99, 95% CI = -3.77 to -2.22, p 0.00001, I2 = 0%].

The investigators found combined results of the studies showed that green tea was effective in lowering diastolic blood pressure in healthy individuals [MD= -0.95, 95% CI = -1.62 to -0.27, p = 0.006, I2 = 0%]. 

The investigators concluded in healthy individuals, green tea supplementation reduces systolic blood pressure by 2.99 mmHg and diastolic blood pressure by 0.95 mmHg.

Original title:
Effect of Green Tea on Blood Pressure in Healthy Individuals: A Meta-Analysis by Ayaz EY, Dincer B and Mesci B.

Link:
https://pubmed.ncbi.nlm.nih.gov/36689359/

Additional information of El Mondo:
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20 g/day olive oil reduce all-cause mortality

Objectives:
Epidemiological studies have shown the preventive effects of olive oil consumption against cardiovascular events and all-cause deaths, but the results remain inconsistent. Therefore, this meta-analysis (review article) has been conducted.

Does higher olive oil consumption reduce the risk of cardiovascular disease and all-cause mortality?

Study design:
This review article included 13 prospective cohort studies.
These studies were published between 2003 and 2022, with follow-up intervals ranging from 4 to 28 years.
Most of studies collected the dietary data on olive oil intake based on food-frequency questionnaires and the outcome events were identified using International Classification of Diseases codes or other medical records.
All of the studies were assigned a NOS score of ≥7, indicating the evidence of high methodological quality.
There was no publication bias.

Results and conclusions:
The investigators found meta-analysis of 8 cohort studies (261,016 participants and 14,033 cardiovascular disease cases) showed versus lowest consumption of olive oil, high consumption of olive oil significantly reduced risk of cardiovascular disease with 15% [pooled RR = 0.85, 95% CI = 0.77 to 0.93, p 0.001, I2 = 41%, p = 0.107].
Subgroup analyses showed no significant differences between strata of study region, sample size, follow-up duration, sex and olive oil type.
The combined risk estimate of cardiovascular disease was not altered in the sensitivity analysis by omitting each study one at a time.

The investigators found meta-analysis of 11 cohort studies (713,000 participants and 173,817 deaths) showed versus lowest consumption of olive oil, high consumption of olive oil significantly reduced risk of all-cause mortality with 17% [pooled RR = 0.83, 95% CI = 0.77 to 0.90, p 0.001, I2 = 93%, p 0.001].
Excluding each report in sequence had no influence on the pooled result.
The combined RRs were similar between subsets stratified by the aforementioned features.

The investigators found in dose-response meta-analysis, a significantly reduced risk of 4% for cardiovascular disease per 5-g/day increase in olive oil intake [RR = 0.96, 95% CI = 0.93 to 0.99, p = 0.005].

The investigators found in dose-response meta-analysis, a significantly reduced risk of 4% for all-cause mortality per 5-g/day increase in olive oil intake [RR = 0.96, 95% CI = 0.95 to 0.96, p 0.001].

The investigators found non-linear associations of olive oil intake with cardiovascular disease and all-cause mortality [both p for non-linearity 0.001], with little additional or no risk reduction observed beyond the consumption of approximately 20 g/day.

The investigators concluded that olive oil consumption reduces the risk of cardiovascular disease and all-cause mortality. Such benefits seem to be obtained with an intake of olive oil up to 20 g/day. These results support the current dietary recommendations to increase the intake of olive oil instead of other fats for improving human health and longevity. Future prospective studies are required to further depict the dose-dependent cardiovascular and survival effects in relation to olive oil consumption.

Original title:
Olive oil consumption and risk of cardiovascular disease and all-cause mortality: A meta-analysis of prospective cohort studies by Xia M, Zhong Y, [...], Qian C.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9623257/

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25-200 g/d peanuts may causally reduce total cholesterol levels

Objectives:
Although numerous studies have reported the protective effect of nut consumption on cardiovascular risk, evidence for the role of peanuts in maintaining cardiometabolic health is inconclusive. Therefore, this meta-analysis (review article) has been conducted.

Does a high consumption of peanuts improve causally cardiovascular risk factors, such as cholesterol levels and LDL/HDL ratio?

Study design:
This review article included 10 RCTs (8 parallel RCTs and 3 crossover RCTs) with a total of 643 participants (316 males and 327 females) aged between 18 and 84 years from Asia, North America, Europa, South America and Australia.

The administered doses of peanuts ranged between 25 and 200 g/d, with follow-up periods of 2-24 weeks.

The strength of evidence varied from very low to moderate, depending on the outcomes.

Results and conclusions:
The investigators found meta-analysis of clinical trials revealed that peanut consumption was significantly associated with a decrease in triglycerides levels compared to the control interventions [MD = -0.13, 95% CI = -0.20 to -0.07, p 0.0001].
This significant reduction was most acute in healthy subjects [MD = -0.13, 95% CI = -0.25 to -0.00, p = 0.04] and in those who consumed peanuts or peanut butter [MD = -0.14, 95% CI = -0.20 to -0.07, p 0.0001].

The investigators found meta-analysis of clinical trials revealed that peanut consumption signicantly lowered total cholesterol levels among healthy consumers [MD = -0.40, 95% CI = -0.71 to -0.09, p = 0.01].

The investigators found meta-analysis of clinical trials revealed that peanut consumption signicantly lowered total cholesterol levels among healthy consumers [MD = -0.40, 95% CI = -0.71 to -0.09, p = 0.01].

The investigators found meta-analysis of clinical trials revealed that peanut consumption resulted in a signicantly lower LDL-cholesterol/HDL-cholesterol ratio among healthy consumers [MD = -0.19, 95% CI = -0.36 to -0.01, p = 0.03].

The investigators found, however, individuals at high cardiometabolic risk experienced a significant increase in body weight after the peanut interventions [MD = 0.97, 95% CI = 0.54 to 1.41, p 0.0001], although not in body fat or body mass index.

The investigators found, according to the dose-response analyses, body weight increased slightly with higher doses of peanuts.

The investigators concluded that consumption of 25-200 g/d peanuts during 2-24 weeks may causally reduce triglycerides and total cholesterol levels. May reduce because the strength of evidence varied from very low to moderate. To gain more knowledge about the effects of peanut products on cardiometabolic risk factors, more carefully designed studies in larger populations are needed.

Original title:
Effect of Peanut Consumption on Cardiovascular Risk Factors: A Randomized Clinical Trial and Meta-Analysis by Parilli-Moser I, Hurtado-Barroso S, […], Lamuela-Raventós RM.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9011914/

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Brassica vegetables causally reduce total cholesterol

Objectives:
Previous studies on the effect of Brassica vegetables on blood glucose and lipid profile have reported inconclusive findings. Therefore, this meta-analysis (review article) has been conducted.

Does higher Brassica vegetables consumption improve causally cardiovascular risk factors (levels of triglycerides, cholesterol, fasting blood sugar and glycated haemoglobin)?

Study design:
This review article included 9 RCTs with a total of 548 participants.

Results and conclusions:
The investigators found pooled analysis indicated a significant reduction in total cholesterol (TC) [SMD = -0.28, 95% CI = -0.48 to -0.08, p = 0.005] following Brassica vegetables consumption.

The investigators found, overall, Brassica vegetables had no significant impact on serum levels of triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, fasting blood sugar and glycated hemoglobin.

The investigators concluded that consumption of Brassica vegetables causally reduces total cholesterol concentration. However, further high-quality studies are needed to firmly establish the clinical efficacy of these plants.

Original title:
The effect of Brassica vegetables on blood glucose levels and lipid profiles in adults. A systematic review and meta-analysis by Darand M, Alizadeh S and Mansourian M.

Link:
https://pubmed.ncbi.nlm.nih.gov/35412701/

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Brassica vegetables are broccoli, Brussels sprouts, cabbage, cauliflower, collard greens, kale and turnips.

Fruits and vegetables reduce endometrial cancer

Objectives:
Does consumption of fruits and vegetables reduce risk of endometrial cancer?

Study design:
This review article included  of 21 case-control studies and 6 cohort studies.

Results and conclusions:
The investigators found that vegetables consumption significantly reduced risk of endometrial cancer with 24% [pooled odds ratio [OR], relative risk [RR], hazard ratio [HR] = 0.76, 95% CI = 0.63 to 0.91].

The investigators found that cruciferous vegetables consumption significantly reduced risk of endometrial cancer with 19% [pooled OR = 0.81, 95% CI = 0.70 to 0.94].

The investigators found that dark green and yellow/orange combined vegetables consumption significantly reduced risk of endometrial cancer with 36% [pooled OR = 0.64, 95% CI = 0.42 to 0.97].

The investigators found that fruits consumption significantly reduced risk of endometrial cancer with 19% [pooled OR = 0.81, 95% CI = 0.70 to 0.92].

The investigators found these results were primarily based on studies of high quality and exhibited either by case-control only or a combination of case-control and cohort studies. Additionally, the results varied by geographic location, such as Western areas, the US and Italy.

The investigators concluded that consumption of fruits and vegetables has beneficial effects on endometrial cancer risk and that specific kinds of fruits and vegetables should be recommended differently due to their outstanding bioactive components.

Original title:
The influence of dietary vegetables and fruits on endometrial cancer risk: a meta-analysis of observational studies by Lu YT, Gunathilake M and Kim J.

Link:
https://pubmed.ncbi.nlm.nih.gov/36151331/

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Higher blood levels of alpha-linolenic acid reduce colorectal cancer

Objectives:
There is keen interest in better understanding the impacts of alpha-linolenic acid (ALA), a plant-derived n-3 fatty acid, in ameliorating the development of cancer. However, results of several prospective cohort studies present an inconsistent association between ALA intake and the incident colorectal cancer (CRC). Therefore, this review article has been conducted.

Does a high dietary intake of alpha-linolenic acid or a high level of alpha-linolenic acid in blood reduce risk of colorectal cancer (colon and rectal cancer)?

Study design:
This review article included 15 cohort studies (11 studies on diet and 5 studies on biomarkers including 4 on blood and 1 on adipose tissue) with 12,239 colorectal cancer cases occurred among 861,725 participants.
The mean follow-up was 9.3 years (ranging from 1 to 28 years).
Among all of the included studies, quality scores assessed by the 9-star NOS ranged from 7 to 9, with a median quality (≤7 stars) in 2 studies and high quality (≥ 8 stars) in 13 studies.

There was no publication bias.

Results and conclusions:
The investigators found higher level of alpha-linolenic acid in blood significantly reduced risk of colorectal cancer with 17% [summary RR = 0.83, 95% CI = 0.69 to 0.99, I2 = 0.0%].

The investigators found each 0.1% increase in the level of alpha-linolenic acid in blood was significantly associated with a 10% reduction in colorectal cancer risk [summary RR = 0.90, 95% CI = 0.80 to 0.99, I2 = 38.6%].

The investigators no significant dose-response association between dietary intake of alpha-linolenic acid and the incident colorectal cancer [p for non-linearity = 0.18; p for linearity = 0.24].

The investigators concluded that higher blood levels of alpha-linolenic acid reduce risk of colorectal cancer while higher dietary intake of alpha-linolenic acid does not reduce risk of colorectal cancer. Encouraging the consumption of foods rich in alpha-linolenic acid to improve its levels in the blood may potentially decrease the risk of colorectal cancer. Nevertheless, well-designed and large-scale cohort studies with biomarkers are still needed for better reconfirming the potential impacts of alpha-linolenic acid intake in the primary prevention of colorectal cancer.

Original title:
Association of Dietary Intake and Biomarker of α-Linolenic Acid With Incident Colorectal Cancer: A Dose-Response Meta-Analysis of Prospective Cohort Studies by Dai ZB, Ren XL, […], Xu L.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9301188/

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Higher dietary fiber intake improves causally cardiovascular risk factors

Objectives:
Although several meta-analyses have revealed the beneficial effects of dietary fiber intake on human health, some have reported inconsistent findings. Therefore, this umbrella meta-analysis (review article) has been conducted.

Does higher dietary fiber intake improve causally cardiovascular risk factors?

Study design:
This umbrella review article included 52 meta-analyses of RCTs with a total of 47,197 subjects.

Of the 52 meta-analyses, 35 used high-quality studies, 9 used studies with moderate quality, 7 did not report the quality of the included studies and 1 used low-quality studies.

The dosages and durations of dietary fiber intervention ranged from 3 g/day to 30 g/day (except for one study, which used guar gum at 15 mg/day and another study that used brown rice at 225 g/d) and 4 to 13 weeks, respectively.

Results and conclusions:
The investigators found, overall, higher dietary fiber intake significantly reduced:
-fasting plasma glucose [ES = -0.55, 95% CI = -0.73 to -0.38, p 0.001];
-fasting plasma insulin [ES = -1.22, 95% CI = -1.63 to -0.82, p 0.001];
-homeostasis model assessment of insulin resistance (HOMA-IR) [ES = -0.43, 95% CI = -0.60 to -0.27, p 0.001];

-glycosylated hemoglobin (HbA1c) [ES = -0.38, 95% CI = -0.50 to -0.26, p 0.001];
-serum level of total cholesterol [ES = -0.28, 95% CI = -0.39 to -0.16, p 0.001];
-low-density lipoprotein cholesterol (bad cholesterol) [ES = -0.25, 95% CI = -0.34 to -0.16, p 0.001];
-tumor necrosis factor-alpha serum levels [ES = -0.78, 95% CI = -1.39 to -0.16, p = 0.013];
-systolic blood pressure [ES = -1.72, 95% CI= -2.13 to -1.30, p 0.001];
-diastolic blood pressure [ES = -0.67, 95% CI = -0.96 to -0.37, p 0.001].
Significant means that there is an association with a 95% confidence.

The investigators found sensitivity analysis showed that the overall ESs did not change by excluding any individual meta-analysis.

The investigators found subgroup analysis revealed that the study population and type of dietary fiber could be partial sources of heterogeneity.

The investigators concluded that the present umbrella meta-analysis strongly support the beneficial effects of dietary fiber intake for the improvement cardiovascular risk factors, in particular cholesterol, fasting blood sugar, HbA1c, tumor necrosis factor-alpha and fasting insulin level, blood pressure and HOMA-IR value. However, it should be noted that the health-promoting effects of dietary fiber intake may differ between populations with different metabolic diseases.

Original title:
Associations between dietary fiber intake and cardiovascular risk factors: An umbrella review of meta-analyses of randomized controlled trials by Fu L, Zhang G, […], Tan M.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9511151/

Additional information of El Mondo:
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A high dietary fiber intake corresponds to a diet with at least 1.5 grams fiber per 100 kcal. Use the 7-points nutrition profile app to see if your daily diet contains 1.5 grams fiber per 100 kcal.
These products in the supermarket contain 1.5 grams fiber per 100 kcal.

An umbrella review article is a scientific article which only includes meta-analyses (also called review articles). The results found in an umbrella review article are more reliable than found in an individual review article.

One swallow does not make a summer. A famous Dutch saying that could not be any more obvious. Just because one single scientific study about a certain topic makes certain claims, it does not necessarily mean it is true. On the other hand, a review article (a collection of scientific studies on a certain topic) of randomized, placebo-controlled double blind clinical trials (RCTs) will answer the following question:
"Do taking dietary supplements make sense?" Yes for a positive conclusion and no for a negative conclusion.

One swallow does not make a summer. A famous Dutch saying that could not be any more obvious. Just because one single scientific study about a certain topic makes certain claims, it does not necessarily mean it is true. On the other hand, a review article (a collection of scientific studies on a certain topic) of (prospective) cohort studies or case-control studies will answer the following question:
"Should I change my diet?".

500 mg/d dietary flavonoid intake reduces cardiovascular disease, diabetes and hypertension

Objectives:
Several epidemiological studies have suggested that flavonoid intake is associated with a decreased risk of cardiometabolic disease. However, the results remained inconsistent and there is no dose-response meta-analysis for specific outcomes. Therefore, this review article has been conducted.

Is there a dose-response relationship between dietary flavonoid intake and reduced risk of cardiometabolic disease?

Study design:
This review article included 47 prospective cohort studies with a total of 1,346,676 participants and 127,507 persons with cardiometabolic disease.

Results and conclusions:
The investigators found for every 500 mg/d increase in dietary flavonoid intake a reduced risk of 7% [summary RR = 0.93, 95% CI = 0.88 to 0.98] for cardiovascular disease.
Significant means that there is an association with a 95% confidence.

The investigators found for every 500 mg/d increase in dietary flavonoid intake a reduced risk of 11% [summary RR = 0.89, 95% CI = 0.84 to 0.94] for diabetes.
Significant because summary RR of 1 was not found in the 95% CI of 0.84 to 0.94. Summary RR of 1 means no risk/association.

The investigators found for every 500 mg/d increase in dietary flavonoid intake a reduced risk of 3% [summary RR = 0.97, 95% CI = 0.94 to 0.99] for hypertension.
Significantly means it can be said with a 95% confidence that every 500 mg/d increase in dietary flavonoid intake really reduced risk of hypertension with 3%.

The investigators found a linearity dose-response association between total dietary flavonoid intake and cardiovascular disease [p nonlinearity = 0.541] and diabetes [p nonlinearity = 0.077].

The investigators concluded that a higher level of dietary flavonoid intake, at least 500 mg/d  is beneficial for the prevention of cardiometabolic diseases, particularly cardiovascular disease, diabetes and hypertension.

Original title:
Total dietary flavonoid intake and risk of cardiometabolic diseases: A dose-response meta-analysis of prospective cohort studies by Li T, Zhao Y, […], Liu J.

Link:
https://pubmed.ncbi.nlm.nih.gov/36148848/

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Cardiometabolic diseases are a group of common but often preventable conditions including heart attack, stroke, diabetes, insulin resistance and non-alcoholic fatty liver disease.

Serum vitamin D concentrations between 40 and 75 nmol/L reduce hypertension in adult

Objectives:
Findings of observational studies that evaluated the association of serum vitamin D status and high blood pressure were contradictory. Therefore, this review article has been conducted.

Does a high serum vitamin D concentration reduce risk of hypertension in the adult population?

Study design:
This review article included 10 prospective cohort, 1 nested case-control study and 59 cross-sectional studies.
Overall 66,757 and 260,944 participants were included in cohort and cross-sectional studies, respectively.
Among cohort studies, the NOS scores were between 6 and 9.
Among cross-sectional studies, the NOS scores ranged between 4 and 10.
There was no publication bias.

Results and conclusions:
The investigators found in the pooled analysis of cohort studies (66,757 participants) a 16% significant decrease in risk of hypertension in participants who had a high level of serum vitamin D compared with those with low level [pooled RR = 0.84, 95% CI = 0.73 to 0.96, I2 = 64%, p = 0.001].
Sensitivity analysis showed that excluding each stuy had no significant effect on pooled RR.

The investigators found combining effect sizes of 10 cohort studies involving a total of 63,602 individuals and 25,019 cases of hypertension showed that each 25 nmol/L increase in serum vitamin D level resulted in a 5% reduction in risk of hypertension [RR = 0.95, 95% CI = 0.90 to 1.00].
Also, a significant non-linear association between serum vitamin D levels and hypertension was observed [p non-inearity 0.001].
A reduction trend in risk of hypertension was observed for serum vitamin D levels between 45 and 70 nmol/L, although for higher vitamin D levels the risk did not decrease anymore and eventually started increasing.

The investigators found meta-analysis of cross-sectional studies showed that highest level of vitamin D in comparison to the lowest level was associated with a 16% significant decrease in risk of hypertension [OR overall = 0.86, 95% CI = 0.79 to 0.90, I2 = 67.5%, p 0.001].
Sensitivity analysis determined that the exclusion of each study did not significantly affect the overall estimate.

The investigators found combining effect sizes of 30 cross-sectional studies involving a total of 139,685 individuals and 40,178 cases of hypertension showed that each 25 nmol/L increase in serum vitamin D level resulted in a 6% reduction in risk of hypertension [OR = 0.94, 95% CI = 0.90 to 0.99].  

Also, a significant non-linear association between serum vitamin D levels and hypertension was seen [p non-linearity 0.001].
A reduction trend in risk of hypertension was observed for serum vitamin D levels between 40 and 75 nmol/L, although higher vitamin D levels did not reduce odds of hypertension.

The investigators concluded that serum vitamin D concentrations between 40 and 75 nmol/L reduce risk of hypertension in the adult population, in both prospective cohort and cross-sectional studies.

Original title:
Serum Vitamin D Levels in Relation to Hypertension and Pre-hypertension in Adults: A Systematic Review and Dose-Response Meta-Analysis of Epidemiologic Studies by Mokhtari E, Hajhashemy Z and Saneei P.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8961407/

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Unsaturated fatty acids improve absorption of carotenoids

Objectives:
Dietary fats are one of the well-known stimulators of carotenoid absorption, but the effects of the quantity and the type of dietary fats on carotenoid absorption have not yet been studied systematically. Therefore, this review article has been conducted.

Do dietary fats improve the absorption of carotenoids?

Study design:
This review article included a total of 27 in vitro studies and 12 RCTs.

Results and conclusions:
The investigators found meta-regression of in vitro studies showed that the bioaccessibility of carotenoids, except for lycopene, was positively associated with the concentration of dietary fats.

The investigators found meta-analysis of RCTs showed that the bioavailability of carotenoids was enhanced when a higher quantity of dietary fats was co-consumed.

The investigators found, moreover, fats rich in unsaturated fatty acids resulted in greater improvement in carotenoid bioavailability [SMD = 0.90, 95% CI = 0.69 to 1.11] as compared with fats rich in saturated fatty acids [SMD = 0.27, 95% CI = 0.08 to 0.47].

The investigators concluded that co-consuming dietary fats, particularly those rich in unsaturated fatty acids, with carotenoid-rich foods can improve the absorption of carotenoids.

Original title:
Effects of dietary fats on the bioaccessibility and bioavailability of carotenoids: a systematic review and meta-analysis of in vitro studies and randomized controlled trials by Yao Y, Tan P and Kim JE.

Link:
https://pubmed.ncbi.nlm.nih.gov/34897461/

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High folate dietary intake reduces colon cancer in people with medium or high alcohol consumption

Objectives:
Colorectal cancer is one of the most commonly diagnosed and deadly cancers worldwide. Epidemiological studies on the relationship between folate intake and the risk of colorectal cancer have reported inconsistent findings since folate fortification in the USA. Therefore, this review article has been conducted.

Does a high folate (folic acid) ietary intake reduce risk of colorectal cancer (colon and rectal cancer)?

Study design:
This review article included 24 cohort studies involving 6,165,894 individuals, of which 37,280 persons with colorectal cancer.

Results and conclusions:
The investigators found compared with the lowest dietary intake, the highest folate dietary intake significantly reduced risk of colorectal cancer with 12% [combined relative risk (RR) = 0.88, 95% CI = 0.83 to 0.92, p = 0.0004].
Significantly means that there is an association with a 95% confidence.

The investigators found compared with the lowest dietary intake, the highest folate dietary intake significantly reduced risk of colorectal cancer with 3% among persons witih medium alcohol consumption [RR = 0.97, 95% CI = 0.96 to 0.99, p = 0.008].
Significantly because RR of 1 was not found in the 95% CI of 0.96 to 0.99. RR of 1 means no risk/association.

The investigators found compared with the lowest dietary intake, the highest folate dietary intake significantly reduced risk of colorectal cancer with 5% among persons witih high alcohol consumption [RR = 0.95, 95% CI = 0.92 to 0.97, p = 0.003].

The investigators found compared with the lowest dietary intake, the highest folate dietary intake did not reduce risk of colorectal cancer among non-drinkers [RR = 1.00, 95% CI = 0.98 to 1.02, p = 0.827].

The investigators found compared with the lowest dietary intake, the highest folate dietary intake significantly reduced risk of colon cancer with 14% [RR = 0.86, 95% CI = 0.81 to 0.92, p = 0.0004].
Significantly because the calculated p-value of 0.0004 was less than the p-value of 0.05.

The investigators found compared with the lowest dietary intake, the highest folate dietary intake did not reduce risk of rectal cancer [RR = 0.92, 95% CI = 0.84 to 1.02, p = 0.112].

The investigators found compared with the lowest dietary intake, the highest folate dietary intake significantly reduced risk of colorectal cancer in USA and Europe but not in other regions.

The investigators concluded that high folate dietary intake reduces risk of colon cancer, particularly in people with medium or high alcohol consumption, but it still needs to be further confirmed.

Original title:
Folate intake and risk of colorectal cancer: a systematic review and up-to-date meta-analysis of prospective studies by Fu H, He J, […], Chang H.

Link:
https://pubmed.ncbi.nlm.nih.gov/35579178/

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Colorectal cancer starts in the colon or the rectum. These cancers can also be called colon cancer or rectal cancer, depending on where they start.

Higher dietary intake of processed meat increases hepatocellular carcinoma

Objectives:
The association between meat intake and hepatocellular carcinoma (HCC) risk is still unclear. Therefore, this review article has been conducted.

Does a higher dietary intake of meat increases the risk of hepatocellular carcinoma?

Study design:
This review article included 17 observational studies involving 2,915,680 participants, of which 4,953 cases of hepatocellular carcinoma.

10 studies reported red meat intake, 9 reported white meat intake, 9 reported fish intake, 7 reported processed meat intake and 5 reported total meat intake.

Results and conclusions:
The investigators found results showed that the consumption of red meat [relative risk = 1.04, 95% CI = 0.91 to 1.18, I2 = 50.50%, p = 0.033] and total meat intake [relative risk = 1.01, 95% CI =  0.90 to 1.13, I2 = 15.50%, p = 0.316] were not significantly associated with risk of hepatocellular carcinoma.

The investigators found, however, a higher dietary intake of processed meat significantly increased the risk of hepatocellular carcinoma with 20% [relative risk = 1.20, 95% CI = 1.02 to 1.41, I2 = 26.30%, p = 0.228].
Significant because relative risk of 1 was not found in the 95% CI of 1.02 to 1.41. Relative risk of 1 means no risk/association.

The investigators found, in contrast, a higher dietary intake of white meat significantly decreased the risk of hepatocellular carcinoma with 24% [relative risk = 0.76, 95% CI = 0.63 to 0.92, I2 = 68.30%, p = 0.001].

The investigators found, in contrast, a higher dietary intake of fish significantly decreased the risk of hepatocellular carcinoma with 9% [relative risk = 0.91, 95% CI = 0.86 to 0.96, I2 = 40.90%, p = 0.095].

The investigators concluded that a higher dietary intake of processed meat increases the risk of hepatocellular carcinoma, while a higher dietary intake of both white meat and fish decrease the risk of hepatocellular carcinoma. Therefore, these findings suggest that dietary intervention may be an effective approach to preventing hepatocellular carcinoma. These need to be verified with further well-designed observational studies and experimental clinical research.  

Original title:
Meat Intake and the Risk of Hepatocellular Carcinoma: A Meta-Analysis of Observational Studies by Yu J, Liu Z, […], Chen W.

Link:
https://pubmed.ncbi.nlm.nih.gov/35583453/

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Processed meats are meats that have been preserved by smoking or salting, curing or adding chemical preservatives. They include deli meats, bacon and hot dogs.