Nutritional advice

Objectives:
Low- and middle-income countries (LMICs) are currently experiencing increasing cardiovascular disease (CVD) rates. Green leafy vegetables (GLV), which are abundant in these countries, are known to be particularly rich in cardioprotective nutrients. Therefore, this review article has been conducted.

Does green leafy vegetables consumption reduce cardiovascular disease?

Study design:
This review article included 17 cohort studies.

Results and conclusions:
The investigators found green leafy vegetables consumption significantly reduced incident cardiovascular disease events with 7% [pooled RR = 0.93, 95% CI = 0.92 to 0.95].

The investigators found in subgroup analyses that green leafy vegetables consumption significantly reduced incident cerebral infarction with 8% [RR = 0.92, 95% CI = 0.88 to 0.96].

The investigators found in subgroup analyses that green leafy vegetables consumption significantly reduced heart disease with 7% [RR = 0.93, 95% CI = 0.87 to 0.99].

The investigators found in subgroup analyses that green leafy vegetables consumption significantly reduced other cardiovascular disease events with 5% [RR = 0.95, 95% CI = 0.93 to 0.98].

The investigators concluded that green leafy vegetables consumption reduces incident cardiovascular disease, particularly incident cerebral infarction and heart disease. These findings are especially important in low- and middle-income countries where the burden of cardiovascular disease remains high.

Original title:
Dietary intakes of green leafy vegetables and incidence of cardiovascular diseases by Ojagbemi A, Okekunle AP, […], Owolabi M.

Link:
https://pubmed.ncbi.nlm.nih.gov/34128951/

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

The green leafy vegetables are:

arugula
beet greens
bok choy
cabbage
collard greens
endive
kale
microgreens
romaine lettuce
spinach
swiss chard
turnip greens
watercress

Objectives:
Does a high BMI increase liver cancer mortality and occurrence of primary liver cancer?

Study design:
This review article included 28 prospective cohort studies with 8,135,906 subjects, of which 6,059,561 subjects (persons) with primary liver cancer occurrence and 2,077,425 subjects with liver cancer-related mortality.

Results and conclusions:
The investigators found in the meta-analysis, that an increase in BMI significantly increased the occurrence of primary liver cancer with 69% [HR = 1.69, 95% CI = 1.50 to 1.90, I2 = 56%].
Significant means that there is an association with a 95% confidence.

The investigators found that a BMI>25 (overweight) significantly increased the occurrence of primary liver cancer with 36% [HR = 1.36, 95% CI = 1.02 to 1.81].
Significant because HR of 1 was not found in the 95% CI of 1.02 to 1.81. HR of 1 means no risk/association.

The investigators found that a BMI>30 (obesity) significantly increased the occurrence of primary liver cancer with 77% [HR = 1.77, 95% CI = 1.56 to 2.01].
Significantly means it can be said with a 95% confidence that a BMI>30 really increased the occurrence of primary liver cancer with 77%.

The investigators found that a BMI>35 significantly increased the occurrence of primary liver cancer with 208% [HR = 3.08, 95% CI = 1.21 to 7.86].

The investigators found that an increase in BMI significantly increased liver cancer-related mortality with 61% [HR = 1.61, 95% CI = 1.14 to 2.27].

The investigators concluded that high BMI increases liver cancer mortality and occurrence of primary liver cancer. Obesity (BMI>30) is an independent risk factor for the occurrence of and mortality from primary liver cancer.

Original title:
Obesity and the risk of primary liver cancer: A systematic review and meta-analysis by Sohn W, Lee S, [...], Yoon SK.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7820201/

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

Am I overweight?

Which products are suitable for persons with overweight?

Use the 7-points nutritional profile app to see if your daily eaten products are suitable for you if you are overweight.

Objectives:
The association of meat consumption with mortality and morbidity for non-communicable diseases has been extensively studied. However, the relation of white meat consumption with health outcomes remains controversial. Therefore, this review article has been conducted.

Does consumption of white meat reduce mortality and morbidity rate?

Study design:
This review article included 22 prospective cohort studies with 3,132,149 subjects.
11 studies (14 data-sets) reported data on all-cause mortality, 10 studies (15 datasets) on cardiovascular mortality and 10 studies (11 datasets) on non-fatal cardiovascular events.
The evaluation of methodological quality of each study showed a median NOS score of 6.

Funnel plot examination suggested the absence of publication bias and of small-study effect, confirmed by the Egger’s test for all-cause mortality.

Results and conclusions:
The investigators found the analysis of the 11 studies (14 datasets) on all-cause mortality showed a statistically significant lower mortality rate of 6% for subjects in the highest vs. lowest unprocessed white meat consumption category [OR = 0.94, 95% CI = 0.90 to 0.97, p 0.001, I2 = 95.6%, p 0.001].

The investigators found an overall neutral association between high unprocessed white meat consumption and cardiovascular mortality and morbidity.

The investigators concluded that consumption of unprocessed white meat reduces all-cause mortality.

Original title:
White Meat Consumption, All-Cause Mortality, and Cardiovascular Events: A Meta-Analysis of Prospective Cohort Studies by Lupoli R, Vitale M, […], Vaccaro O.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7924043/

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

Objectives:
Does carotenoid (like astaxanthin, lutein/zeaxanthin, β-cryptoxanthin and lycopene) supplementation have protective effects on inflammatory biomarkers (like C-reactive protein and interleukin-6)?

Study design:
This review article included 26 RCTs with 35 effect sizes.

Results and conclusions:
The investigators found carotenoid supplementation significantly reduced C-reactive protein (CRP) [WMD = -0.54 mg/L, 95% CI = -0.71 to -0.37, p 0.001].
Significantly because the calculated p-value of 0.001 was less than the p-value of 0.05.

The investigators found carotenoid supplementation significantly reduced interleukin-6 (IL-6) [WMD = -0.54 pg/mL, 95% CI = -1.01 to -0.06, p = 0.025].
Significant means that there is an association with a 95% confidence.

The investigators found in subgroup analyses that astaxanthin supplementation significantly reduced C-reactive protein (CRP) [WMD = -0.30 mg/L, 95% CI = -0.51 to -0.09, p = 0.005].

The investigators found in subgroup analyses that lutein/zeaxanthin supplementation significantly reduced C-reactive protein (CRP) [WMD = -0.30 mg/L, 95% CI = -0.45 to -0.15, p 0.001].

The investigators found in subgroup analyses that β-cryptoxanthin supplementation significantly reduced C-reactive protein (CRP) [WMD = -0.35 mg/L, 95% CI = -0.54 to -0.15, p 0.001].

The investigators found in subgroup analyses that lycopene supplementation significantly reduced interleukin-6 (IL-6) [WMD = -1.08 pg/mL, 95% CI = -2.03 to -0.12, p = 0.027].

The investigators concluded that carotenoid supplementation (like astaxanthin, lutein/zeaxanthin, β-cryptoxanthin and lycopene) has protective effects on inflammatory biomarkers.

Original title:
Carotenoids supplementation and inflammation: a systematic review and meta-analysis of randomized clinical trials by Hajizadeh-Sharafabad F, Zahabi ES, […], Alizadeh M.

Link:
https://pubmed.ncbi.nlm.nih.gov/33998846/

Additional information of El Mondo:
Find here more information/studies about review article/significant, carotenoid and inflammation.
 

Objectives:
Does coffee or tea consumption reduce the risk of glioma?

Study design:
This review article included 12 unique studies (cohort and case-control studies) comprising of 1,960,731 participants with 2,987 glioma cases.

Results and conclusions:
The investigators found in pooled analyses that higher tea consumption was significantly associated with a lower risk of 16% for glioma [RR = 0.84, 95% CI = 0.71 to 0.98, p = 0.030, I2 = 16.42%].

The investigators found in cohort studies that higher coffee consumption was significantly associated with a lower risk of 15% for glioma [RR = 0.85, 95% CI = 0.72 to 1.00, p = 0.046, I2 = 0%].

The investigators found in cohort studies that higher tea consumption was significantly associated with a lower risk of 19% for glioma [RR = 0.81, 95% CI = 0.70 to 0.93, p = 0.004, I2 = 0%].

The investigators found in dose-response meta-analysis that every one cup of coffee per day significantly decreased the risk of glioma by 3% [RR = 0.97, 95% CI = 0.94 to 0.99, p = 0.016, p non-linearity = 0.054]. 

The investigators found in dose-response meta-analysis that every one cup of tea per day significantly decreased the risk of glioma by 3% [RR = 0.97, 95% CI = 0.94 to 1.00, p = 0.048]. 

The investigators found meta-regression showed that the association between coffee and glioma was reduced by smoking [p = 0.029].

The investigators concluded both coffee (at least one cup of coffee per day) and tea consumption (at least one cup of tea per day) reduce the risk of glioma.

Original title:
Coffee and tea consumption and the risk of glioma: a systematic review and dose-response meta-analysis by Pranata R, Feraldho A, […], July J.

Link:
https://pubmed.ncbi.nlm.nih.gov/33750490/

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

Glioma is a type of tumor that occurs in the brain and spinal cord. About 33 percent of all brain tumors are gliomas, which originate in the glial cells that surround and support neurons in the brain, including astrocytes, oligodendrocytes and ependymal cells.
Gliomas can affect all ages, but they are most often seen in adults. Gliomas are slightly more likely to occur in men than in women and more common in Caucasians than in African Americans.

Objectives:
The associations of alcohol consumption and venous thromboembolism (VTE) have been investigated widely, but the conclusions were inconsistent. Therefore, this review article has been conducted.

Does alcohol intake decrease risk of venous thromboembolism?

Study design:
This review article included 14 cohort studies and 4 case-control studies.

Results and conclusions:
The investigators found, compared with non-drinkers, the risk of venous thromboembolism was significantly decreased with 7% [RR = 0.93, 95% CI = 0.88 to 0.99] for alcohol drinkers.

The investigators found, compared with no alcohol intake, the risk of venous thromboembolism was significantly decreased with 9% [RR = 0.91, 95% CI = 0.84 to 0.99] for low to moderate alcohol intake (0.1-14.0 drinks/week).

The investigators concluded that low to moderate alcohol intake (0.1-14.0 drinks/week) decreases risk of venous thromboembolism. However, precautions are needed when providing personal drinking advice considering the potential harm of alcohol. Further studies are warranted to determine whether moderate alcohol consumption has a causal role in venous thromboembolism.

Original title:
Meta-analysis of alcohol consumption and venous thromboembolism by Zhang X, Chen X, [...], Li K.

Link:
https://pubmed.ncbi.nlm.nih.gov/33824981/

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

Objectives:
Dyslipidemia/hyperlipidemia is recognized among the risk factors for lifestyle related diseases. A healthy diet, rich in vegetable oils such as rice bran oil (RBO), may aid to improve serum lipid levels. Therefore, this review article has been conducted.

Does rice bran oil decrease causally the levels of serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c) and triglyceride (TG) levels in adults?

Study design:
This review article included 8 eligible RCTs with 14 effect sizes.
The effect sizes were expressed as weighted mean difference (WMD) with 95% confidence intervals (CI).
 
Results and conclusions:
The investigators found that the consumption of rice bran oil significantly decreased serum
total cholesterol [WMD = -7.29 mg/dL, 95% CI = -11.32 to -3.25, p = 0.000];
LDL- cholesterol (bad cholesterol) [WMD = -7.62 mg/dL, 95% CI = -11.10 to -4.14, p = 0.000] and;
triglyceride [WMD = -9.19 mg/dL, 95% CI = -17.99 to -0.38, p = 0.041] levels in adults.
Significantly because the calculated p-value of = 0.041 was less than the p-value of 0.05.

The investigators concluded that the consumption of rice bran oil causally decreases serum
total cholesterol, LDL-cholesterol (bad cholesterol) and triglyceride levels in adults. Hence, it may play a role in reducing dyslipidemia/hyperlipidemia risk.

Original title:
The impact of rice bran oil consumption on the serum lipid profile in adults: a systematic review and meta-analysis of randomized controlled trials by Pourrajab B, Sohouli MH, […], Shidfar F.

Link:
https://pubmed.ncbi.nlm.nih.gov/33715544/

Additional information of El Mondo:
Find more information/studies on oil consumption, lowering cholesterol levels and cardiovascular disease right here.

Objectives:
Recently, it has been shown that coronavirus disease 2019 (COVID-19), which has caused a pandemic since December 2019, can be accompanied by some neurological disorders and therefore, this review article has been conducted.

What are the most prevalent neurological manifestations of COVID-19 infection?

Study design:
This review article included 26 observational studies and 31 case reports with a total of 6,597 COVID-19 patients.

Results and conclusions:   
The investigators found the most prevalent general symptoms were fever, cough and dyspnea with 84.6% [95% CI = 75.3 to 92.1, I2 = 98.7%], 61.3% [95% CI = 55.3 to 67.0, I2 = 94.6%] and 34.2% [95% CI = 25.6 to 43.4, I2 = 97.7%], respectively.

The investigators found neurological symptoms observed among COVID-19 patients were fatigue, gustatory dysfunction, anorexia, olfactory dysfunction, headache, dizziness and nausea with 42.9% [95% CI = 36.7 to 49.3, I2 = 92.8%], 35.4% [95% CI = 11.2 to 64.4, I2 = 99.2%], 28.9% [95% CI = 19.9 to 38.8, I2 = 96.3%], 25.3% [95% CI = 1.6 to 63.4, I2 = 99.6%], 10.1% [95% CI = 2.7 to 21.0, I2 = 99.1%], 6.7% [95% CI = 3.7 to 10.5, I2 = 87.5%] and 5.9% [95% CI = 3.1 to 9.5, I2 = 94.5%], respectively.

The investigators found the most prevalent neurological comorbidity in COVID-19 was cerebrovascular disease with 4.3% [95% CI = 2.7 to 6.3, I2 = 78.7%].

The investigators concluded the most prevalent neurological manifestations of COVID-19 include fatigue, gustatory dysfunction, anorexia, olfactory dysfunction, headache, dizziness and nausea. Cerebrovascular disorders can either act as a risk factor for poorer prognosis in COVID-19 patients or occur as a critical complication in these patients. Guillain-Barre syndrome, encephalitis and meningitis have also been reported as complications of COVID-19.

Original title:
Neurological Symptoms, Comorbidities, and Complications of COVID-19: A Literature Review and Meta-Analysis of Observational Studies by Vakili K, Mobina Fathi  M, […], Rezaei-Tavirani M.

Link:
https://pubmed.ncbi.nlm.nih.gov/34044408/

Additional information of El Mondo:
Find more information/studies on cerebrovascular disease and coronavirus right here.

Objectives:
Cohort studies report inconsistent associations between fish consumption, a major source of long-chain ω-3 fatty acids and risk of cardiovascular disease (CVD) and mortality. Whether the associations vary between those with and those without vascular disease is unknown. Therefore, this review article has been conducted.

Do the associations of fish consumption with risk of cardiovascular disease or of mortality differ between individuals with and individuals without vascular disease?

Study design:
This review article included 4 cohort studies from 58 countries with 191,558 participants with a mean (SD) age of 54.1 (8.0) years and 91,666 (47.9%) were male.
 
Results and conclusions:
The investigators found during 9.1 years of follow-up in PURE, compared with little or no fish intake (≤50 g/mo), an intake of 350 g/wk or more was not associated with risk of major cardiovascular disease [HR = 0.95, 95% CI = 0.86 to 1.04] or total mortality [HR = 0.96, 95% CI = 0.88 to 1.05].
Not associated because HR of 1 was found in the 95% CI of 0.86 to 1.04. HR of 1 means no risk/association.

The investigators found, by contrast, in the 3 cohorts of patients with vascular disease, the HR for risk of major cardiovascular disease [HR = 0.84, 95% CI = 0.73 to 0.96] and total mortality [HR = 0.82, 95% CI = 0.74 to 0.91] was lowest with dietary intakes of at least 175 g/wk (or approximately 2 servings/wk) compared with 50 g/mo or lower, with no further apparent decrease in HR with consumption of 350 g/wk or higher. 

The investigators found fish with higher amounts of ω-3 fatty acids (also called oily fish) were strongly associated with a lower risk of cardiovascular disease [HR = 0.94, 95% CI = 0.92 to 0.97 per 5-g increment of intake], whereas other fish were neutral (collected in 1 cohort of patients with vascular disease).
The association between fish intake and each outcome varied by cardiovascular disease status, with a lower risk found among patients with vascular disease but not in general populations [for major cardiovascular disease: I2 = 82.6%, p = 0.02 and for death: I2 = 90.8%, p = 0.001].

The investigators concluded that fish intake of 175-350g weekly is associated with lower risk of major cardiovascular disease and mortality among patients with prior cardiovascular disease but not in general populations. The consumption of fish (especially oily fish) should be evaluated in randomized trials of clinical outcomes among people with vascular disease.

Original title:
Associations of Fish Consumption With Risk of Cardiovascular Disease and Mortality Among Individuals With or Without Vascular Disease From 58 Countries by Mohan D, Mente A, […], Yusuf S.

Link:
https://pubmed.ncbi.nlm.nih.gov/33683310/

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

Objectives:
Soy has several beneficial effects on cardiovascular disease (CVD). However, results of clinical trial studies are equivocal. Therefore, this review article has been conducted.

Is there a causal relationship between soy consumption and improvements in blood pressure in adults?

Study design:
This review article included 17 RCTs.

Results and conclusions:
The investigators found pooled effects from 17 studies revealed a significant improvement in systolic blood pressure (SBP) [MD = -1.64, 95% CI = -3.25 to -0.04 mmHg, I2 = 50.5%] following soy consumption, in comparison with controls (groups without soy consumption).

The investigators found pooled effects from 17 studies revealed a significant improvement in diastolic blood pressure (DBP) [MD = -1.21, 95% CI = -2.29 to -0.12 mmHg, I2 = 50.7%] following soy consumption, in comparison with controls (groups without soy consumption).

The investigators found subgroup analysis demonstrated a reduction in both systolic blood pressure and diastolic blood pressure in younger participants with lower baseline blood pressure and intervention durations of 16 weeks.

The investigators concluded there is a causal relationship between soy consumption and improvements in blood pressure in adults.

Original title:
Soy intake is associated with lowering blood pressure in adults: A systematic review and meta-analysis of randomized double-blind placebo-controlled trials by Mosallanezhad Z, Ranjbar S, […], Jalali M.

Link:
https://pubmed.ncbi.nlm.nih.gov/33636295/

Additional information of El Mondo:
Find more information/studies on soy consumption and lowering blood presurre right here.

Objectives:
Evidence suggests that vitamin C supplementation could be a potential therapy in type 2 diabetes. However, its effectiveness and evidence quality require further evaluation. Therefore, this review article has been conducted.

Does oral vitamin C supplementation improve glycemic control, cardiovascular risk factors and oxidative stress in people with type 2 diabetes?

Study design:
This review article included 28 RCTs with in totaal 1,574 participants.
RCTs were predominantly short term (6 months) with a small number of participants (n 100).

Results and conclusions:
The investigators found that oral vitamin C supplementation significantly reduced systolic blood pressure [mean difference = -6.27, 95% CI = -9.60 to -2.96 mmHg, p = 0.0002, with moderate evidence certainty].

The investigators found that oral vitamin C supplementation significantly reduced HbA1c levels [mean difference = -0.54%, 95% CI = -0.90 to -0.17, p = 0.004, with very low evidence certainty].

The investigators found that oral vitamin C supplementation significantly reduced diastolic blood pressure [mean difference = -3.77, 95% CI = -6.13 to -1.42 mmHg, p = 0.002, with very low evidence certainty].

The investigators concluded evidence from short-term RCTs suggests that oral vitamin C supplementation may improve glycemic control and blood pressure in people with type 2 diabetes. However, vitamin C supplementation cannot currently be recommended as a therapy until larger, long-term and high-quality trials confirm these findings.

Original title:
Effects of Vitamin C Supplementation on Glycemic Control and Cardiovascular Risk Factors in People With Type 2 Diabetes: A GRADE-Assessed Systematic Review and Meta-analysis of Randomized Controlled Trials by Mason SA, Keske MA and Wadley GD.

Link:
https://pubmed.ncbi.nlm.nih.gov/33472962/

Additional information of El Mondo:
Find more information/studies on vitamin C, reducing blood pressure and diabetes right here.
 

Objectives:
Is fish or omega-3 fatty acids consumption associated with a lower risk of venous thromboembolism (VTE)?

Study design:
This review article included 8 prospective cohort studies.
The follow-up duration ranged from 0.5 to 19 years.
The sample size ranged from 595 to 80,263.
The fish and omega-3 fatty acids consumption was assessed by food-frequency questionnaire (FFQ) in all studies.
The diagnosis of venous thromboembolism was obtained in registered medical record (imaging or autopsy) and food was considered as the source of omega-3 fatty acids in all included studies.
Begg's rank-correlation test showed no evidence of publication bias.

Results and conclusions:
The investigators found the overall multi-variable adjusted RR showed no significant relationship between fish consumption and the risk of venous thromboembolism [RR = 1.02, 95% CI = 0.93 to 1.11, p = 0.709, I2 = 33%, p = 0.176].
The sensitivity analysis showed only minimal changes in magnitude of the pooled RR when any study was excluded from the meta-analysis, suggesting that no individual study had excessive influence on these robust aggregate results.

The investigators found the overall multi-variable adjusted RR showed that omega-3 fatty acids consumption was associated with a lower risk of 11% for venous thromboembolism [RR = 0.89, 95% CI = 0.80 to 0.98, p = 0.024, I2 = 0%, p = 0.469].
The sensitivity analysis showed only minimal changes in magnitude of the pooled RR when any study was excluded from the meta-analysis, suggesting that no individual study had excessive influence on these robust aggregate results.

The investigators found the overall multi-variable adjusted RR showed that omega-3 fatty acids consumption was associated with a lower risk of 55% for recurrent venous thromboembolism [RR = 0.45, 95% CI = 0.25 to 0.81, p = 0.008, I2 = 26.4%, p = 0.244].
Significant because RR of 1 was not found in the 95% CI of 0.25 to 0.81. RR of 1 means no risk/association.

The investigators concluded omega-3 fatty acids consumption is associated with a lower risk of both venous thromboembolism and recurrent venous thromboembolism.

Original title:
Associations of Fish and Omega-3 Fatty Acids Consumption With the Risk of Venous Thromboembolism. A Meta-Analysis of Prospective Cohort Studies by Zhang Y, Ding J, [...],Li Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7793732/

Additional information of El Mondo:
Find more information/studies on omega-3 and fish consumption and cardiovascular diseases right here.

Venous thromboembolism (VTE) is a condition in which a blood clot forms most often in the deep veins of the leg, groin or arm (known as deep vein thrombosis, DVT) and travels in the circulation, lodging in the lungs (known as pulmonary embolism, PE).

Objectives:
Many studies have investigated the association between dietary iron intake and death due to cardiovascular disease (CVD), but the results were inconsistent. Therefore, this review article has been conducted.

Does dietary iron intake increase risk of death due to cardiovascular disease (cardiovascular disease mortality)?

Study design:
This review article included 19 prospective cohort studies including 720,427 participants (46,045 deaths due to cardiovascular disease).

Results and conclusions:
The investigators found when comparing the highest versus lowest level, the highest level of dietary heme iron intake significantly increased risk of death due to cardiovascular disease with 19% [pooled RR = 1.19, 95% CI = 1.01-1.39].

The investigators found every 1-mg/day increase in dietary heme iron intake significantly increased risk of death due to cardiovascular disease with 25% [pooled RR = 1.25, 95% CI = 1.17-1.33].

The investigators found every 1-mg/day increase in dietary heme iron intake significantly increased risk of death due to stroke with 17% [pooled RR = 1.17, 95% CI = 1.04-1.32].

The investigators found the association between dietary iron intake and cardiovascular disease mortality was linear [p nonlinearity > 0.05].

The investigators concluded higher dietary intake of heme iron (at least 1-mg/day) is associated with a greater risk of cardiovascular disease mortality. Therefore, reducing consumption of heme iron may help to prevent premature death due to cardiovascular disease.

Original title:
Dietary iron intake and risk of death due to cardiovascular diseases: A systematic review and dose-response meta-analysis of prospective cohort studies by Han M, Guan L, […], Lu J.

Link:
https://pubmed.ncbi.nlm.nih.gov/32674239/

Additional information of El Mondo:
Find more information/studies on significant/cohort studies, iron consumption and cardiovascular disease right here.

Food items of heme iron are:

• Beef or chicken liver
• Beef
• Canned light tuna
• Canned sardines
• Organ meats
• Oysters, clams, mussels
• Poultry

Objectives:
Previous studies lack consistent conclusions as to whether astaxanthin is actually linked to various health benefits as claimed. Therefore, this review article has been conducted.

Is there a causal relationship between astaxanthin consumption and improvements in risk factors for diabetes or cardiovascular disease?

Study design:
This review article included 14 RCTs.

Results and conclusions:
The investigators found that astaxanthin consumption was not associated with FBS, HbA1c, TC, LDL-C, TG, BMI, BW, DBP and SBP.

The investigators found that astaxanthin consumption was associated with an increase in HDL cholesterol levels [WMD = 1.473 mg/dL, 95% CI = 0.319 to 2.627, p = 0.012].

The investigators found that astaxanthin consumption during ≥12 weeks was associated with a decrease in CRP levels [WMD = -0.528 mg/L, 95% CI = -0.990 to -0.066].

The investigators found that >12 mg/day astaxanthin consumption was associated with a decrease in CRP levels [WMD = -0.389 mg/dL, 95% CI = -0.596 to -0.183].

The investigators concluded that astaxanthin consumption is causally associated with an increase in HDL cholesterol levels (good cholesterol) and a decrease in CRP levels for >12 mg/day astaxanthin consumption during ≥12 weeks. Significant associations are not observed for other outcomes.

Original title:
The effects of astaxanthin supplementation on obesity, blood pressure, CRP, glycemic biomarkers, and lipid profile: A meta-analysis of randomized controlled trials by Xia W, Tang N, [...], Zhu Y.

Link:
https://pubmed.ncbi.nlm.nih.gov/32755613/

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Find here more information/studies about astaxanthin consumption and cholestrerol.

Objectives:
Dyslipidemia is a common metabolic disease worldwide and also an important predisposing factor for cardiovascular diseases (CVDs). Coffee is loved by people all over the world; however, the association between coffee consumption and blood lipids has yielded inconsistent results. Therefore, this review article has been conducted.

Is there a causal relationship between coffee consumption and dyslipidemia?

Study design:
This review article included 12 RCTs.

Results and conclusions:
The investigators found pooled results showed that coffee consumption significantly increased total cholesterol (TC) levels [WMD = 0.21 mmol/L, 95% CI = 0.04 to 0.39, p = 0.017].  
Significant means that there is an association with a 95% confidence.

The investigators found pooled results showed that coffee consumption significantly increased triglyceride (TG) levels [WMD = 0.12 mmol/L, 95% CI = 0.03 to 0.20, p = 0.006].  
Significant because the calculated p-value of 0.006 was less than the p-value of 0.05.

The investigators found pooled results showed that coffee consumption significantly increased LDL cholesterol (bad cholesterol) levels [WMD = 0.14 mmol/L, 95% CI = 0.05 to 0.24, p = 0.003].  

The investigators found pooled results showed that coffee consumption had no significant effect on HDL cholesterol (good cholesterol) levels [WMD = -0.01 mmol/L, 95% CI = -0.06 to 0.04, p = 0.707].
No significant means that there is no association with a 95% confidence.

The investigators found dose-response analysis results revealed significant positive nonlinear associations between coffee consumption and the increase in total cholesterol, LDL cholesterol and triglyceride levels.

The investigators concluded that coffee consumption is associated with an elevated risk for dyslipidemia and cardiovascular diseases. So a reasonable habit of coffee consumption (3 cups/d) is essential for the prevention of dyslipidemia.  

Original title:
Effect of coffee consumption on dyslipidemia: A meta-analysis of randomized controlled trials by Du Y, Lv Y, […], Luo Q.

Link:
https://pubmed.ncbi.nlm.nih.gov/33239163/

Additional information of El Mondo:
Find more information/studies on significant/RCTs/causal relationship, coffee consumption, lowering cholesterol levels and cardiovascular disease right here.

Dyslipidemia is elevation of plasma cholesterol, triglycerides (TGs), or both, or a low HDL cholesterol (good cholesterol) level that contributes to the development of atherosclerosis. Atherosclerosis is the main underlying cause of cardiovascular disease (CVD).

Objectives:
Dietary sodium intake has received considerable attention as a potential risk factor of cardiovascular disease. However, evidence on the dose-response association between dietary sodium intake and cardiovascular disease risk is unclear. Therefore, this review article has been conducted.

Is there a dose-response association between dietary sodium intake and cardiovascular disease (CVD) risk?

Study design:
This review article included 36 cohort studies with a total of 616,905 participants.
The duration of follow-up ranged from 2.7 years to 29 years.

For dietary sodium intake assessment, 18 of the studies were based on twenty-four urinary excretion, 7 used food frequency questionnaires, 8 used 24 h dietary recall, 2 used dietary records; 1 used a self-administered questionnaire and 1 used single spot urine sodium excretion.
The daily dietary sodium intake ranged from 1.0 to 7.5 g.

The mean score (± standard deviation) for the quality of the included studies was 8.0 ± 1.0 according to the Newcastle-Ottawa Scale.

Results and conclusions:
The investigators found compared with individuals with low sodium intake, individuals with high sodium intake had an 19%-higher adjusted risk of cardiovascular disease [rate ratio = 1.19, 95% CI = 1.08 to 1.30].

The investigators found in dose-response meta-analysis that the risk of cardiovascular disease significantly increased by 6% when 1 g dose of sodium was ingested [rate ratio = 1.06, 95% CI = 1.01 to 1.11].

The investigators concluded that high sodium intake is an important risk factor of cardiovascular disease (CVD) and in dose-response meta-analysis, every 1 g of dietary sodium intake increases the risk of cardiovascular disease by 6%.

Original title:
Dietary Sodium Intake and Risk of Cardiovascular Disease: A Systematic Review and Dose-Response Meta-Analysis by Wang YJ, Yeh TL, [...], Chien KL.

Link:
https://www.mdpi.com/2072-6643/12/10/2934/htm

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1 gram salt (sodium chloride) = 0.4 gram sodium.

Objectives:
Epidemiological studies on the impact of fish consumption on coronary heart disease (CHD) incidence have shown inconsistent results. Therefore, this review article has been conducted.

Does dietary intake of fish reduce coronary heart disease incidence and mortality?

Study design:
This review article included 40 prospective cohort studies (22 studies investigated the association between fish consumption and coronary heart disease incidence (28,261 persons with coronary heart disease and 918,783 participants) and 27 studies investigated the association between fish consumption and coronary heart disease mortality (10,568 events and 1,139,553 participants)).

No evidence of publication bias was found.

Results and conclusions:
The investigators found higher fish consumption was significantly associated with a 9%-lower coronary heart disease risk [RR = 0.91, 95% CI = 0.84 to 0.97, I2 = 47.4%].

The investigators found a significant correlation between fish consumption and coronary heart disease risk in the female subgroup [RR = 0.85, 95% CI = 0.78 to 0.92, I2 = 5.6%], the subgroup with a follow-up period of ≥10 years [RR = 0.91, 95% CI = 0.84 to 0.99, I2 = 51.5%] and the subgroup with an article quality of ≥7 points [RR = 0.90, 95% CI = 0.83 to 0.98, I2 = 50.6%].
However, it was not found in the male subgroup, the subgroup with a follow-up period of 10 years and the subgroup with an article quality of 7 points.

The investigators found higher fish intake was significantly associated with a 15%-lower coronary heart disease mortality risk [RR = 0.85, 95% CI = 0.77 to 0.94, I2 = 51.3%].

The investigators found the summary results did not change significantly in sensitivity analysis.

The investigators found dose-response analysis showed that the coronary heart disease incidence and mortality were reduced by 4%, respectively, with a 20 g/day increment in fish consumption.

The investigators concluded that a higher dietary intake of fish reduces coronary heart disease incidence and mortality. This finding has important public health implications in terms of the prevention of coronary heart disease. Since most of the research was conducted in male groups and Western countries, further research needs to be performed in female groups and other regions.

Original title:
Fish Consumption and Coronary Heart Disease: A Meta-Analysis by Zhang B, Xiong K, […], Ma A.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7468748

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Find more information/studies/nutritional advices on fish consumption and coronary heart disease right here.

In practice, higher fish consumption means at least twice a week of fish consumption (150 grams of fish at a time).

Objectives:
Observational studies regarding the putative associations between dietary intake of homocysteine metabolism-related B-vitamins (vitamin B6, folate and vitamin B12) and stroke risk have yielded inconsistent results. Therefore, this review article has been conducted.

Does dietary intake of vitamin B6, folate or vitamin B12 reduce stroke risk?

Study design:
This review article included 1 nested case-control study and 11 prospective cohort studies comprising 389,938 participants and 10,749 cases (persons with stroke).

The studies were published from 2002 through to 2019 and the follow-up period ranged from 4.2 to 19 years.

All 12 studies provided risk estimates adjusted for cigarette smoking and most studies also adjusted for other conventional risk factors, including BMI, energy intake, alcohol consumption, hypertension and/or physical activity.

Study quality scores ranged from 5 to 9; the mean quality score was 7.4.

There was no evidence of publication bias.

Results and conclusions:
The investigators found for the highest versus the lowest category of dietary vitamin B6 intake, a significantly reduced risk of 16% for stroke [RR = 0.84, 95% CI = 0.73 to 0.97, I2 = 48.8%].

The investigators found in dose-response analysis that each 0.5 mg/d increment in vitamin B6 dietary intake was associated with a 6% reduction in the risk of stroke [RR = 0.94, 95% CI = 0.89 to 0.99, I2 = 77.0%].

The investigators found for the highest versus the lowest category of dietary folate intake, a significantly reduced risk of 15% for stroke [RR = 0.85, 95% CI = 0.78 to 0.94, I2 = 11.5%].

The investigators found in dose-response analysis that each 100 μg/d increase in dietary folate intake was associated with a 6% reduction in the risk of stroke [RR = 0.94, 95% CI = 0.90 to 0.98, I2 = 46.8%].

The investigators found, in contrast, no significant association between dietary vitamin B12 intake and the risk of stroke, with an RR of 1.01 [95% CI = 0.97 to 1.06] per 3 μg/d increase.

The investigators concluded increased dietary intake of vitamin B6 (at least 0.5 mg/d) and dietary folate intake (at least 100 μg/d) is associated with a reduced risk of stroke, supporting the notion that increasing habitual folate and vitamin B6 intake may provide a small but beneficial effect with respect to stroke.

Original title:
Dietary Intake of Homocysteine Metabolism-Related B-Vitamins and the Risk of Stroke: A Dose-Response Meta-Analysis of Prospective Studies by Chen L, Li Q, [...], Wang F.

Link:
https://academic.oup.com/advances/advance-article/doi/10.1093/advances/nmaa061/5854025

Additional information of El Mondo:
Find more information/studies on vitamin B6, folate and lowering of stroke right here.

Objectives:
Hypertension is regarded as a major and independent risk factor of cardiovascular diseases and numerous studies observed an inverse correlation between vitamin C intake and blood pressure. Therefore, this review article has been conducted.

Does a high serum vitamin C reduce blood pressure?

Study design:
This review article included 11 cross-sectional studies and 7 case-control studies. These studies comprised 22,200 observational subjects and were conducted from the year 1990 to 2017. Of the 18 articles, 14 were published in the English language and 4 were in Chinese.

Assessed with NOS, all the case-control studies yield a high quality averaging with 7.143 scores. And the result of AHRQ indicates a moderate quality with all cross-sectional studies scoring between 4 and 7.

Results and conclusions:
The investigators found random-effects model showed serum level of vitamin C of hypertensive subjects was 15.13 μmol/L lower than the normotensives [MD = -15.13, 95% CI = -24.19 to -6.06, p = 0.001, I2 = 98%].

The investigators found subgroup analysis showed that hypertensive subjects who took antihypertensive drugs had a 15.97 μmol/L lower serum vitamin C compared with normotensive ones.

The investigators found serum vitamin C had a significant inverse relation with both systolic blood pressure [Fisher′s Z = -0.17, 95% CI = -0.20 to -0.15, p 0.00001] and diastolic blood pressure [Fisher′s Z = -0.15, 95% CI = -0.20 to -0.10, p 0.00001].

The investigators concluded people with hypertension have a relatively low serum vitamin C and vitamin C is inversely associated with both systolic blood pressure and diastolic blood pressure.

Original title:
Association between Serum Vitamin C and the Blood Pressure: A Systematic Review and Meta-Analysis of Observational Studies by Ran L, Zhao W, […], Bu H.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7211237/

Additional information of El Mondo:
Find more information/studies on vitamin C and lowering of blood pressure right here.

Objectives:
Is there a causal relationship between black or green tea consumption and lowering blood pressure in subjects with elevated blood pressure (BP) or hypertension?
 
Study design:
This review article included 5 RCTs with 408 individuals.

None of the studies reported any side effects.

Results and conclusions:
The investigators found regular tea consumption significantly reduced systolic blood pressure [WMD = -4.81 mmHg, 95% CI = -8.40 to -1.58, p = 0.004] in subjects with elevated blood pressure (BP) or hypertension.

The investigators found regular tea consumption significantly reduced diastolic blood pressure [WMD = -1.98 mmHg, 95% CI = -3.77 to -0.20, p = 0.029] in subjects with elevated blood pressure (BP) or hypertension.

The investigators found, however, excluding the most heterogeneous trials showed that regular tea intake significantly reduced systolic blood pressure and diastolic blood pressure by about -3.53 and -0.99 mmHg, respectively.

The investigators found based on meta-regression findings, the longer the duration of tea intake (≥3 months), the higher the decrease in both systolic blood pressure and diastolic blood pressure.

The investigators found categorized studies, according to the tea type, revealed that the hypotensive effects of green tea were more pronounced compared to black tea.

The investigators concluded regular tea consumption, particularly green tea during ≥3 months reduces systolic blood pressure and diastolic blood pressure in subjects with elevated blood pressure (BP) or hypertension. Hence, it may be applicable to physicians, health care providers and particularly hypertension patients.

Original title:
The Effects of Regular Consumption of Green or Black Tea Beverage on Blood Pressure in Those With Elevated Blood Pressure or Hypertension: A Systematic Review and Meta-Analysis by Mahdavi-Roshan M, Salari A, […], Ashouri A.

Link:
https://www.sciencedirect.com/science/article/abs/pii/S0965229919316899?via%3Dihub

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Find more information/studies on green tea consumption and lowering of blood pressure right here.

Objectives:
Epidemiologic studies, including trials, suggest an association between potassium intake and blood pressure (BP). However, the strength and shape of this relationship is uncertain. Therefore, this review article has been conducted.

What is the strength and shape of the relationship between potassium intake and blood pressure (BP)?
 
Study design:
This review article included 32 RCTs with a duration ≥4 weeks using the recently developed 1‐stage cubic spline regression model. This model allows use of trials with at least 2 exposure categories.
Most trials were conducted in adults with hypertension using a crossover design and potassium supplementation doses that ranged from 30 to 140 mmol (1173 and 5474 mg) per day.

Results and conclusions:
The investigators found a U‐shaped relationship between 24‐hour active and control arm differences in potassium excretion and blood pressure (BP) levels, with weakening of the blood pressure reduction effect above differences of 30 mmol/d and a blood pressure increase above differences ≈80 mmol/d.

The investigators found achieved potassium excretion analysis also identified a U‐shaped relationship. The blood pressure lowering effects of potassium supplementation were stronger in participants with hypertension and at higher levels of sodium intake.

The investigators found blood pressure increased with high potassium excretion in participants with antihypertensive drug‐treated hypertension but not in their untreated counterparts.

The investigators concluded that an adequate intake of potassium (≤30 mmol (1173 mg) per day) is desirable to achieve a lower blood pressure level but excessive potassium supplementation (>80 mmol (3128 mg) per day) should be avoided, particularly in specific subgroups.

Original title:
Potassium Intake and Blood Pressure: A Dose‐Response Meta‐Analysis of Randomized Controlled Trials by Filippini T, Naska A, […], Whelton PK.

Link:
https://www.ahajournals.org/doi/full/10.1161/JAHA.119.015719?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed&

Additional information of El Mondo:
Find more information/studies on potassium consumption and lowering of blood pressure right here.

Objectives:
Is there a causal relationship between tomato consumption and lowering effects on cholesterol, triglycerides or fasting blood sugar levels?
 
Study design:
This review article included 6 RCTs.

Results and conclusions:
The investigators found tomato consumption significantly reduced total plasma cholesterol levels [WMD = -4.39 mg/dL, 95% CI = -7.09 to -1.68, I2 = 48%, p = 0.05].

The investigators found tomato consumption significantly reduced plasma triglyceride (TG) levels [WMD = -3.94 mg/dL, 95% CI = -7.67 to -0.21, I2 = 90%, p = 0.001].
A higher reduction effect was found on younger participants.

The investigators found tomato consumption significantly reduced plasma LDL cholesterol (bad cholesterol) levels [WMD = -2.09 mg/dL, 95% CI = -3.73 to -0.81, I2 = 78%, p = 0.001].
A higher reduction effect was found on younger participants.

The investigators found tomato consumption significantly increased plasma HDL cholesterol (good cholesterol) levels [WMD = 2.25 mg/dL, 95% CI = 0.41 to 4.10, I2 = 97%, p = 0.001].

The investigators found tomato consumption had no significant effect on plasma fasting blood sugar levels [WMD = 0.59 mg/dL, 95% CI = -0.28 to 1.46, I2 = 95%, p = 0.001].

The investigators concluded that tomato consumption increases plasma HDL cholesterol (good cholesterol) levels and decreases plasma total cholesterol, LDL cholesterol (bad cholesterol) and triglyceride levels.

Original title:
Effect of Tomato Consumption on Fasting Blood Glucose and Lipid Profiles: A Systematic Review and Meta-Analysis of Randomized Controlled Trials by Li H, Chen, A, [...],Yin X.

Link:
https://pubmed.ncbi.nlm.nih.gov/32243013/

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Find more information/studies on tomato consumption and lowering of cholesterol levels right here.

Patients with heart disease often have high LDL cholesterol, low HDL cholesterol and high triglycerides levels.

Objectives:
Do dietary calcium intakes or calcium supplements increase risk of cardiovascular disease?
 
Study design:
This review article included 26 prospective cohort studies and 16 RCTs.

Results and conclusions:
The investigators found in cohort studies that dietary calcium intakes ranging from 200 to 1500 mg/d did not affect the risk of cardiovascular disease [relative risk = 0.96, 95% CI = 0.87 to 1.05].

The investigators found in cohort studies that dietary calcium intakes ranging from 200 to 1500 mg/d did not affect the risk of coronary heart disease [relative risk = 0.98, 95% CI = 0.88 to 1.08].

The investigators found in cohort studies that dietary calcium intakes ranging from 200 to 1500 mg/d did not affect the risk of stroke [relative risk = 0.94, 95% CI = 0.85 to 1.04].

The investigators found in RCTs that calcium supplements significantly increased risk of coronary heart disease with 20% [relative risk = 1.20, 95% CI = 1.08 to 1.33, I2 = 0.0%].

The investigators found in RCTs that calcium supplements significantly increased risk of myocardial infarction with 21% [relative risk = 1.21, 95% CI = 1.08 to 1.35, I2 = 0.0%].

The investigators concluded that 200-1500 mg/d calcium intake from dietary sources do not increase the risk of cardiovascular disease, including coronary heart disease and stroke, while calcium supplements increase coronary heart disease risk, especially myocardial infarction.

Original title:
The Evidence and Controversy Between Dietary Calcium Intake and Calcium Supplementation and the Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis of Cohort Studies and Randomized Controlled Trials by Yang C, Shi X, […], Sun G.

Link:
https://pubmed.ncbi.nlm.nih.gov/31625814/

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Find more information/studies on calcium and lowering of blood pressure right here.

Objectives:
Is there a causal relationship between daily egg consumption and positive effects on blood pressure?
 
Study design:
This review article included 15 RCTs with a total of 748 participants and mean age range from 23.3 to 67.1 years old.

All included studies used whole egg as an intervention which varied from one egg/day to three eggs/day and duration of supplementation ranged from 3 to 12 weeks.

No evidence of publication bias was seen in the meta-analyse (review article) of systolic blood pressure [Begg’s p = 0.235, Eggers’s p = 0.433] and diastolic blood pressure [Begg’s p = 0.254, Eggers’s p = 0.267].

No heterogeneity was found among included studies.

Results and conclusions:
The investigators found, overall, egg consumption had no significant effect on systolic blood pressure [WMD = 0.046 mmHg, 95% CI = - 0.792 to 0.884, p = 0.914, I2 = 0.0%, p = 0.453] and diastolic blood pressure [WMD = -0.603 mmHg, 95% CI = -1.521 to 0.315, p = 0.198, I2 = 38.1%, p = 0.067].
Subgroup analyses had no effect on pooled results.
Sensitivity analysis indicated that excluding each trial did not significantly change the overall observed effects of egg consumption.

The investigators found nonlinear dose-response meta-analysis did not reveal a significant effect of egg consumption [p-nonlinearity = 0.76] and study duration on diastolic blood pressure [p-nonlinearity = 0.63].

The investigators found subgroup analyses based on study design, sex, population health status, obesity and hypertension status, diet adherence, study duration and amount of egg consumption did not affect the overall effects of egg consumption on systolic blood pressure and diastolic blood pressure values.

The investigators concluded that 1-3 eggs/day during 3 to 12 weeks have no effect on blood pressure. However, high-quality RCTs with longer durations are needed to further confirm the effects of egg consumption on blood pressure.

Original title:
Effect of Egg Consumption on Blood Pressure: a Systematic Review and Meta-analysis of Randomized Clinical Trials by Kolahdouz-Mohammadi R, Malekahmadi M, […], Soltani S.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7189334/

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Find more information/studies on causal relationship/significantly, egg consumption and lowering of blood pressure right here.

Objectives:
Does Alzheimer disease increase risk of stroke?

Study design:
This review article included 8 studies, representing 121,719 individuals (Alzheimer disease = 73,044 and non-Alzheimer disease = 48,675).

Results and conclusions:
The investigators found patients with Alzheimer disease had a significantly increased risk of 42% [relative risk = 1.42, 95% CI = 1.23 to 1.64] for hemorrhagic stroke.

The investigators concluded Alzheimer disease increases risk of hemorrhagic stroke.

Original title:
Risk of hemorrhagic and ischemic stroke in patients with Alzheimer disease: A synthesis of the literature by Waziry R, Chibnik LB, […], Hofman A.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31949087

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