Nutritional advice

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

Do fruits and vegetables reduce lung cancer risk?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Objectives:
What is the effect of aerobic exercise performed in the fasted versus fed states on fat and carbohydrate metabolism in adults?

Study design:
This review article included 27 studies with a total of 273 participants.

Results and conclusions:
The investigators found a significant increase in fat oxidation during aerobic exercise (duration ≤120 min) performed in the fasted state compared with fed state [WMD = -3.08 g, 95% CI = -5.38 to -0.79, I2 = 39.1%].

The investigators found the weighted mean difference of onesterified fatty acids (NEFA) concentrations was not significantly different between states [WMD = 0.00 mmol/L, 95 % CI = -0.07 to 0.08, I2 = 72.7 %].

The investigators found, however, the weighted mean differences of glucose [WMD = 0.78 mmol/L, 95% CI = 0.43 to 1.14, I2 = 90.8%] and insulin concentrations [WMD = 104.5 pmol/L, 95% CI = 70.8 to 138.2, I2 = 94.5%] were significantly higher for aerobic exercise (duration ≤120 min) performed in the fed state.

The investigators concluded that aerobic exercise (duration ≤120 min) performed in the fasted state induces higher fat oxidation than aerobic exercise performed in the fed state.

Original title:
Effects of aerobic exercise performed in fasted v. fed state on fat and carbohydrate metabolism in adults: a systematic review and meta-analysis by Vieira AF, Costa RR, […], Kruel LF.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/27609363

Additional information of El Mondo:
Find more studies/information on physical activity and energy right here.

Aerobic exercise is any exercise that raises the heart rate and increases respiration (breathing). Examples of aerobic exercise are:

• Cross-country skiing
• Cycling
• Dancing
• Fast walking
• Hiking
• Jogging or running
• Swimming
   

Objectives:
The association between elevated serum phosphorus concentration and cardiovascular or all-cause mortality yielded conflicting results. Therefore, this review article (meta-analysis) has been conducted.

Does an elevated serum phosphorus concentration increase cardiovascular and all-cause mortality in the general population?

Study design:
This review article included 6 prospective cohort studies involving 120,269 subjects.

Results and conclusions:
The investigators found when compared the highest with the reference concentration of serum phosphorus, a significant increased risk of 36% for cardiovascular mortality [pooled RR = 1.36, 95% CI = 1.07-1.72]. Significant because RR of 1 was not found in the 95% CI of 1.07 to 1.72. RR of 1 means no risk/association.

The investigators found when compared the highest with the reference concentration of serum phosphorus, a significant increased risk of 33% for all-cause mortality [pooled RR = 1.33, 95% CI = 1.15-1.58]. Significant means that there is an association with a 95% confidence.

The investigators found stratified analyses revealed that elevated serum phosphorus significantly increased all-cause mortality risk with 33% among men [RR 1.33, 95% CI = 1.11-1.60], but not in women [RR = 1.09, 95% CI = 0.89-1.33].

The investigators concluded elevated serum phosphorus concentration is independently associated with excessive risk of cardiovascular and all-cause mortality in the general population without chronic kidney disease. Serum phosphorus on all-cause mortality risk appears to be pronounced in men but exhibits no clear effect on women. However, gender difference of elevated serum phosphorus on mortality risk should be verified by more prospective cohort studies.

Original title:
Serum phosphorus, cardiovascular and all-cause mortality in the general population: A meta-analysis by Bai W, Li J and Liu J.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/27475981

Additional information of El Mondo:
Find more studies/information on elderly and phosphorus right here.

Objectives:
Reported associations between protein intake from different sources and type 2 diabetes (T2D) have been inconsistent.Therefore, this review article has been conducted.

Study design:
This review article included 11 prospective cohort studies with 505,624 participants and 37,918 type 2 diabetes cases (follow-up range: 5-24 years).

Results and conclusions:
The investigators found for the comparison of the highest with lowest categories of total protein intakes a significant higher risk of 9% for type 2 diabetes [RR = 1.09, 95% CI = 1.06 to 1.13]. Significant means that there is an association with a 95% confidence.

The investigators found for the comparison of the highest with lowest categories of animal protein intakes a significant higher risk of 19% for type 2 diabetes [RR = 1.19, 95% CI = 1.11 to 1.28].

The investigators found for the comparison of the highest with lowest categories of plant protein intakes a non-significant reduced risk of 5% for type 2 diabetes [RR = 0.95, 95% CI = 0.89 to 1.02]. Non-significant means it cannot be said with a 95% confidence that a daily higher intake of plant protein really reduced risk of type 2 diabetes with 5%.

The investigators found for the comparison of the highest with lowest categories of plant protein intakes a significant reduced risk of 7% for type 2 diabetes among women [RR = 0.93, 95% CI = 0.85 to 1.00].

The investigators found for the comparison of the highest with lowest categories of plant protein intakes a significant reduced risk of 9% for type 2 diabetes among US populations [RR = 0.91, 95% CI = 0.84 to 0.97].

The investigators concluded that a higher intake of total and animal protein are both associated with an increased risk of of type 2 diabetes. However, a higher intake of plant protein decreases risk of type 2 diabetes among women and US populations.

Original title:
Dietary protein intake and risk of type 2 diabetes: results from the Melbourne Collaborative Cohort Study and a meta-analysis of prospective studies by Shang X, Scott D, […], Sanders KM.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/27629053

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

Objectives:
The aim of this review article (meta-analysis) was to assess the clinical efficacy and safety of oral ginger for symptomatic treatment of osteoarthritis (OA).

Study design:
This review article included 5 RCTs with in total 593 patients.

The average age of the patients ranged from 47 years to 66 years and the percentage of women included in the studies ranged from 26% to 80%.
The dose of oral administration of ginger ranged from 500 mg/day to 1000 mg/day.
Trial duration ranged from 3 to 12 weeks.

Results and conclusions:
The investigators found compared to placebo, ginger intake significantly reduced pain [SMD = -0.30, 95% CI = -0.50 to -0.09, p = 0.005, I2 = 27%].

The investigators found compared to placebo, ginger intake showed a statistically significant reduction in disability [SMD = -0.22, 95% CI = -0.39 to -0.04, p = 0.01, I2 = 0%].

The investigators found patients given ginger were more than twice as likely to discontinue (due to adverse events) treatment compared to placebo [RR = 2.33, 95% CI = 1.04 to 5.22, p = 0.04, I2 = 0%].

The investigators concluded that 500-1000 mg/day oral ginger intake is able to reduce pain and disability in osteoarthritis patients.

Original title:
Efficacy and safety of ginger in osteoarthritis patients: a meta-analysis of randomized placebo-controlled trials by Bartels EM, Folmer VN, […], Christensen R.

Link:
http://www.oarsijournal.com/article/S1063-4584(14)01276-X/pdf

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Objectives:
The aim of this review article was to evaluate the diagnostic accuracy of ultrasound in assessing active Crohn’s disease (CD) in adults.

Study design:
This meta-analysis included 15 studies involving 1558 adults with active Crohn’s disease.

Results and conclusions:
The investigators found overall, the pooled sensitivity (0.88) and LR- (0.14) were not heterogeneous, whereas the pooled specificity [0.97, I2 = 72.9%] and LR + [15.10, I2 = 71.8 %] were.

The investigators found the DOR of ultrasound for assessing active CD was 121.70, with significant heterogeneity (I2 = 63.3%).
A symmetrical summary ROC curve was plotted showing that the area under the curve was 0.94, indicating good diagnostic accuracy.

The investigators found meta-regression and subgroup analysis showed that the disease location may be a major cause of heterogeneity.

The investigators concluded ultrasound has high diagnostic accuracy in detecting active Crohn’s disease in adults, especially for small bowel Crohn’s disease.

Original title:
Ultrasound as a diagnostic tool in detecting active Crohn’s disease: a meta-analysis of prospective studies by Dong J, Wang H, [...], Li J.

Link:
http://link.springer.com/article/10.1007/s00330-013-2973-0

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Objectives:
Does allium vegetable consumption reduce gastric cancer risk?

Study design:
This review article included 22 case-control and 4 cohort studies with more than 10,000 cases.

Results and conclusions:
The investigators found in 10 case-control and 4 cohort studies for the highest versus lowest allium vegetables intake category a significant reduced risk of 22% for gastric cancer [OR = 0.78, 95% CI = 0.67-0.91].

The investigators found in 12 case-control studies for the highest versus lowest garlic intake category a significant reduced risk of 40% for gastric cancer [OR = 0.60, 95% CI = 0.47-0.76].

The investigators found in 13 case-control studies for the highest versus lowest onion intake category a significant reduced risk of 45% for gastric cancer [OR = 0.55, 95% CI = 0.41-0.73].

The investigators found in 4 cohort studies for the highest versus lowest allium vegetables intake category a non-significant increased risk of 2% for gastric cancer [RR = 1.02, 95% CI = 0.88-1.18]. Non-significant means no association with 95% confidence.

The investigators concluded high allium vegetable consumption, like garlic and onion is likely to reduce gastric cancer risk. Likely because this evidence is derived mainly from case-control studies. Therefore, further data from large cohorts are desirable for conclusive confirmation.

Original title:
Allium vegetable intake and gastric cancer: a case-control study and meta-analysis by Turati F, Pelucchi C, […], Galeone C.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/25215621

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

Objectives:
Garlic is a common spicy flavouring agent also used for certain therapeutic purposes. Garlic's effects on blood glucose have been the subject of many clinical and animal studies. However, studies reporting hypoglycemic effects of garlic in humans are conflicting. Therefore, this review article (meta-analysis) has been conducted.

Has garlic supplementation lowering effects on glycemic control measurements such as fasting blood glucose (FBG), postprandial glucose (PPG) and glycated haemoglobin (HbA1c)?

Study design:
This review article included a total of 7 RCTs (parallel design) that involved 9 comparisons with 513 subjects. The trials varied in size from 33 to 180 subjects. The study duration varied from 4 to 24 week (median: 12 week). The trials enrolled male and female subjects, both healthy and with diabetes.

Doses of garlic in the treatment group ranged from 600 to 1500 mg/d.

Results and conclusions:
The investigators found pooled analyses showed that garlic supplementation resulted in a statistically significant lowering in fasting blood glucose [SMD = -1.67, 95% CI = -2.80 to -0.55, p = 0.004].

The investigators could not perform a pooled analyse for postprandial glucose (PPG) control and glycosylated haemoglobin (HbA1c) outcomes, because only 1 study included in the meta-analysis reported PPG variables and only 2 studies reported HbA1c variables.

The investigators concluded that garlic supplementation (600 to 1500 mg/d) during 12 weeks results in a lowering in fasting blood glucose. More trials are needed to investigate the effectiveness of garlic on HbA1c and PPG.

Original title:
Garlic intake lowers fasting blood glucose: meta-analysis of randomized controlled trials by Hou LQ, Liu YH and Zhang YY.

Link:
http://apjcn.nhri.org.tw/server/APJCN/24/4/575.pdf

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

Objectives:
Emerging randomized controlled trials (RCTs) investigating the effect of green tea or green tea extract (GTE) supplementation on blood pressure (BP) among overweight and obese adults reported inconsistent findings. Therefore, this review article has been conducted.

Does tea consumption decrease blood pressure among overweight and obese adults?

Study design:
This review article included 14 RCTs with 971 participants (47% women).

Results and conclusions:
The investigators found green tea or green tea extract supplementation compared with placebo, significantly reduced systolic blood pressure with 1.42 mmHg [95% CI = -2.47 to -0.36, p  =  0.008, I2  =  52%, p for heterogeneity =  0.01 ] among overweight and obese adults.

The investigators found green tea or green tea extract supplementation compared with placebo, significantly reduced diastolic blood pressure with 1.25 mmHg [95% CI = -2.32 to -0.19, p = 0.02, I2 = 74%, p for heterogeneity   0.001] among overweight and obese adults.

The investigators found the quality of evidence across studies was low. Similar results were found in subgroup and sensitivity analyses.

The investigators concluded among overweight and obese adults, green tea or green tea extract supplementation is found to cause a small but significant reduction in blood pressure. However, more high-quality RCTs with large sample sizes are needed to further confirm the efficacy on blood pressure and make strong recommendations for green tea or green tea extract supplementation among the overweight and obese adults.

Original title:
Effect of green tea supplementation on blood pressure among overweight and obese adults: a systematic review and meta-analysis by Li G, Zhang Y, […], Holbrook A.

Link:
http://journals.lww.com/jhypertension/Abstract/2015/02000/Effect_of_green_tea_supplementation_on_blood.6.aspx

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

Objectives:
There are conflicting reports on the correlation between manganese (Mn) levels and breast cancer. Therefore, this review article (meta-analysis) has been conducted.

Does manganese deficiency increase risk of breast cancer?

Study design:
This review article included 11 case-control studies involving 1302 subjects.

There was no evidence of publication bias. Sensitivity analysis showed that excluding any one study from the pooled analysis did not vary the results substantially.

Results and conclusions:
The investigators found the random-effects meta-analysis results indicated that subjects with breast cancer had lower manganese levels in serum and hair than healthy controls [SMD = -1.51, 95% CI = -2.47 to -0.56, I2 = 97.8%, p 0.001].

The investigators found in subgroup analysis that subjects with breast cancer had lower manganese levels than healthy controls in China [SMD = -1.32, 95% CI = -2.33 to -0.32] and Korea [SMD = -4.08, 95% CI = -4.63 to -3.54], but not in Turkey [SMD = -0.96, 95% CI = -3.19 to 1.27].

The investigators found in subgroup analysis that the differences of manganese levels between patients with breast cancer and healthy controls were similar in different sample specimens:
serum [SMD = -1.24, 95% CI = -2.31 to -0.16];
hair [SMD = -1.99, 95% CI = -3.91 to -0.06] and;
different types of manganese measurement:

ICP-AAS [SMD = -1.14, 95% CI = -2.24 to -0.04];
GFAAS [SMD = -1.94, 95% CI = -2.38 to -1.49];
ICP-AES [SMD = -3.77, 95% CI = -4.70 to -2.85]. These findings can well explain that  the between-study variability was the main source of heterogeneity.

The investigators concluded there is an association between deficient manganese concentration and breast cancer. However, the subgroup analysis found that there was contradiction regarding races and geography, like China and Turkey. Thus this finding needs further confirmation by trans-regional multicenter, long-term observation in a cohort design to obtain better understanding of causal relationships between manganese levels and breast cancer, through measuring manganese at baseline to investigate whether the highest manganese category versus lowest was associated with breast cancer risk.

Original title:
The association between deficient manganese levels and breast cancer: a meta-analysis by Shen F, Cai WS, [...],Xu B.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4443096/

Additional information of El Mondo:
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Objectives:
Approximately 5.7 million Americans carry the diagnosis of systolic heart failure (HF), a major health care burden. Heart failure is a known manifestation of thiamine deficiency (TD). Therefore, this review article has been conducted.

Is thiamine deficiency (vitamin B1 deficiency) a risk factor of systolic heart failure?

Study design:
This review article included 9 studies (observational studies and RCTs).

Results and conclusions:
The investigators found systolic heart failure patients had a higher risk of 153% of getting a thiamine deficiency [odds ratio = 2.53, 95% CI = 1.65-3.87].

The investigators found diuretic use, changes in dietary habits and altered thiamine absorption and metabolism were identified as possible mechanisms of thiamine deficiency in heart failure patients.

The investigators found small observational studies and randomized control trials suggested that thiamine supplementation in heart failure population could improve ejection fraction and reduce symptoms.

The investigators concluded thiamine deficiency is more prevalent in heart failure population, and its supplementation may be beneficial. The therapeutic role of thiamine in heart failure warrants further study.

Original title:
Determining the Role of Thiamine Deficiency in Systolic Heart Failure: A Meta-Analysis and Systematic Review by Jain A, Mehta R, […], Winchester DE.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/26497757

Additional information of El Mondo:
Find more information/studies on cardiovascular disease and vitamin B1 (thiamine) right here.

Objectives:
Micronutrient deficiencies impose a considerable burden of disease on many middle and low income countries. Several strategies have been shown to be effective in improving micronutrient deficiencies. However, the impact of fortified condiments as well as fortified noodles is less well documented. Therefore, this meta-analysis (review article) has been conducted.

What is the impact of micronutrient fortified condiments on hemoglobin, anemia and functional outcomes in children and adults (age: 5 to 50 years)?

Study design:
This review article included 14 RCTs comprising 8845 people with a mean age between 7.3 and 34 years. Mean follow-up was 0.88 years (range: 2.4 months to 2 years).

Only in 2 trials was multi-micronutrient fortification used, e.g. additional fortification with vitamin A, zinc and folate. In the other 12 studies, iron was the net difference in multi-micronutrient exposition between intervention and control groups.

Results and conclusions:
The investigators found in 12 RCTs that micronutrient fortification of condiments significantly increased hemoglobin concentrations by 0.74 g/dL [95% CI = 0.56 to 0.93].

The investigators found different types of iron preparations showed no differences in rise of hemoglobin concentrations (NaFeEDTA: 0.69 g/dL vs. 0.68 g/dL for other preparations).

The investigators found micronutrient fortification also led to a reduced risk of 41% for having anemia [risk ratio 0.59, 95% CI = 0.44 to 0.80].

The investigators found ferritin concentrations significantly increased with fortified condiments.

The investigators concluded the use of micronutrient fortified condiments can be a strategy to reduce anemia in children and adults due to micronutrient deficiencies beyond supplementation programs and fortification of staple food.

Original title:
Micronutrient Fortified Condiments and Noodles to Reduce Anemia in Children and Adults—A Literature Review and Meta-Analysis by Hess S, Tecklenburg L and Eichler K.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4772051/

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

Objectives:
Is there an association of intake of different vitamins and multiple-vitamin supplements and the incidence of colorectal cancer?

Study design:
This review article included 47 articles (cohort studies).

There was unacceptable heterogeneity for studies of multiple-vitamin supplements, so findings were inconclusive.

Results and conclusions:
The investigators found a significant reduced risk of 12% [multivariable-adjusted RR = 0.88, 95% CI = 0.81-0.95] for colorectal cancer when comparing the highest versus lowest dietary vitamin B9 (folate) intake. Significant means that there is an association with a 95% confidence.

The investigators found a significant reduced risk of 13% [multivariable-adjusted RR = 0.87, 95% CI = 0.77-0.99] for colorectal cancer when comparing the highest versus lowest dietary vitamin D intake. Significant because RR of 1 was not found in the 95% CI of 0.77 to 0.99. RR of 1 means no risk/association.

The investigators found a significant reduced risk of 12% [multivariable-adjusted RR = 0.88, 95% CI = 0.79-0.99] for colorectal cancer when comparing the highest versus lowest dietary vitamin B6 intake.

The investigators found a significant reduced risk of 14% [multivariable-adjusted RR = 0.86, 95% CI = 0.76-0.97] for colorectal cancer when comparing the highest versus lowest dietary vitamin B2 intake.

The investigators found, however, no association between both dietary vitamine A, C, E, B3 and B12 and the risk of colorectal cancer.

The investigators concluded high dietary vitamin B9 (folate), D, B6 and B2 intake reduces risk of colorectal cancer, but further study is needed.

Original title:
Vitamin and multiple-vitamin supplement intake and incidence of colorectal cancer: a meta-analysis of cohort studies by Liu Y, Yu Q, […], Li K.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/25491145

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

Objectives:
Red meat intake has been associated with risk of colorectal cancer, potentially mediated through heterocyclic amines. The metabolic efficiency of N-acetyltransferase 2 (NAT2) required for the metabolic activation of such amines is influenced by genetic variation. The interaction between red meat intake, NAT2 genotype and colorectal cancer has been inconsistently reported. Therefore, this review article has been conducted.

Is there an interaction between red meat intake, NAT2 genotype and colorectal cancer?

Study design:
This review article included 11 retrospective case-control studies with 8,290 colorectal cancer cases and 9,115 controls (subjects without colorectal cancer).

Results and conclusions:
The investigators found the highest quartile of red meat intake was associated with a 41% increased risk of colorectal cancer compared with the lowest quartile [OR = 1.41, 95% CI = 1.29-1.55].
However, a significant association was observed only for studies with retrospective diet data, not for studies with diet prospectively assessed before cancer diagnosis.

The investigators found when combining all studies, high red meat intake was similarly associated with colorectal cancer in those with a rapid/intermediate NAT2 genotype [OR = 1.38, 95% CI = 1.20-1.59] as with a slow genotype [OR = 1.43, 95% CI = 1.28-1.61, p interaction = 0.9].

The investigators concluded high red meat intake was associated with increased risk of colorectal cancer only from retrospective case-control studies and not modified by NAT2 enzyme activity.

Original title:
Red Meat Intake, NAT2, and Risk of Colorectal Cancer: A Pooled Analysis of 11 Studies by Ananthakrishnan AN, Du M, […], Chan AT.

Link:
http://cebp.aacrjournals.org/content/cebp/24/1/198.full.pdf

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Objectives:
Does a high GI or GL diet increase risk of stroke events?

Study design:
This review article included 7 prospective cohort studies with 225000 participants free of diabetes from 6 different countries. 3046 stroke events were included and the follow-up range was 5 to 18 years.

Results and conclusions:
The investigators found a high GI diet was not significantly associated with a 10% increased risk for stroke events [pooled RR = 1.10, 95% CI = 0.99-1.21]. Not significantly means, there is no association with a 95% confidence.

However, the investigators found high GL was significantly associated with a 19% increased risk for stroke events [pooled RR = 1.19, 95% CI = 1.05-1.36].

The investigators found there was no significant association between high carbohydrate intake and stroke risk [RR = 1.12, 95% CI = 0.93-1.35].

The investigators concluded a daily high GL diet (but not GI diet) is the risk factor of stroke event. Further researches are needed to verify the meta-analyses results and study associated mechanisms.

Original title:
Carbohydrate Intake, Glycemic Index, Glycemic Load, and Stroke: A Meta-analysis of Prospective Cohort Studies by Cai X, Wang C, [...], Ding F.

Link:
http://www.ncbi.nlm.nih.gov/pubmed/25593213

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Objectives:
Does garlic supplementation reduce cardiovascular disease risk?

Study design:
This review article included original studies and previous review articles (meta-analyses).

Results and conclusions:
The investigators found in 4 meta-analyses and 2 original studies that garlic supplementation significantly reduced blood pressure by 7-16 mmHg (systolic) and 5-9 mmHg (diastolic). Significant means that there is an association with a 95% confidence.

The investigators found in 8 meta-analyses that garlic supplementation significantly reduced total cholesterol by 7.4-29.8 mg/dL.

The most consistent benefits were shown in studies that used aged garlic extract (AGE).

The investigators found a few small studies that used aged garlic extract also showed favourable effects on C-reactive protein (CRP), pulse wave velocity (PWV), and coronary artery calcium (CAC).

Although garlic is generally safe, rare adverse reactions have been documented with limited causality established.

The investigators concluded garlic supplementation has the potential for cardiovascular protection based on risk factor reduction (hypertension and total cholesterol) and surrogate markers (C-reactive protein, pulse wave velocity and coronary artery calcium) of atherosclerosis. Larger studies are warranted to evaluate these effects further.

Original title:
Garlic and Heart Disease by Varshney R and Budoff MJ.

Link:
http://jn.nutrition.org/content/146/2/416S.long

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Find more information/studies on garlic consumption and cardiovascular disease right here.

Objectives:
Is there an association between serum non-ceruloplasmin copper and Alzheimer's disease risk?

Study design:
This review article included studies carried out from 1996 until March 2013.

Ten studies were analyzed in the meta-analysis for Non-Cp copper and % Non-Cp copper reaching a pooled total of 599 Alzheimer's disease subjects and 867 controls.
For Adj-Cp copper, 14 studies were analyzed with a pooled total of 879 Alzheimer's disease subjects and 1712 controls.
27 studies were considered for systemic total copper meta-analysis, with a pooled total of 1393 Alzheimer's disease subjects and 2159 controls.

Results and conclusions:
The investigators found all copper indices analyzed were significantly higher in Alzheimer's disease subjects compared to healthy controls.

The investigators concluded serum non-ceruloplasmin copper is higher in Alzheimer's disease.

Original title:
Meta-analysis of serum non-ceruloplasmin copper in Alzheimer's disease by Squitti R, Simonelli I, […], Bush AI.

Link:
http://www.ncbi.nlm.nih.gov/pubmed/24072069

Additional information of El Mondo:
Find more studies/information on elderly and copper.

Objectives:
Does DHA, alone or combined with EPA, contribute to improved memory function in older adults with mild memory complaints?

Study design:
This review article included 15 intervention trials and 13 observational studies. Most intervention trials were conducted with subjects ≥ 45 years of age (n = 11). The majority of studies were conducted in subjects without cognitive complaints (n = 9) and ranged from 28-730 days in duration, averaging 4-6 months.

Results and conclusions:
The investigators found episodic memory of subjects with mild memory complaints significantly improved in response to DHA supplementation, alone or in combination with EPA [p 0.004].

The investigators found regardless of cognitive status at baseline, >1 g/day DHA/EPA significantly improved episodic memory of subjects with mild memory complaints [p 0.04].

The investigators found there was a trend for episodic memory improvement in response to supplementation in subjects 45 years or older [p 0.058].

The investigators found DHA intake above the mean DHA level studied (580 mg/day) significantly improved episodic memory in all subjects [p 0.009] and in subjects with mild memory complaints [p 0.019]. Significant means that there is an association with a 95% confidence.

The investigators found observational studies supported a beneficial association between intake/blood levels of DHA/EPA and memory function in older adults.

The investigators concluded DHA (>580 mg/day), alone or combined with EPA (>1 g/day DHA/EPA), contributes to improved memory function in older adults (45 years or older) with mild memory complaints.

Original title:
Docosahexaenoic Acid and Adult Memory: A Systematic Review and Meta-Analysis by Yurko-Mauro K, Alexander DD and Van Elswyk ME.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4364972/

Additional information of El Mondo:
Find more studies/information on elderly and EPA&DHA.

This meal provides at least 580 mg DHA.
1 g/day DHA/EPA corresponds to meals providing 4 days of DHA&EPA.

Episodic memory is the type of long-term, declarative memory in which we store memories of personal experiences that are tied to particular times and places.
Some examples of episodic memory:

• Your skiing vacation last winter;
• The first time you traveled by airplane;
• Your first high school day.

Objectives:
Zinc deficiency is a global nutritional problem, particularly in children and women residing in settings where diets are cereal based and monotonous. It has several negative health consequences. Fortification of staple foods with zinc may be an effective strategy for preventing zinc deficiency and improving zinc-related health outcomes. Therefore, this meta-analysis (review article) has been conducted.

What are the beneficial and adverse effects of fortification of staple foods with zinc on health-related outcomes and biomarkers of zinc status in the general population?

Study design:
This review article included 8 RCTs (709 participants); seven were from middle-income countries of Asia, Africa, Europe and Latin America where zinc deficiency is likely to be a public health problem.
The interventions lasted between one and nine months.

Results and conclusions:
The investigators found in 3 studies with 158 participants that foods fortified with zinc increased the serum or plasma zinc levels with 2.12 µmol/L in comparison to foods without added zinc [MD = 2.12 µmol/L, 95% CI = 1.25 to 3.00 µmol/L; low-quality evidence].

The investigators found in 2 studies with 397 participants that participants consuming foods fortified with zinc versus participants consuming the same food without zinc had similar risk of underweight [average risk ratio = 3.10, 95% CI = 0.52 to 18.38; low-quality evidence].

The investigators found in 2 studies with 397 participants that participants consuming foods fortified with zinc versus participants consuming the same food without zinc had similar risk of stunting [RR = 0.88, 95% CI = 0.36 to 2.13; low-quality evidence].

The investigators found no significant difference in serum or plasma zinc levels in participants consuming foods fortified with zinc plus other micronutrients comparing with participants consuming the same foods with micronutrients but no added zinc [MD = 0.03 µmol/L, 95% CI = -0.67 to 0.72 µmol/L; 4 studies of  low-quality evidence with 250 participants].

The investigators found no adverse effect of fortification of foods with zinc on indicators of iron or copper status.

The investigators concluded fortification of foods with zinc may improve the serum zinc status of populations if zinc is the only micronutrient used for fortification. However, when zinc is added to food in combination with other micronutrients, it may make little or no difference to the serum zinc status. Effects of fortification of foods with zinc on other outcomes including zinc deficiency, children's growth, cognition, work capacity of adults or on haematological indicators are unknown. Given the small number of trials and participants in each trial, further investigation of these outcomes is required.

Original title:
Fortification of staple foods with zinc for improving zinc status and other health outcomes in the general population by Shah D, Sachdev HS, […], Peña-Rosas JP.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/27281654

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

Objectives:
Anemia is a leading cause of maternal deaths and adverse pregnancy outcomes in developing countries. To present knowledge, no previous study has estimated the population-attributable fraction (PAF) of adverse pregnancy outcomes for maternal anemia. Therefore, this meta-analysis (review article) has been conducted.

Is there an association between maternal anemia and pregnancy outcomes in low- and middle-income countries?

Study design:
This review article included 24 prospective cohorts and 5 retrospective cohort studies.

The number of subjects per study ranged from 253 to 399,274 with a total of ∼0.72 million pregnant women with a mean age that ranged from 20 to 30 years.

Results and conclusions:
The investigators found overall, 42.7% [95% CI = 37.0% to 48.4%] of women experienced anemia during pregnancy in low- and middle-income countries.

The investigators found pregnant women with anemia had a significant higher risk of 31% for low birth weight [RR = 1.31, 95% CI = 1.13-1.51].

The investigators found pregnant women with anemia had a significant higher risk of 63% for preterm birth [RR = 1.63, 95% CI = 1.33-2.01].

The investigators found pregnant women with anemia had a significant higher risk of 51% for perinatal mortality [RR = 1.51, 95% CI = 1.30-1.76].

The investigators found pregnant women with anemia had a significant higher risk of 172% for neonatal mortality [RR = 2.72, 95% CI = 1.19-6.25].

The investigators found South Asian, African and low-income countries had a higher pooled anemia prevalence than did other Asian and upper-middle-income countries.

The investigators found in low- and middle-income countries, 12% of low birth weight, 19% of preterm births and 18% of perinatal mortality were attributable to maternal anemia.

The investigators concluded maternal anemia is a risk factor for adverse birth and perinatal health outcomes in low- and middle-income countries. Significantly higher risk of low birth weight and preterm birth were observed in low-income countries and in South Asian countries despite the greater priority and larger investment on maternal and child health programs in recent decades.

Original title:
Maternal anemia and risk of adverse birth and health outcomes in low- and middle-income countries: systematic review and meta-analysis by Rahman MM, Abe SK, […], Shibuya K.

Link:
http://ajcn.nutrition.org/content/103/2/495.long

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

Objectives:
Does sodium iron ethylenediaminetetraacetate (NaFeEDTA)-fortified soy sauce reduce anemia prevalence in the Chinese population?

Study design:
This review article included a total of 16 studies for anemia rate analysis (aged from 3 to >55 years and from different provinces, with 8411 in the intervention groups and 8408 in the control groups), of which 12 studies for hemoglobin analysis (4037 subjects from the intervention groups and 4034 from the control groups with an age group from 3 to >55 years and from different provinces).

Results and conclusions:
The investigators found hemoglobin concentration increased and anemia rates decreased significantly as compared with the non-fortified soy sauce groups.

The investigators found for anemia rates, a pooled estimate odds ratio of 0.25 [95% CI = 0.19-0.35].

The investigators found for hemoglobin concentrations a pooled weighted mean difference of 8.81g/L [95% CI = 5.96-11.67].

The investigators concluded long-term intervention with NaFeEDTA-fortified soy sauce results in 8.81g/L increase of hemoglobin level and a 25% decrease in the anemia rate in the Chinese high-risk anemic population.

Original title:
Effect of NaFeEDTA-Fortified Soy Sauce on Anemia Prevalence in China: A Systematic Review and Meta-analysis of Randomized Controlled Trials by Huo JS, Yin JY, […], Chen CM.

Link:
http://www.besjournal.com/Articles/Archive/2015/No11/201512/t20151218_123669.html

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