Nutritional advice

Objectives:
Genistein (4',5,7-trihydroxyisoflavone) is a phytoestrogen with potential health benefits in the prevention of cardiovascular disease. However, the evidence regarding its effects on hypertension has not been conclusive. Therefore, this review article has been conducted.

Do genistein supplements reduce blood pressure?

Study design:
This review article included 4 RCTs (4 treatment arms).

Results and conclusions:
The investigators found genistein supplements did not show any significant reduction of systolic blood pressure [WMD = -5.32 mmHg, 95% CI = -14.59 to 3.96] and diastolic blood pressure [WMD = -2.06 mmHg, 95% CI = -6.41 to 2.28] compared to that of the placebo group.

The investigators found, however, subgroup analysis by intervention duration showed that more than 6 months genistein supplementation in metabolic syndrome patients significantly decreased systolic blood pressure [WMD = -13.73 mmHg, 95% CI = -18.10 to -9.37] and diastolic blood pressure [WMD = -5.18 mmHg, 95% CI = -6.62 to -3.74].

The investigators concluded genistein supplementation of more than 6 months reduces blood pressure among metabolic syndrome patients.

Original title:
Effects of genistein on blood pressure: A systematic review and meta-analysis by Hemati N, Asis M, […], Abdollahi M.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31955737

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Find more information/studies on genistein and overweight right here.

Objectives:
Does dietary intake of fiber reduce risk of endometrial cancer?

Study design:
This review article included 16 studies, involving 6,563 cases (persons with endometrial cancer).

Results and conclusions:
The investigators found dietary fiber intake significantly reduced risk of endometrial cancer with 14% [RR = 0.86, 95% CI = 0.78 to 0.93].
In stratified analysis, this trend was more pronounced in the case-control studies and in studies conducted in the Americas and Asia.

The investigators found dietary fiber intake significantly reduced risk of endometrial cancer with 26% after adjusting for education level [RR = 0.74, 95% CI = 0.60 to 0.88].

The investigators found dietary fiber intake significantly reduced risk of endometrial cancer with 30% after adjusting for age [RR = 0.70, 95% CI = 0.57 to 0.83].

The investigators found dietary fiber intake significantly reduced risk of endometrial cancer with 19% in studies with NOS scores of 6 (the higher the NOS scores, the more reliable the studies are) [RR = 0.81, 95% CI = 0.67 to 0.95].

The investigators found dietary fiber intake significantly reduced risk of endometrial cancer with 25% in studies with NOS scores of 7 [RR = 0.75, 95% CI = 0.62 to 0.88].

The investigators concluded dietary fiber intake reduces risk of endometrial cancer. Further efforts should be made to confirm these findings.

Original title:
Association between dietary fiber and endometrial cancer: a meta-analysis by Li H, Mao H, [...], Nan Y.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31584301

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Objectives:
Does dehydroepiandrosterone (DHEA) supplementation improve the outcomes of in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) in women with diminished ovarian reserve (DOR) and/or poor ovarian response (POR)?

Study design:
This review article included 9 RCTs, published between 2010 and 2017.
The sample sizes ranged from 24 to 208, with a total of 862 patients.
All of included patients had been diagnosed with diminished ovarian reserve (DOR) and/or poor ovarian response (POR).

The treatment intervention was 75 mg daily DHEA versus placebo.

The lack of significant asymmetry of funnel plot indicated the lack of potential publication bias in the included studies.

Results and conclusions:
The investigators found in a pooled analysis using the random effects model revealed a statistically significant increase in retrieved oocytes in the DHEA group, compared to the control group [MD = 0.91, 95% CI = 0.23 -1.59, p = 0.009, I2  = 53%, p = 0.06].

The investigators found in 8 studies (405 in the DHEA group and 415 in the control group) a statistically significant increase in the clinical pregnancy rate in the DHEA group compared to the control group [RR = 1.27, 95% CI = 1.01 -1.61, p = 0.04, I2 = 0%, p = 0.57].

The investigators found in 5 studies (189 in the DHEA group and 190 in the control group) a statistically significant increase in the live birth rate in the DHEA group, compared to the control group [RR = 1.76, 95% CI = 1.17 -2.63, p = 0.006, I2  = 0%, p = 0.43].

The investigators found in 3 studies (96 in the DHEA group and 99 in the control group) no significant difference in the miscarriage rates between the DHEA and control groups [RR = 0.37, 95% CI = 0.12-1.13, p = 0.08, I2 = 25%, p = 0.26].

The investigators concluded 75 mg daily DHEA supplementation increases the retrieved oocytes, clinical pregnancy rate and live birth rate in women with diminished ovarian reserve and/or poor ovarian response, who are undergoing in vitro fertilization or intracytoplasmic sperm injection.

Original title:
The Effect of Dehydroepiandrosterone (DHEA) Supplementation on IVF or ICSI: A Meta-Analysis of Randomized Controlled Trials by Xu L, Hu C, […], Li Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6620181/

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Your body naturally produces the hormone dehydroepiandrosterone (DHEA) in the adrenal gland. In turn, DHEA helps produce other hormones, like testosterone and estrogen. Natural dehydroepiandrosterone levels peak in early adulthood and then slowly fall as you age.

 

Objectives:
Can the biomarker miRNAs predict Alzheimer's disease?

Study design:
This review article included 10 studies containing 770 Alzheimer's disease and 664 normal controls (persons without Alzheimer's disease).

Results and conclusions:
The investigators found miRNAs presented excellent diagnostic performance and the overall sensitivity was 0.80 [95% CI = 0.75-0.83], specificity was 0.83 [95% CI = 0.78-0.87] and diagnostic odds ratio was 14 [95% CI = 11-19].

The investigators found subgroup analysis suggested that the Caucasian group and blood group showed a better performance in Alzheimer's disease diagnosis and the diagnostic odds ratio was 42 and 34, respectively.

The investigators concluded that miRNAs may be a promising biomarker for Alzheimer's disease.

Original title:
Blood circulating miRNAs as biomarkers of Alzheimer's disease: a systematic review and meta-analysis by Zhang YH, Bai SF and Yan JQ.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31385521

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Objectives:
Some evidence indicates that carotenoids may reduce the risk of bladder cancer (BC), but the association is unclear. Therefore, this review article has been conducted.

Do carotenoids (β-cryptoxanthin, α-carotene, β-carotene and lutein and zeaxanthin) reduce risk of bladder cancer?

Study design:
This review article included a total of 22 studies (case-control and cohort studies) involving 516,740 adults.

Results and conclusions:
The investigators found for the highest compared with the lowest category of carotenoid dietary intake a non-significantly reduced risk of 12% [RR = 0.88, 95% CI = 0.76 to 1.03] for bladder cancer.
Non-significantly because RR of 1 was found in the 95% CI of 0.76 to 1.03. RR of 1 means no risk/association.

The investigators found for the highest compared with the lowest category of circulating carotenoid concentrations a non-significantly reduced risk of 64% [RR = 0.36, 95% CI = 0.12 to 1.07] for bladder cancer.

The investigators found for the highest compared with the lowest category of circulating lutein and zeaxanthin concentrations a significantly reduced risk of 47% [RR = 0.53, 95% CI = 0.33 to 0.84] for bladder cancer.
Significantly because RR of 1 was not found in the 95% CI of 0.33 to 0.84. RR of 1 means no risk/association.

The investigators found dose-response analysis showed that bladder cancer risk significantly decreased by 42% [RR = 0.58, 95% CI = 0.36 to 0.94] for every 1 mg increase in daily dietary β-cryptoxanthin intake.

The investigators found dose-response analysis showed that bladder cancer risk significantly decreased by 76% [RR = 0.24, 95% CI = 0.08 to 0.67] for every 1 μmol/L increase in circulating concentration of α-carotene.

The investigators found dose-response analysis showed that bladder cancer risk significantly decreased by 27% [RR = 0.73, 95% CI = 0.57 to 0.94] for every 1 μmol/L increase in circulating concentration of β-carotene.

The investigators found dose-response analysis showed that bladder cancer risk significantly decreased by 56% [RR = 0.44, 95% CI = 0.28 to 0.67] for every 1 μmol/L increase in circulating concentrations of lutein and zeaxanthin.

The investigators concluded dietary β-cryptoxanthin intake and circulating concentrations of α-carotene, β-carotene and lutein and zeaxanthin reduce risk of bladder cancer.

Original title:
Carotenoid Intake and Circulating Carotenoids Are Inversely Associated with the Risk of Bladder Cancer: A Dose-Response Meta-analysis by Wu S, Liu Y, […], Ramirez AG.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31800007

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Objectives:
The morbidity of eczema has increased in the recent years and the methods to prevent or ameliorate its effects are becoming more important. Therefore, this review article has been conducted.

Do vitamin supplements reduce risk of eczema?

Study design:
This review article included 10 RCTs with a total of 456 patients.
The sample sizes ranged from 5 to 57. The studies were published from 2008 to 2018.
5 studies were conducted on atopic dermatitis, 3 studies were conducted on pediatric atopic dermatitis and 2 studies were conducted on winter-related atopic dermatitis.

Results and conclusions:
The investigators found that the SCORAD index or EASI scores significantly decreased in patients given vitamin D3 (cholecalciferol) supplements [mean difference = -5.96, 95% CI = -7.69 to -4.23, I2 = 33%].

The investigators found that the SCORAD index significantly decreased after the topical application of vitamin B12-containing cream [mean difference = -3.19, 95% CI = -4.27 to -2.10, I2 = 0%]. 

The investigators found that the SCORAD index significantly improved after vitamin E supplementation [mean difference = -5.72, 95% CI = -11.41 to -0.03, I2 = 0%]. 

The investigators concluded vitamin D3, B12 and E supplements could be important therapeutics to help manage eczema patients.

Original title:
Assessment of the Effectiveness of Vitamin Supplement in Treating Eczema: A Systematic Review and Meta-Analysis by Zhu Z, Yang Z, [...], Liu H.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6875217/

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Find here more information/studies about vitamin B12, D and E and chronic disease.

Objectives:
Current efforts for the prevention of malaria have resulted in notable reductions in the global malaria burden. However, they are not enough. Good hygiene is universally considered one of the most efficacious and straightforward measures to prevent disease transmission. Therefore, this review article has been conducted.

Do improved drinking water and sanitation (WS) conditions decrease risk of malaria infection?

Study design:
This review article included 49 eligible surveys comprising data for 247,440 individuals. Of the included individuals, 213,920 children aged 0-59 months were tested for malaria infection using microscopy, with a prevalence of 18.8%, whereas 59,988 (24.2%) positive cases were identified in 247,440 children by a malaria rapid diagnostic test (RDT).

Across all surveys, the average age of the children was 32.6 months and 50.2% were male.

The surveys were adjusted for age, gender, indoor residual spraying (IRS), insecticide-treated net (ITN) use, house quality and the mother's highest educational level.

Results and conclusions:
The investigators found in across all surveys, unprotected water was associated with an increased malaria risk of 17% [adjusted OR = 1.17, 95% CI = 1.07-1.27, p = 0.001] according to microscopy.

The investigators found in across all surveys, no facility users had an increased malaria risk of 35% [adjusted OR = 1.35, 95% CI = 1.24-1.47, p 0.001] according to microscopy.

The investigators found in across all surveys, piped water was associated with a decreased malaria risk of 48% [adjusted OR = 0.52, 95% CI = 0.45 -0.59, p 0.001] according to microscopy.

The investigators found in across all surveys, flush-toilet users had a decreased malaria risk of 49% [adjusted OR = 0.51, 95% CI = 0.43 -0.61, p 0.001] according to microscopy.

The investigators found the trends of individuals diagnosed by malaria rapid diagnostic test were consistent with those of individuals diagnosed by microscopy.

The investigators found in children with a “poor” socioeconomic status, no significant associations between unprotected water and flush toilets in relation to malaria infection, whereas in children with a “nonpoor” socioeconomic status, the associations between unimproved sanitation conditions (including unprotected water or no facilities) and the risk of malaria appeared to be pronounced.

The investigators concluded sanitation (WS) conditions are a vital risk factor for malaria infection among children (0-59 months) across sub-Saharan Africa (SSA) after adjustments for age, gender, IRS in the past 12 months and insecticide-treated use, house quality and mother’s highest educational level. Therefore, improved sanitation conditions should be considered a potential intervention for the prevention of malaria in the long term.

Original title:
Drinking water and sanitation conditions are associated with the risk of malaria among children under five years old in sub-Saharan Africa: A logistic regression model analysis of national survey data by Yang D, He Y, […], Liua Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6796660/

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

Objectives:
The relationship between serum copper (Cu) level and overweight/obesity remains controversial. Therefore, this review article (meta-analysis) has been conducted.

Does a high serum copper level increase overweight/obesity risk?

Study design:
This review article included 21 articles.

Results and conclusions:
The investigators found compared with controls, serum copper level was significantly higher in obese children [SMD = 0.74, 95% CI = 0.16 to 1.32] and in obese adults [SMD = 0.39, 95% CI = 0.02 to 0.76].

The investigators found no significant difference in serum copper level between overweight and control groups in children [SMD = 1.52, 95% CI = -0.07 to 3.12] and in adults [SMD = 0.16, 95% CI = -0.06 to 0.38].

The investigators found subgroup analysis revealed a higher serum copper level in obese children [SMD = 0.90, 95% CI = 0.36 to 1.45] and obese adults [SMD = 0.47, 95% CI = 0.05 to 0.88] compared with healthy weight controls.

The investigators found the SMD differed significantly between obese children diagnosed by weight-for-height and controls [SMD = 1.56, 95% CI = 0.57 to 2.55] and there was a significant difference of serum copper level between obese adults diagnosed by BMI (WHO) and controls [SMD = 0.54, 95% CI = 0.08 to 1.01].

The investigators concluded that a higher serum copper level increases risk of obesity in children and adults and these findings need to be further confirmed.

Original title:
The Relationship Between Serum Copper and Overweight/Obesity: a Meta-analysis by Gu K, Li X, […], Jiang X.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31300957

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Objectives:
Does alcohol consumption increase of risk of osteoporosis?

Study design:
This review article included  3 case control studies, 2 cohort studies and 1 cross-sectional study.

Results and conclusions:
The investigators found no association between consuming 0.5-1 drinks per day and the risk of developing osteoporosis [adjusted RR = 1.38, 95% CI = 0.90-2.12].
No association because RR of 1 was found in the 95% CI of 0.90 to 2.12. RR of 1 means no risk/association.

The investigators found compared with abstainers of alcohol, persons consuming 1-2 drinks per day had 1.34 times the risk of developing osteoporosis [adjusted RR = 1.34, 95% CI = 1.11-1.62].

The investigators found compared with abstainers of alcohol, persons consuming 2 drinks or more per day had 1.63 times the risk of developing osteoporosis [adjusted RR = 1.63, 95% CI = 1.01-2.65].

The investigators found a positive association between alcohol consumption and osteoporosis in the case-control studies [adjusted OR = 2.95, 95% CI = 1.78-4.90].

The investigators concluded there is a positive relationship between alcohol consumption, particularly 1 drink or more per day and osteoporosis.

Original title:
The effect of alcohol on osteoporosis: A systematic review and meta-analysis by Cheraghi Z, Doosti-Irani A, Almasi-Hashiani A, […], Mansournia MA.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30844616

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

Objectives:
Undernutrition is associated with an elevated risk of mortality among children in low- and middle-income countries. Small-quantity lipid-based nutrient supplements (LNS) have been evaluated as a method to prevent undernutrition and improve infant development, but the effects on mortality are unknown. Therefore, this review article has been conducted.

Do lipid-based nutrient supplements (LNS) reduce all-cause mortality among children 6-24 months old?

Study design:
This review article included 18 RCTs conducted in 11 countries that enrolled 41,280 children and reported 586 deaths.

Results and conclusions:
The investigators found in 13 RCTs compared to non-lipid-based nutrient supplements groups, that children in the lipid-based nutrient supplements groups had a significantly reduced risk of 27% [RR = 0.73, 95% CI = 0.59 to 0.89] for all-cause mortality among children 6-24 months old.
However, estimates were similar when trials with maternal lipid-based nutrient supplements intervention arms were added or when alternative formulations of lipid-based nutrient supplements were excluded.

The investigators found the results appeared stronger in trials in which lipid-based nutrient supplements were compared with passive control arms.
Excluding these contrasts and only comparing multicomponent arms with lipid-based nutrient supplements groups and comparison groups that contained all the same components without lipid-based nutrient supplements attenuated the effect estimate [RR = 0.82, 95% CI = 0.61 to 1.10]. 

The investigators concluded lipid-based nutrient supplements reduce all-cause mortality among children 6-24 months old. But more trials with appropriate comparison groups allowing isolation of the effect of lipid-based nutrient supplements alone are needed.

Original title:
Lipid-based nutrient supplements and all-cause mortality in children 6-24 months of age: a meta-analysis of randomized controlled trials by Stewart CP, Wessells KR, […], Dewey KG.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31697329

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Objectives:
Free fatty acids, also known as nonesterified fatty acids, are proinflammatory molecules that induce insulin resistance in nonpregnant individuals. Nevertheless, the concentration of these molecules has not been systematically addressed in pregnant women. Therefore, this review article has been conducted.

Do higher plasma levels of free fatty acids increase risk of gestational diabetes mellitus?

Study design:
This review article included 12 case-control studies with a total of 2,426 women, from these, 21% (507/2,426) had a diagnosis of having gestational diabetes.

The mean gestational age at inclusion was 30.3 weeks of gestation.
The mean maternal age was 29 years.
No significant publication bias was found nor a trend towards greater results in small studies.

Results and conclusions:
The investigators found in random-effects model, when compared to controls, women with gestational diabetes had higher levels of free fatty acids [SMD = 0.86, 95% CI = 0.54-1.18, p 0.001, I2 = 91%].
Pooled results showed higher plasma levels of free fatty acid among women with gestational diabetes mellitus during the second trimester of pregnancy [SMD = 1.05 vs. 0.75].

The investigators found meta-regression analysis showed that the gestational age at inclusion was the only cofactor influencing the mean levels of free fatty acids, indicating a trend towards lower plasma levels of free fatty acids later in gestation [estimate = -0.074, 95% CI = -0.143 to -0.004, p = 0.036].

The investigators concluded that plasma levels of free fatty acids are higher in women diagnosed with gestational diabetes mellitus and that this difference is higher during the second trimester of pregnancy. However, more investigation is needed to assess the potential role of free fatty acids in the prediction of gestational diabetes earlier in pregnancy.

Original title:
Plasma Levels of Free Fatty Acids in Women with Gestational Diabetes and Its Intrinsic and Extrinsic Determinants: Systematic Review and Meta-Analysis by Villafan-Bernal JR, Acevedo-Alba M, […], Martinez-Portilla RJ.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6721400/

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Objectives:
The role of zinc in the etiology of type 2 diabetes has been widely reported in recent decades. However, much remains uncertain concerning the effect of zinc on the risk of developing type 2 diabetes. Therefore, this review article has been conducted.

Does zinc reduce risk of type 2 diabetes?

Study design:
This review article included 16 studies.
There was no publication bias.

Results and conclusions:
The investigators found in 7 prospective cohort studies and 1 cross-sectional study (146,027 participants aged between 18 and 84 years and of both genders, belonging to different ethnic groups. Of which, 11,511 type 2 diabetes cases) when comparing the highest versus lowest dietary zinc intakes, a significantly reduced risk of 13% [OR = 0.87, 95% CI = 0.78-0.98, I2 = 64.5%, p = 0.003] for type 2 diabetes.
This relationship was stronger and more evident in rural compared to urban areas [rural areas: OR = 0.59, 95% CI = 0.48-0.73, I2 = 0.0%, p = 0.843 versus urban areas: OR = 0.94, 95% CI = 0.86-1.02, I2 = 43.9%, p = 0.113].

The investigators found no association between supplementary [OR = 0.94, 95% CI = 0.75-1.19, I2 = 85.4%, p = 0.009] or total zinc intake from both diet and supplementation [OR = 0.95, 95% CI = 0.82-1.11, I2 = 56.5%, p = 0.129] and type 2 diabetes risk.

The investigators found in population-based studies that high serum/plasma zinc levels significantly increased risk of type 2 diabetes with 64% [OR = 1.64, 95% CI = 1.25-2.14, I2 > 22.5%, p = 0.275].

The investigators concluded high dietary zinc intake reduces risk of type 2 diabetes. This relationship is stronger and more evident in rural compared to urban areas. However, an elevated serum/plasma zinc concentration is associated with an increased risk of type 2 diabetes in the general population.

Link:
Zinc Intake and Status and Risk of Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis by Fernández-Cao JC, Warthon-Medina M, […], Lowe NM.

Link:
https://www.mdpi.com/2072-6643/11/5/1027/htm

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Find more information/studies on diabetes and zinc consumption right here.

Serum/plasma zinc levels can be increased by eating products that contain a lot of zinc and/or taking zinc supplements.
 

Objectives:
Does vitamin K reduce risk of cardiovascular disease (CVD) events and mortality?

Study design:
This review article included 21 articles with 222,592 participants.

Results and conclusions:
The investigators found dietary phylloquinone (vitamin K1) intake significantly reduced risk of total cardiovascular disease with 8% [pooled HR = 0.92, 95% CI = 0.84 to 0.99, I2 = 0%, 4 studies].
Significant means that there is an association with a 95% confidence.

The investigators found dietary menaquinone (vitamin K2) intake significantly reduced risk of total cardiovascular disease with 30% [pooled HR = 0.70, 95% CI = 0.53 to 0.93, I2 = 32.1%, 2 studies].
Significant because HR of 1 was not found in the 95% CI of 0.53 to 0.93. HR of 1 means no risk/association.

The investigators found no significant association between dietary vitamin K and all-cause mortality, cardiovascular disease mortality or stroke.

The investigators found elevated plasma desphospho-uncarboxylated MGP (dp-ucMGP), a marker of vitamin K deficiency, was associated with an increased risk of 84% [HR = 1.84, 95% CI = 1.48 to 2.28, I2 = 16.8%, 5 studies] for all-cause mortality.

The investigators found elevated plasma desphospho-uncarboxylated MGP (dp-ucMGP), a marker of vitamin K deficiency, was associated with an increased risk of 96% [HR = 1.96, 95% CI = 1.47 to 2.61, I2 = 0%, 2 studies] for cardiovascular disease mortality.

The investigators found no significant association between circulating total osteocalcin and all-cause mortality or total cardiovascular disease.

The investigators concluded higher dietary vitamin K consumption reduces risk of cardiovascular disease and higher plasma dp-ucMGP concentration, but not total circulating osteocalcin, increases risk of all-cause and cardiovascular disease mortality. However, causal relations cannot be established because of limited number of available studies and larger prospective studies and randomized clinical trials are needed to validate these findings.  

Original title:
Association of vitamin K with cardiovascular events and all-cause mortality: a systematic review and meta-analysis by Chen HG, Sheng LT, […], Pan A.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31119401

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100 grams of fresh parsley provide 548 micrograms (548 mcg) of vitamin K1 or 4.5 days.
 

Objectives:
Patients with autoimmune inflammatory rheumatic diseases (AIIRD) are at increased risk of influenza, pneumococcal, herpes zoster and human papillomavirus infections, indicating the importance of their monitoring and use of vaccination to decrease the risk of these infections. Since 2009, a significant body of data has been published in the field of epidemiology of vaccine preventable infections (VPI) within autoimmune inflammatory rheumatic diseases population, including influenza, pneumococcal disease, herpes zoster, hepatitis B and human papillomavirus infection. However, no systematic literature review has been carried out yet. Therefore, this review article has been conducted.

Does vaccination decrease infections in patients with autoimmune inflammatory rheumatic diseases (AIIRD)?

Study design:
This review article included 63 studies (influenza (n=4), pneumococcal disease (n=7), hepatitis B (n=10), herpes zoster (HZ) (n=29), human papillomavirus (HPV) infection (n=13)).

Results and conclusions:
The investigators found an increased incidence of influenza and pneumococcal disease was reported in patients with autoimmune inflammatory rheumatic diseases.

The investigators found versus general population, patients with autoimmune inflammatory rheumatic diseases had a significantly increased risk of 190% [incidence rate ratio = 2.9, 95% CI = 2.4 to 3.3] for herpes zoster infection incidence.

The investigators found versus general population, patients with autoimmune inflammatory rheumatic diseases had a significantly increased risk of 410% [incidence rate ratio = 5.1, 95% CI = 4.3 to 5.9] for inflammatory myositis.

The investigators found versus general population, patients with autoimmune inflammatory rheumatic diseases had a significantly increased risk of 300% [incidence rate ratio = 4.0, 95% CI = 2.3 to 5.7] for systemic lupus erythematosus (SLE).

The investigators found versus general population, patients with autoimmune inflammatory rheumatic diseases had a significantly increased risk of 130% [incidence rate ratio = 2.3, 95% CI = 2.1 to 2.6] for rheumatoid arthritis.

The investigators found based on studies mainly conducted in the systemic lupus erythematosus population in Latin America and Asia, versus general population, patients with autoimmune inflammatory rheumatic diseases had a non-significantly increased risk of 60% [incidence rate ratio = 1.6, 95% CI = 0.7 to 3.4] for human papillomavirus (HPV) infection.

The investigators found pooled prevalence of hepatitis B surface antigen and hepatitis B core antibody in patients with autoimmune inflammatory rheumatic diseases was similar to the general population, 3% [95% CI = 1% to 5%] and 15% [95% CI = 7% to 26%], respectively.

The investigators concluded current evidence shows an increased risk of vaccine preventable infections in patients with autoimmune inflammatory rheumatic diseases, emphasising that prevention of infections is essential in these patients. In addition, it highlights the importance of the epidemiological research of the incidence and prevalence of vaccine preventable infections in patients with autoimmune inflammatory rheumatic diseases. The proposed research agenda, therefore, includes the collection of reliable epidemiological data using standardised methodology of disease rates and development of prevention and control strategies for infectious diseases in patients with autoimmune inflammatory rheumatic diseases.

Original title:
Incidence and prevalence of vaccine preventable infections in adult patients with autoimmune inflammatory rheumatic diseases (AIIRD): a systemic literature review informing the 2019 update of the EULAR recommendations for vaccination in adult patients with AIIRD by Furer V, Rondaan C, [...], Elkayam O.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6803008/

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Objectives:
Is there an association between dietary fat intake and the risk of three major types of skin cancer including basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and cutaneous malignant melanoma (CMM)?

Study design:
This review article included 3 prospective cohort studies (175,675 participants and 30,915 basal cell carcinoma cases, 4,106 squamous cell carcinoma cases and 1,638 cutaneous malignant melanoma cases) and 9 case-control studies (328 basal cell carcinoma cases, 493 squamous cell carcinoma cases, 1,547 cutaneous malignant melanoma cases and 2,660 controls).

Results and conclusions:
The investigators found pooled results indicated that dietary consumption of total fat and saturated fat were not associated with 3 major types of skin cancer.

The investigators found high consumption of monounsaturated fat was significantly associated with a decreased risk of 10% for basal cell carcinoma [RR = 0.90, 95% CI = 0.85 to 0.96]. 

The investigators found high consumption of polyunsaturated fat was significantly associated with an increased risk of 19% for squamous cell carcinoma [RR = 1.19, 95% CI = 1.06 to 1.33]. 

The investigators concluded high consumption of monounsaturated fat decreases risk of basal cell carcinoma while high consumption of polyunsaturated fat increases risk of squamous cell carcinoma. However, these findings should be confirmed by further evidence from well-designed and large-scale prospective cohort studies.

Original title:
Dietary Fat Intake and the Risk of Skin Cancer: A Systematic Review and Meta-Analysis of Observational Studies by Ruan L, Cheng SP and Zhu QX.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31298947

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Find more information/studies on fat consumption and cancer right here.
 

Objectives:
Do older adults benefit from high protein intake (>0.8 g/kg body weight/day)?

Study design:
This review article included 12 cohort studies and 1 RCT.
Studies had an intervention duration of at least 6 months.

Results and conclusions:
The investigators found meta-analysis of the cohort studies showed that high vs low protein intake resulted in a statistically significant decrease of 11% for hip fractures [pooled HR = 0.89, 95% CI = 0.84 to 0.94, p 0.001, I2 = 0.0%, p = 0.614].
Sensitivity analyses showed that there was no single study affecting the overall estimate considerably.

The investigators concluded there is an association between a dietary protein intake above the current RDA of 0.8 g/kg body weight/day and a reduced hip fracture risk in older adults. In comparison with younger adults, the body of evidence from the included studies is not strong enough to increase the protein recommendation for older adults with respect to bone health.

Original title:
High Versus low Dietary Protein Intake and Bone Health in Older Adults: a Systematic Review and Meta-Analysis by Groenendijk I, den Boeft L , [...], de Groot LCPGM.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6704341/

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

A protein intake higher than 0.8 g/kg body weight/day corresponds to a diet with a minimum of 11 En% protein. The easiest way to follow a diet with at least 11 En% protein is to choose only products that contain at least 11 En% protein. These products from the supermarket contain at least 11% En% protein.
 

Objectives:
Does strength training improve total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), C-reactive protein (CRP) and adiponectin levels of adults?

Study design:
This review article included clinical trials up to May 2017.

Results and conclusions:
The investigators found strength training significantly reduced total cholesterol levels [ES = -0.399, p  0.001]. 

The investigators found strength training significantly reduced triglycerides levels [ES = -0.204, p = 0.002]. 

The investigators found strength training significantly reduced LDL cholesterol levels [ES = -0.451, p  0.001]. 

The investigators found strength training significantly reduced CRP levels [ES = -0.542, p = 0.01]. 

The investigators found strength training significantly increased HDL cholesterol levels [ES = 0.363, p  0.001]. 

The investigators found strength training significantly increased adiponectin levels [ES = 1.105, p = 0.01]. 

The investigators concluded strength training promotes decreases in total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL) (also called bad cholesterol), C-reactive protein (CRP) levels and increases high-density lipoprotein (HDL) (also called good cholesterol) and adiponectin levels of adults. Thus, progressive strength training could be a potential therapeutic option for improving abnormalities in lipid and inflammatory outcomes in adults.

Original title:
Effect of Strength Training on Lipid and Inflammatory Outcomes: Systematic Review With Meta-Analysis and Meta-Regression by Costa RR, Buttelli ACK, […], Kruel LFM.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31023184

Additional information of El Mondo:
Find here more information/studies cholesterol and sport nutrition.

Objectives:
Pregnancy-associated malaria (PAM) has been associated with adverse pregnancy outcomes like preterm birth (PTB) and low birth weight (LBW), which are among the leading causes of infant mortality globally. Rates of preterm birth and low birth weight are high in countries with a high burden of malaria. Pregnancy-associated malaria may be a contributing factor to preterm birth and low birth weight, but is not well understood. Therefore, this review article has been conducted.

Does pregnancy-associated malaria increase risk of preterm birth and low birth weight?

Study design:
This review article included 18 studies (8 studies examined associations between pregnancy-associated malaria and preterm birth and 10 examined associations between pregnancy-associated malaria and low birth weight).

The population size ranged from 35 to 9,956 women.

Results and conclusions:
The investigators found when compared with women without pregnancy-associated malaria, pregnancy-associated malaria significantly increased risk of low birth weight with 63% [95% CI = 1.48-1.80].

The investigators found when compared with women without pregnancy-associated malaria, pregnancy-associated malaria significantly increased risk of preterm birth with 23% [95% CI = 1.07-1.41].

The investigators concluded pregnancy-associated malaria increases risk of preterm birth and low birth weight. Further understanding of the pathogenesis of disease and the immunologic changes that occur during pregnancy is essential for reducing the disproportional effects this disease has on this vulnerable population.

Original title:
Relationship Between Pregnancy-Associated Malaria and Adverse Pregnancy Outcomes: a Systematic Review and Meta-Analysis by Thompson JM, Eick SM, […], Welton M.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31598714

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

Objectives:
Does consumption of fruit or vegetables reduce risk of metabolic syndrome (MetS)?

Study design:
This review article included 9 observational studies (7 cross-sectional studies and 2 cohort studies).

Results and conclusions:
The investigators found in a dose-response analysis of 2 cohort studies and 7 cross-sectional studies, that an increase of 100 g/d in fruit consumption significantly reduced risk of metabolic syndrome with 3% [OR = 0.97, 95% CI = 0.95 to 0.99, I2 = 26.7%], whereas an increase of 100 g/d in vegetable consumption (9 studies) was not associated with a reduction in the metabolic syndrome [OR = 0.98, 95% CI = 0.96 to 1.01, I2 = 54.6%].

The investigators concluded 100 g/d fruit consumption reduces risk of metabolic syndrome. However, prospective studies or randomised clinical trials are needed to identify the effects of fruits by variety on the risk of the metabolic syndrome.

Original title:
Fruit and vegetable consumption and the metabolic syndrome: a systematic review and dose-response meta-analysis by Lee M, Lim M and Kim J.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31514758

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

Objectives:
Does magnesium reduce risk of type 2 diabetes?

Study design:
This review article included 35 cohort studies and 26 RCTs (1,168 participants).

Results and conclusions:
The investigators found compared to the lowest magnesium dietary intake, the highest level was associated with a 22% lower risk for type 2 diabetes.

The investigators found the risk for type 2 diabetes was reduced by 6% for each 100mg increment in daily magnesium dietary intake.

The investigators found in 26 RCTs (1,168 participants) that magnesium supplementation significantly reduced:
-the fasting plasma glucose (FPG) level [SMD = -0.32, 95% CI = -0.59 to -0.05];
-2-h oral glucose tolerance test (2-h OGTT) result [SMD = -0.30, 95% CI = -0.58 to -0.02];
-fasting insulin level [SMD = -0.17, 95% CI = -0.30 to -0.04];
-homeostatic model assessment-insulin resistance (HOMA-IR) score [SMD = -0.41, 95% CI = -0.71 to -0.11];
-triglyceride (TG) level;
-systolic blood pressure (SBP) and;
-diastolic blood pressure (DBP).

The investigators found trial sequential analysis (TSA) showed an inverse association, with most benefits of magnesium supplementation on glucose metabolism being stable.

The investigators concluded magnesium dietary intake has an inverse dose-response association with type 2 diabetes incidence and supplementation appears to be advisable in terms of glucose parameters in type 2 diabetes/high-risk individuals.

Original title:
Association of Magnesium Consumption with Type 2 Diabetes and Glucose Metabolism: a Systematic Literature Review and Pooled Study with Trial Sequential Analysis by Zhao B, Deng H, [...], Zhang W.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31758631

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

Objectives:
Do low folate levels and vitamin B12 levels increase risk of depression among the aged people?

Study design:
This review article included both gender data of 11 folate-related (7,949 individuals) and 9 B12-related studies (6,308 individuals) and gender-specific data of 4 folate-related (3,409 individuals) and 3 B12-related studies (1,934 individuals).

Results and conclusions:
The investigators found low folate levels significantly increased risk of depression among the aged people with 23% [OR =1.23, 95% CI =1.07-1.43]. 

The investigators found low vitamin B12 levels significantly increased risk of depression among the aged people with 20% [OR =1.20, 95% CI =1.02-1.42]. 

The investigators found in subgroup analysis low vitamin B12 levels significantly increased risk of depression among the aged women with 33% [OR =1.33, 95% CI =1.02-1.74]. 

The investigators concluded both low folate levels and low vitamin B12 levels increase risk of depression among the aged people.

Original title:
Folate and B12 serum levels in association with depression in the aged: a systematic review and meta-analysis by Petridou ET, Kousoulis AA, [...], Stefanadis C.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/26055921

Additional information of El Mondo:
Find more information/studies on vitamin B12, folate and elderly.
 

Objectives:
Low-potassium diets are recommended to reduce serum potassium (Sk) and prevent complications of chronic kidney disease (CKD), but evidence underpinning this recommendation has not been systematically reviewed and synthesized. Therefore, this review article has been conducted.

Do patients with chronic kidney disease benefit from low-potassium diets?

Study design:
This review article included 7 studies  with 3,489 participants.

Results and conclusions:
The investigators found in very-low-quality studies that restricted (1,295 mg/d) versus unrestricted (1,570 mg/d) dietary potassium lowered serum potassium by 0.22 mEq/L [95% CI = -0.33 to -0.10, I2 = 0%].

The investigators found in very-low-quality studies that lower (1,725 mg/d) versus higher (4,558 mg/d) dietary potassium was not significantly associated with disease progression [HR = 1.14, 95% CI = 0.77 to 1.70, I2 = 57%].

The investigators found in very-low-quality studies that lower (1,670 mg/d), compared with higher (4,414 mg/d) dietary potassium intake was associated with a 40% reduction in mortality hazard [HR = 0.60, 95% CI = 0.40 to 0.89, I2 = 56%].

The investigators concluded very-low-quality evidence supports consensus that dietary potassium restriction reduces serum potassium in normokalemia and is associated with a reduced risk of death in those with chronic kidney disease. However, high-quality randomized controlled trials are needed to confirm these findings.

Original title:
Effect of Dietary Potassium Restriction on Serum Potassium, Disease Progression, and Mortality in Chronic Kidney Disease: A Systematic Review and Meta-Analysis by Morris A, Krishnan N, […], Lycett D.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31734057

Additional information of El Mondo:
Find here more information/studies about potassium and kidney disease.

Objectives:
Observational evidence suggests higher nut consumption is associated with better glycemic control. However, it is unclear if this association is causal. Therefore, this review article has been conducted.

Is there a causal relationship between consumption of tree nuts or peanuts and reduced risk of type 2 diabetes?

Study design:
This review article included a total of 40 RCTs with 2,832 unique participants, with a median duration of 3 months (range: 1-12 months).

Results and conclusions:
The investigators found overall consumption of tree nuts or peanuts had a favourable effect on HOMA-IR values [WMD = -0.23, 95% CI = -0.40 to -0.06, I2 = 51.7%] and fasting insulin levels [WMD = -0.40 μIU/mL, 95% CI = -0.73 to -0.07 μIU/mL, I2 = 49.4%].

The investigators found, however, there was no significant effect of nut consumption on fasting blood glucose levels [WMD = -0.52 mg/dL, 95% CI = -1.43 to 0.38 mg/dL, I2 = 53.4%] or HbA1c [WMD = 0.02%, 95% CI = -0.01% to 0.04%, I2 = 51.0%].

The investigators concluded consumption of peanuts or tree nuts decreases HOMA-IR and fasting insulin levels. These findings suggest that nut consumption may improve insulin sensitivity. In the future, well-designed clinical trials are required to elucidate the mechanisms that account for these observed effects.

Original title:
The effect of nuts on markers of glycemic control: a systematic review and meta-analysis of randomized controlled trials by Tindall AM, Johnston EA, […], Petersen KS.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30722007

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

Objectives:
Parkinson's disease (PD) is the most common neurodegenerative disease after Alzheimer's dementia. Whereas the exact etiology of Parkinson's disease remains unknown, risk of developing Parkinson's disease seems to be related to a combination of genetic and environmental factors. This also includes abnormal exposure to trace elements of nutritional and toxicological interest. Therefore, this review article has been conducted.

Is there a relationship between exposure to trace elements and Parkinson’s disease risk?

Study design:
This review article included 56 case-control studies reporting data for selenium (cases/controls: 588/721), copper (2,190/2,522), iron (2,956/3,469) and zinc (1,798/1,913) contents in cerebrospinal fluid (CSF) and blood.

Results and conclusions:
The investigators found patients with Parkinson's disease had significantly higher levels of selenium in cerebrospinal fluid compared with controls [+51.6%, WMD = 5.49, 95% CI = 2.82 to 8.15], while levels in serum were similar [-0.2%, WMD = -0.22, 95% CI = -8.05 to 7.62].

The investigators found patients with Parkinson's disease had non-significantly higher levels of copper in cerebrospinal fluid compared with controls [+4.5%, WMD = 1.87, 95% CI = -3.59 to 7.33] and non-significantly lower levels of copper in serum [WMD = -42.79, 95% CI = -134.35 to 48.76].

The investigators found patients with Parkinson's disease had significantly higher levels of iron in cerebrospinal fluid compared with controls [+9.5%, WMD = 9.92, 1.23 to 18.61] and significantly lower levels of iron both in serum/plasma [-5.7%, WMD = -58.19, 95% CI = -106.49 to -9.89] and whole blood [-10.8%, WMD = -95.69, 95% CI = -157.73 to -33.65].

The investigators found patients with Parkinson's disease had significantly lower levels of zinc in cerebrospinal fluid compared with controls [-10.8%, WMD = -7.34, 95% CI = -14.82 to -0.14] and significantly lower levels of zinc in serum/plasma [-7.5%, WMD = -79.93, 95% CI = -143.80 to -16.06].

The investigators found a longer duration of the disease tends to be associated with overall lower trace element levels in either cerebrospinal fluid or blood.

The investigators concluded higher levels of both selenium and iron in cerebrospinal fluid increase Parkinson's disease, while higher levels of zinc in cerebrospinal fluid decrease Parkinson's disease.

Original title:
Selenium and Other Trace Elements in the Etiology of Parkinson's Disease: A Systematic Review and Meta-Analysis of Case-Control Studies by Adani G, Filippini T, […], Vinceti M.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31454800

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

Objectives:
Does omega-3 fatty acids supplementation improve serum levels of inflammatory biomarkers (C-reactive protein [CRP], high-sensitivity CRP [hs-CRP], tumor necrosis factor-alpha, interleukin-6) and albumin in patients on hemodialysis?

Study design:
This review article included 8 RCTs comprising 371 patients on hemodialysis.

Results and conclusions:
The investigators found omega-3 supplementation significantly decreased serum levels of CRP in patients on hemodialysis [SMD = -1.95 mg/dL, 95% CI = -3.09 to -0.80] and hs-CRP [SMD = -2.09, 95% CI = -3.62 to -0.56].

The investigators found, however, omega-3 supplementation did not significantly improved albumin [SMD = 0.91, 95% CI = -0.78 to 2.59], tumor necrosis factor-alpha [SMD = -1.51, 95% CI = -3.24 to 0.22] and interleukin-6 levels [SMD = 0.72, 95% CI = -0.56 to 1.99] in patients on hemodialysis.

The investigators concluded omega-3 supplementation leads to a significant decrease in serum levels of CRP and hs-CRP in patients on hemodialysis.

Original title:
The Effect of Omega-3 Supplementation on Serum Levels of Inflammatory Biomarkers and Albumin in Hemodialysis Patients: A Systematic Review and Meta-analysis by Dezfouli M, Moeinzadeh F, [...], Feizi A.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31420233

Additional information of El Mondo:
Find here more information/studies about omega-3 fatty acids and kidney disease.