Nutritional advice

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Does probiotics supplementation prevent overweight/obesity in adults?

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

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

There was no significant publication bias.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Does intake of fruits and vegetables reduce risk of fractures?

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

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

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

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

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

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

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

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

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

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

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

Study design:
This review article included 17 RCTs.

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

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

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

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

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

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

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

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

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

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

Study design:
This review article included 11 RCTs.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Objectives:
Malaria parasites have developed resistance to most of the known antimalarial drugs in clinical practice, with reports of artemisinin resistance emerging in South East Asia (SEA). Therefore, this review article (meta-analysis) has been conducted.

The aim of this review article is find the status of artemisinin resistance and efficacy of different modalities of the current artemisinin-based combination therapies (ACTs).

Study design:
This review article included 82 studies for qualitative and quantitative analysis.

Results and conclusions:
The investigators found artemisinin resistance was only reported in South East Asia. K13 mutation C580Y was the most abundant mutation associated with resistance having an abundance of 63.1% among all K13 mutations reported.

The investigators found although the overall network meta-analysis had shown good performance of dihydroartemisinin piperaquine in the early years, a subgroup analysis of the recent years revealed a poor performance of the drug in relation to recrudescence, clinical failure and parasitological failure especially in the artemisinin resistant regions.

The investigators concluded with report of high resistance and treatment failure against the leading artemisinin combination therapy in South East Asia, it is imperative that a new drug or a formulation is developed before further spread of resistance.

Original title:
Efficacy and resistance of different artemisinin-based combination therapies: a systematic review and network meta-analysis by Mathenge PG, Low SK, […], Hirayama K.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31015034

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Find more information/studies on food fortification/malnutrition and malaria right here.

Objectives:
The associations between dietary fat intake and cognitive function are inconsistent and inconclusive. Therefore, this review article has been conducted.

Is there a relationship between different types of fat intake and cognitive impairment?

Study design:
This review article included 9 prospective cohort studies covering a total of 23,402 participants.

Results and conclusions:
The investigators found compared with the lowest category of consumption, the highest category of saturated fat consumption significantly increased risk of cognitive impairment with 40% [RR = 1.40, 95% CI = 1.02-1.91].

The investigators found compared with the lowest category of consumption, the highest category of saturated fat consumption significantly increased risk of Alzheimer disease with 87% [RR = 1.87, 95% CI = 1.09-3.20].

The investigators found total and unsaturated fat dietary intakes were not statistically associated with cognitive outcomes with significant between-study heterogeneity.

The investigators concluded there is an increased risk between saturated fat consumption and both cognitive impairment and Alzheimer disease. Given the substantial heterogeneity in the sample size and methodology used across studies, the evidence presented here should be interpreted with caution.

Original title:
Dietary Fat Intake and Cognitive Function among Older Populations: A Systematic Review and Meta-Analysis by Cao GY, Li M, […], Xu B.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31062836

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Find more information/studies on saturated fat intake, dementia and elderly right here.

A diet with a high saturated fat intake is a diet with >10 En% saturated fat.
>10 En% saturated fat means that the total amounts of saturated fat make up for >10% of the total kcal of the diet.
The easiest way to follow this diet is to choose only meals/products that also contain 10 En% saturated fat.
Check here which products contain >10 En% saturated fat.

A diet with a low saturated fat intake is a diet with 7 En% saturated fat.

Objectives:
Dietary polyphenols, including flavonoids, have been the focus of major recent attentions due to their wide content in a variety of foods commonly consumed and the findings from numerous studies showing evidence of an association with positive outcomes on human health. Therefore, this review article has been conducted.

Does dietary intake of flavonoids (e.g., anthocyanins, isoflavones, flavones, flavonols, flavanones, flavan-3-ols) reduce hypertension?

Study design:
This review article included 15 cross-sectional investigations and 7 prospective cohort studies (1 study reported on 3 prospective cohort studies).
5 prospective cohort studies, comprising 200,256 individuals and 45,732 cases of hypertension were included in the quantitative analysis.

All studies included covariates that may have significantly influenced the endpoint outcome (hypertension), such as age, sex (when not analyzed separately), BMI, education, physical activity and smoking status. However, not all studies adjusted for key dietary factors that might influence risk of hypertension, such as sodium and potassium intake.

There was no publication bias.

Results and conclusions:
The investigators found analysis by extreme quantiles of intake of flavonoid showed a non-significant association with decreased risk of hypertension [risk ratio = 0.96, 95% CI = 0.89 to 1.03, I2 = 74%, p = 0.01].
Non-significant because RR of 1 was found in the 95% CI of 0.89 to 1.03. RR of 1 means no risk/association.

The investigators found taking into consideration individual flavonoid subclasses, dietary intake of anthocyanins was associated with 8% reduction in risk of hypertension, when comparing highest vs. lowest exposure [risk ratio = 0.92, 95% CI = 0.88 to 0.97].
Significant because RR of 1 was not found in the 95% CI of 0.88 to 0.97. RR of 1 means no risk/association.

The investigators concluded dietary intakes of anthocyanins reduce risk of hypertension. However, further studies are needed to elucidate the retrieved association between polyphenol consumption and decreased risk of hypertension and to clarify whether individual subclasses, rather than the total content of polyphenols, may exert beneficial effects on blood pressure.

Original title:
Dietary Polyphenol Intake, Blood Pressure, and Hypertension: A Systematic Review and Meta-Analysis of Observational Studies by Godos J, Vitale M, […], Grosso G.

Link:
https://www.mdpi.com/2076-3921/8/6/152/htm

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

Objectives:
Does dietary intake of n-3 PUFAs (such as DHA, EPA, DPA and ALA) or fish consumption improve lung function?

Study design:
This review article included 9 cohort studies from the Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium (n = 37,077 black and white participants).

In each cohort and each ancestry, separately, associations of dietary n-3 PUFA/fish intake with lung function were estimated in linear regression models.
Fixed-effects meta-analysis was used to generate summarized effect estimates across the cohorts and ancestries.

The lung function was measured by the forced expiratory volume in 1 second (FEV1) and the forced vital capacity (FVC).

Results and conclusions:
The investigators found dietary DPA, DHA, EPA and fish intake significantly improved forced expiratory volume in one second (FEV1) and forced vital capacity (FVC).
However, dietary α-linolenic acid (ALA) had little to no association with these lung function parameters.

The investigators found associations were similar for black and white participants and consistent in direction and magnitude across most cohort studies.

The investigators found for all participants, 1 standard deviation (SD) higher dietary intake of DPA (∼30 mg/d), DHA (∼200 mg/d) and EPA (∼150 mg/d) were associated with 12-16 mL higher FEV1 and 10-15 mL higher FVC.
The effect estimates for fish consumption were in the same direction but smaller in magnitude.

The investigators found ∼200 mg/d DHA and ∼150 mg/d EPA were associated with 28-32 mL higher FEV1 and 24-25 mL higher FVC in current smokers.

The investigators found ∼200 mg/d DHA and ∼150 mg/d EPA were associated with 17-21 mL higher FEV1 and 7-12 mL higher FVC in former smokers.

The investigators found ∼200 mg/d DHA and ∼150 mg/d EPA had little to no association with FEV1 and FVC in never smokers.

The investigators concluded that dietary ∼200 mg/d DHA, ∼30 mg/d DPA and ∼150 mg/d EPA and fish intake are associated with higher lung function, especially among current and former smokers.

Original title:
Positive Associations of Dietary Marine Omega-3 Polyunsaturated Fatty Acids with Lung Function: A Meta-analysis (P18-087-19) by Patchen B, Xu J, […], Cassano P.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6579416/  

Additional information of El Mondo:
Find more information/studies on fish consumption, review article/significantly and chronic disease right here.

DHA, DPA and EPA are found in fish.

 

Objectives:
Whether exercise can improve cardiovascular health in kidney transplant recipients (KTRs) is unclear. Therefore, this review article (meta-analysis) has been conducted.

Does exercise improve cardiovascular health in kidney transplant recipients?

Study design:
This review article included 12 RCTs (trials) in the review and 11 RCTs for further qualitative analysis.
Most trials provided a 30-60 minutes exercise session for 2-4 times per week.
In terms of the total intervention period, most trials ranged from 10 weeks to 6 months.

Results and conclusions:
The investigators found in 5 trials with a total of 199 participants that exercise had no effects on either systolic [MD = 1.67, 95% CI = -2.17 to 5.51, p = 0.39] or diastolic blood pressure [MD = 0.65, 95% CI = -4.02 to 5.32, p = 0.78].

The investigators found in 3 trials with a total of 261 participants that exercise had no significant benefits in overall lipid profile [MD = 0.03, 95% CI = -0.09 to 0.15, p = 0.62].
In subgroup analysis, total cholesterol [p = 0.15], LDL cholesterol [p = 0.83] and triglyceride [p = 0.82] were not ameliorated by exercise.

The investigators found in 2 trials with 22 subjects in the exercise group and 28 controls that a 12 months of resistance training or regimens of aerobic or resistance training for 12 weeks was not associated with an improvement in kidney function [MD = 2.60, 95% CI = -12.88 to 13.09, p = 0.74].

The investigators found that aerobic training, resistance training or the combination during 12 weeks to 12 months was not associated with an improvement on body weight [MD = -2.02, 95% CI = -8.24 to 4.20, p = 0.52, n = 3] or BMI [MD = 0.12, 95% CI = -1.52 to 1.77, p = 0.88, n = 4].

The investigators found in 2 trials with a total of 64 participants that a 12-week exercise showed a consistent improvement in small arterial stiffness [MD = -1.14, 95% CI = -2.19 to -0.08, p = 0.03].

The investigators found in 5 trials with a total of 202 participants that aerobic training, resistance training or combined method over the course of 12 weeks to 12 months had a significant improvement in exercise capacity (VO₂ peak) [MD = 2.25, 95% CI = 0.54 to 3.69, p = 0.01]. 

The investigators found exercise improved quality of life in different aspects, with significant enhancement in social functioning [MD = 16.76, 95% CI = 2.16 to 31.37, p = 0.02] and overall QOL scores [MD = 12.87, 95% CI = 6.80 to 18.94, p 0.01].

The investigators concluded exercise intervention in kidney transplant recipients improves arterial stiffness and it also improves exercise tolerance and quality of life. Additional long-term RCTs examining a greater number of patients are needed to understand the effects of exercise on cardiovascular health in kidney transplant recipients.

Original title:
Effects of exercise training on cardiovascular risk factors in kidney transplant recipients: a systematic review and meta-analysis by Chen G, Liu Gao L and Li X.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6534232/

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

Objectives:
Recent evidence has encouraged low- and middle-income countries to consider transitioning from long-standing iron and folic acid supplementation (IFA) to multiple micronutrient supplementation (MMS) during pregnancy; however, global guidance is limited. Therefore, this review article (meta-analysis) has been conducted.

The aim of this review article is to evaluate the incremental cost-effectiveness of transitioning from long-standing iron and folic acid supplementation (IFA) to multiple micronutrient supplementation (MMS).

Study design:
This review article included data of 2 meta-analyses published in 2017 (Cochrane and The Lancet).

Impacts on health outcomes were aggregated using disability-adjusted life years (DALYs). Costs included the supplements and their distribution through antenatal care. The incremental cost-effective ratio (ICER) for transitioning from IFA to MMS was calculated for each country under each meta-analysis scenario and Monte Carlo simulations were applied to generate a measure of certainty around the results.

Results and conclusions:
The investigators found the effectiveness of transitioning from long-standing iron and folic acid supplementation (IFA) to multiple micronutrient supplementation (MMS)
under the Cochrane scenario was smaller and less certain compared with The Lancet scenario.

The investigators found, however, even under the Cochrane scenario, MMS would avert 4,391, 5,769 and 8,578 more DALYs than IFA per 100,000 pregnancies in Pakistan, India and Bangladesh, respectively (62.6%, 76.8% and 82.6% certainty).

The investigators found the ICER of transitioning from IFA to MMS was 41.54, 31.62 and 21.26 US dollars (USD 2016) per DALY averted, respectively.

The investigators concluded despite discrepancies in the overall effect of multiple micronutrient supplementation (MMS) depending on the meta-analysis used, multiple micronutrient supplementation is cost-effective and generates positive health outcomes for both infants and pregnant women. Whilst the effectiveness of multiple micronutrient supplementation is sensitive to the prevalence of certain health outcomes under the conservative scenario (Cochrane), multiple micronutrient supplementation nevertheless averts more DALYs than long-standing iron and folic acid supplementation (IFA) with high certainty and should re-enter public health discussion in Pakistan, India and Bangladesh.

Original title:
Multiple Micronutrient Supplements Are More Cost-effective Than Iron and Folic Acid: Modeling Results from 3 High-Burden Asian Countries by Kashi B, M Godin C, [...[, De-Regil LM.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31131412

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

Objectives:
The role of fruit and vegetables (FVs) consumption in decreasing gallstone disease risk remains contradictory.Therefore, this review article has been conducted.

Does fruit or vegetables consumption reduce risk of gallstone disease?

Study design:
This review article included 1 cross-sectional study, 1 case-control studie and 9 cohort studies, covering approximately 33,983 patients with gallstone disease and 1,53,3752 participants.

Results and conclusions:
The investigators found in a pooled analysis, vegetables consumption was significantly related to a decreased gallstone disease risk of 17% [RR  =  0.83, 95% CI = 0.74-0.94, I2  =  91.1%]. This reduced gallstone disease risk was solid in most subgroup analysis.

The investigators found in a pooled analysis, fruits consumption was significantly related to a decreased gallstone disease risk of 12% [RR  =  0.88, 95% CI = 0.83-0.92, I2  =  0.01%].  
This reduced gallstone disease risk was solid in most subgroup analysis.

The investigators found nonlinear dose-response analysis indicated that gallstone risk was reduced by 4% [RR  =  0.96, 95% CI = 0.93-0.98, p =0.001] for every 200 g per day increment in vegetables consumption.

The investigators found nonlinear dose-response analysis indicated that gallstone risk was reduced by 3% [RR  =  0.97, 95% CI = 0.96-0.98, p =0.001] for every 200 g per day increment in fruits consumption.

The investigators concluded that vegetables and fruits consumption, particularly 200g fruits or 200g vegetables per day is correlated with a reduced risk of gallstone disease.

Original title:
Fruits and vegetables consumption and the risk of gallstone diasease: A systematic review and meta-analysis by Zhang JW, Xiong JP, [...], Zhao HT.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31305451

Additional information of El Mondo:
Find here more information/studies about chronic disease and vegetables and fruits consumption.

Objectives:
Preventing cardiovascular disease (CVD) is the top priority in public health. Hyperlipidemia and hypertension are key contributors to cardiovascular disease which can be easily modified with dietary and lifestyle interventions. Therefore, this review article has been conducted.

Does cashew consumption reduce blood lipids levels (i.e., triglyceride, total cholesterol, HDL cholesterol (good cholesterol) and LDL cholesterol (bad cholesterol) and blood pressure?

Study design:
This review article included 5 RCTs with 246 participants receiving cashew nut (intervention group) and 235 receiving placebo (placebo group).

There was no publication bias.

Results and conclusions:
The investigators found overall analysis showed a statistically significant reducing effect of cashew nut consumption on triglyceride levels [WMD = -14.39, 95% CI = -27.30 to -1.49, I2 = 82%].
Significant means that there is an association with a 95% confidence.

The investigators found overall analysis showed a statistically significant reducing effect of cashew nut consumption on systolic blood pressure [WMD = -1 mm/Hg, 95% CI = -5.12 to -3.01, I2 = 0%].

The investigators found overall analysis showed a statistically significant reducing effect of cashew nut consumption on diastolic blood pressure [WMD = -4.06 mm/Hg, 95% CI = -1.65 to -0.35, I2 = 0%].

The investigators found, however, no statistically significant changes of other cardiovascular risk markers including total cholesterol [WMD = -1.89, 95% CI = -9.17 to 5.39, p = 0.61], LDL cholesterol [WMD = -5.49, 95% CI = -16.76 to 5.78, p = 0.34] and HDL cholesterol [WMD = -0.67, 95% CI = -2.54 to 1.19, p = 0.48] were observed after cashew nut consumption.
No statistically significant because the calculated p-values of e.g. 0.61 or 0.34 were larger than the p-value of 0.05.

The investigators concluded that cashew consumption improves triglyceride levels as well as systolic and diastolic blood pressure with no significant effects on other cardiometabolic factors (i.e., total cholesterol, HDL cholesterol (good cholesterol) and LDL cholesterol (bad cholesterol)). Further studies are warranted with different calories and dietary compositions.

Original title:
The Effect of Cashew Nut on Cardiovascular Risk Factors and Blood Pressure: A Systematic Review and Meta-analysis (P06-117-19) by Mahboobi S.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6573847/

Additional information of El Mondo:
Find more information/studies on cashew consumption, cholesterol and cardiovascular diseases right here.

Objectives:
Does calcium supplement with or without other drugs reduce risk of preeclampsia and gestational hypertension?

Study design:
This review article included 27 RCTs, with 28,492 pregnant women.

Results and conclusions:
The investigators found calcium supplement significantly reduced risk of preeclampsia with 49% [RR = 0.51, 95% CI = 0.40 to 0.64].

The investigators found calcium supplement significantly reduced risk of gestational hypertension with 30% [RR = 0.70, 95% CI = 0.60 to 0.82].

The investigators found sub-analyses revealed high-dose (1.2-2 g/day), moderate-dose (0.6-1.2 g/day) and low-dose (0.6 g/day) of calcium supplement significantly reduced risk of preeclampsia.

The investigators found sub-analyses revealed high-dose (1.2-2 g/day) and moderate-dose (0.6-1.2 g/day) of calcium supplement significantly reduced risk of gestational hypertension.

The investigators concluded high-dose (1.2-2 g/day) and moderate-dose (0.6-1.2 g/day) of calcium supplement reduced both risk of preeclampsia and gestational hypertension. However, further studies with direct comparison of different dose of calcium supplementation are needed to explore the ideal dose of calcium supplementation to prevent preeclampsia and gestational hypertension.

Original title:
The association between calcium supplement and preeclampsia and gestational hypertension: a systematic review and meta-analysis of randomized trials by Sun X, Li H, [...], Zhang X.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30935246

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

 

Objectives:
Has L-carnitine supplementation positive effects on inflammatory mediators including C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6)?

Study design:
This review article included 13 RCTs.

Results and conclusions:
The investigators found L-carnitine supplementation was significantly associated with lower levels of CRP in comparison to controls [WMD = -1.23 mg/L, 95% CI = -1.73 to -0.72 mg/dL, p  0.0001].
This reduced effect was greatest during an intervention of more than 12 weeks.

The investigators found L-carnitine supplementation was also significantly associated with lower levels of IL-6 in comparison to controls [WMD = -0.85 pg/dL, 95% CI = -1.38 to -0.32 pg/dL, p = 0.002].
This reduced effect was greatest during an intervention of more than 12 weeks.

The investigators found L-carnitine supplementation was also significantly associated with lower levels of TNF-α in comparison to controls [WMD = -0.37 pg/dL, 95% CI = -0.68 to -0.06 pg/dL, p = 0.018].
This reduced effect was greatest during an intervention of more than 12 weeks.

The investigators concluded that L-carnitine supplementation reduces levels of inflammatory mediators, especially in studies with a duration of more than 12 weeks. Further studies with different doses and intervention durations and separately in men and women are necessary.

Original title:
The effect of L-carnitine on inflammatory mediators: a systematic review and meta-analysis of randomized clinical trials by Haghighatdoost F, Jabbari M and Hariri M.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30915521 

Additional information of El Mondo:
Find here more information/studies about chronic disease and L-carnitine.

Objectives:
Does maternal vitamin D deficiency during pregnancy increase risk of low birth weight?

Study design:
This review article included a total of 16 studies.

Results and conclusions:
The investigators found when compared with normal serum levels of vitamin D, maternal vitamin D deficiency had an increased risk of 139% of low birth weight [OR = 2.39, 95% CI = 1.25-4.57, p = 0.008] and same results were found in the comparison of the mean [total mean birth weight decreased by 0.08 kg, 95% CI = -0.10 to -0.06, p 0.001].

The investigators concluded there is a consistent association between vitamin D deficiency during pregnancy and an increased risk of low birth weight and preventing maternal vitamin D deficiency may be an important public health strategy to help decrease the risk of low birth weight.

Original title:
Maternal vitamin D deficiency during pregnancy and low birth weight: a systematic review and meta-analysis by Fang K, He Y, […], Liu K.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31122092

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

Objectives:
Although many studies have shown that low zinc status is associated with diabetes, the putative effects of zinc supplementation on glycemic control are inconclusive. Therefore, this review article (meta-analysis) has been conducted.

Does zinc supplementation reduce risk of diabetes mellitus?

Study design:
This review article included 32 RCTs, involving a total of 1,700 participants in 14 countries.

Results and conclusions:
The investigators found overall, compared with their respective control groups, the subjects in the zinc supplementation group had a statistically significant reduction in concentrations of :
-fasting glucose [WMD = -14.15 mg/dL, 95% CI = -17.36 to -10.93 mg/dL];
-2-h postprandial glucose [WMD = -36.85 mg/dL, 95% CI = -62.05 to -11.65 mg/dL];
-fasting insulin [WMD = -1.82 mU/L, 95% CI = -3.10 to -0.54 mU/L];
-homeostasis model assessment for insulin resistance [WMD = -0.73, 95% CI = -1.22 to -0.24]:
-glycated hemoglobin [WMD = -0.55%, 95% CI = -0.84 to -0.27%] and;
-high-sensitivity C-reactive protein [WMD = -1.31 mg/L, 95% CI = -2.05 to -0.56 mg/L].

The investigators found, moreover, subgroup analyses revealed that the effects of zinc supplementation on fasting glucose were significantly influenced by diabetic status and the formulation of the zinc supplement.

The investigators concluded several key glycemic indicators are significantly reduced by zinc supplementation, particularly the fasting glucose in subjects with diabetes and in subjects who received an inorganic zinc supplement. Together, these findings support the notion that zinc supplementation may have clinical potential as an adjunct therapy for preventing or managing diabetes.

Original title:
Zinc supplementation improves glycemic control for diabetes prevention and management: a systematic review and meta-analysis of randomized controlled trials by Wang X, Wu W, [...], Wang F.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31161192

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

Objectives:
Iron has been shown to promote breast carcinogenesis in animal models through generation of oxidative stress and interaction with estrogen. Heme iron, which is found exclusively in animal-sourced foods, is suggested to have a more detrimental effect. Epidemiological evidence of the association between iron and breast cancer risk remains inconclusive and has not been comprehensively summarized. Therefore, this review article has been conducted.

Does dietary iron consumption increase breast cancer risk?

Study design:
This review article included 15 case-control studies and 12 prospective cohort studies.

Of the 17 studies assessing iron intake, 7 were cohort studies with study size ranging from 4,646 to 193,742 participants, follow-up ranging from 5.5 to 20 years and number of breast cancer cases ranging from 188 to 9,305. The remaining 10 studies were case-control studies, of which 4 were hospital-based, 3 were population-based and 3 were nested within existing cohorts, with case numbers ranging from 220 to 3,452.

Of the 11 studies assessing body iron status, 5 were cohort studies with study size ranging from 1,795 to 164,355 participants, follow-up ranging from 7.1 to 17.6 years and number of cases ranging from 80 to 3,238. The remaining 6 studies used a nested case-control or case-cohort design, with follow-up (where reported) ranging from 4 to 15.7 years and case numbers ranging from 107 to 795.

Overall, NOS scores ranged from 4 to 9 (mean = 7.0).

No publication bias was found.

Results and conclusions:
The investigators found compared to lowest category, highest dietary heme iron intake significantly increased risk of breast cancer with 12% [pooled RR = 1.12, 95% CI = 1.04-1.22, I2 = 39%, p heterogeneity = 0.15].

The investigators found each 1 mg/day increase in dietary heme iron intake, was associated with a statistically significant 8% increase in breast cancer risk [pooled RR = 1.08, 95% CI = 1.002–1.17].

The investigators found compared to lowest levels, highest serum iron levels significantly increased risk of breast cancer with 22% [pooled RR = 1.22, 95% CI = 1.01-1.47, I2 = 61%, p heterogeneity = 0.04].

The investigators found serum iron levels exhibited a J-shaped dose-response relationship with breast cancer risk, with strong evidence of a nonlinear effect [p nonlinearity  0.001].

Specifically, a steady increase in risk was noted for serum iron levels above ~ 100 μg/dL, with the association becoming statistically significant at just beyond ~ 125 μg/dL.

The investigators concluded that higher dietary heme iron intake and higher serum iron levels increase breast cancer risk. Further research is needed to better elucidate the association between iron intake/status and risk of breast cancer.

Original title:
Iron intake, body iron status, and risk of breast cancer: a systematic review and meta-analysis by Chang VC, Cotterchio M and Khoo E.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6555759/

Additional information of El Mondo:
Find more information/studies on iron consumption, review article/significantly and breast cancer right here.
 

Objectives:
Dietary proteins, including those obtained from animal and plant sources, have inconsistently been correlated with type 2 diabetes mellitus (T2DM) risk. Therefore, this review article (meta-analysis) has been conducted.

Does dietary protein intake increase risk of type 2 diabetes mellitus?

Study design:
This review article included 21 cohort studies with a total of 487,956 individuals and 38,350 T2DM cases (persons with type 2 diabetes mellitus).

Results and conclusions:
The investigators found high total dietary protein intake was associated with an increased risk of 10% for type 2 diabetes mellitus [RR = 1.10, p = 0.006] whereas moderate total dietary protein intake was not significantly associated with type 2 diabetes mellitus risk [RR = 1.00,  p = 0.917].  
Not significantly because the calculated p-value of 0.917 was larger than the p-value of 0.05.

The investigators found, moreover, an increased risk of 13% [RR = 1.13, p = 0.013] for type 2 diabetes mellitus was observed with high  dietary animal protein intake whereas moderate animal protein intake had little or no effect on type 2 diabetes mellitus risk [RR = 1.06, p = 0.058].

The investigators found, high dietary intake of plant protein did not affect type 2 diabetes mellitus risk [RR = 0.93, p = 0.074], whereas moderate intake was associated with a reduced risk of 6% for type 2 diabetes mellitus [RR = 0.94, p  0.001].

The investigators concluded high dietary total protein and dietary animal protein intakes are associated with an increased risk of type 2 diabetes mellitus, whereas moderate plant protein intake is associated with a decreased risk of type 2 diabetes mellitus.

Original title:
Dietary protein intake and subsequent risk of type 2 diabetes: a dose-response meta-analysis of prospective cohort studies by Ye J, Yu Q, [...], Wang Y.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30929078

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

A diet with high protein intake is a diet with a minimum of 35 En% protein (En% = energy percentage). These products from the supermarket contain at least 35 En% protein.
35 En% protein means that the amounts of protein contribute 35% to the total calories (kcal) of the diet.
If the diet contains 2000 kcal, 175 grams of protein contribute 35% to this 2000 kcal.
1 gram of protein gives 4 kcal. Thus, 175 grams of protein provide 700 kcal and 700 kcal is 35% of 2000 kcal.

A diet with moderate protein consumption is a diet with 20-25 En% protein. The easiest way to follow a diet with moderate protein consumption is to choose only products/meals that also contain 20-25 En% protein. These products from the supermarket contain 20-25 En% protein.

 

Objectives:
Anemia is one of the most common hematologic problems occurs among patients with tuberculosis (TB). Many studies have been carried out estimating the prevalence of anemia among tuberculosis patients in different countries reported various results. Therefore, this review article has been conducted.

Does tuberculosis increase risk of anemia?

Study design:
This review article included 41 studies.

Results and conclusions:
The investigators found the prevalence of anemia among all tuberculosis patients was 61.53% [95% CI = 53.44-69.63].  

The investigators found the prevalence of anemia among male tuberculosis patients was 66.95% [95% CI = 51.75-82.14].

The investigators found the prevalence of anemia among female tuberculosis patients was 72.67 [95% CI = 60.79-84.54].

The investigators found the prevalence of mild anemia among all tuberculosis patients was 35.67% [95% CI = 27.59-43.46].  

The investigators found the prevalence of moderate anemia among all tuberculosis patients was 31.19% [95% CI = 25.15-37.24].  

The investigators found the prevalence of severe anemia among all tuberculosis patients was 11.61% [95% CI = 7.88-15.34].

The investigators found the prevalence of chronic disease anemia among all tuberculosis patients was 49.82% [95% CI = 15.58-84.07].

The investigators found the prevalence of iron deficiency anemia among all tuberculosis patients was 20.17% [95% CI = 6.68-33.65].

The investigators concluded the prevalence of anemia among tuberculosis patients is high especially among women. More than 43% of these patients suffer from moderate and severe anemia and about half of them has chronic disease anemia.

Original title:
Prevalence of anemia among patients with tuberculosis: A systematic review and meta-analysis by Barzegari S, Afshari M2, […], Moosazadeh M.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31151500

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Find more information/studies on food fortification/malnutrition right here.