Nutritional advice

Objectives:
Is there a causal relationship between intake of pomegranate and decreased risk of getting inflammation in adults?

Study design:
This review article included 16 randomized controlled trials (RCTs) involving 572 subjects.

Results and conclusions:
The investigators found when compared to placebo, that pomegranate supplementation significantly reduced hs-CRP levels [WMD = -6.57 mg/L, 95% CI = -10.04 to -3.10, p = 0.000].

The investigators found when compared to placebo, that pomegranate supplementation significantly reduced IL-6 levels [WMD = -1.68 pg/mL, 95% CI = -3.52 to -0.157, p = 0.000].

The investigators found when compared to placebo, that pomegranate supplementation significantly reduced TNF-α levels [WMD = -2.37 pg/mL, 95% CI = -3.67 to -1.07, p = 0.00].

The investigators found no association between pomegranate supplementation and CRP levels [WMD = 2.19 mg/dL, 95% CI = -3.28 to 7.67, p = 0.61], E-selectin levels [WMD = 8.42 ng/mL, 95% CI = -22.9 to 39.8, p = 0.599], ICAM levels [WMD = -17.38 ng/mL, 95% CI = -53.43 to 18.66, p = 0.107], VCAM levels [WMD = -69.32 ng/mL, 95% CI = -229.26 to 90.61, p = 0.396] or MDA levels [WMD = 0.031 μmol/L, 95% CI = -1.56 to 0.218, p = 0.746].

The investigators concluded pomegranate supplementation reduces hs-CRP levels, IL-6 levels and TNF-α levels in adults.

Original title:
The effects of pomegranate supplementation on biomarkers of inflammation and endothelial dysfunction: A meta-analysis and systematic review by Wang P, Zhang Q, [...], Yao G.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32147056

Additional information of El Mondo:
Find here more information/studies about fruit and chronic diseases.

Inflammation in humans can be measured by biomarkers, such as highly sensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6) and the tumor necrosis factor alpha (TNF-α).

Inflammation in humans can lower the resistance. A low resistance makes the body susceptible to diseases.
 

Objectives:
Plasmodium vivax is a frequent cause of recurring malaria in endemic areas as in its latent stage it resides in liver and is responsible for relapse. Treatment with 8 aminoquinoline Primaquine is given for 14 days, however studies have shown dismal results with adherence to therapy. A new long acting 8 aminoquinoline, Tafenoquine was introduced that showed efficacy and safety almost similar to Primaquine in a single dose regimen, hence giving hopes for improved compliance and help in eradicating malaria.

The goal of this review article is to determine whether Tafenoquine as a single dose is an effective alternative to Primaquine for prevention of recurrence of P vivax malaria.

Study design:
This review article included 4 RCTs.

Results and conclusions:
The investigators found pooled analysis showed that the number of episodes of recurrence at 6 months between Tafenoquine and Primaquine [RR = 1.08, 95% CI = 0.74 to 1.59] and between Tafenoquine and placebo [RR = 0.17, 95% CI = 0.03 to 1.11] was statistically insignificant.

The investigators found comparison of serious adverse events did not show any significant risk associated with the use of Tafenoquine as compared to Primaquine when analyzed till day 29, which was the time period considered to show most probable drug associated events.

The investigators concluded Tafenoquine as a single dose is an effective alternative to Primaquine for prevention of recurrence of P vivax malaria, with a reasonable safety profile.

Original title:
Single dose tafenoquine for preventing relapse in people with plasmodium vivax malaria-an updated meta-analysis by Anjum MU, Naveed AK, […], Naveed OK.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32036012

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

Objectives:
Vitamin C as a supplement to treat hypertension has been proposed. However, it remains controversial whether vitamin C can improve blood pressure in patients with primary hypertension. Therefore, this review article has been conducted.

Do vitamin C supplements reduce blood pressure in patients with primary hypertension?

Study design:
This review article included 8 RCTs involving 614 participants.
There was no publication bias.

Results and conclusions:
The investigators found vitamin C supplements significantly reduced systolic blood pressure in patients with essential hypertension [WMD  = -4.09, 95% CI = -5.56 to -2.62, p 0 .001, I2  =  35%, p = 0.15].

The investigators found vitamin C supplements significantly reduced diastolic blood pressure in patients with essential hypertension [WMD  = -2.30, 95% CI = -4.27 to -0.331, p  = 0 .02, I2 = 75%, p = 0 .0002].

The investigators found vitamin C supplements significantly reduced systolic blood pressure for the subgroup with an age ≥60 years and that with ≥35 participants [WMD = -3.75, 95% CI = -6.24 to -1.26, p  = 0 .003].

The investigators found vitamin C supplements significantly reduced diastolic blood pressure for the subgroup with an age ≥60 years and that with ≥35 participants [WMD = -3.29, 95% CI = -5.98 to -0.60, p  = 0 .02].

The investigators found in the subgroup analysis that vitamin C supplements during ≥6 weeks significantly reduced systolic blood pressure in patients with essential hypertension [WMD = -4.77, 95% CI = -6.46 to -3.08, p   0 .001].

The investigators found in the subgroup analysis that ≥500 mg/d vitamin C supplements significantly reduced systolic blood pressure in patients with essential hypertension [WMD  =  -5.01, 95% CI = -8.55 to -1.48, p  = 0.005, I2  =  44%, p =  0.13].

The investigators concluded ≥500 mg/d vitamin C supplements during ≥6 weeks reduce blood pressure in patients with primary hypertension. However, in view of the current level of evidence, large-scale trials should be conducted and attention should be paid to the evaluation of blood pressure variability.

Original title:
Effects of vitamin C supplementation on essential hypertension: A systematic review and meta-analysis by Guan Y, Dai P and Wang H.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7034722/

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Find more information/studies on lowering of blood pressure, vitamin C and cardiovascular disease right here.

Objectives:
Does high waist circumference increase liver cancer?

Study design:
This review article included  5 prospective cohort studies with 2,547,188 participants.
Participants were aged 46-58 years, with a mean age of 51 years.
The mean follow-up of participants in the studies was 7.8 years.
The mean quality (NOS scores) of the studies included was 7 (ranging from 5 to 9).

Funnel plots did not show significant asymmetry between the studies included.
Furthermore, Begg's and Egger's regression test did not show any significant publication bias (p = 0.62 and p = 0.60, respectively).

Results and conclusions:
The investigators found combined results of the studies included with random-effects model showed that the highest waist circumference category was significantly associated with an increased risk of 59% for liver cancer [HR = 1.59, 95% CI = 1.38-1.83, I2 = 0%, p = 0.42] compared to the lowest waist circumference category.

The investigators concluded that waist circumference is a significant risk factor related to the incidence of liver cancer.

Original title:
Waist Circumference and Risk of Liver Cancer: A Systematic Review and Meta-Analysis of over 2 Million Cohort Study Participants by Rahmani J, Kord Varkaneh H, [...], Zhang Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7024879/

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Objectives:
Clinical trials examining the cardiovascular protective effects of quercetin in humans have reported conflicting results. Therefore, this review article has been conducted.

Do quercetin supplements reduce plasma lipid levels and blood pressure?

Study design:
This review article included 17 RCTs with a total of 896 participants.

Results and conclusions:
The investigators found pooled results showed that quercetin supplements significantly lowered both systolic blood pressure [WMD = -3.09 mmHg, 95% CI = -4.59 to -1.59, p = 0.0001] and diastolic blood pressure [WMD = -2.86 mmHg, 95% CI = -5.09 to -0.63, p = 0.01].
Neither lipid profiles nor glucose concentrations changed significantly.

The investigators found in subgroup analyses, significant changes in high-density lipoprotein (HDL or good) cholesterol and triglycerides were observed in trials with a parallel design and in which participants consumed quercetin for 8 weeks or more.

The investigators concluded quercetin supplements decrease blood pressure in humans. Moreover, participants who consume quercetin for 8 weeks or more show significantly changed levels of high-density lipoprotein cholesterol (good cholesterol) and triglycerides in trials with a parallel design.  

Original title:
Effect of quercetin supplementation on plasma lipid profiles, blood pressure, and glucose levels: a systematic review and meta-analysis by Huang H, Liao D, [...], Pu R.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31940027

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Find more information/studies on lowering of cholesterol level and blood pressure and cardiovascular disease right here.

Objectives:
Pregnant women represent a category at high risk of severe measles infection, that negatively affects the fetus as well.

The goal of this review article is to determine clinical outcomes of measles infection in gravid subjects and antibodies prevalence among pregnant women.

Study design:
This review article included 29 studies with a total of 420 cases of measles in 20,546 gravid women (pregnant women), from 1941 to 2012.

Results and conclusions:
The investigators found among women, 18 deaths (4.3%) occurred and the most frequent complication was pneumonia [75/420, 17.9%].

The investigators found prematurity was the most important complication concerning fetal outcomes [55 out of 410 cases with available data, 13.4%].

The investigators found the random-effects pooled seroprevalence of measles in 20,546 gravid women worldwide was 89.3% [95% CI = 87.3 to 91.1%], that decreased, although not in a statistically significant way, over time [p = 0.54].

The investigators concluded measles infection in pregnancy is dangerous both for the mother and the fetus. Antibody seroprevalence among gravid women on a global scale is lower than the herd immunity threshold.

Original title:
Measles in pregnant women: A systematic review of clinical outcomes and a meta-analysis of antibodies seroprevalence by Congera P, Maraolo AE, […], Tosone G.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31891729

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

Objectives:
Is there a causal relationship between psyllium (a dietary fiber) consumption and improvements of risk factors of diabetes?

Study design:
This review article included 9 RCTs with 395 participants.

Results and conclusions:
The investigators found psyllium consumption significantly reduced triglycerides levels with 19.18 mg/dL [WMD = -19.18 mg/dL, 95% CI = -31.76 to -6.60, I2 = 98%].

The investigators found psyllium consumption significantly reduced low-density lipoprotein cholesterol levels with 8.96 mg/dL [WMD = -8.96 mg/dL, 95% CI = -13.39 to -4.52, I2 = 97%].

The investigators found psyllium consumption significantly reduced fasting blood sugar levels with 8.96 mg/dL [WMD = -31.71 mg/dL, 95% CI = -50.04 to -13.38, I2 = 97%].

The investigators found psyllium consumption significantly reduced hemoglobin A1c levels with 0.91% [WMD = -0.91%, 95% CI = -1.31 to -0.51, I2 = 99%].

The investigators found no significant change in high-density lipoprotein, body mass index, cholesterol and weight following psyllium consumption.

The investigators concluded there is a significant reduction in triglycerides, low-density lipoprotein cholesterol (bad cholesterol), fasting blood sugar and hemoglobin A1c levels following psyllium consumption among diabetic patients.

Original title:
The effect of psyllium consumption on weight, body mass index, lipid profile, and glucose metabolism in diabetic patients: A systematic review and dose-response meta-analysis of randomized controlled trials by Xiao Z, Chen H, [...], Wei Y.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31919936

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

Psyllium is a form of fiber made from the husks of the Plantago ovata plant’s seeds. The psyllium husk is a naturally occurring source of soluble fiber.
Psyllium is commonly found in cereals, dietary supplements and is also added to some foods including baked products such as breads, cereal bars and rice/grain cakes.
 

Objectives:
Data from in vitro and animal studies support the preventive effect of tea (Camellia sinensis) against colorectal cancer. Further, many epidemiologic studies evaluated the association between tea consumption and colorectal cancer risk, but the results were inconsistent. Therefore, this review article has been conducted.

Does tea consumption reduce colorectal cancer risk?

Study design:
This review article included 20 cohort studies with 2,068,137 participants and 21,437 colorectal cancer cases.

Results and conclusions:
The investigators found that tea consumption had no significant association with colorectal cancer risk for the highest vs. lowest categories [combined RR = 0.97, 95% CI = 0.94-1.01, I2 = 24.0%, p = 0.093] among all studies.

The investigators found stratified analysis showed no significant differences in all subgroups.

The investigators found no significant association between tea consumption and colorectal cancer risk in male [combined RR = 0.97, 95% CI = 0.90-1.04].

The investigators found, however, tea consumption had a marginal significant inverse impact on colorectal cancer risk in female [combined RR = 0.93, 95% CI = 0.86-1.00].

The investigators found a significantly reduced risk of 10% for colorectal cancer for tea consumption among the female studies with no adjustment of coffee intake [RR = 0.90, 95% CI = 0.82-1.00, p  0.05].
However, this reduced risk was not significant among the female studies that adjusted for coffee intake [RR = 0.97, 95% CI = 0.87-1.09, p > 0.05].

The investigators concluded that tea consumption may reduce colorectal cancer risk in female. May reduced because this reduced risk was not significant among the female studies that adjusted for coffee intake.

Original title:
Tea consumption and colorectal cancer risk: a meta-analysis of prospective cohort studies by Zhu MZ, Lu DM, […], Liu ZH.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32078065

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

Objectives:
There are differences among the outcomes regarding cognitive impairment in heart failure (HF) because the evidence is fragmented and sample size is small. Therefore, this review article has been conducted.

Does heart failure increase risk of dementia?

Study design:
This review article included 12 studies with 2,406,680 heart failure patients.

Begg test, Egger tests and funnel plots showed no significant risks of publication bias.

Results and conclusions:
The investigators found heart failure significantly increased risk of all-cause dementia with 28% [OR/RR  =  1.28, 95% CI = 1.15 to 1.43, I2 = 70.0%, p    0.001].
Sensitivity analysis showed no changes in the direction of effect when any one study was excluded for the studies on associations between heart failure and all-cause dementia.

The investigators found no significant association between heart failure and risk of Alzheimer's disease [OR/RR  =  1.38, 95% CI = 0.90 to 2.13, I 2 =  74.8%, p =  0.008].
Sensitivity analysis showed no changes in the direction of effect when any one study was excluded for the studies on associations between heart failure and Alzheimer's disease.

The investigators concluded heart failure increases risk of all-cause dementia. In addition, large scale prospective studies are essential to explore the associations between heart failure and risk of Alzheimer's disease.

Original title:
Associations between heart failure and risk of dementia: A PRISMA-compliant meta-analysis by Li J, Wu Y, [...], Nie J.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004760/

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Objectives:
The efficacy of n-3 fatty acids supplementation on the prevention of pregnancy-induced hypertension or preeclampsia remains unclear. Therefore, this meta-analysis (systematic review) has been conducted.

Does n-3 fatty acids supplementation (EPA and/or DHA and/or ALA) decrease risk of pregnancy-induced hypertension and preeclampsia during pregnancy?

Study design:
This review article included 14 RCTs.

Results and conclusions:
The investigators found that n-3 fatty acids supplementation significantly reduced risk of preeclampsia with 18% [RR = 0.82, 95% CI = 0.70 to 0.97, p = 0.024. I2 = 19.0%].
However, n-3 fatty acids supplementation did not associated with a reduced risk of pregnancy-induced hypertension [RR = 0.98, 95% CI = 0.90 to 1.07, p = 0.652, I2 = 0%].

The investigators concluded n-3 fatty acids supplementation (EPA and/or DHA and/or ALA)  reduces risk of preeclampsia during pregnancy.

Original title:
Efficacy of n-3 fatty acids supplementation on the prevention of pregnancy induced-hypertension or preeclampsia: A systematic review and meta-analysis by Bakouei F, Delavar MA, […], Taheri Z.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32039806

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Objectives:
The goal of this review article is to determine the effectiveness of micronutrients in the cure and treatment of pulmonary tuberculosis.

Study design:
This review article included a total of 16 RCTs (receiving oral micronutrients for at least 4 weeks compared with placebo) with 4,398 people.

Results and conclusions:
The investigators found zinc supplementation did not significantly reduced mortality [MD = 0.04, 95% CI = 0.00 to 0.08] in patients with pulmonary tuberculosis.

The investigators found zinc supplementation significantly increased muscle mass index [MD = 1.20, 95% CI = 0.04 to 2.36] in patients with pulmonary tuberculosis.

The investigators found zinc supplementation significantly increased weight [MD = 3.10, 95% CI = 0.66 to 5.54] in patients with pulmonary tuberculosis.

The investigators found zinc plus A supplementation significantly increased weight [MD = 3.10, 95% CI = 2.78 to 3.42] in patients with pulmonary tuberculosis.

The investigators found zinc plus A supplementation significantly improved karnofsky scale [MD = 2.50, 95% CI = 2.22 to 2.78] in patients with pulmonary tuberculosis.

The investigators found vitamin D supplementation accelerated the sputum conversión time [RD = 0.38, 95% CI = 0.03 to 0.73] in patients with pulmonary tuberculosis.

The investigators found hemoglobin (Hb) with vitamin A and zinc achieved statistically significant changes [MD = 0.69, 95% CI = 0.28 to 1.09] and [MD = 0.52, 95% CI = 0.21 to 0.83] and reduced area of cavitations in chest X-ray [MD = -0.33, 95% CI = -0.60 to -0.06] in patients with pulmonary tuberculosis.

The investigators concluded micronutrient supplementation could achieve weight gain, hemoglobin, accelerated sputum conversion and improvement in quality of life in patients with pulmonary tuberculosis. There are no changes in mortality that may be attributable to the suboptimal dose, larger studies are suggested with adequate doses.

Original title:
Effectiveness of micronutrients supplement in patients with active tuberculosis on treatment: Systematic review/Meta-analysis by Cabrera Andrade BK and Garcia-Perdomo HA.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31987251

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Objectives:
The benefits of LDL cholesterol-lowering treatment for the prevention of atherosclerotic cardiovascular disease are well established. However, the extent to which these effects differ by baseline LDL cholesterol, atherosclerotic cardiovascular disease risk and the presence of comorbidities remains uncertain. Therefore, this review article has been conducted.

Does LDL cholesterol-lowering treatment reduce risk of major vascular events (a composite of cardiovascular mortality, non-fatal myocardial infarction, non-fatal ischaemic stroke or coronary revascularisation)?

Study design:
This review article included 52 RCTs with a total of 327,037 patients.

Results and conclusions:
The investigators found each 1 mmol/L reduction in LDL cholesterol (bad cholesterol) was associated with a 19% relative risk (RR) reduction for major vascular events [RR = 0.81, 95% CI = 0.78 to 0.84,  p 0.0001].

The investigators found similar reductions (per 1 mmol/L reduction in LDL cholesterol) in trials with participants with LDL cholesterol level of 2.60 mmol/L or lower, 2.61-3.40 mmol/L, 3.41-4.10 mmol/L and more than 4.1 mmol/L [p = 0.232 for interaction] and in a subgroup of patients who all had a baseline LDL cholesterol level less than 2.07 mmol/L [80 mg/dL: RR = 0.83, 95% CI = 0.75-0.92, p = 0.001].

The investigators found greater RR reductions in patients at lower 10-year atherosclerotic cardiovascular disease risk [change in RR per 10% lower 10-year atherosclerotic cardiovascular disease = 0.97, 95% CI = 0.95 to 0.98, p 0.0001] and in patients at younger age across a mean age of 50-75 years [change in RR per 10 years younger age = 0.92, 95% CI = 0.83 to 0.97, p = 0.015].

The investigators found no difference in RR reduction for participants with or without diabetes [p = 0.878 for interaction] and chronic kidney disease [p = 0.934 for interaction].

The investigators concluded for each 1 mmol/L LDL cholesterol lowering, the risk reduction of major vascular events is independent of the starting LDL cholesterol or the presence of diabetes or chronic kidney disease. Patients at lower cardiovascular risk and younger age might have a similar relative reduction in risk with LDL-cholesterol lowering therapies and future studies should investigate the potential benefits of earlier intervention.

Original title:
Intensive LDL cholesterol-lowering treatment beyond current recommendations for the prevention of major vascular events: a systematic review and meta-analysis of randomised trials including 327 037 participants by Wang N, Fulcher J, […], Lal S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31862150

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Objectives:
Epidemiologic studies have investigated the association between nut intake and risk for multiple cancers. However, current findings are inconsistent and no definite conclusion has been drawn from prospective studies. Therefore, this review article has been conducted.

Does nut consumption reduce cancer risk?

Study design:
This review article included 33 cohort studies with more than 50,000 cancer cases.

Results and conclusions:
The investigators found when comparing the highest with the lowest category of nut consumption, high consumption of nuts significantly decreased risk of overall cancer with 10% [RR = 0.90, 95% CI = 0.85-0.95].
Significant association was only obtained for intake of tree nuts.

The investigators found when comparing the highest with the lowest category of nut consumption, high consumption of nuts significantly decreased risk of cancer from the digestive system with 17% [RR = 0.83, 95% CI = 0.77-0.89].

The investigators found per 20 g/day increase in nut consumption was related to a 10% [RR = 0.90, 95% CI = 0.82-0.99] decrease in cancer risk.

The investigators concluded that consumption of 20 grams of tree nuts per day reduces cancer of the digestive system.

Original title:
Nut Consumption and Risk of Cancer: A Meta-analysis of Prospective Studies by Long J, Ji Z, […], Cheng L.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32041895

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Objectives:
The activity of hepatitis B virus (HBV) as a risk factor for the incidence and progression of chronic kidney disease (CKD) has not been clarified. Therefore, this review article has been conducted.

Does hepatitis B virus infection increase risk of chronic kidney disease?

Study design:
This review article included 33 studies with a total of 7,849,849 patients.

Results and conclusions:
The investigators found in 11 cohort studies with 1,056,645 patients, that a positive HBV serologic status (hepatitis B virus infection) significantly increased risk of incidence of chronic kidney disease with 40% [adjusted HR = 1.40, 95% CI = 1.16 to 1.69, p 0.001, I2 = 49.5%, p 0.0001].

The investigators found in 10 cross-sectional studies with 3,222,545 patients, no relationship between hepatitis B virus infection and prevalence of chronic kidney disease [adjusted OR = 1.04, 95% CI = 0.90 to 1.218, p = 0.5].

The investigators found meta-regression analysis reported a relationship between positive HBsAg status and incidence of chronic kidney disease in the general population [p 0.015].

The investigators concluded hepatitis B virus infection increases risk of developing of chronic kidney disease in the adult general population. Studies aimed to understand the mechanisms responsible of such association are underway.

Original title:
HBV infection is a risk factor for chronic kidney disease: Systematic review and meta-analysis by Fabrizi F, Cerutti R, […], Messa P.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32037008

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Find here more information/studies about kidney disease.
 

Objectives:
Adolescents and young adults are at a high risk of developing human papillomavirus (HPV) infections, which can be prevented with the use of vaccines. Moreover, a combined immunization strategy for administration of HPV vaccines with other routine vaccines may lead to better compliance.

The goal of this review article is to evaluate immunogenicity and safety in the case of concomitantly administered HPV vaccine in individuals aged 9-25 years.

Study design:
This review article included a total of 13 studies (11,657 participants).

Results and conclusions:
The investigators found between the concomitant and nonconcomitant administration groups, the seroconversion rate for the specific antibodies against all HPV types (type 16-, 18-, 6-, 11-, 31-, 33-, 45-, 52- and 58) were the same [pooled RR = 1.00, 95% CI = 1.00-1.00] for the bivalent HPV (2vHPV) vaccine.

The investigators found between the concomitant and nonconcomitant administration groups, the risks of local adverse events showed no significant difference [pooled RR = 1.00, 95% CI = 0.97-1.04] and the risks of systemic adverse events were almost similar [pooled RR = 1.10, 95% CI = 1.03-1.18] for the non-bivalent HPV (4vHPV and 9vHPV) vaccines.

The investigators found between the concomitant and nonconcomitant administration groups, the risks of local adverse events were slightly higher in the concomitant administration groups [pooled RR = 1.31, 95% CI = 1.17-1.47] and the risks of systemic adverse events were higher in the concomitant administration groups [pooled RR = 2.09, 95% CI = 1.69-2.59].

The investigators concluded that the concomitant administration of other vaccines along with HPV vaccine is acceptable and there is no interference with the immune response to HPV vaccine. Concomitant vaccine administration has the potential to minimize the number of vaccination visits, leading to increased compliance, hence more effective disease prevention.

Original title:
Immunogenicity and safety of human papillomavirus vaccine coadministered with other vaccines in individuals aged 9-25 years: A systematic review and meta-analysis by Li Y, Zhu P, […], Li L.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31831220

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Objectives:
Alzheimer's disease (AD) is a common type of dementia, which has caused heavy global economic and health burden and the using of statins to treat Alzheimer disease has caused widely debated. Therefore, this review article has been conducted.

Does statin use decrease Alzheimer disease?

Study design:
This review article included a total of 9 RCTs containing 1,489 patients. Of them, 742 patients in the statins group, 747 patients in the control group (group without statins).

There were 9 studies used the MMSE scale, 5 studies used the ADAS-Cog scale, 4 studies used the NPI scale and 6 studies used the ADL scale.

Sensitivity analysis and publication bias test were both negative and the results were relatively reliable and stable.

Results and conclusions:
The investigators found meta-analysis of the 9 studies that reported the MMSE scale scores indicated that there was no significant effect of statins as compared with control group [pooled WMD = 1.09, 95% CI = -0.00 to 2.18, p = 0.05, I2 = 87.9%].

The investigators found meta-analysis of the 5 studies that reported the ADAS-Cog scale scores also indicated that there was no significant effect of statins as compared with control group [pooled WMD = -0.16, 95% CI = -2.67 to 2.36, p = 0.90, I2 = 80.1%].

The investigators found meta-analysis of the 4 studies that reported the NPI scale scores indicated that treatment with statins significantly slowed the rise in the NPI scale scores as compared with control group [pooled WMD = -1.16, 95% CI = -1.88 to -0.44, p = 0.002, I2 = 45.4%].

The investigators found meta-analysis of the 6 studies that reported the ADL scale scores indicated that treatment with statins significantly improve patients' daily living ability [pooled WMD = -4.06, 95% CI = -6.88 to -1.24, p = 0.005, I2 = 86.7%].

The investigators found results of subgroup analysis indicated that the use of statins in the short term (≤ 12 months) associated with the change of the MMSE scale scores [pooled WMD = 1.78, 95% CI = 0.53 to 3.04, p = 0.005, I2 = 79.6%].

The investigators concluded statins used in Alzheimer disease patients have beneficial effects on the scores of MMSE scale in the short term (≤ 12 months) and statins slow the deterioration of neuropsychiatric status and improve activities of daily living ability in Alzheimer disease patients.

Original title:
The efficacy of statins in the treatment of Alzheimer's disease: a meta-analysis of randomized controlled trial by Xuan K, Zhao T, […], Sun Y.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31930449

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

Objectives:
Which factors are associated with the risk of stomach cancer?

Study design:
This review article included 232 observational studies involving 33,831,063 participants.

Results and conclusions:
The investigators found H. pylori infection significantly increased risk of stomach cancer with 156% [OR = 2.56, 95% CI = 2.18 to 3.00].

The investigators found formerly smoked significantly increased risk of stomach cancer with 43% [OR = 1.43, 95% CI = 1.29 to 1.59].

The investigators found currently smoking significantly increased risk of stomach cancer with 61% [OR = 1.61, 95% CI = 1.49 to 1.75].

The investigators found currently drinking significantly increased risk of stomach cancer with 19% [OR = 1.19, 95% CI = 1.10 to 1.29].

The investigators found formerly drank significantly increased risk of stomach cancer with 73% [OR = 1.73, 95% CI = 1.17 to 2.56].

The investigators found intake of fruits ≥3 times/week significantly decreased risk of stomach cancer with 52% [OR = 0.48, 95% CI = 0.37 to 0.63].

The investigators found intake of vegetables ≥3 times/week significantly decreased risk of stomach cancer with 38% [OR = 0.62, 95% CI = 0.49 to 0.79].

The investigators found using pickled vegetables significantly increased risk of stomach cancer with 28% [OR = 1.28, 95% CI = 1.09 to 1.51].

The investigators found green tea significantly decreased risk of stomach cancer with 12% [OR = 0.88, 95% CI = 0.80 to 0.97].

The investigators concluded that both smoking, drinking and H. pylori infection increase the risk of stomach cancer, while both ≥3 times/week fruit and vegetables and green tea reduce the risk of developing stomach cancer.

Original title:
Risk factors for stomach cancer: a systematic review and meta-analysis by Poorolajal J, Moradi L, [...], Gohari-Ensaf F.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32023777

Additional information of El Mondo:
Find more information/studies on alcohol, tea, vegetable and fruit and cancer right here.

Objectives:
Micronutrient deficiencies continue to be widespread among children under-five in low- and middle-income countries (LMICs), despite the fact that several effective strategies now exist to prevent them. This kind of malnutrition can have several immediate and long-term consequences, including stunted growth, a higher risk of acquiring infections and poor development outcomes, all of which may lead to a child not achieving his or her full potential.

The goal of this review article is, what is the available evidence on the strategies used to prevent micronutrient malnutrition among children under-five in low- and middle-income countries (LMICs), including single and multiple micronutrient (MMN) supplementation, lipid-based nutrient supplementation (LNS), targeted and large-scale fortification and point-of-use-fortification with micronutrient powders (MNPs)?

Study design:
This review article included 197 unique studies.

Results and conclusions:
The investigators found the risk of anemia was significantly reduced with iron alone, iron-folic acid, multiple micronutrient supplementation, point-of-use-fortification with micronutrient powders, targeted fortification and large-scale fortification.

The investigators found stunting and underweight, however, were significantly improved only among children who were provided with lipid-based nutrient supplementation, though multiple micronutrient supplementation also slightly increased length-for-age z-scores.

The investigators found vitamin A supplementation significantly reduced all-cause mortality, while zinc supplementation decreased the incidence of diarrhea.

The investigators found, importantly, many effects of lipid-based nutrient supplementation and point-of-use-fortification with micronutrient powders held when pooling data from effectiveness studies.

The investigators concluded this evidence supports the importance of micronutrient supplementation for reducing the burden of micronutrient malnutrition in children under-five in low- and middle-income countries. Population and context should be considered when selecting one or more appropriate interventions for programming.

Original title:
Micronutrient Supplementation and Fortification Interventions on Health and Development Outcomes among Children Under-Five in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis by Tam E, Keats EC, […], Bhutta AZA.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31973225

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

Objectives:
Despite growing evidence for the association between other dietary macronutrients and bone health, limited and inconsistent knowledge is available regarding carbohydrate intake. Therefore, this review article has been conducted.

Does a high carbohydrate intake increase risk of fracture?

Study design:
This review article included observational studies.

Results and conclusions:
The investigators found no association between carbohydrate intake and the risk of fracture in high versus low intake meta-analysis [overall relative risk = 1.24, 95% CI = 0.84 to 1.84, p = 0.27, I2 = 57.7%, p = 0.05].

The investigators found, moreover, there was no relationship between carbohydrate intake and the risk of fracture in both linear [overall RR = 1.00, 95% CI = 0.94 to 1.05, p = 0.88, I2 = 68.1%, p = 0.48] and nonlinear [p non-linearity = 0.14] models.

The investigators concluded high carbohydrate intake does not increase risk of fracture.

Original title:
Dietary carbohydrate intake and risk of bone fracture: a systematic review and meta-analysis of observational studies by Mozaffari H, Daneshzad E and Azadbakht L.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31982636

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

Objectives:
Evidence has shown that essential nutrients are highly correlated with the occurrence of esophageal cancer (EC). However, findings from observational studies on the associations between dietary carbohydrate, salt consumption and the risk of esophageal cancer remain controversial. Therefore, this review article has been conducted.

Does carbohydrate or salt consumption (dietary salt intake) increase risk of esophageal cancer?

Study design:
This review article included 11 case-control studies and 1 cohort study, examined carbohydrates consumption and 16 case-control studies and 2 cohort studies, examined salt consumption.

Results and conclusions:
The investigators found dietary carbohydrate intake significantly reduced risk of esophageal cancer with 38% [pooled OR = 0.62, 95% CI = 0.50-0.77].

The investigators found dietary salt intake significantly increased risk of esophageal cancer with 97% [OR = 1.97, 95% CI = 1.50-2.61] in case-control studies.

The investigators found dietary salt intake significantly increased risk of esophageal cancer with 4% [RR = 1.04, 95% CI = 1.00-1.08] in cohort studies.

The investigators concluded dietary salt intake increases risk of esophageal cancer.

Original title:
Associations of dietary carbohydrate and salt consumption with esophageal cancer risk: a systematic review and meta-analysis of observational studies by Banda KJ, Chiu HY, [...], Huang HC.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31995192

Additional information of El Mondo:
Find more information/studies on carbohydrate, salt and cancer right here.

According to WHO, a high salt intake is a salt intake of more than 5 grams salt per day.

A diet with more than 5 grams salt per day is a diet with mainly products/meals with more than 0.25 grams salt per 100 kcal. Check here which products contain maximum 5 grams salt per 100 kcal.
Use the 7-points nutritional profile app to see whether your daily diet contains maximum 5 grams salt per 100 kcal.

 

Objectives:
Are growth parameters at birth associated with maternal urinary iodine concentration (UIC) or normal ranges of thyroid hormones during pregnancy?

Study design:
This review article included 11 studies.

The pooled mean birth weight, length and head circumference values and 95% confidence intervals were estimated in newborns born to women with UIC  150 μg/L and UIC ≥150 μg/L during pregnancy.

Results and conclusions:
The investigators found pooled mean birth weight, length and head circumference in newborns whose mothers had UIC  150 μg/L vs UIC ≥150 μg/L were 2,898g vs 2,900g [p = 0.970], 49.6 cm vs 49.4 cm [p = 0.880] and 34.0 cm vs 34.1 cm [p = 0.933], respectively.

The investigators found dose-response meta-analyses revealed no significant linear or nonlinear associations between maternal urinary iodine concentration during pregnancy and anthropometric measures at birth.

The investigators found high vs normal values of maternal free thyroxine and thyrotropin during pregnancy were inversely associated with neonatal birth weight.

The investigators concluded that birth weight is affected by even mild variations in the normal concentrations of maternal thyroid hormones. However, in the current meta-analysis, birth anthropometric measures are not associated with maternal urinary iodine concentration during pregnancy.

Original title:
Do maternal urinary iodine concentration or thyroid hormones within the normal range during pregnancy affect growth parameters at birth? A systematic review and meta-analysis by Nazeri P, Shab-Bidar S, […], Shariat M.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31923312

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

Objectives:
Lead is a known risk factor for amyotrophic lateral sclerosis (ALS). However, the results of studies exploring the relationship between lead exposure and the occurrence of ALS are inconsistent. Therefore, this review article has been conducted.

Does a high lead exposure increase risk of ALS?

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

Results and conclusions:
The investigators found a high lead exposure significantly increased risk of ALS with 28% [OR = 1.28, 95% CI = 1.02 to 1.63].
Subgroup and sensitivity analyses showed stable results.

The investigators concluded a high lead exposure increases risk of ALS.

Original title:
Population-based study of environmental/occupational lead exposure and amyotrophic lateral sclerosis: a systematic review and meta-analysis by Meng E, Mao Y, […], Jin W.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31578652

Additional information of El Mondo:
Find here more information/studies about chronic diseases.
 

Objectives:
Low-carbohydrate diets are associated with cardiovascular risk factors; however, the results of different studies are inconsistent. Therefore, this review article has been conducted.

Do low-carbohydrate diets (diets with less than 40 En% carbohydrates) reduce cardiovascular risk factors?

Study design:
This review article included 12 RCTs with a total of 820 in the observation group (intervention group or low carbohydrate group) and 820 in the control group. The largest sample size was 403 cases and the smallest was 42 cases. The patients’ ages ranged from 31 to 65 years old.
The intervention was a diet with less than 40 En% carbohydrates in the observation group and a diet with 45 En% to 55 En% carbohydrates in the control group.

Results and conclusions:
The investigators found compared with the control group, the triglyceride levels of the low-carbohydrate group (less than 40 En% carbohydrates) significantly decreased by 0.15 mmol/L [95% CI = -0.23 to -0.07, I2 = 75%, p = 0.001].
The results remained unchanged in the sensitivity analysis (after subtracting each of the included studies individually).

The results of the publication bias analysis showed that the funnel plot was not symmetric. The asymmetry of the funnel plot may have been caused by publication bias and other issues.

The investigators found in subgroup analyses, low-carbohydrate diet interventions lasting less than 6 months significantly decreased the triglyceride levels by 0.23 mmol/L [95% CI = -0.32 to -0.15] and those of 12-23 months decreased the levels by 0.17 mmol/L [95% CI = -0.32 to -0.01].

The investigators found compared with the control group, the plasma HDL-cholesterol level (good cholesterol) of the low-carbohydrate group significantly increased by 0.1 mmol/L [95% CI = 0.08 to 0.12, I2 = 41%, p = 0.02].
The results remained unchanged in the sensitivity analysis (after subtracting each of the included studies individually).

The investigators found in subgroup analyses, the increase in plasma HDL-cholesterol levels was 0.08 mmol/L [95% CI = 0.27 to 0.57] for interventions lasting less than 6 months, 0.12 mmol/L [95% CI = 0.09 to 0.15] for those lasting 6-11 months, 0.12 mmol/L [95% CI = 0.08 to 0.15] for those lasting 12-23 months and 0.08 mmol/L [95% CI = 0.04 to 0.12] for those lasting 24 months. 

The investigators found compared with the control group, the serum total cholesterol level of the low-carbohydrate group significantly increased by 0.13 mmol/L [95% CI = 0.08 to 0.19].
The results remained unchanged in the sensitivity analysis (after subtracting each of the included studies individually).

The investigators found compared with the control group, the plasma LDL-cholesterol level (bad cholesterol) of the low-carbohydrate group significantly increased by 0.11 mmol/L [95% CI = 0.02 to 0.19, I2 = 71%, p = 0.0001].
The results remained unchanged in the sensitivity analysis (after subtracting each of the included studies individually).

The investigators found compared with the control group, the body weight of the low-carbohydrate group significantly decreased by 1.58 kg [95% CI = -1.58 to -0.75, I2 = 49%, p = 0.01].
The results remained unchanged in the sensitivity analysis (after subtracting each of the included studies individually).

The investigators found in subgroup analyses, the decrease in body weight was 1.14 kg [95% CI = -1.65 to -0.63] for interventions lasting less than 6 months and 1.73 kg [95% CI = -2.7 to -0.76] for those lasting 6-11 months.

The investigators found compared with the control group, the overall systolic blood pressure of the low-carbohydrate group significantly decreased by 1.41 mmHg [95% CI = -2.26 to -0.56, I2 = 0%, p = 0.84].
The results remained unchanged in the sensitivity analysis (after subtracting each of the included studies individually).

The investigators found in subgroup analyses, the overall systolic blood pressure significantly decreased by 2.97 mmHg [95% CI = -4.62 to -1.31] in the group that received interventions lasting less than 6 months.

The investigators found compared with the control group, the diastolic blood pressure of the low-carbohydrate group significantly decreased by 1.71 mmHg [95% CI = -2.36 to -1.06, I2 = 14%, p = 0.29].
The results remained unchanged in the sensitivity analysis (after subtracting each of the included studies individually).

The investigators found in subgroup analyses, the diastolic blood pressure significantly decreased by 2.76 mmHg [95% CI = -4.07 to -1.46] in the group that received interventions lasting less than 6 months and 2.11 mmHg [95% CI = -3.28 to -0.93] for those lasting 6-11 months.

The investigators concluded low-carbohydrate diets (diets less than 40 En% carbohydrates) have beneficial effects on cardiovascular risk factors at less than 6 months and 6-11 months, but after 2 years of a low-carbohydrate diet, there is no significant effect on cardiovascular risk factors.

Original title:
The effects of low-carbohydrate diets on cardiovascular risk factors: A meta-analysis by Dong T, Guo M, [...], Chen B.

Link:
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0225348

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

40 En% carbohydrates means that the total amounts of carbohydrate make up for a 40% of the total kcal of the diet. The easiest way to follow this diet is to choose only meals/products that also contain 40 En% carbohydrates. These products in the supermarket contain 40 En% carbohydrates.

Objectives:
Previous findings on the associations of legume and soy intake with the risk of type 2 diabetes are conflicting. Therefore, this review article (meta-analysis) has been conducted.

Does legume or soy dietary intake reduce risk of type 2 diabetes?

Study design:
This review article included 15 unique cohort studies with a total of 565,810 individuals and 32,093 incident cases (persons with type 2 diabetes).

Overall quality of evidence was rated as moderate for total legumes and low for total soy and soy subtypes.

Results and conclusions:
The investigators found no association between total legumes dietary intake and risk of type 2 diabetes [summary RR = 0.95, 95% CI = 0.79 to 1.14, I2 = 84.8%].
No association because RR of 1 was found in the 95% CI of 0.79 to 1.14. RR of 1 means no risk/association.

The investigators found no association between total soy dietary intake and risk of type 2 diabetes [summary RR = 0.83, 95% CI = 0.68 to 1.01, I2 = 90.8%].

The investigators found no association between soy milk dietary intake and risk of type 2 diabetes [summary RR = 0.89, 95% CI = 0.71 to 1.11, I2 = 91.7%].

The investigators found tofu dietary intake significantly reduced risk of type 2 diabetes with 8% [summary RR = 0.92, 95% CI = 0.84 to 0.99].
Significantly because RR of 1 was not found in the 95% CI of 0.84 to 0.99. RR of 1 means no risk/association.

The investigators found soy protein dietary intake significantly reduced risk of type 2 diabetes with 16% [summary RR = 0.84, 95% CI = 0.75 to 0.95].

The investigators found soy isoflavones dietary intake significantly reduced risk of type 2 diabetes with 12% [summary RR = 0.88, 95% CI = 0.81 to 0.96].

The investigators found in dose-response analysis, significant linear inverse associations for tofu, soy protein and soy isoflavones [all p 0.05].

The investigators concluded dietary intakes of tofu, soy protein and soy isoflavones reduce incident type 2 diabetes. These findings support recommendations to increase intakes of certain soy products for the prevention of type 2 diabetes. However, the overall quality of evidence was low and more high-quality evidence from prospective studies is needed.

Original title:
Legume and soy intake and risk of type 2 diabetes: a systematic review and meta-analysis of prospective cohort studies by Tang J, Wan Y, […], Feng F.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31915830

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

Objectives:
Which factors increase risk of dementia?

Study design:
This review article included 34 prospective cohort studies, among which 24 were eligible for meta-analysis. A total of 159,594 non-demented adults were enrolled at baseline before 65 years and 13,540 people were diagnosed with dementia after follow-up.

Results and conclusions:
The investigators found obesity significantly increased risk of dementia with 78% [RR = 1.78, 95% CI = 1.31-2.41].

The investigators found diabetes mellitus significantly increased risk of dementia with 69% [RR = 1.69, 95% CI = 1.38-2.07].

The investigators found current smoking significantly increased risk of dementia with 61% [RR = 1.61, 95% CI = 1.32-1.95].

The investigators found hypercholesterolemia significantly increased risk of dementia with 57% [RR = 1.57, 95% CI = 1.19-2.07].
However, the sensitivity analyses showed that the result of hypercholesterolemia was not reliable, which need to be confirmed by more high-quality studies.

The investigators found hypertension significantly increased risk of dementia with 41% [RR = 1.41, 95% CI = 1.23-1.62] for borderline blood pressure.

The investigators found hypertension significantly increased risk of dementia with 72% [RR = 1.72, 95% CI = 1.25-2.37] for high systolic blood pressure.
However, the sensitivity analyses showed that the result of high systolic blood pressure was not reliable, which need to be confirmed by more high-quality studies.

The investigators found hyperhomocysteinemia, psychological stress and heavy drinking were also associated with elevated dementia risk.

The investigators found, in addition, physical exercise, a healthy diet and hormone therapy in middle age were associated with the reduction of dementia risk.

The investigators concluded middle-aged people with obesity or diabetes and current smokers in midlife are at higher risk of developing dementia later in life.

Original title:
Midlife Modifiable Risk Factors for Dementia: A Systematic Review and Meta-analysis of 34 Prospective Cohort Studies by Li XY, Zhang M, [...], Tan L.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31902364

Additional information of El Mondo:
Find more information/studies on obesity, diabetes, hypertension and dementia right here.