Nutritional advice

Objectives:
The associations between intake of anthocyanins and anthocyanin-rich berries and cardiovascular risks remained to be established. Therefore, this review article has been conducted.

Do purified anthocyanin supplements and dietary intakes of anthocyanin-rich berries reduce cardiovascular risk?

Study design:
This review article included 44 eligible RCTs consisting of 52 comparison groups and 2,353 subjects and 15 prospective cohort studies with 5,54,638 subjects (persons).

7 of the 44 RCTs were crossover trials with the rest parallel-designed.
15 of the included studies investigated the effects of purified anthocyanins, all of which were produced from berries. For the remaining anthocyanin-rich berry studies, interventions were blueberry in 13 studies, cranberry in 12 studies, bilberry in 3 studies and blackcurrant in 1 study.
The intervention durations ranged from 2 weeks to 24 months with a median of 8 weeks.
24 of the 44 RCTs were rated as high quality with the others as low to moderate quality.

The follow-up periods of 15 cohort studies ranged from 4.3 to 24 years with a median of 12 years. Most of the included cohort studies used FFQ to assess dietary anthocyanin intake and only 3 of them used dietary records.
12 of the 15 cohort studies were rated as high quality.

There was no publication bias, except for the effects of purified anthocyanins on HDL cholestrerol levels [Begg's p = 0.016].

Results and conclusions:
The investigators found pooled analysis of RCTs showed that purified anthocyanin supplements significantly reduced blood LDL cholesterol (bad cholesterol) concentrations [WMD = -5.43 mg/dL, 95% CI = -8.96 to -1.90 mg/dL, p = 0.003]. 

The investigators found pooled analysis of RCTs showed that purified anthocyanin supplements significantly reduced triglyceride concentrations [WMD = -6.18 mg/dL, 95% CI = -11.67 to -0.69 mg/dL, p = 0.027, I2 = 0%]. 

The investigators found pooled analysis of RCTs showed that purified anthocyanin supplements significantly increased HDL cholesterol (good cholesterol) concentrations [WMD = 2.76 mg/dL, 95% CI = 1.34 to 4.18 mg/dL, p 0.001, I2 = 43.5%].
Subgroup analysis showed that the effects on HDL cholesterol concentrations were not significantly influenced by study duration, health status of subjects, anthocyanin doses, study quality and funding source.

The investigators found pooled analysis of RCTs showed that purified anthocyanin supplements significantly reduced tumor necrosis factor alpha concentrations [WMD = -1.62 pg/mL, 95% CI = -2.76 to -0.48 pg/mL, p = 0.005, I2 = 0%].

The investigators found pooled analysis of RCTs showed that purified anthocyanin supplements significantly reduced C-reactive protein concentrations [WMD = -0.028 mg/dL, 95% CI = -0.050 to -0.005 mg/dL, p = 0.014, I2 = 26%].

The investigators found pooled analysis of RCTs showed administration of anthocyanin-rich berries (blueberry, cranberry, bilberry and blackcurrant) significantly reduced blood total cholesterol concentrations [WMD = -4.48 mg/dL, 95% CI = -8.94 to -0.02 mg/dL, p = 0.049]. 

The investigators found pooled analysis of RCTs showed administration of anthocyanin-rich berries (blueberry, cranberry, bilberry and blackcurrant) significantly reduced C-reactive protein concentrations [WMD = -0.046 mg/dL, 95% CI = -0.070 to -0.022 mg/dL, p 0.001, I2 = 0%].

The investigators found pooled analysis of cohort studies showed high dietary anthocyanins intakes significantly reduced risk of coronary heart disease (CHD) with 17% [relative risk = 0.83, 95% CI = 0.72 to 0.95, p = 0.009, I2 = 51.2%].

The investigators found pooled analysis of cohort studies showed high dietary anthocyanins intakes significantly reduced risk of total cardiovascular disease incidence with 27% [relative risk = 0.73, 95% CI = 0.55 to 0.97, p = 0.03, I2 = 76.7%].

The investigators found pooled analysis of cohort studies showed high dietary anthocyanins intakes significantly reduced risk of cardiovascular disease deaths with 9% [relative risk = 0.91, 95% CI = 0.87 to 0.96, p 0.001, I2 = 0%].

Subgroup analysis revealed that the protective roles of dietary anthocyanins against cardiovascular disease deaths was only found in women [RR = 0.89, 95% CI = 0.82 to 0.96, p = 0.003, I2 = 0.0%] and not in men [RR = 0.92, 95% CI = 0.79 tot 1.07, p = 0.263, I2 = 0.0%].

The investigators concluded current clinical and epidemiological evidence show the protective roles of purified anthocyanin supplements during 8 weeks and anthocyanin-rich berries (blueberry, cranberry, bilberry and blackcurrant) on cardiovascular health. These results suggest that regular consumption of either purified anthocyanins or anthocyanin-rich berries could prevent cardiovascular disease through their lipid-lowering and anti-inflammatory properties. Therefore, anthocyanins and anthocyanin-rich berries should be taken into consideration when formulating cardioprotective diets in the future.

Original title:
Anthocyanins, Anthocyanin-Rich Berries, and Cardiovascular Risks: Systematic Review and Meta-Analysis of 44 Randomized Controlled Trials and 15 Prospective Cohort Studies by Xu L, Tian Z, […], Yang Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8714924/

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

Objectives:
Previous studies have not fully described the relationship between high-density lipoprotein cholesterol (HDL-C) and death risks from all cause and cardiovascular disease (CVD). Therefore, this review article has been conducted.

Does a high HDL cholesterol level (good cholesterol) reduce all cause and cardiovascular disease mortality risk?

Study design:
This review article included 32 prospective cohort studies with a total of 369,904 participants and 33,473 total deaths (9,426 cardiovascular disease deaths or cardiovascular disease mortality).

Results and conclusions:
The investigators found compared to the lowest HDL cholesterol level, the highest HDL cholesterol level significantly reduced all cause mortality risk by 18% [RR = 0.82, 95% CI = 0.73 to 0.93].
The lowest all cause mortality risk was observed at approximately 1.34 mmol/L.

The investigators found compared to the lowest HDL cholesterol level, the highest HDL cholesterol level significantly reduced cardiovascular disease mortality risk by 36% [RR = 0.64, 95% CI = 0.46 to 0.89].
The lowest cardiovascular disease mortality risk was observed at approximately 1.55 mmol/L.

The investigators found every increment of HDL cholesterol level with 1 mmol/L significantly reduced all cause mortality risk by 15% [RR = 0.85, 95% CI = 0.79 to 0.92].
Significant means that there is an association with a 95% confidence.

The investigators found every increment of HDL cholesterol level with 1 mmol/L significantly reduced cardiovascular disease mortality risk by 23% [RR = 0.77, 95% CI = 0.69 to 0.87].

The investigators found evidence of nonlinear and negative dose-response associations of HDL cholesterol level with all cause and cardiovascular disease mortality risk [p nonlinearity 0.001].

The investigators concluded HDL cholesterol level (good cholesterol) reduces all cause and cardiovascular disease mortality risk under approximately 2.05 and 2.33 mmol/L, respectively. Optimal doses require investigation via clinical practice or high-quality research.

Original title:
A dose-response meta-analysis to evaluate the relationship between high-density lipoprotein cholesterol and all-cause and cardiovascular disease mortality by Liu L, Han M, […], Hong F.

Link:
https://pubmed.ncbi.nlm.nih.gov/34676492/

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

Objectives:
Do diets rich in protein causually reduce body weight of adults with overweight or obesity? 

Study design:
This review article included 37 RCTs.
The diets were included during a mean of 32 weeks interventions, ranging from 8 to 104 weeks.

There was no publication bias.

Results and conclusions:
The investigators found protein intake (ranging from 18-59 energy percentage [En%]) significantly reduced body weight by 1.6 kg [95% CI = 1.2 to 2.0 kg, I2 = 56%] compared to controls (digestible carbohydrate, fiber, fat or no supplementation (no placebo used)).
This result was also found in sensitivity analysis.

The investigators found the effect size of dietary protein in body weight management was dependent on specific phenotypes, where individuals with prediabetes had more benefit compared to individuals with normoglycemia.
Furthermore, individuals without the obesity risk allele (AA genotype) had more benefit compared to individuals with the obesity risk alleles (AG and GG genotypes).

The investigators concluded that diets rich in protein (18-59 energy percentage [En%]) during 32 weeks causally have a moderate beneficial effect on body weight management of adults with overweight or obesity.

Original title:
Are Dietary Proteins the Key to Successful Body Weight Management? A Systematic Review and Meta-Analysis of Studies Assessing Body Weight Outcomes after Interventions with Increased Dietary Protein by Hansen TT, Astrup A and Sjödin A.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8468854/

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Find more information/studies on protein consumption and overweight right here.

A diet rich in protein with 18-59 energy percentage [E%] or a diet with 18-59 En% protein means that the amounts of protein contribute 18 to 59% to the total calories (kcal) of the diet.
If the diet contains 2000 kcal, 90 grams of protein contribute 18% to this 2000 kcal.
1 gram of protein gives 4 kcal. Thus 90 grams of protein provide 360 kcal (90x4 kcal) and 360 kcal is 18% of 2000 kcal.

The most easy way to follow a diet rich in protein with 18-59 energy percentage is to choose only meals/products with 18-59 En% protein. Check here which products contain 18-59 En% protein.

However, the most practical way to follow a diet with 18-59 En% protein is, all meals/products that you eat on a daily basis should contain on average 18-59 En% protein.

To do this, use the 7-points nutritional profile app to see whether your daily diet contains 18-59 En% protein.

A high-protein diet is a diet with at least 20 En% protein.

 

Objectives:
Are high CRP levels a biomarker for the early detection and monitoring of malaria severity?

Study design:
This review article included 29 studies. All included studies reported the quantitative data of CRP in patients were published between 1989 and 2021.
Among the included studies, there were 731 cases of severe malaria, 1,600 cases of uncomplicated malaria, 1,697 cases of asymptomatic malaria and 3,658 cases of healthy/febrile controls.

The quality of the included studies was assessed using the NOS, which has a maximum total of 7 stars. 16 studies were rated 7 stars in total, while 14 studies were rated 6 stars in total as febrile patients had been used as a control group.

Results and conclusions:
The investigators found in meta-analysis that mean CRP levels in patients with severe malaria were significantly higher compared with uncomplicated malaria [SMD = 1.52, 95% CI = 0.91 to 2.12, p 0.001, I2 = 95.1%].

The investigators found in meta-analysis that mean CRP levels in patients with uncomplicated malaria were significantly higher compared with asymptomatic malaria [SMD = 1.65, 95% CI = 0.67 to 2.62, p = 0.001, I2 = 96.7%].

The investigators found in meta-analysis that mean CRP levels in patients with uncomplicated malaria were significantly higher compared with febrile/healthy controls [SMD = 2.38, 95% CI = 1.37 to 3.40, p 0.001, I2 = 98.5%].

The investigators found in meta-analysis that mean CRP levels in patients with asymptomatic malaria were significantly higher compared with febrile/healthy controls [SMD = 2.55, 95% CI = 1.60 to 3.50, p 0.001, I2 = 99.2%].

The investigators concluded that high CRP levels are a biomarker for the early detection and monitoring of malaria severity.

Original title:
C-reactive protein as an early biomarker for malaria infection and monitoring of malaria severity: a meta-analysis by Wilairatana P, Mahannop P, […], Kotepui M.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8585865/

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Objectives:
The association between vitamin C and metabolic syndrome (MetS) has been evaluated in several epidemiological studies with conflicting results. Therefore, this review article has been conducted.

Do dietary vitamin C intake and circulating vitamin C level reduce risk of metabolic syndrome? 

Study design:
This review article included 26 cross-sectional studies and 2 cohort studies with a total number of 110,771 participants. 23 studies were related to the dietary vitamin C level.
The sample size ranged from 143 to 27,656 persons.
The dietary vitamin C level was assessed by food-frequency questionnaire (FFQ) in 4 studies, a 24-h or 3-day recall in 18 studies and a 4-day record in 1 study.

No evidence of publication bias existed according to Begg's rank correlation test [p = 0.495].

Results and conclusions:
The investigators found when compared to the lowest dietary vitamin C intake, that the highest dietary vitamin C intake significantly reduced risk of metabolic syndrome with 7% [overall multivariable-adjusted RR = 0.93, 95% CI = 0.88 to 0.97, p = 0.003, I2 = 54.5%, p = 0.003]. The above findings were confirmed in cross-sectional studies [RR = 0.92, 95% CI = 0.87 to 0.97, p = 0.001] and 24-h or 3-day recall [RR = 0.89, 95% CI = 0.86 to 0.93, p 0.001] studies.

The investigators found when compared to the lowest circulating vitamin C level, that the highest circulating vitamin C level significantly reduced risk of metabolic syndrome with 40% [overall multivariable-adjusted RR = 0.60, 95% CI = 0.49 to 0.74, p 0.001, I2 = 22.7%, p = 0.249].

The investigators concluded that both the dietary and the circulating vitamin C level reduce risk of metabolic syndrome. However, due to the limitation of the available evidence, more well-designed prospective studies are still needed.

Original title:
Vitamin C and Metabolic Syndrome: A Meta-Analysis of Observational Studies by Guo H, Ding J, [...], Zhang Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8531097/

Additional information of El Mondo:
Find more information/studies on vitamin C consumption and overweight right here.

In practice, a lot of dietary vitamin C intake amounts to 200 to 300 grams of vegetables and 2-5 pieces of fruit per day. Vitamin C is found in fruit and vegetables.

A high circulating vitamin C level can be obtained through vitamin C-rich food and/or taking vitamin C supplements.

 

Objectives:
The associations between dietary carbohydrate and diverse health outcomes remain controversial and confusing. Therefore, this review article (meta-analyse) has been conducted.

What is the association between dietary carbohydrate intake and diverse health outcomes?

Study design:
This review article included 43 meta-analyses of observational research studies with 23 health outcomes, including cancer (n = 26), mortality (n = 4), metabolic diseases (n = 4), digestive system outcomes (n = 3) and other outcomes [coronary heart disease (n = 2), stroke (n = 1), Parkinson's disease (n = 1) and bone fracture (n = 2)].

This umbrella review summarized 281 individual studies with 13,164,365 participants.

33.3% studies were considered to be of high quality and 66.7% of moderate quality.

Results and conclusions:
The investigators found highly suggestive evidence showed that dietary carbohydrate intake significantly increased risk of metabolic syndrome with 25% [adjusted summary odds ratio = 1.25, 95% CI = 1.15 to 1.37].

The investigators found suggestive evidence showed that dietary carbohydrate intake significantly decreased risk of esophageal adenocarcinoma with 43% [adjusted summary hazard ratio = 0.57, 95% CI = 0.42 to 0.78].

The investigators found suggestive evidence showed that dietary carbohydrate intake significantly increased risk of all-cause mortality with 19% [adjusted summary hazard ratio 1.19, 95% CI = 1.09 to 1.30].

The investigators concluded despite the fact that numerous systematic reviews and meta-analyses have explored the relationship between carbohydrate intake and diverse health outcomes, there is no convincing evidence of a clear role of carbohydrate intake. However, highly suggestive evidence shows carbohydrate intake is associated with higher risk of metabolic syndrome. Suggestive evidence shows carbohydrate intake is associated with higher risk of all-cause mortality and lower risk of esophageal adenocarcinoma.

Original title:
Dietary Carbohydrate and Diverse Health Outcomes: Umbrella Review of 30 Systematic Reviews and Meta-Analyses of 281 Observational Studies by Liu YS, Wu QJ […], Zhao YH.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8116488/

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Find more information/studies on carbohydrate consumption and obesity/overweight right here.

Objectives:
Chemotherapy-induced peripheral neuropathy (CIPN) is a common symptom, but prophylactic measures cannot still be carried out effectively. In addition, the efficacy of vitamin E in preventing peripheral neurotoxicity caused by chemotherapy is inconclusive. Therefore, this review article has been conducted.

Does vitamin E supplementation decrease risk of chemotherapy-induced peripheral neuropathy?

Study design:
This review article included 8 RCTs with a total of 488 patients.
The number of participants in each arm ranged from 13 to 96.
The experimental intervention was vitamin E supplementation as an adjuvant to cisplatin, paclitaxel and other chemotherapies.
There was no publication bias.

Results and conclusions:
The investigators found patients who received vitamin E supplementation of 600 mg/day had a significantly lower incidence of chemotherapy-induced peripheral neuropathy of 69% [risk ratio = 0.31, 95% CI = 0.14 to 0.65, p = 0.002, I2 = 0%] than the placebo group (group without vitamin E).

The investigators found patients in the cisplatin chemotherapy group who received vitamin E supplementation had a significantly lower incidence of chemotherapy-induced peripheral neuropathy of 72% [risk ratio = 0.28, 95% CI = 0.14 to 0.54, p = 0.0001, I2 = 0%]  than the placebo group.

The investigators found, moreover, vitamin E supplementation significantly decreased patients’ sural amplitude after 3 rounds of chemotherapy [MD = -2.66, 95% CI = -5.09 to -0.24, p = 0.03, I2 = 0%] in contrast with that of placebo supplementation, while no significant difference was observed when patients were treated with vitamin E after 6 rounds of chemotherapy [MD = -1.28, 95% CI = -3.11 to 0.54, p = 0.17, I2 = 40%].

The investigators found, in addition, the vitamin E-supplemented group had better improvement in the neurotoxicity score and lower incidence of reflexes and distal paraesthesias than the control group.

The investigators concluded that vitamin E supplementation of 600 mg/day decreases risk of chemotherapy-induced peripheral neuropathy, particularly in the cisplatin chemotherapy group. More high-quality trials with standardized reporting of clinical outcomes about peripheral neuropathy are needed to explore the exact role of vitamin E in the prevention of chemotherapy-induced peripheral neuropathy.

Original title:
Protective Effects of Vitamin E on Chemotherapy-Induced Peripheral Neuropathy: A Meta-Analysis of Randomized Controlled Trials by Miao H, Li R [...], Wen Z.

Link:
https://www.karger.com/Article/FullText/515620

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Objectives:
With the increasing incidence of osteoporosis, vitamin K and calcium have been linked to bone mineral density (BMD) and undercarboxylated osteocalcin (UcOC) in many studies, but the results of studies of the combined effect of vitamin K and calcium on BMD and UcOC in humans have been inconsistent. Therefore, this review article has been conducted.

Do vitamin K and calcium supplements used in combination increase bone mineral density and decrease undercarboxylated osteocalcin level?

Study design:
This review article included 10 randomized controlled trials (RCTs) with a total of 1,346 patients.

Results and conclusions:
The investigators found that the combination of vitamin K and calcium supplements was significantly associated with a higher lumbar spine bone mineral density [SMD = 0.20, 95% CI = 0.07 to 0.32, I2 = 46.9%, p = 0.049].
However, after applying trim and fill method (where correction was made for publication bias), the results were not statistically significant [estimate = 0.067, 95% CI = -0.044 to 0.178].

The investigators found that vitamin K and calcium supplementation led to a significant decrease in undercarboxylated osteocalcin [SMD = -1.71, 95% CI = - 2.45 to -0.96, I2 = 95.7%, p  0.01].
The results did not change after correcting publication bias [estimate = - 0.947, 95% CI = -1.211 to - 0.687].
The SMD in the sensitivity analysis was -0.82 [95% CI = - 1.10 to -0.55, I2 = 65.4%, p  0.01].

The investigators found in subgroup analysis that the combination of vitamin K2 and calcium supplements was significantly associated with a higher lumbar spine bone mineral density [SMD = 0.30, 95% CI = 0.10 to 0.51, I2 = 0%].

The investigators found in subgroup analysis that the combination of vitamin K and  ≤ 1000 mg/d calcium supplements was significantly associated with a higher lumbar spine bone mineral density [SMD = 0.19, 95% CI = 0.05 to 0.32, I2 = 62.3%].

The investigators found in subgroup analysis that the combination of  ≤100 µg/d vitamin K and calcium supplements was significantly associated with a higher lumbar spine bone mineral density [SMD = 0.40, 95% CI = 0.20 to 0.61, I2 = 49.9%].

The investigators found in subgroup analysis that the combination of vitamin K and calcium supplements during ≤1 year was significantly associated with a higher lumbar spine bone mineral density [SMD = 0.38, 95% CI = 0.19 to 0.57, I2 = 40%].

The investigators concluded that ≤100 µg/d vitamin K2 and ≤1000 mg/d calcium supplements used in combination are associated with a higher lumbar spine bone mineral density and a lower undercarboxylated osteocalcin level.

Original title:
The combined effect of vitamin K and calcium on bone mineral density in humans: a meta-analysis of randomized controlled trials by Hu L, Ji J, [...], Yu B.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8515712/

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Find more information/studies on review article/RCTs/publication bias, vitamin K, calcium and increasing bone mineral density right here.

Objectives:
The efficacy of dendritic cell vaccine for newly diagnosed glioblastoma remains controversial. Therefore, this review article has been conducted.

Does dendritic cell vaccine provide benefits for the newly diagnosed glioblastoma?

Study design:
This review article included 3 randomized controlled trials (RCTs).

Results and conclusions:
The investigators found overall, compared with control group for newly diagnosed glioblastoma, dendritic cell vaccine showed no substantial effect on:
-median overall survival [SMD = 0.11, 95% CI = -0.18 to 0.41, p = 0.45];
-median progression-free survival [SMD = 0.12, 95% CI = -0.24 to 0.48, p = 0.50];
-progression-free survival rate [risk ratio = 1.29, 95% CI = 0.82 to 2.04, p = 0.27];
-overall survival rate [risk ratio = 1.29, 95% CI = 0.61 to 2.72, p = 0.50] or;
-nervous system disorders [risk ratio = 0.80, 95% CI= 0.59 to 1.08, p = 0.14].

The investigators concluded dendritic cell vaccine provides no obvious benefits for the newly diagnosed glioblastoma.

Original title:
The Efficacy of Dendritic Cell Vaccine for Newly Diagnosed Glioblastoma: A Meta-analysis of Randomized Controlled Studies by Tan L, Peng J, […], Wu Q.

Link:
https://pubmed.ncbi.nlm.nih.gov/34767325/

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Dendritic cells (DCs) are professional antigen-presenting cells that link innate and adaptive immunity and are critical for the induction of protective immune responses against pathogens.

Glioblastoma is an aggressive type of cancer that can occur in the brain or spinal cord.

Objectives:
Leg cramps are one of the common symptoms during pregnancy. About 30%-50% of pregnant women experience leg cramps twice a week. Leg cramps may cause severe pain and sleep disturbance, hinder performance of daily activities and may lengthen the duration of pregnancy and the type of childbirth. Therefore, this review article has been conducted.

Does oral magnesium supplementation reduce leg cramps during pregnancy?

Study design:
This review article included 4 RCTs with a total of 332 pregnant women.

Results and conclusions:
The investigators found the frequency of leg cramps during pregnancy was not significantly decreased in the magnesium group compared to the control group (group without magnesium) [WMD = -0.47, 95% CI = -1.14 to 0.20, p = 0.167].

The investigators found oral magnesium supplementation did not significantly improved the recovery from leg cramps during pregnancy compared to the control group [OR = 0.47, 95% CI = 0.14 to 1.52, p = 0.207].

The investigators found oral magnesium supplementation had no significant side effects in the treatment group (group with magnesium) compared to the control group [OR = 1.82, 95% CI = 0.90 to 3.69, p = 0.094].

The investigators concluded that oral magnesium supplementation is not effective in the treatment of leg cramps during pregnancy.

Original title:
Effect of oral magnesium supplementation for relieving leg cramps during pregnancy: A meta-analysis of randomized controlled trials by Liu J, Song G, [...], Meng T.

Link:
https://pubmed.ncbi.nlm.nih.gov/34247796/

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Objectives:
What is the prevalence of insufficient iodine intake in pregnant women from different regions of the world?

Study design:
This review article included 61 observational articles with a total of 163,021 pregnant women adults and adolescents.

Results and conclusions:
The investigators found the overall prevalence of insufficient iodine intake was 53% [95% CI = 47 to 60, I2 = 99.8%].

The investigators found pregnant women who live in insufficient iodine status country had a higher prevalence [86%, 95% CI = 78 to 93, I2 = 97.0%] of inadequate iodine nutritional status than to those living in country considered sufficient [51%, 95% IC = 45 to 57, I2 = 99.8%].

The investigators concluded despite the progress in iodine fortification policies and periodic monitoring of the iodine nutritional status of the population worldwide, salt iodination alone may not be sufficient to provide adequate iodine status to pregnant women. Thus, other actions may be necessary to improve the nutritional clinical care of pregnant group.

Original title:
Prevalence of insufficient iodine intake in pregnancy worldwide: a systematic review and meta-analysis by Patriota ESO, Lima ICC, […], Pizato N.

Link:
https://pubmed.ncbi.nlm.nih.gov/34545212/

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Find more information/studies on RCTs/cohort/significantly/review article, iodine, pregnancy, food fortification and malnutrition right here.

The iodine levels in blood can be increased through eating iodine fortified foods, like salt and/or taking iodine supplements.

Objectives:
The relation between sodium intake and cardiovascular disease remains controversial, owing in part to inaccurate assessment of sodium intake. Assessing 24-hour urinary excretion over a period of multiple days is considered to be an accurate method. Therefore, this review article has been conducted.

Do higher sodium and lower potassium dietary intakes, as measured in multiple 24-hour urine samples, reduce in a dose-response manner cardiovascular risk?

Study design:
This review article included 6 prospective cohort studies with a total of 10,709 healthy adults (54.2% women), of whom, 571 cardiovascular events were ascertained during a median study follow-up of 8.8 years (incidence rate: 5.9 per 1000 person-years).

The mean (±SD) age was 51.5±12.6 years.

Results and conclusions:
The investigators found that the median 24-hour urinary sodium excretion was 3,270 mg (10th to 90th percentile, 2099 to 4899).

The investigators found higher sodium excretion, lower potassium excretion and a higher sodium-to-potassium ratio were all significantly associated with a higher cardiovascular risk in analyses that were controlled for confounding factors [p ≤ 0.005 for all comparisons].

The investigators found in analyses that compared quartile 4 of the urinary biomarker (highest) with quartile 1 (lowest), the hazard ratios were 1.60 [95% CI = 1.19 to 2.14] for sodium excretion, 0.69 [95% CI = 0.51 to 0.91] for potassium excretion and 1.62 [95% CI = 1.25 to 2.10] for the sodium-to-potassium ratio.

The investigators found each daily increment of 1,000 mg in 24-hour urinary sodium excretion was significantly associated with an 18% increase in cardiovascular risk [hazard ratio = 1.18, 95% CI = 1.08 to 1.29].

The investigators found each daily increment of 1,000 mg in 24-hour urinary potassium excretion was significantly associated with an 18% decrease in cardiovascular risk [hazard ratio = 0.82, 95% CI = 0.72 to 0.94].

The investigators concluded higher sodium and lower potassium dietary intakes, as measured in multiple 24-hour urine samples, reduce in a dose-response manner cardiovascular risk. These findings may support reducing sodium intake and increasing potassium intake from current levels.

Original title:
24-Hour Urinary Sodium and Potassium Excretion and Cardiovascular Risk by Ma Y, He FJ, […], Hu FB.

Link:
https://pubmed.ncbi.nlm.nih.gov/34767706/

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A 24-hour urine sample is simply a collection of all urine passed over a 24-hour period of time. The test is used to check kidney function.
The normal range for 24-hour urine volume is 800 to 2,000 milliliters per day (with a normal fluid intake of about 2 liters per day).

Objectives:
Whether mushroom consumption, which is a rich source of potent antioxidants ergothioneine and glutathione, vitamins and minerals (e.g., selenium & copper), is associated with a lower mortality risk is not well understood. Therefore, this review article (meta-analysis) has been conducted.

Does mushroom consumption reduce all-cause mortality?

Study design:
This review article included 5 prospective cohort studies with a total of 50,787 cases of deaths accrued in 601,893 men and women.

Results and conclusions:
The investigators found in a meta-analysis that mushroom consumption was significantly associated with an 6% decrease of the risk of all-cause mortality [pooled risk ratio = 0.94, 95% CI = 0.91 to 0.98].  

The investigators concluded that a meta-analysis of prospective cohort studies shows mushroom consumption reduces all-cause mortality. These findings can be used to support public health recommendations and increase awareness about the health-promoting effects of mushrooms. Large prospective cohort studies with repeated dietary data measurements are needed to replicate these findings and clarify the potential protective role of mushrooms against premature mortality.

Original title:
Prospective study of dietary mushroom intake and risk of mortality: results from continuous National Health and Nutrition Examination Survey (NHANES) 2003-2014 and a meta-analysis by Ba DM, Gao X, [...], Richie Jr JP.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8454070/

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Objectives:
Lactoferrin (Lf) is one of the key immunomodulatory substances found naturally in various body fluids, such as saliva, tears  and breast milk and forms a vital part of the innate defense against invading pathogens. Various studies have demonstrated antibacterial, antifungal and antiviral properties of Lf and its protective role against respiratory tract infections (RTIs). Therefore, this review article has been conducted.

Does lactoferrin supplementation reduce risk of respiratory illness?

Study design:
This review article included 9 RCTs with a total of 1,194 participants.

Results and conclusions:
The investigators found meta-analysis revealed a significantly reduced risk of 43% for developing respiratory infections with the use of lactoferrin relative to the control [pooled odds ratio = 0.57, 95% CI = 0.44 to 0.74], with sufficient evidence against the hypothesis of 'no significant difference' at the current sample size.

The investigators concluded that the administration of lactoferrin (Lf) shows promising efficacy in reducing the risk of respiratory tract infections (RTIs). Current evidence also favours Lf fortification of infant formula. Lf may also have a beneficial role in managing symptoms and recovery of patients suffering from RTIs and may have potential for use as an adjunct in COVID-19, however this warrants further evidence from a large well-designed RCT.

Original title:
Lactoferrin reduces the risk of respiratory tract infections: A meta-analysis of randomized controlled trials by Ali AS, Hasan SS, […], Merchant HA.

Link:
https://pubmed.ncbi.nlm.nih.gov/34620326/

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Lactoferrin is a natural iron-binding glycoprotein found in cow milk and human milk. Colostrum, the first milk produced after a baby is born, contains about seven times more lactoferrin than is found in milk produced later on. Lactoferrin's main functions in the body include binding with and transporting iron.

Objectives:
Since WHO recommended introduction of at least a single dose of inactivated poliovirus vaccine (IPV) in routine immunisation schedules, there have been global IPV shortages. Fractional-dose IPV (fIPV) administration is one of the strategies to ensure IPV availability. Therefore, this review article has been conducted.

Is there a difference in seroconversion and antibodies response between fractional-dose IPV (fIPV) and full-dose IPV?

Study design:
This review article included 14 articles: 2 ongoing trials and 12 articles reporting on 10 completed studies.

The seroconversion meta-analysis for the three-dose comparison was homogeneous [p = 0.45, I2 = 0%], whereas heterogeneity was observed in the two-dose [p 0.00001, I2 = 88%] and one-dose [p = 0.0004, I2 = 74%] comparisons.
Heterogeneity was observed in meta-analyses of GMTs for one-dose [p 0.00001, I2 = 92%, two-dose [p = 0.002, I2 = 80%] and three-dose [p 0.00001, I2 = 93%] comparisons. Findings for types 1 and 3 were similar to those for type 2.
The certainty of the evidence was high for the three-dose comparisons and moderate for the rest of the comparisons.

Results and conclusions:
The investigators found for poliovirus type 2, there were no significant differences in the proportions of seroconversions between fractional and full doses of IPV for 2 or 3 doses: the risk ratio for serconversion at 1 dose was 0.61 [95% CI = 0.51 to 0.72], at 2 doses was 0.90 [95% CI = 0.82 to 1.00] and at 3 doses was 0.95 [95% CI = 0.91 to 1.00].

The investigators found geometric mean titres (GMTs) for poliovirus type 2 were lower for fIPV than for full-dose IPV [-0.51, 95% CI = -0.87 to -0.14] at 1 dose [-0.49, 95% CI = -0.70 to -0.28] at 2 doses and [-0.98, 95% CI = -1.46 to -0.51] at 3 doses.

The investigators concluded that there is no substantial difference in seroconversion between 3 doses of fractional-dose IPV (fIPV) and 3 doses of full-dose poliovirus vaccine (IPV), although the full dose gives higher titres of antibodies for poliovirus type 1, 2 and 3. Use of fractional IPV instead of the full dose can stretch supplies and possibly lower the cost of vaccination.

Original title:
Fractional dose compared with standard dose inactivated poliovirus vaccine in children: a systematic review and meta-analysis by Mashunye TR, Ndwandwe DE, [...], Wiysonge CS.

Link:
https://pubmed.ncbi.nlm.nih.gov/33939958/

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Objectives:
Previous meta-analysis studies have indicated inverse associations between some carotenoids and risks of metabolic syndrome, cardiovascular disease, cancer and all-cause mortality. However, the results for associations between carotenoids and type 2 diabetes (T2D) remain inconsistent and no systematic assessment has been done on this topic. Therefore, this review article (meta-analysis) has been conducted.

Do higher dietary intakes and circulating concentrations of carotenoids reduce risk of type 2 diabetes?

Study design:
This review article included 13 studies.

Results and conclusions:
The investigators found for the the highest versus the lowest categories of dietary intake of β-carotene a significantly reduced risk of 22% for type 2 diabetes [pooled RR = 0.78, 95% CI = 0.70 to 0.87, I2 = 13.7%, n = 6].
This significantly reduced risk was also found for total carotenoids (n = 2), α-carotene (n = 4), and lutein/zeaxanthin (n = 4), with pooled RRs ranging from 0.80 to 0.91, whereas no significant associations were observed for β-cryptoxanthin and lycopene.

The investigators found for the the highest versus the lowest categories of circulating concentration of β-carotene a significantly reduced risk of 40% for type 2 diabetes [pooled RR = 0.60, 95% CI = 0.46 to 0.78, I2 = 56.2%, n = 7].
This significantly reduced risk was also found for total carotenoids (n = 3), lycopene (n = 4), and lutein (n = 2), with pooled RRs ranging from 0.63 to 0.85, whereas no significant association was found for circulating concentrations of α-carotene and zeaxanthin when comparing extreme categories.

The investigators found dose-response analysis indicated that nonlinear relations were observed for circulating concentrations of α-carotene, β-carotene, lutein and total carotenoids [all p-nonlinearity 0.05], but not for other carotenoids or dietary exposures.

The investigators concluded that higher dietary intakes and circulating concentrations of total carotenoids, especially β-carotene, are associated with a lower risk of type 2 diabetes. More studies are needed to confirm the causality and explore the role of foods rich in carotenoids in prevention of type 2 diabetes.

Original title:
Dietary Intake and Circulating Concentrations of Carotenoids and Risk of Type 2 Diabetes: A Dose-Response Meta-Analysis of Prospective Observational Studies by Jiang YW, Sun ZH, [...], Pan A.

Link:
https://pubmed.ncbi.nlm.nih.gov/33979433/

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Objectives:
Do HPV vaccines reduce risk of HPV-related oropharyngeal cancer?

Study design:
This review article included 2 randomized controlled trials (RCTs) and 4 cross-sectional studies with a total of 15,240 participants.

Results and conclusions:
The investigators found in a meta-analysis that vaccinated individuals were 46% [risk ratio = 0.54, 95% CI = 0.32 to 0.91, p = 0.02] less likely to develop oral vaccine-type HPV infection compared to controls.  

The investigators found in a second meta-analysis of 4 studies (1 randomized controlled trial and 3 cross-sectional studies and 13,285 participants) an 80% [risk ratio = 0.20, 95% CI = 0.09 to 0.43, p 0.0001] less likelihood of oral HPV16 infection.

The investigators concluded that HPV vaccines show protection against oral vaccine-type HPV infection including high-risk HPV16 infection, thus reducing the incidence of HPV-related oropharyngeal cancer (OPC). Vaccination against HPV, especially in males, who are predominantly affected by HPV-related OPC, could result in the prevention of this disease.

Original title:
Human Papillomavirus Vaccine to End Oropharyngeal Cancer. A Systematic Review and Meta-Analysis by Tsentemeidou A, Fyrmpas G, […],Tsetsos N.

Link:
https://pubmed.ncbi.nlm.nih.gov/34110733/

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Objectives:
Does fruits and vegetables (FVs) consumption reduce risk of frailty?

Study design:
This review article included 10 cohort studies and 4 cross-sectional studies with 18,616 subjects with frailty and 101,969 controls (persons without frailty).

Based on the NutriGrade score, the quality of evidence for a protective effect of fruits and vegetables consumption on frailty was "moderate".

Results and conclusions:
The investigators found in 7 cohort studies for the highest versus lowest category of fruits and vegetables consumption a significantly reduced risk of 35% for frailty [RR = 0.65, 95% CI = 0.50 to 0.84, I2 = 81%].

The investigators found that every 200g per day increment in fruits and vegetables consumption was significantly associated with a 14% lower risk of frailty.
The risk of frailty decreased linearly up to fruits and vegetables consumption of 700 g/d, with flattening the curve at higher intake.

The investigators found that pooled analysis regarding fruits and vegetables separately did not indicate a significant association with the risk of frailty.

The investigators concluded that 200-700 g/d fruits and vegetables consumption decreases risk of frailty. Further large-scale prospective cohort studies are needed to reach more confident conclusions.

Original title:
Fruit and vegetable intake and risk of frailty: A systematic review and dose response meta-analysis by Ghoreishy SM, Asoudeh F, […], Mohammadi H.

Link:
https://pubmed.ncbi.nlm.nih.gov/34534684/

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Objectives:
Potential effects of inositol supplementation on blood pressure (BP) have been examined in several interventional studies. Nevertheless, findings in this context are controversial. Therefore, this review article has been conducted.

Do inositol supplements reduce blood pressure in humans?

Study design:
This review article included 7 eligible RCTs.

Results and conclusions:
The investigators found significant decline in both systolic blood pressure (SBP) [WMD = -5.69 mmHg, 95% CI = -7.35 to -4.02, p 0.001] and diastolic blood pressure (DBP) [WMD = -7.12 mmHg, 95% CI = -10.18 to -4.05, p 0.001] following supplementation with inositol.

The investigators found subgroup analysis showed that studies performed in individuals with metabolic syndrome with a longer duration (>8 weeks) and a dose of 4000 mg inositol supplements resulted in a more effective reduction in systolic blood pressure and diastolic blood pressure with acceptable homogeneity.

The investigators concluded that 4000 mg inositol supplements during at least 8 weeks reduce blood pressure, particularly in individuals with metabolic syndrome. Further large-scale RCTs with better design are needed to confirm these findings.

Original title:
The effect of inositol supplementation on blood pressure: A systematic review and meta-analysis of randomized-controlled trials by Tari SH, Sohouli MH, […], Rahideh ST.

Link:
https://pubmed.ncbi.nlm.nih.gov/34330516/

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Objectives:
What is the efficacy of vitamin D fortification and supplementation in children?

Study design:
This review article included 31 studies.

Results and conclusions:
The investigators found significant raises in circulating 25(OH)D concentrations were observed in both groups that took vitamin D supplement [MD = 28.7, 95% CI = 22.5 to 34.9] and vitamin D-fortified foods [MD = 20.29, 95% CI = 13.3 to 27.2].

The investigators found the meta-regression revealed a significant association between age of participants [B = -1.4, 95% CI = -2.8 to -0.02, p = 0.047] and dose of vitamin D [B = 0.007, 95% CI = 0.003 to 0.01, p 0.001], with the effect on serum 25(OH)D concentrations.

The investigators found that serum 25(OH)D concentration increased by 0.7 nmol/L for every 100 IU of vitamin D intake after adjustment for age, baseline serum 25(OH)D and latitude which is far less than the reported amount in adults.

The investigators concluded that serum 25(OH)D concentration increases by 0.7 nmol/L for every 100 IU of vitamin D intake. These findings indicate that in a mass vitamin D fortification program, circulating 25(OH)D concentration response in children may be lower in children than in adults and vitamin D supplementation may still be needed in this subpopulation.

Original title:
How Much Does Serum 25(OH)D Improve by Vitamin D Supplement and Fortified Food in Children? A Systematic Review and Meta-Analysis by Nikooyeh B, Ghodsi D and Neyestani TR.

Link:
https://pubmed.ncbi.nlm.nih.gov/34520402/

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Objectives:
It has been theorized that folic acid supplementation improves inflammation. However, its proven effects on inflammatory markers are unclear as clinical studies on this topic have produced inconsistent results. Therefore, this review article has been conducted.

Have folic acid supplements positive effects on inflammatory markers, like CRP, IL-6 and TNF-α?

Study design:
This review article included 12 RCTs with a total of 1,392 participants.
The studies were conducted between 2003 and 2018 and their sample size varied from 19 to 530 participants.
The mean age of the participants ranged from 24.1 to 68.1 years old.
The supplementation period ranged from 2 to 52 weeks.
The daily mentioned dosage of folic acid varied between 0.8 mg and 10 mg/d.

There was no publication bias.

Results and conclusions:
The investigators found a significant effect of folic acid supplementation on serum concentrations of CRP [WMD = -0.59 mg/L, 95% CI = -0.85 to -0.32, p 0.001, I2 = 91.3%, p 0.001].
This significantly reduced effect was also found in the subgroup and sensitivity analysis.
Subgroup analysis showed that baseline serum concentrations of CRP, duration of intervention, dosage and the participants’ age and gender explained this heterogeneity.

The investigators concluded that 0.8-10 mg/d folic acid supplements decrease serum concentrations of CRP.

Original title:
Effects of Folic Acid Supplementation on Inflammatory Markers: A Grade-Assessed Systematic Review and Dose-Response Meta-Analysis of Randomized Controlled Trials by Asbaghi O, Ashtary-Larky D, […], Naeini AA.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8308638/

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Objectives:
What is the association between red meat and poultry consumption and the risk of metabolic syndrome?

Study design:
This review article included 9 prospective cohort studies, which involved a total of 21,869 participants.
Among them, 8 studies were identified for red meat consumption.

No publication bias was observed according to the Begg's rank-correlation test and the Egger's test.  

Results and conclusions:
The investigators found that red meat consumption was significantly associated with a higher risk of 35% for metabolic syndrome [multi-variable adjusted RR = 1.35, 95% CI = 1.13 to 1.62, p = 0.001, I2 = 54.4%, p = 0.032].  
The same results were obtained in subgroup analysis for >5 years follow-up [RR = 1.36, 95% CI = 1.09 to 1.7, p = 0.006], non-National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP III) [RR = 1.34, 95% CI = 1.12 to 1.62, p = 0.002], Non-Asia [RR = 1.51, 95% CI = 1.29 to 1.77, p 0.001], adjustment of BMI [RR = 1.4, 95% CI = 1.23 to 1.6, p 0.001] and physical activity studies [RR = 1.48, 95% CI = 1.29 to 1.71, p 0.001].

The investigators found that unprocessed red meat consumption was significantly associated with a higher risk of 32% for metabolic syndrome [multi-variable adjusted RR = 1.32, 95% CI = 1.14 to 1.54, p = 0.0003, I2 = 0%, p = 0.397].  

The investigators found that processed red meat consumption was significantly associated with a higher risk of 48% for metabolic syndrome [multi-variable adjusted RR = 1.48, 95% CI = 1.11 to 1.97, p = 0.007, I2 = 64.7%, p = 0.097].  

The investigators found that poultry consumption was significantly associated with a lower risk of 15% for metabolic syndrome [multi-variable adjusted RR = 0.85, 95% CI = 0.75 to 0.97, p = 0.02, I2 = 0%, p = 0.707].  

The investigators concluded that red meat (processed and unprocessed) consumption is associated with a higher risk of metabolic syndrome, whereas, poultry consumption is associated with a lower risk of metabolic syndrome. More well-designed randomized controlled trials are still needed to address the issues further.

Original title:
Association of Red Meat and Poultry Consumption With the Risk of Metabolic Syndrome: A Meta-Analysis of Prospective Cohort Studies by Guo H, Ding J, [...], Zhang Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8295459/

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Objectives:
Can vitamin D-fortified products be a suitable solution for tackling vitamin D deficiency in adults?

Study design:
This review article included 23 studies.

Results and conclusions:
The investigators found pooled data comparing fortification with vitamin D +/- Ca with control showed statistically significant effect on total 25(OH)D concentrations [MD = 25.4 nmol/L, 95% CI = 19.5 to 31.3, n = 2,002 participants].

The investigators found the subgroup analysis by duration of intervention (less than 12 weeks versus more than 12 weeks) and type of vehicle (dairy product, juice, grain product, oil and combination of dairy and grain products), isoform of the vitamin (D3 versus D2) and dose of the fortificant (≥ 1000 IU/d versus 1000 IU/d) also indicated significant effect of fortification with vitamin D on serum 25(OH)D concentrations.

The investigators found an average of 2 nmol/L increase in circulating 25(OH)D concentration for each 100 IU vitamin D intake per day in general adult population.

The investigators concluded that the circulating 25(OH)D response to vitamin D-fortified food consumption is influenced by age, BMI and the baseline 25(OH)D concentrations. Notwithstanding, an average of 2 nmol/L increase in circulating 25(OH)D concentration for each 100 IU vitamin D intake per day is expected for general adult population. These findings can be informative for policymakers to tackle vitamin D deficiency through food fortification strategy.

Original title:
The effects of vitamin D-fortified foods on circulating 25(OH)D concentrations in adults: a systematic review and meta-analysis by Nikooyeh B and Neyestani TR.

Link:
https://pubmed.ncbi.nlm.nih.gov/34308818/

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Objectives:
Small-quantity lipid-based nutrient supplements (SQ-LNSs) were designed to provide multiple micronutrients within a food base that also provides energy, protein and essential fatty acids, targeted towards preventing malnutrition in vulnerable populations. Previous meta-analyses demonstrated beneficial effects of SQ-LNSs on child growth, anemia and mortality. However, to further examine the efficacy and effectiveness of SQ-LNSs and explore study-level and individual-level effect modifiers, this review article has been conducted.

Do small-quantity lipid-based nutrient supplements reduce child malnutrition and promote healthy development?

Study design:
This review article included 14 randomized controlled trials (RCTs) of small-quantity lipid-based nutrient supplements (SQ-LNSs) provided to children 6-24 months of age ( n = 37,066).

Most trials began child supplementation with SQ-LNSs at 6 mo of age and the intended duration ranged from 6 to 18 mo of supplementation; 4 trials included intervention arms that also provided SQ-LNSs to mothers during pregnancy and the first 6 mo postpartum.
All trials provided peanut- and milk-based SQ-LNS in at least 1 of the arms.

Results and conclusions:
The investigators found children who received small-quantity lipid-based nutrient supplements had a 12-14% lower prevalence of stunting, wasting and underweight compared with control group children.  

The investigators found children who received small-quantity lipid-based nutrient supplements were 16-19% less likely to score in the lowest decile for language, social-emotional and motor development compared with control group children.  

The investigators found children who received small-quantity lipid-based nutrient supplements had a 16% lower prevalence of anemia and had a 64% lower prevalence of iron-deficiency anemia compared with control group children.

The investigators found for most outcomes, beneficial effects of small-quantity lipid-based nutrient supplements were evident regardless of study-level characteristics, including region, stunting burden, malaria prevalence, sanitation, water quality, duration of supplementation, frequency of contact or average reported compliance with small-quantity lipid-based nutrient supplements.

The investigators found for development, the benefits of small-quantity lipid-based nutrient supplements were greater in populations with higher stunting burden, in households with lower socioeconomic status and among acutely malnourished children.

The investigators found for hemoglobin and iron status, benefits were greater in populations with higher anemia prevalence and among acutely malnourished children, respectively.

The investigators concluded that small-quantity lipid-based nutrient supplements reduce child malnutrition and promote healthy development. Therefore, policymakers and program planners should consider including small-quantity lipid-based nutrient supplements in strategies to reduce child mortality, stunting, wasting, anemia, iron deficiency and delayed development.

Original title:
Small-quantity lipid-based nutrient supplements for the prevention of child malnutrition and promotion of healthy development: overview of individual participant data meta-analysis and programmatic implications by Dewey KG, L Prado EL, […], Arnold CD.

Link:
https://academic.oup.com/ajcn/advance-article/doi/10.1093/ajcn/nqab279/6378016

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Objectives:
Epidemiological studies have shown that higher intake of flavonoid is inversely associated with coronary heart disease (CHD) risk. However, which flavonoid subclass (including anthocyanins, flavonols) could reduce CHD risk has remained controversial. Therefore, this review article has been conducted.

Do dietary intakes of anthocyanins, proanthocyanidins, flavonols, flavones and isoflavones reduce coronary heart disease?

Study design:
This review article included 19 independent prospective cohort studies with 894,471 participants and 34,707 persons with coronary heart disease.
 
Results and conclusions:
The investigators found that dietary intakes of anthocyanins significantly reduced risk of coronary heart disease with 10% [RR = 0.90, 95% CI = 0.83 to 0.98].

The investigators found that dietary intakes of proanthocyanidins significantly reduced risk of coronary heart disease with 22% [RR = 0.78, 95% CI = 0.65 to 0.94].

The investigators found that dietary intakes of flavonols significantly reduced risk of coronary heart disease with 12% [RR = 0.88, 95% CI = 0.79 to 0.98].

The investigators found that dietary intakes of flavones significantly reduced risk of coronary heart disease with 6% [RR = 0.94, 95% CI = 0.89 to 0.99].

The investigators found that dietary intakes of isoflavones significantly reduced risk of coronary heart disease with 10% [RR = 0.90, 95% CI = 0.83 to 0.98].

The investigators found in dose-response analysis that increment of 50 mg/d dietary anthocyanins significantly reduced risk of coronary heart disease with 5%.

The investigators found in dose-response analysis that increment of 100 mg/d dietary proanthocyanidins significantly reduced risk of coronary heart disease with 5%.

The investigators found in dose-response analysis that increment of 25 mg/d dietary flavonols significantly reduced risk of coronary heart disease with 5%.

The investigators found in dose-response analysis that increment of 5 mg/d dietary flavones significantly reduced risk of coronary heart disease with 5%.

The investigators found in dose-response analysis that increment of 0.5 mg/d dietary isoflavones significantly reduced risk of coronary heart disease with 5%.

The investigators found sensitivity and subgroup analyses supported these associations.

The investigators concluded that daily dietary intakes of 50mg anthocyanins, 100 mg proanthocyanidins, 25mg flavonols, 5mg flavones or 0.5mg isoflavones reduce coronary heart disease.

Original title:
Flavonoid subclasses and coronary heart disease risk: a meta-analysis of prospective cohort studies by Fan ZK, Wang C, [...], Li D.

Link:
https://pubmed.ncbi.nlm.nih.gov/34470681/

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