Nutritional advice

Most prevalent neurological comorbidity in COVID-19 is cerebrovascular disease

Afbeelding

Objectives:
Recently, it has been shown that coronavirus disease 2019 (COVID-19), which has caused a pandemic since December 2019, can be accompanied by some neurological disorders and therefore, this review article has been conducted.

What are the most prevalent neurological manifestations of COVID-19 infection?

Study design:
This review article included 26 observational studies and 31 case reports with a total of 6,597 COVID-19 patients.

Results and conclusions:   
The investigators found the most prevalent general symptoms were fever, cough and dyspnea with 84.6% [95% CI = 75.3 to 92.1, I2 = 98.7%], 61.3% [95% CI = 55.3 to 67.0, I2 = 94.6%] and 34.2% [95% CI = 25.6 to 43.4, I2 = 97.7%], respectively.

The investigators found neurological symptoms observed among COVID-19 patients were fatigue, gustatory dysfunction, anorexia, olfactory dysfunction, headache, dizziness and nausea with 42.9% [95% CI = 36.7 to 49.3, I2 = 92.8%], 35.4% [95% CI = 11.2 to 64.4, I2 = 99.2%], 28.9% [95% CI = 19.9 to 38.8, I2 = 96.3%], 25.3% [95% CI = 1.6 to 63.4, I2 = 99.6%], 10.1% [95% CI = 2.7 to 21.0, I2 = 99.1%], 6.7% [95% CI = 3.7 to 10.5, I2 = 87.5%] and 5.9% [95% CI = 3.1 to 9.5, I2 = 94.5%], respectively.

The investigators found the most prevalent neurological comorbidity in COVID-19 was cerebrovascular disease with 4.3% [95% CI = 2.7 to 6.3, I2 = 78.7%].

The investigators concluded the most prevalent neurological manifestations of COVID-19 include fatigue, gustatory dysfunction, anorexia, olfactory dysfunction, headache, dizziness and nausea. Cerebrovascular disorders can either act as a risk factor for poorer prognosis in COVID-19 patients or occur as a critical complication in these patients. Guillain-Barre syndrome, encephalitis and meningitis have also been reported as complications of COVID-19.

Original title:
Neurological Symptoms, Comorbidities, and Complications of COVID-19: A Literature Review and Meta-Analysis of Observational Studies by Vakili K, Mobina Fathi  M, […], Rezaei-Tavirani M.

Link:
https://pubmed.ncbi.nlm.nih.gov/34044408/

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No effect of vitamin E supplementation on weight, BMI and waist circumference

Objectives:
Several mechanisms have been proposed for the effect of vitamin E on weight loss. Yet various interventional studies with wide ranges of doses and durations have reported contradictory results. Therefore, this review article has been conducted.

Does vitamin E supplementation reduce overweight?

Study design:
This review article included 24 RCTs.

Results and conclusions:
The investigators found there was no significant effect of vitamin E supplements on weight [WMD = 0.15, 95% CI = -1.35 to 1.65, p = 0.847], body mass index (BMI) [WMD = 0.04, 95% CI = -0.29 to 0.37, p = 0.815] and waist circumference (WC) [WMD = -0.19 kg, 95% CI = -2.06 to 1.68, p = 0.842], respectively.

The investigators found, however, subgroup analysis revealed that vitamin E supplementation in studies conducted on participants with normal BMI (18.5-24.9) had increasing impact on BMI [p = 0.047].  

The investigators concluded there is no significant effect of vitamin E supplementation on weight, BMI and waist circumference (WC). However, vitamin E supplementation increases BMI in participants with normal BMI (18.5-24.9).

Original title:
Can vitamin E supplementation affect obesity indices? A systematic review and meta-analysis of twenty-four randomized controlled trials by Emami MR, Jamshidi S, […], Aryaeian N.

Link:
https://pubmed.ncbi.nlm.nih.gov/33632535/

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1 cup/d green tea reduces esophageal cancer among women

Afbeelding

Objectives:
Controversial results of the association between green tea consumption and risk for esophageal cancer (EC) were reported by previous meta-analysis. Therefore, this review article (meta-analysis) has been conducted.

Does green tea consumption reduce esophageal cancer risk?

Study design:
This review article included 14 studies with a total of 5,057 esophageal cancer cases among 493,332 participants.

Results and conclusions:
The investigators found in the dose-response analysis, no association for a 1 cup/d increase in green tea and esophageal cancer risk [the summary OR = 1.00, 95% CI = 0.95 to 1.04, I2 = 77%].

The investigators found no nonlinearity association was observed between tea consumption and risk for esophageal cancer [p = 0.71 for nonlinearity].

The investigators found in the subgroup analysis of sex, a significantly reduced risk of 21% for esophageal cancer among women for a 1 cup/d increase in green tea [summary OR = 0.79, 95% CI = 0.68 to 0.91, I2 = 0%].
However, this reduced risk was not found for men [summary OR for a 1 cup/d increase in green tea = 1.03, 95% CI = 0.95 to 1.11, I2 = 67%].
Significant because OR of 1 was not found in the 95% CI of 0.68 to 0.91. OR of 1 means no risk/association.

The investigators concluded that a 1 cup/d increase in green tea consumption reduces esophageal cancer among women. Notably, these findings might be influenced by limited studies and potential bias, such as dose of green tea assessment and select bias of case-control studies. Further larger number, prospective and well-designed larger-scale studies are needed to provide more precise evidence, especially in women and more regions (United States and Europe).

Original title:
Green tea consumption and risk for esophageal cancer: A systematic review and dose-response meta-analysis by Zhao H, Mei K, […], Lixia Xie L.

Link:
https://pubmed.ncbi.nlm.nih.gov/33744644/

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Patients with diabetes mellitus should be vaccinated against herpes zoster

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Objectives:
Is diabetes mellitus a risk factor for the development of herpes zoster?

Study design:
This review article included 5 cohort studies.
The incidence of herpes zoster in patients with diabetes mellitus varied greatly between studies, ranging from 2.11 per 1,000 person-years to 9.38 per 1,000 person-years.
The overall incidence of herpes zoster in patients with diabetes mellitus was 7.22 per 1,000 person-years.
The pooled incidence of herpes zoster in patients without diabetes mellitus was 4.12 per 1,000 person-years.

The Newcastle-Ottawa Scale (NOS) score of 5 eligible studies was 8. The NOS score above 6 was regarded as a high-quality study.

Results and conclusions:
The investigators found the overall risk of developing herpes zoster was significantly higher in patients with diabetes mellitus when compared to those with no diabetes mellitus [incidence rate ratio = 1.60, 95% confidence interval (CI) = 1.33 to 1.93].

The investigators found sub-analysis including 2 eligible studies demonstrated that the pooled incidence of herpes zoster was higher in patients aged ≥65 than that in patients aged 18 to 64 among both diabetes and non-diabetes groups.
Patients aged ≥65 in diabetes group had the highest incidence rate of herpes zoster [11.91 per 1,000 person-years].

The investigators concluded patients with diabetes mellitus are substantially at increased risk for the development of herpes zoster. Patients with diabetes mellitus should take into consideration the vaccination to prevent herpes zoster.

Original title:
The incidence of herpes zoster in patients with diabetes mellitus: A meta-analysis of cohort studies by Lai SW, Liu CS, […], Liao KF.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8078473/

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Varicella-zoster virus (VZV) is a ubiquitous human alphaherpesvirus that causes varicella (chicken pox) and herpes zoster (shingles). Varicella is a common childhood illness, characterized by fever, viremia and scattered vesicular lesions of the skin.

Herpes zoster, caused by varicella-zoster virus reactivation, is a localized, painful, vesicular rash involving one or adjacent dermatomes.

Weekly 175-350 grams oily fish lower cardiovascular disease among patients with vascular disease

Afbeelding

Objectives:
Cohort studies report inconsistent associations between fish consumption, a major source of long-chain ω-3 fatty acids and risk of cardiovascular disease (CVD) and mortality. Whether the associations vary between those with and those without vascular disease is unknown. Therefore, this review article has been conducted.

Do the associations of fish consumption with risk of cardiovascular disease or of mortality differ between individuals with and individuals without vascular disease?

Study design:
This review article included 4 cohort studies from 58 countries with 191,558 participants with a mean (SD) age of 54.1 (8.0) years and 91,666 (47.9%) were male.
 
Results and conclusions:
The investigators found during 9.1 years of follow-up in PURE, compared with little or no fish intake (≤50 g/mo), an intake of 350 g/wk or more was not associated with risk of major cardiovascular disease [HR = 0.95, 95% CI = 0.86 to 1.04] or total mortality [HR = 0.96, 95% CI = 0.88 to 1.05].
Not associated because HR of 1 was found in the 95% CI of 0.86 to 1.04. HR of 1 means no risk/association.

The investigators found, by contrast, in the 3 cohorts of patients with vascular disease, the HR for risk of major cardiovascular disease [HR = 0.84, 95% CI = 0.73 to 0.96] and total mortality [HR = 0.82, 95% CI = 0.74 to 0.91] was lowest with dietary intakes of at least 175 g/wk (or approximately 2 servings/wk) compared with 50 g/mo or lower, with no further apparent decrease in HR with consumption of 350 g/wk or higher. 

The investigators found fish with higher amounts of ω-3 fatty acids (also called oily fish) were strongly associated with a lower risk of cardiovascular disease [HR = 0.94, 95% CI = 0.92 to 0.97 per 5-g increment of intake], whereas other fish were neutral (collected in 1 cohort of patients with vascular disease).
The association between fish intake and each outcome varied by cardiovascular disease status, with a lower risk found among patients with vascular disease but not in general populations [for major cardiovascular disease: I2 = 82.6%, p = 0.02 and for death: I2 = 90.8%, p = 0.001].

The investigators concluded that fish intake of 175-350g weekly is associated with lower risk of major cardiovascular disease and mortality among patients with prior cardiovascular disease but not in general populations. The consumption of fish (especially oily fish) should be evaluated in randomized trials of clinical outcomes among people with vascular disease.

Original title:
Associations of Fish Consumption With Risk of Cardiovascular Disease and Mortality Among Individuals With or Without Vascular Disease From 58 Countries by Mohan D, Mente A, […], Yusuf S.

Link:
https://pubmed.ncbi.nlm.nih.gov/33683310/

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400 μg folic acid during pregnancy reduce offspring's autism spectrum disorders

Afbeelding

Objectives:
Does intake of folic acid during pregnancy reduce risk of offspring's autism spectrum disorders?

Study design:
This review article included 10 studies with 23 sub-studies (9,795 autism spectrum disorders cases).

Results and conclusions:
The investigators found folic acid supplementation during early pregnancy significantly reduced risk of offspring's autism spectrum disorders with 43% [OR = 0.57, 95% CI = 0.41 to 0.78].

The investigators found the consumption of a daily amount of at least 400 μg folic acid from dietary sources and supplements significantly reduced risk of offspring's autism spectrum disorders with 45% [OR = 0.55, 95% CI = 0.36 to 0.83].

The investigators concluded that the consumption of a daily amount of at least 400 μg (400 mcg) folic acid from dietary sources and supplements during pregnancy reduces risk of offspring's autism spectrum disorders.

Original title:
Prenatal Folic Acid Supplements and Offspring's Autism Spectrum Disorder: A Meta-analysis and Meta-regression by Liu X, Zou M, [...], Chen WX.

Link:
https://pubmed.ncbi.nlm.nih.gov/33743119/

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Asymptomatic malaria infection in Sub-Saharan African pregnant women is prevalent

Objectives:
In Sub-Saharan Africa (SSA), where malaria transmission is stable, malaria infection in pregnancy adversely affects pregnant women, fetuses and newborns and is often asymptomatic. So far, a plethora of primary studies have been carried out on asymptomatic malaria infection in pregnant women in Sub-Saharan Africa. Nevertheless, no meta-analysis estimated the burden of asymptomatic malaria infection in pregnant women in Sub-Saharan Africa. Therefore, this review article (meta-analysis) has been conducted.  

What is the burden of asymptomatic malaria infection in pregnant women in Sub-Saharan Africa?

Study design:
This review article included 35 eligible studies. All included studies were conducted in 14 different countries; the largest number of included studies (n = 16, 45.7%) was conducted in Nigeria, while 3 in Ethiopia, 2 in DR Congo, 2 in Burkina Faso, 2 in Tanzania, 1 in Ghana, 1 in Kenya, 1 in Malawi, 1 in Madagascar, 1 in Liberia, 1 in Uganda, 1 in Zambia, 1 in Mozambique, 1 in Gabon and 1 in Cameroon.
The largest number of included studies (n = 20) used microscopy to diagnose asymptomatic malaria, while the remaining 9, 4 and 2 used molecular methods, microscopy and rapid diagnostic test and rapid diagnostic test, respectively.
The sample size of eligible studies ranges from 50 to 2,459.
All included studies were conducted between 2002 and 2020, with 9, 7 and 18 of the included studies were conducted between 2002 and 2010, 2011-2014 and 2015-2020, respectively.
The risk of bias assessment of included studies showed that 17 and 18 of them had a low and moderate risk of bias, respectively.

Both Egger’s regression test (p = 0.287) and Begg’s correlation test (p = 0.966) showed the absence of publication bias.

Results and conclusions:
The investigators found the overall prevalence estimate of asymptomatic Plasmodium infection prevalence was 26.1% [95% CI = 21% to 31.2%, I2 = 99.0%].
The result of sensitivity analysis demonstrated that the overall estimate of asymptomatic malaria infection prevalence was robust and it was not influenced by a single study.

The investigators found according to species-specific pooled prevalence estimate, Plasmodium falciparum was dominant species [22.1%, 95% CI = 17.1% to 27.2%, I2 = 98.6%], followed by Plasmodium vivax, Plasmodium malariae and Plasmodium ovale [3%, 95% CI = 0% to 5%, I2 = 88.3%, 0.8%, 95% CI = 0.3% to 0.13%, I2 = 60.5% and 0.2%, 95% CI = -0.01% to 0.5%, I2 = 31.5%], respectively.

The investigators found result of meta-regression analysis pointed out that the overall prevalence of asymptomatic malaria infection did not showed a statistically significant rise between the years 2002 and 2020 [coef. = -0.0221807, p = 0.200].
Also, the overall estimate of asymptomatic malaria infection was not impacted by an increase in sample size [coef. = -0.0000877, p = 0.55].

The investigators found asymptomatic malaria-infected pregnant women were 2.28 times more likely anemic [OR = 2.28, 95% CI = 1.66 to 3.13, I2 = 56.3%] than in non-infected pregnant women.

The investigators found asymptomatic malaria infection was 1.54 times higher [OR = 1.54, 95% CI = 1.28 to 1.85, I2 = 11.5%] in primigravida women compared to multigravida women (women who have been pregnant more than once).

The investigators concluded in Sub-Saharan Africa (SSA), asymptomatic malaria infection in pregnant women is prevalent and it is associated with an increased likelihood of anemia compared to non-infected pregnant women. Thus, screening of asymptomatic pregnant women for malaria and anemia should be included as part of antenatal care.

Original title:
A systematic review and meta-analysis of asymptomatic malaria infection in pregnant women in Sub-Saharan Africa: A challenge for malaria elimination efforts by Yimam Y, Nateghpour M, […], Afshar MJA.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8016273/

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Coenzyme Q10 supplementation reduces oxidative stress

Objectives:
Does coenzyme Q10 supplementation improve oxidative stress variables?

Study design:
This review article included 17 RCTs with 972 participants.

Results and conclusions:
The investigators found the pooled analysis of primary studies showed that coenzyme Q10 supplementation increased serum total antioxidant capacity [SMD = 0.62 mmol/L, 95% CI = 0.18 to 1.05, I2 = 76.1%, p ˂ 0.001] and superoxide dismutase [SMD = 0.40 U/mg, 95% CI = 0.12 to 0.67, I2 = 9.6%, p ˂ 0.345] levels and decreased malondialdehyde [SMD = -1.02 mmol/L, 95% CI = -1.60 to -0.44, I2 = 88.2%, p ˂ 0.001] level significantly compared to the placebo group.

The investigators found, however, the effect of coenzyme Q10 supplementation on nitric oxide [SMD = 1.01 µmol/L, 95% CI = -1.53 to 3.54, I2 = 97.8%, p ˂ 0.001] and glutathione peroxidase [SMD -0.01 mmol/L, 95% CI = -0.86 to 0.84, I2 = 88.6%, p ˂ 0.001] was not significant.

The investigators concluded that coenzyme Q10 supplementation improves antioxidant defense status against reactive oxygen species.

Original title:
Diabetes, Age, and Duration of Supplementation Subgroup Analysis for the Effect of Coenzyme Q10 on Oxidative Stress: A Systematic Review and Meta-Analysis by Hajiluian G, Heshmati J, […], Shidfar F.

Link:
https://pubmed.ncbi.nlm.nih.gov/33866314/

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Oxidative stress is an imbalance between the reactive oxygen species and antioxidant system.
Total antioxidant capacity (TAC), superoxide dismutase, malondialdehyde, nitric oxide and glutathione peroxidase are biomarkers of oxidative stress.


 

<11 g/day alcohol and <2.8 cups/day coffee reduce cognitive deficits

Objectives:
Lifestyle interventions are an important and viable approach for preventing cognitive deficits. However, the results of studies on alcohol, coffee and tea consumption in relation to cognitive decline have been divergent, likely due to confounds from dose-response effects. Therefore, this review article (meta-analysis) has been conducted.

Does alcohol, coffee or tea consumption reduce the risk of cognitive deficits (such as dementia or Alzheimer's disease)?

Study design:
This review article included 29 prospective cohort studies from America, Japan, China and some European countries (131,777 participants for alcohol, 333,843 participants for coffee and 20,411 participants for tea).

The NOS score was 8.

Results and conclusions:
The investigators found dose-response relationships showed that compared to non-drinkers, low consumption (11 g/day) of alcohol significantly reduced the risk of cognitive deficits or only dementias, but there was no significant effect of heavier drinking (>11 g/day).

The investigators found dose-response relationships showed that compared to non-drinkers, low consumption of coffee significantly reduced the risk of any cognitive deficit (2.8 cups/day) or dementia (2.3 cups/day).
However, coffee drinking was not a significant protective factor for cognitive deficits in groups of average age 60 years.

The investigators found dose-response relationships showed that compared to non-drinkers, every cup of green tea per day significantly reduced risk of cognitive deficits with 6% [relative risk = 0.94, 95% CI = 0.92 to 0.97].  

The investigators concluded that light consumption of alcohol (11 g/day) and coffee (2.8 cups/day) reduces risk of cognitive deficits. Cognitive benefits of green tea consumption increases with the daily consumption.

Original title:
Alcohol, coffee and tea intake and the risk of cognitive deficits: a dose-response meta-analysis by Ran LS, Liu WH, […], Wang W.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8061189/

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L-arginine supplements do not reduce diabetes in adults

Afbeelding

Objectives:
Does L-arginine supplementation improve biomarkers (fasting blood sugar, insulin, HbA1c and HOMA-IR values) of glycemic control in adults?

Study design:
This review article included 12 randomised clinical trials (RCTs).

Results and conclusions:
The investigators found L-arginine supplementation had no significant effect on serum fasting blood sugar (FBS) [weighted mean difference (WMD) = -3.38 mg/dL, 95% CI = -6.79 to 0.04, p = 0.53], serum insulin [WMD = -0.12 Hedges' g, 95% CI = -0.33 to 0.09, p = 0.27], glycated haemoglobin A1c (HbA1c) [WMD = -0.04%, 95% CI = -0.25 to 0.17, p = 0.71] and homeostasis model assessment for insulin resistance (HOMA-IR) [WMD = -0.48, 95% CI = -1.15 to 0.19, p = 0.15].
No significant because the calculated p-value of 0.15 was larger than the p-value of 0.05.

The investigators concluded although several animal studies have proposed that L-arginine supplementation might improve blood glucose control, the present review article could not confirm this benefit in humans.

Original title:
Effects of L-arginine supplementation on biomarkers of glycemic control: a systematic review and meta-analysis of randomised clinical trials by Karimi E, Hatami E, […], Askari G.

Link:
https://pubmed.ncbi.nlm.nih.gov/33426939/

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Arginine is classified as a semiessential or conditionally essential amino acid, depending on the developmental stage and health status of the individual, that helps the body build protein. L-arginine is also found in most protein-rich foods, including fish, red meat, poultry, soy, whole grains, beans and dairy products.
 

No association between potato consumption and cancers

Afbeelding

Objectives:
The etiology of cancer type may vary significantly due to anatomy, embryology and physiology of the cancer site. Although the association between potato consumption and colorectal cancer (CRC) was summarized in a 2018 meta-analysis of 5 cohort studies, however, no meta-analysis has evaluated potato consumption in relation to multiple cancer sites in adults. Therefore, this review article has been conducted.

Do potato intakes increase multiple cancer sites risk?

Study design:
This review article included 20 prospective cohort studies (with a total of 785,348 participants, of which 19,882 incident cases (persons with cancer)) and 36 case-control studies ( with a total of 21,822 cases (persons with cancer) and 66,502 controls (persons without cancer)).

Certainty of the evidence was low for total cancer, colorectal cancer, colon, rectal, renal, pancreatic, breast, prostate and lung cancer and very low for gastric and bladder cancer.

Results and conclusions:
The investigators found among cohort studies, no association between high versus low intake of total potato (white and yellow) consumption and overall cancers [RR = 1.04, 95% CI = 0.96 to 1.11, tau2 = 0.005, n = 18].

The investigators found no relation between total potato consumption (high compared with low intake) and risk of colorectal, pancreatic, colon, gastric, breast, prostate, kidney, lung or bladder cancer in cohort or case-control studies.

The investigators found no association between high versus low consumption of potato preparations (boiled/fried/mashed/roasted/baked) and risk of gastrointestinal-, sex-hormone-, or urinary-related cancers in cohort or case-control studies.

The investigators concluded that potato intakes or potato preparations are not associated with multiple cancer sites when comparing high and low intake categories. This finding is consistent with the findings from the 2018 meta-analysis regarding potato intake and risk of colorectal cancer.

Original title:
Potato Consumption and Risk of Site-Specific Cancers in Adults: A Systematic Review and Dose-Response Meta-Analysis of Observational Studies by Mofrad MD, Mozaffari H, […], Azadbakht L.

Link:
https://pubmed.ncbi.nlm.nih.gov/33861304/

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Tart cherry supplementation improves recovery from strenuous exercise

Afbeelding

Objectives:
Does tart cherry (TC) supplementation improve recovery following strenuous exercise?

Study design:
This review article included 14 studies.

Results and conclusions:
The investigators found tart cherry supplementation had a small significant beneficial effect in reducing muscle soreness [effect size (ES) = -0.44, 95% CI = -0.87 to -0.02].

The investigators found a moderate significant beneficial effect was observed for recovery of muscular strength [ES = -0.78, 95% CI = -1.11 to -0.46] for tart cherry supplementation.

The investigators found a moderate significant effect was observed for muscular power [ES = -0.53, 95% CI = -0.77 to -0.29] for tart cherry supplementation.
A further subgroup analysis on this variable indicated a large significant effect of tart cherry supplementation on recovery of jump height [ES = -0.82, 95% CI = -1.18 to -0.45] and a small significant effect of tart cherry supplementation on sprint time [ES = -0.32, 95% CI = -0.60 to -0.04]. 

The investigators found a small significant effect was observed for both C-reactive protein [ES = -0.46, 95% CI = -0.93 to -0.00] and Interleukin-6 [ES = -0.35, 95% CI = -0.68 to -0.02] for tart cherry supplementation.

The investigators found no significant effects were observed for creatine kinase and tumor necrosis factor alpha (TNF-α) for tart cherry supplementation. 

The investigators concluded that tart cherry supplementation improves aspects of recovery from strenuous exercise.

Original title:
Tart Cherry Supplementation and Recovery From Strenuous Exercise: A Systematic Review and Meta-Analysis by Hill JA, Keane KM, […], Howatson G.

Link:
https://pubmed.ncbi.nlm.nih.gov/33440334/

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1.5 g/day garlic supplementation reduces adiponectin level among participants ˂30 years

Afbeelding

Objectives:
Does garlic supplementation reduce adiponectin and leptin serum levels?

Study design:
This review article included 5 RCTs.

Results and conclusions:
The investigators found that garlic supplementation did not significantly affect adiponectin [Hedges's = 0.20, 95% CI = -0.06 to 0.47, p = 0.12] and leptin [Hedges's = 0.08, 95% CI = -0.26 to 0.41, p = 0.65] concentrations in comparison with placebo.

The investigators found, however, in the subgroup analysis, significantly increased serum adiponectin level was seen following garlic supplementation in trials with a mean age of participants ˂30 years [Hedges's = 0.44, 95% CI = 0.01 to 0.87, p = 0.04], the doses ˂1.5 g/day [Hedges's = 0.38, 95% CI = 0.02 to 0.71, p = 0.04] and trials with duration ≥8 weeks [Hedges's = 0.48, 95% CI = 0.08 to 0.89, p = 0.02].

The investigators concluded that ˂1.5 g/day garlic supplementation during ≥8 weeks reduces adiponectin level among participants ˂30 years.

Original title:
Systematic review and meta-analysis of randomized, controlled trials on the effects of garlic supplementation on serum adiponectin and leptin levels by Shekarchizadeh-Esfahani P, Hassani B, […], Soraya N.

Link:
https://pubmed.ncbi.nlm.nih.gov/33792129/

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Adiponectin is a fat-derived hormone that appears to play a crucial role in protecting against insulin resistance/diabetes and atherosclerosis (atherosclerosis is the dominant cause of cardiovascular disease (CVD)). Decreased adiponectin levels are thought to play a central role in the development of obesity, cardiovascular disease and type 2 diabetes in humans.

A loading dose of tafenoquine alone is effective in preventing malaria in short-term travellers

Afbeelding

Objectives:
Chemoprophylaxis with weekly doses of tafenoquine (200 mg/day for 3 days before departure [loading dose], 200 mg/week during travel and one-week post-travel [maintenance doses]) is effective in preventing malaria. Effectiveness of malaria chemoprophylaxis drugs in travellers is often compromised by poor compliance. Shorter schedules that can be completed before travel, allowing “drug-free holidays”, could increase compliance and thus reduce travel-related malaria. Therefore, this review article (meta-analysis) has been conducted.

Is a loading dose of tafenoquine alone effective in preventing malaria in short-term travellers?

Study design:
This review article included 9 RCTs with a total of 1,714 participants.

Results and conclusions:
The investigators found in long-term travellers, compared to mefloquine, tafenoquine with maintenance doses [OR = 1.05, 95% CI = 0.44 to 2.46] was equally effective in preventing malaria, while there was an increased risk of infection with the loading dose of tafenoquine alone [OR = 2.89, 95% CI = 0.78 to 10.68] and placebo [OR = 62.91, 95% CI = 8.53 to 463.88].

The investigators found in short-term travellers, loading dose of tafenoquine alone [OR = 0.98, 95% CI = 0.04 to 22.42] and tafenoquine with maintenance doses [OR = 1.00, 95% CI = 0.06 to 16.10] were as effective as mefloquine.

The investigators found the risk of adverse events (AEs) with tafenoquine with maintenance doses [OR = 1.03, 95% CI = 0.67 to 1.60] was similar to mefloquine, while loading dose of tafenoquine alone [OR = 0.58, 95% CI = 0.20 to 1.66] was associated with lower risk of AEs, although the difference was not statistically significant.

The investigators concluded for short-term travellers, loading dose of tafenoquine alone is equally effective, has possibly lower rate of adverse events (AEs) and likely better compliance than standard tafenoquine or mefloquine chemoprophylaxis schedules with maintenance doses. Studies are needed to confirm if short-term travellers remain free of infection after long-term follow-up.

Original title:
Efficacy of a 3-day pre-travel schedule of Tafenoquine for malaria chemoprophylaxis: A network meta-analysis by Islam N, Wright S, […], Furuya-Kanamori L.

Link:
https://pubmed.ncbi.nlm.nih.gov/33834208/

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100 mg/d dietary magnesium intakes reduce cancer mortality

Objectives:
Do magnesium intakes reduce risk of all-cause, cancer and cardiovascular disease (CVD) mortality?

Study design:
This review article included 19 prospective cohort studies with a total of 1,168,756 participants (52,378 deaths from all causes (all-cause mortality), 23,478 from cardiovascular disease (CVD) and 11,408 from cancer).
The follow-up period was 3.5 to 32 years.

Results and conclusions:
The investigators found dietary magnesium intake was significantly associated with a lower risk of 13% for all-cause mortality [pooled effect size (ES) = 0.87, 95% CI = 0.79 to 0.97, p = 0.009, I2 = 70.7%, p 0.001].

The investigators found dietary magnesium intake was significantly associated with a lower risk of 20% for cancer mortality [pooled ES = 0.80, 95% CI = 0.67 to 0.97, p = 0.023, I2 = 55.7%, p = 0.027].

The investigators found for supplemental and total magnesium intakes, no significant associations with risks of all-cause, cardiovascular disease and cancer mortality.

The investigators found, however, linear dose-response meta-analysis indicated that each additional intake of 100 mg/d of dietary magnesium was significantly associated with a 6% and 5% reduced risk of all-cause and cancer mortality, respectively.

The investigators concluded that higher intake of dietary magnesium (at least 100 mg/d of dietary magnesium) is associated with a reduced risk of all-cause and cancer mortality, but not cardiovascular disease mortality. Supplemental and total magnesium intakes are not associated with the risk of all-cause, cardiovascular disease and cancer mortality. These findings indicate that consumption of magnesium from dietary sources may be beneficial in reducing all-cause and cancer mortality and thus have practical importance for public health.  

Original title:
Total, Dietary, and Supplemental Magnesium Intakes and Risk of All-Cause, Cardiovascular, and Cancer Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies by Bagheri A, Naghshi S, […], Esmaillzadeh A.

Link:
https://pubmed.ncbi.nlm.nih.gov/33684200/

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Peanut butter consumption may reduce type 2 diabetes

Objectives:
Previous meta-analyses, with some methodological controversies, have assessed the relation between nut consumption and type 2 diabetes (T2D) risk and pointed to contradictory results. Therefore, this review article has been conducted.

Does nut consumption reduce risk of type 2 diabetes?

Study design:
This review article included 5 prospective cohort studies and 3 cross-sectional studies.
The certainty of the evidence using NutriGrade was very low for all the exposures.

Results and conclusions:
The investigators found meta-analyses of cross-sectional studies and prospective cohort studies, comparing the highest with the lowest categories, revealed a nonsignificant association between total nut consumption and type 2 diabetes.
Nonsignificant means that there is no association with a 95% confidence.

The investigators found meta-analyses of prospective cohort studies showed that peanut butter consumption significantly reduced type 2 diabetes incidence with 13% [RR = 0.87, 95% CI = 0.77 to 0.98, I2 = 50.6%, p = 0.16], whereas no association was observed between peanuts or tree nuts and type 2 diabetes.

The investigators found there was no evidence of a linear dose-response or nonlinear dose-response gradient for total nut and peanut consumption in prospective cohort studies.

The investigators concluded peanut butter consumption may reduce type 2 diabetes incidence. May reduce because the certainty of the evidence using NutriGrade was very low.

Original title:
Nut consumption and type 2 diabetes risk: a systematic review and meta-analysis of observational studies by Becerra-Tomás N, Paz-Graniel I, […], Salas-Salvadó J.

Link:
https://pubmed.ncbi.nlm.nih.gov/33471083/

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Multiple-micronutrient supplementation improves birth outcomes among pregnant adolescents in low- and middle-income countries

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Objectives:
Approximately 7.3 million births occur annually among adolescents in low- and middle-income countries. Pregnant adolescents constitute a nutritionally vulnerable group that could benefit from intervention to mitigate the mortality and adverse birth outcomes associated with adolescent pregnancy. Therefore, this review article (meta-analysis) has been conducted.

The aim of this systematic review and meta-analysis was to assess the following:
(1) the effect of multiple-micronutrient (MMN) supplementation vs iron and folic acid (IFA) supplementation among adolescents on maternal morbidity, birth outcomes and mortality outcomes.
(2) the effects of multiple-micronutrient supplementation in adolescents compared with the effects in adult women and
(3) the effect modification, if any, of multiple-micronutrient supplementation by baseline and geographic characteristics of adolescents.

Study design:
This review article included 13 randomized controlled trials (RCTs) conducted in Africa and Asia with a total of 15,283 adolescents and 44,499 adult women with singleton births.

Effect modification by baseline characteristics and geographic region was inconclusive.

Results and conclusions:
The investigators found in adolescents, multiple-micronutrient (MMN) supplementation significantly reduced low birth weight [1-stage OR = 0.87, 95% CI = 0.77 to 0.97 and 2-stage OR = 0.81, 95% CI = 0.74 to 0.88], preterm birth [1-stage OR = 0.88, 95% CI = 0.80 to 0.98 and 2-stage OR = 0.86, 95% CI = 0.79 to 0.95] and small-for-gestational-age births [1-stage OR = 0.90, 95% CI = 0.81 to 1.00 and 2-stage OR = 0.86, 95%CI = 0.79 to 0.95] when compared with iron and folic acid (IFA) supplementation.

The investigators found the effects of multiple-micronutrient supplementation did not differ between adolescents and older women, although a potentially greater reduction in small-for-gestational-age births was observed among adolescents.

The investigators concluded multiple-micronutrient (MMM) supplementation improves birth outcomes among pregnant adolescents in low- and middle-income countries. Policy related to antenatal care in these settings should prioritize multiple-micronutrient supplementation over the currently recommended iron and folic acid (IFA) supplementation for all pregnant women, especially adolescents.

Original title:
Multiple-micronutrient supplementation in pregnant adolescents in low- and middle-income countries: a systematic review and a meta-analysis of individual participant data by Keats EC, Akseer N, […], Bhutta ZA.

Link:
https://pubmed.ncbi.nlm.nih.gov/33846729/

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400 mg/day vitamin B2 supplementation decrease migraine attacks

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Objectives:
Migraine is a common disease worldwide and migraine prevention is primarily currently based on pharmaceuticals. The mechanism of vitamin B2 may positively contribute to migraine. Therefore, this review article has been conducted.

Does vitamin B2 supplementation decrease migraine?

Study design:
This review article included 8 randomized controlled trials and 1 controlled clinical trial with 673 subjects.

Results and conclusions:
The investigators found 400 mg/day vitamin B2 supplementation for 3 months significantly decreased migraine days [p = 0.005, I2 = 89%], duration [p = 0.003, I2 = 0], frequency [p = 0.001, I2 = 65%] and pain score [p = 0.015, I2 = 84%].

The investigators concluded that 400 mg/day vitamin B2 supplementation for 3 months has significant effect on days, duration, frequency and pain score of migraine attacks.

Original title:
Effect of Vitamin B2 supplementation on migraine prophylaxis: a systematic review and meta-analysis by Chen YS, Lee HF, […], Hu FW.

Link:
https://pubmed.ncbi.nlm.nih.gov/33779525/

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Higher plasma DHA and EPA levels reduce advanced age-related macular degeneration

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Objectives:
Previous population studies on the associations between dietary fatty acids (FAs), plasma FAs levels and the risk of age-related macular degeneration (AMD) have yielded inconclusive results. Therefore, this review article (meta-analysis) has been conducted.

Do higher dietary fatty acids (EPA and DHA) intakes or higher plasma fatty acids levels reduce risk of age-related macular degeneration?

Study design:
This review article included 11 prospective cohort studies with 167,581 participants. During the follow-up periods (ranging from 3 to 28 years), 6,318 cases of age-related macular degeneration were recorded.

Results and conclusions:
The investigators found that each 1 g/day increment of dietary intake of docosahexaenoic acid (DHA) and eicosatetraenoic acid (EPA) combined significantly reduced risk of early age-related macular degeneration with 33% [RR = 0.67, 95% CI = 0.51 to 0.88].
Significantly means that there is an association with a 95% confidence.

The investigators found that each 1 g/day increment of dietary intake of docosahexaenoic acid (DHA) significantly reduced risk of early age-related macular degeneration with 50% [RR = 0.50, 95% CI = 0.32 to 0.78].
Significantly means it can be said with a 95% confidence that each 1 g/day increment of dietary intake of docosahexaenoic acid (DHA) really reduces risk of early age-related macular degeneration with 50%.

The investigators found that each 1 g/day increment of dietary intake of eicosatetraenoic acid (EPA) significantly reduced risk of early age-related macular degeneration with 60% [RR = 0.40, 95% CI = 0.18 to 0.87].
Significantly because RR of 1 was not found in the 95% CI of 0.18 to 0.87. RR of 1 means no risk/association.

The investigators found that higher plasma docosahexaenoic acid (DHA) levels significantly reduced risk of advanced age-related macular degeneration with 28% [RR = 0.72, 95% CI = 0.55 to 0.95].

The investigators found that higher plasma eicosatetraenoic acid (EPA) levels significantly reduced risk of advanced age-related macular degeneration with 43% [RR = 0.57, 95% CI = 0.40 to 0.81].

The investigators concluded that 1 g/day of dietary intake DHA and 1 g/day of dietary intake EPA and higher plasma DHA and EPA levels are associated with a reduced risk of age-related macular degeneration.

Original title:
Dietary fatty acid intake, plasma fatty acid levels, and the risk of age-related macular degeneration (AMD): a dose-response meta-analysis of prospective cohort studies by Zhong Y, Wang K, [...], Yao K.

Link:
https://pubmed.ncbi.nlm.nih.gov/33469697/

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A high plasma EPA and DHA content can be obtained by eating a lot of oily fish and/or by taking EPA and DHA supplements (fish oil supplements).
Oily fish contains more EPA and DHA than non-oily fish.

Early age-related macular degeneration: most people do not experience adverse symptoms or vision loss in the early stage of age-related macular degeneration, but night vision problems are often reported. Though no pigmentary abnormalities are apparent upon examination, medium-sized drusen (>63 μm and ≤125 μm) are present.

Vaccinations reduce childhood leukemia

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Objectives:
Infections may play a role in the etiology of childhood cancer and immunizations may be protective because vaccinations stimulate the immune system. Observational studies reported inconsistent associations between vaccination and risk of childhood cancer. Therefore, this review article has been conducted.

Does vaccination reduce the risk of childhood leukemia?

Study design:
This review article included 35 studies for inclusion in 27 specific analyses on 11 different childhood cancer outcomes after exposure to 9 different types of vaccination.
The minority of the studies included in the meta-analysis were retrospective cohort or case cohort studies (31%), the majority were case-control studies (69%), of which 18 included population-based and 4 hospital-based controls.
Studies were published between 1968 and 2019 and covered a study period of 65 years (1943 to 2008).
The studies were conducted in Europe (57%), North America (26%), South America (8%), Australia or New Zealand (6%) and Asia (3%) with sample sizes ranging from 148 to 1,224,914 participants.
Most studies examined only children under 18 years of age.
Overall, the methodological quality assessments of the 35 studies included in the meta-analysis yielded an average score of 4.7 out of 9.0 for the NOS.

Results and conclusions:
The investigators found a significantly reduced risk of 51% for leukemia death [summary OR = 0.49, 95% CI = 0.32 to 0.74, I2 = 36%, n = 4, p value = 0.20] after bacillus Calmette-Guérin (BCG) vaccination, compared to children without this vaccination.

The investigators found a significantly reduced risk of 24% for acute lymphoblastic leukemia [summary OR = 0.76, 95% CI = 0.65 to 0.90, I2 = 20%, n = 5, p value = 0.29] after Haemophilus influenzae type b vaccination, compared to children without this vaccination.

The investigators found a significantly reduced risk of 43% for leukemia [summary OR = 0.57, 95% CI = 0.36 to 0.88, I2 = 74%, n = 4, p value = 0.01] after three or more vaccinations of any type, compared to children without these vaccinations.

The investigators found a significantly reduced risk of 38% for acute lymphoblastic leukemia [summary OR = 0.62, 95% CI = 0.46 to 0.85, I2 = 55%, n = 5, p value = 0.06] after three or more vaccinations of any type, compared to children without these vaccinations.

The investigators concluded these results are consistent with the hypothesis that vaccinations reduce the risk of childhood leukemia. However, the robustness and validity of these results is limited due to the small number, substantial heterogeneity and methodological limitations of available studies.

Original title:
Vaccination and the Risk of Childhood Cancer-A Systematic Review and Meta-Analysis by Marron M, Brackmann LK, […], Ahrens W.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7862764/

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Acute lymphocytic leukemia (ALL) is also called acute lymphoblastic leukemia and is a type of cancer of the blood and bone marrow - the spongy tissue inside bones where blood cells are made.
 “Acute” means that the leukemia can progress quickly and if not treated, would probably be fatal within a few months.
"Lymphocytic" means it develops from early (immature) forms of lymphocytes, a type of white blood cell.
Acute lymphocytic leukemia is the most common type of cancer in children and treatments result in a good chance for a cure.

Alcohol consumption increases risk of any fractures

Objectives:
Previous studies on the association between alcohol intake and risk of fracture have reached conflicting findings. Therefore, this review article has been conducted.

Does alcohol consumption increase risk of fractures?

Study design:
This review article included 38 prospective cohort studies with a total sample size of 5,053,117 participants and 169,560 cases of fracture.

Results and conclusions:
The investigators found in a random-effects meta-analysis, that alcohol consumption significantly increased risk of total fractures with 35% [RR = 1.35, 95% CI = 1.01 to 1.81] and any fractures with 24% [RR= 1.24, 95% CI = 1.11 to 1.38].
Significant because RR of 1 was not found in the 95% CI of 1.01 to 1.81. RR of 1 means no risk/association.

The investigators found, however, no significant association between alcohol intake and risk of hip fractures [RR = 1.19, 95% CI = 0.96 to 1.48], osteoporotic fractures [RR = 2.01, 95% CI = 0.76 to 5.34], vertebral fractures [RR = 0.98, 95% CI = 0.68 to 1.40] and wrist fractures [RR = 0.99, 95% CI = 0.85 to 1.16].
No significant because RR of 1 was found in the 95% CI of 0.85 to 1.06. RR of 1 means no risk/association.

The investigators concluded that alcohol consumption is positively associated with risk of total fractures and any fractures.

Original title:
A systematic review and meta-analysis of prospective cohort studies on the association between alcohol intake and risk of fracture by Asoudeh F, Salari-Moghaddam A, […], Esmaillzadeh A.

Link:
https://pubmed.ncbi.nlm.nih.gov/33596741/

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Soy consumption causally lowers blood pressure in adults

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Objectives:
Soy has several beneficial effects on cardiovascular disease (CVD). However, results of clinical trial studies are equivocal. Therefore, this review article has been conducted.

Is there a causal relationship between soy consumption and improvements in blood pressure in adults?

Study design:
This review article included 17 RCTs.

Results and conclusions:
The investigators found pooled effects from 17 studies revealed a significant improvement in systolic blood pressure (SBP) [MD = -1.64, 95% CI = -3.25 to -0.04 mmHg, I2 = 50.5%] following soy consumption, in comparison with controls (groups without soy consumption).

The investigators found pooled effects from 17 studies revealed a significant improvement in diastolic blood pressure (DBP) [MD = -1.21, 95% CI = -2.29 to -0.12 mmHg, I2 = 50.7%] following soy consumption, in comparison with controls (groups without soy consumption).

The investigators found subgroup analysis demonstrated a reduction in both systolic blood pressure and diastolic blood pressure in younger participants with lower baseline blood pressure and intervention durations of 16 weeks.

The investigators concluded there is a causal relationship between soy consumption and improvements in blood pressure in adults.

Original title:
Soy intake is associated with lowering blood pressure in adults: A systematic review and meta-analysis of randomized double-blind placebo-controlled trials by Mosallanezhad Z, Ranjbar S, […], Jalali M.

Link:
https://pubmed.ncbi.nlm.nih.gov/33636295/

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Dihydroartemisinin-piperaquine should be first-line treatment of uncomplicated falciparum malaria in Ugandan children

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Objectives:
The emergence of artemisinin resistance in Southeast Asia and Plasmodium falciparum kelch13 propeller gene mutations in sub-Saharan African pose the greatest threat to global efforts to control malaria. This is a critical concern in Uganda, where artemisinin-based combination therapy (ACT) is the first-line treatment for uncomplicated falciparum. Therefore, this review article has been conducted.

The objective of this review article is to compare the efficacy and safety of dihydroartemisinin-piperaquine (DHA-PQ) and artemether-lumefantrine (AL) for the treatment of uncomplicated falciparum malaria in Ugandan children?

Study design:
This review article included 11 RCTs with a total of 3,798 participants.

A target dose (range) of 4 (2-10) mg/kg bw per day dihydroartemisinin and 18 (16-27) mg/kg bw per day piperaquine given once a day for 3 days for adults and children weighing ≥ 25 kg. The target doses and ranges for children weighing  25 kg are 4 (2.5-10) mg/kg bw per day dihydroartemisinin and 24 (20-32) mg/kg bw per day piperaquine once a day for 3 days.

A total dose of 5-24 mg/kg bw of artemether and 29-144 mg/kg bw of lumefantrine. Artemether + lumefantrine is given twice a day for 3 days (total, six doses). The first two doses should, ideally, be given 8 h apart.

Results and conclusions:
The investigators found PCR unadjusted treatment failure was significantly lower with dihydroartemisinin-piperaquine at day 28 [RR = 0.30, 95% CI = 0.19 to 0.49, participants = 7,863, studies = 5, I2 = 93%, low quality evidence] and at day 42 [RR = 0.53, 95% CI = 0.38 to 0.76, participants = 1,618, studies = 4, I2 = 79%, moderate quality of evidence].

The investigators found PCR adjusted treatment failure at day 42 was significantly lower with dihydroartemisinin-piperaquine treatment group [RR = 0.45, 95% CI = 0.28 to 0.72, participants = 1,370, studies = 5, high quality of evidence] and it was below 5% in both arms at day 28 (moderate quality of evidence).

The investigators found artemether-lumefantrine showed a longer prophylactic effect on new infections which may last for up to 63 days [PCR-adjusted treatment failure: RR = 2.04, 95% CI = 1.13 to 3.70, participants = 1,311, studies = 2, moderate quality of evidence].

The investigators found compared to artemether-lumefantrine, dihydroartemisinin-piperaquine was associated with a slightly higher frequency of cough [RR = 1.07, 95% CI = 1.01 to 1.13, 2,575 participants, 6 studies, high quality of evidence].
In both treatment groups, the risk of recurrent parasitaemia due to possible recrudescence was less than 5% at day 28.

The investigators found the appearance of gametocyte between 29 and 42 days was also significantly lower in dihydroartemisinin-piperaquine than artemether-lumefantrine [RR = 0.26, 95% CI = 0.12 to 0.56, participants = 623, studies = 2, I2 = 0%].

The investigators concluded compared to artemether-lumefantrine, dihydroartemisinin-piperaquine appears to reduce treatment failure and gametocyte carriage in Ugandan children. This may trigger dihydroartemisinin-piperaquine to become the first-line treatment option of uncomplicated falciparum malaria in Ugandan children. Both treatments were safe and well-tolerated.

Original title:
Efficacy and safety of dihydroartemisinin-piperaquine versus artemether-lumefantrine for treatment of uncomplicated Plasmodium falciparum malaria in Ugandan children: a systematic review and meta-analysis of randomized control trials by Assefa DG, Zeleke ED, [...], Manyazewal T.

Link:
https://pubmed.ncbi.nlm.nih.gov/33794897/

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A higher manganese level increases MS

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Objectives:
What are the blood concentrations of zinc, iron, manganese, magnesium, selenium and copper of patients with multiple sclerosis (MS)?

Study design:
This review article included 32 studies with 1,567 MS patients and 1,328 controls (people without MS).

Results and conclusions:
The investigators found pooled results using random-effects model indicated that the levels of zinc [WMD = -7.83 mcg/dL, 95% CI = -12.78 to -2.87, z = 3.09, p = 0.002] and iron [WMD = -13.66 mcg/dL, 95% CI = -23.13 to -4.19, z = 2.83, p = 0.005] were significantly lower in MS patients than in controls.

The investigators found, however, the levels of manganese [WMD = 0.03 mcg/dL, 95% CI = 0.01 to 0.04, z = 2.89, p = 0.004] were significantly higher in MS patients.

The investigators found no significant differences in the levels of magnesium, selenium and copper between both groups.

The investigators concluded that the circulating levels of zinc and iron are significantly lower in MS patients and that manganese level is significantly higher than those in the control group (people without MS).

Original title:
Blood Trace Element Status in Multiple Sclerosis: a Systematic Review and Meta-analysis by Nirooei E, Kashani SMA, […], Akbari H.

Link:
https://pubmed.ncbi.nlm.nih.gov/33611740/

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Peripheral neuropathy is associated with lowered plasma vitamin B12 levels

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Objectives:
Peripheral neuropathy (PN) is common in patients with diseases that are in turn associated with deficiency of the B-vitamins, and vitamin treatment has shown mixed results. Therefore, this review article has been conducted.

Does a low vitamin B level increase the risk of peripheral neuropathy?

Study design:
This review article included 46 observational studies and 7 interventional studies.

Results and conclusions:
The investigators found the presence of peripheral neuropathy was significantly associated with lowered B12 levels [1.51, 95% CI = 1.23 to 1.84, n = 34, I2 = 43.3%, p = 0.003].

The investigators found the presence of peripheral neuropathy was significantly associated with elevated methylmalonic acid levels [2.53, 95% CI = 1.39 to 4.60, n = 9, I2 = 63.8%, p = 0.005].

The investigators found the presence of peripheral neuropathy was significantly associated with elevated homocysteine levels [3.48, 95% CI = 2.01 to 6.04, n = 15, I2 = 70.6%, p 0.001].

The investigators found treatment with vitamin B1 was associated with a significant improvement in symptoms of peripheral neuropathy [5.34, 95% CI = 1.87 to 15.19, n = 3, I2 = 64.6%, p = 0.059].

The investigators found B12 treatment (vs. the comparators) showed a non-significant association with symptom improvement [1.36, 95% CI = 0.66 to 2.79, n = 4, I2 = 28.9%].

The investigators found analysis of 7 trials combined showed a non-significant higher odds ratio for improvement under treatment with the B-vitamins [2.58, 95% CI = 0.98 to 6.79, I2 = 80.0%, p 0.001].

The investigators concluded peripheral neuropathy is associated with lowered plasma vitamin B12 and elevated methylmalonic acid and homocysteine levels. Well-designed studies, especially in non-diabetes peripheral neuropathy, are needed.

Original title:
Association between neuropathy and B-vitamins: A systematic review and meta-analysis by Stein J, Geisel J and Obeid R.

Link:
https://pubmed.ncbi.nlm.nih.gov/33619867/

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Peripheral neuropathy refers to the conditions that result when nerves that carry messages to and from the brain and spinal cord from and to the rest of the body are damaged or diseased.

Increased methylmalonic acid levels are a sensitive indicator of mild vitamin B12 deficiency.