Nutritional advice

500 mL/d orange juice consumption causally reduce bad cholesterol

Afbeelding

Objectives:
Does orange juice consumption causally improve lipid profile?

Study design:
This review article included 9 RCTs with a total of 386 participants.
The mean age of the participants ranged from 36 to 56 years.
All the RCTs used a parallel study design.
The dosage of orange juice ranged from 250 to 1000 mL/d.
The duration of interventions ranged from 3 to 12 weeks.

Results and conclusions:
The investigators found orange juice consumption significantly reduced LDL cholesterol (bad cholesterol) levels [WMD  = -8.35 mg/dL, 95% CI = -15.43 to 1.26, p = 0.021, I2 = 45.8%, p = 0.055].

The investigators found in subgroup analysis based on the administered dosage, LDL cholesterol levels significantly decreased following the consumption of >500 mL/d orange juice [WMD = -9.85 mg/dL, 95% CI = -18.18 to -1.52, p = 0.02].
Moreover, the subgroup analyses based on the duration of intervention revealed that the effect of orange juice supplementation on LDL cholesterol levels was significantly greater in trials lasting ≤8 weeks [WMD = -7.91 mg/dL, 95% CI = -15.91 to -36, p = 0·04].
Also, studies conducted on both genders were observed to be significantly more likely to reduce blood LDL-C levels [WMD = -12.61 mg/dL, 95% CI = -21.19 to -4.04, p = 0.004].

The investigators concluded that  at least 500 mL/d orange juice consumption causally reduce LDL cholesterol (bad cholesterol) levels.

Original title:
Orange juice intake and lipid profile: a systematic review and meta-analysis of randomised controlled trials by Amini MR, Sheikhhossein F, […], Askarpour M.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10052563/

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30g/d whole grains consumption reduce all-cause mortality

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Objectives:
Although relationships between the intake of whole grains and refined grains and the incidence of cardiovascular disease (CVD) events and all-cause mortality have been investigated, the conclusions have been inconclusive. Therefore, this review article has been conducted.

Does consumption of whole grains reduce risk of stroke, coronary heart disease, heart  failure, cardiovascular disease and all-cause mortality?

Study design:
This review article included 68 prospective cohort studies (46 for whole grains and 22 for refined grains) with 1,624,407 participants.

The included studies had follow-up periods between 5.4 y and 26 y, with sample sizes varying from 535 to 461,047 participants.

Based on NOS, the mean score of the included studies was 7.74 for whole grains and 7.45 for refined grains.

Egger’s test and funnel plot did not indicate any publication bias for the relationships between 30g/d increases in whole grain consumption and the risk of stroke [p = 0.481], cardiovascular disease [p= 0.144] or all-cause mortality [p = 0.409].

The quality of meta-evidence for the association between whole grain consumption and risks of stroke, coronary heart disease, heart failure, cardiovascular disease and all-cause mortality was moderate, moderate, low, high and high, respectively.
The quality of evidence for refined grain was low.

Results and conclusions:
The investigators found a significantly reduced risk of 3% for stroke per 30-g increase in daily whole grain consumption [RR = 0.97, 95% CI = 0.96 to 0.99, I2 = 0%].

The investigators found a significantly reduced risk of 6% for coronary heart disease (CHD) per 30-g increase in daily whole grain consumption [RR = 0.94, 95% CI = 0.92 to 0.97, I2 = 54.4%].
Sensitivity analyses indicated that the result was stable.

The investigators found a significantly reduced risk of 8% for cardiovascular disease (CVD) per 30-g increase in daily whole grain consumption [RR = 0.92, 95% CI = 0.88 to 0.96, I2 = 82.9%].
Sensitivity analyses indicated that the result was stable.

The investigators found a significantly reduced risk of 6% for all-cause mortality per 30-g increase in daily whole grain consumption [RR = 0.94, 95% CI = 0.92 to 0.97, I2 = 89.8%].
Sensitivity analyses indicated that the result was stable.

The investigators found whole grain consumption was linearly associated with coronary heart disease [p nonlinearity = 0.231] and nonlinearly associated with cardiovascular disease [p nonlinearity = 0.002] and all-cause mortality [p nonlinearity = 0.001].

The investigators concluded that consumption of at least 30g/d whole grains reduce stroke, coronary heart disease, cardiovascular disease and all-cause mortality.

Original title:
Consumption of whole grains and refined grains and associated risk of cardiovascular disease events and all-cause mortality: a systematic review and dose-response meta-analysis of prospective cohort studies by Hu H, Zhao Y, […], Hu D.

Link:
https://www.sciencedirect.com/science/article/pii/S0002916522105186?via%3Dihub

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Dietary intake of 200-700 mg/day calcium reduces stroke among Asians

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Objectives:
Prospective cohorts are inconsistent regarding the association between dietary calcium intake and the risk of stroke. Therefore, this review article has been conducted.

Does dietary intake of calcium reduce risk of stroke?

Study design:
This review article included 18 prospective cohort studies witth19,557 stroke cases (persons) among 882,181 participants.

Results and conclusions:
The investigators found a nonlinear association between calcium intake and risk of stroke [p nonlinearity 0.003].

The investigators found compared with the lowest value of zero assumed as the reference, dietary intake of 200 mg/day calcium significantly reduced stroke risk with 5% [95% CI = 0.92 to 0.98].
This protective effect was only found in Asian countries.

The investigators found compared with the lowest value of zero assumed as the reference, dietary intake of 300 mg/day calcium significantly reduced stroke risk with 6% [95% CI = 0.90 to 0.98].
This protective effect was only found in Asian countries.

The investigators found compared with the lowest value of zero assumed as the reference, dietary intake of 500 mg/day calcium significantly reduced stroke risk with 5% [95% CI = 0.90 to 0.99].
This protective effect was only found in Asian countries.

The investigators found no protective effect for stroke at dietary intake of 700 mg/day calcium or higher.

The investigators concluded dietary intake of 200-700 mg/day calcium reduces stroke risk among Asians.

Original title:
Dietary calcium intake and the risk of stroke: Meta-analysis of cohort studies by Wang ZM, Bu XX, […], Nie ZL.

Link:
https://pubmed.ncbi.nlm.nih.gov/36958976/

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Green tea may causally improve risk factors of cardiovascular disease

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Objectives:
Is there a causal relationship between drinking green tea and improving risk factors of cardiovascular disease, like cholesterol, fasting blood sugar, blood pressure, HbA1c, HOMA-IR?

Study design:
This review article included 55 RCTs with 63 effect sizes with 2,487 participants in the green tea group and 2,387 in the placebo group (group without green tea).

The participants’ mean age ranged between 18 and 68.7 years and the period of intervention ranged between 2 to 48 weeks.
Some of the studies enrolled only males or females and some of them included both genders.

TC, LDL, HDL, FBS, HbA1c and DBP-related evidence had moderate quality due to the serious inconsistency reasons. Additionally, it was shown that evidence regarding TG, fasting insulin, SBP and CRP had low quality due to serious imprecision and inconsistency reasons. The evidence relating to HOMA-IR was also downgraded to very low quality because of the serious inconsistency, imprecision and publication bias.

Results and conclusions:
The investigators found green tea supplementation significantly reduced total cholesterol levels (TC) [WMD = -7.62, 95% CI = -10.51 to -4.73, p ≤ 0.001, I2 = 90.9%].
This significantly reduced effect was also found if females or both males and females were included, the dosage of supplementation was less than 1,000 mg/d, the baseline BMI was between 25-29.9 kg/m2 and the baseline value of TC was more than 200 mg/dL.

The investigators found green tea supplementation significantly reduced LDL cholesterol levels (LDL-C) [WMD = -5.80, 95% CI = -8.30 to -3.30, p ≤ 0.001, I2 = 90.5%].
This significantly reduced effect was also found if males or both males and females were included, the baseline BMI was between 25-29.9 kg/m2 and participants were not affected by T2DM.

The investigators found green tea supplementation significantly reduced fasting blood sugar levels (FBS) [WMD = -1.67, 95% CI = -2.58 to -0.75, p ≤ 0.001, I2 = 72.2%].

This significantly reduced effect was also found when the baseline BMI of participants was between 25-29.9 kg/m2, female or both male and female were included, the duration of intervention was more than 12 weeks, the dosage of supplementation was less than 1,000 mg/d and baseline values of FBS were less than 100 mg/dL.

The investigators found green tea supplementation significantly reduced HbA1c levels [WMD = -0.15, 95% CI = -0.26 to -0.04, p = 0.008, I2 = 71.3%].
This significantly reduced effect was also found if the duration of intervention was ≤ 12 weeks, the dosage of supplementation was ≥ 1,000 mg/d, baseline values of HbA1c were less than 6.5%, male or both genders were involved and the baseline value of BMI was ≥ 30 kg/m2.

The investigators found green tea supplementation significantly reduced diastolic blood pressure (DBP) [WMD = -0.87, 95% CI = -1.45 to -0.29, p = 0.003, I2 = 92.4%].
This significantly reduced effect was also found if the duration of intervention was ≤ 12 weeks, the dosage of supplementation was less than 1,000 mg/d, baseline values of DBP were more than 80 mmHg and the baseline value of BMI was ≥ 30 kg/m2.

The investigators found green tea supplementation significantly increased HDL cholesterol levels (HDL-C) [WMD = 1.85, 95% CI = 0.87 to 2.84, p = 0.010, I2 = 94.4%].
This significantly increased effect was also found if females were included, the baseline BMI was lower more than 30 kg/m2, there was no past medical history of T2DM, the duration of intervention was more than 12 weeks, the dosage of supplementation was less than 1,000 mg/d and baseline values of HDL were more than 50 mg/dL.

The investigators found sensitivity analysis showed no significant difference in results with removing one single study for all considered cardiovascular risk factors including lipid profiles, glycemic indices, SBP and DBP and CRP.

The investigators concluded drinking ≤1,000 mg/d green tea may causally improve risk factors of cardiovascular disease. May improve because the RCTs are of low quality.

Original title:
The effects of green tea supplementation on cardiovascular risk factors: A systematic review and meta-analysis by Zamani M, Kelishadi MR, […], Asbaghi O.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9871939/

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Green tea causally lowers blood pressure in healthy individuals

Afbeelding

Objectives:
Is there a causal relationship between drinking green tea and lowering blood pressure in healthy individuals?

Study design:
This review article included 9 RCTs with 345 healty individuals in the intervention group (group with green tea) and 335 healthy individuals in the control group (group without green tea).

The mean age of the individuals in the intervention group was 35.89 ± 8.52, while the mean age of the control group was 36.48 ± 7.68.
All studies clearly described allocation randomization, none had incomplete outcome data, and all used appropriate statistical analysis.
The completion rate of the consumption of green tea ranged from 85-100%.
No publication bias was observed in the studies.

Results and conclusions:
The investigators found combined results of the studies showed that green tea was effective in lowering systolic blood pressure in healthy individuals [MD = -2.99, 95% CI = -3.77 to -2.22, p 0.00001, I2 = 0%].

The investigators found combined results of the studies showed that green tea was effective in lowering diastolic blood pressure in healthy individuals [MD= -0.95, 95% CI = -1.62 to -0.27, p = 0.006, I2 = 0%]. 

The investigators concluded in healthy individuals, green tea supplementation reduces systolic blood pressure by 2.99 mmHg and diastolic blood pressure by 0.95 mmHg.

Original title:
Effect of Green Tea on Blood Pressure in Healthy Individuals: A Meta-Analysis by Ayaz EY, Dincer B and Mesci B.

Link:
https://pubmed.ncbi.nlm.nih.gov/36689359/

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High dietary vitamin E intake reduces risk of stroke

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Objectives:
Findings from observational studies on the associations between vitamin E intake and stroke risk remain controversial and the dose-response relationship between vitamin E intake and risk of stroke remains to be determined. Therefore, this review article has been conducted.

Does dietary vitamin E intake reduce risk of stroke?

Study design:
This review article included 9 prospective cohort studies involving 3,284 cases of stroke among 220,371 participants.

Results and conclusions:
The investigators found high dietary vitamin E intake significantly reduced risk of overall stroke with 17% [RR = 0.83, 95% CI = 0.73 to 0.94].
Omission of any single study (=sensitivity analysis) did not alter the summary result.

The investigators found high dietary vitamin E intake significantly reduced risk of overall stroke with 16% [RR = 0.84, 95% CI = 0.72 to 0.91] among individuals who were followed-up for 10 years.

The investigators found a non-linear association between dietary vitamin E intake and stroke risk [p = 0.0249].

The investigators concluded that a higher dietary vitamin E intake is associated with a lower stroke risk.

Original title:
Vitamin E intake and risk of stroke: a meta-analysis by Cheng P, Wang L, [...], Zhu J.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30401005

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Diet with medium-chain saturated fatty acids leads to higher HDL cholesterol

Afbeelding

Objectives:
Medium-chain saturated fatty acids (MCFAs) may affect circulating lipids and lipoproteins differently than long-chain saturated fatty acids (LCSFAs), but the results from human intervention trials have been equivocal. Therefore, this review article has been conducted.

Have medium-chain saturated fatty acids (MCFAs) and long-chain saturated fatty acids (LCSFAs) differential impacts on blood lipids and lipoproteins in humans?

Study design:
This review article included 11 crossover and 1 parallel trial with a total of 299 participants [weighted mean ± SD age: 38 ± 3 y; weighted mean ± SD body mass index (kg/m2): 24 ± 2]

There was no evidence of statistical heterogeneity for HDL cholesterol, apoA-I and triglyceride concentrations. However, significant heterogeneity was observed for the total cholesterol [I2 = 49%] and LDL cholesterol analysis [I2 = 58%].

Results and conclusions:
The investigators found diets enriched with medium-chain saturated fatty acids led to significantly higher HDL cholesterol (good cholesterol) concentrations than diets enriched with long-chain saturated fatty acids [MD = 0.11 mmol/L, 95% CI = 0.07 to 0.15 mmol/L] with no effect on triglyceride, LDL cholesterol (bad cholesterol) and total cholesterol concentrations.

The investigators found consumption of diets rich in medium-chain saturated fatty acids significantly increased apolipoprotein A-I (apoA-I) concentrations compared with diets rich in long-chain saturated fatty acids [MD = 0.08 g/L, 95% CI = 0.02 to 0.14 g/L].  

The investigators concluded diets enriched with medium-chain saturated fatty acids lead to higher HDL cholesterol concentrations and apolipoprotein A-I (apoA-I) concentrations than diets enriched with long-chain saturated fatty acids. However, further investigations are warranted to elucidate the mechanism by which the lipid profile is altered.

Original title:
Differential effects of medium- and long-chain saturated fatty acids on blood lipid profile: a systematic review and meta-analysis by Panth N, Abbott KA, […], Garg ML.

Link:
https://academic.oup.com/ajcn/article-abstract/108/4/675/5100313?redirectedFrom=fulltext

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Medium-chain saturated fatty acids (MCFAs) have approximately 6 to 12 carbon atoms in the chain. Coconut oil, palm kernel oil and coconut milk are by far the foods with the highest amounts of medium-chain saturated fatty acids.

Apolipoprotein AI (apo AI) is the major apoprotein of HDL and its serum concentration also correlates inversely with the risk for coronary heart disease (CHD).

 

150 g/day French-fries consumption increases risk of hypertension

Afbeelding

Objectives:
Is there a relationship between different types of potato consumption and risk of all-cause mortality, coronary heart disease (CHD), stroke, type 2 diabetes (T2D), colorectal cancer (CRC) and hypertension?

Study design:
This review article included 28 reports.

The quality of evidence was rated mostly low (moderate quality of evidence for the risk-associations of French-fries).

Results and conclusions:
The investigators found per one daily/serving (150 g/day) increase of total potato consumption did not associate with:
-all-cause mortality [RR = 0.88, 95% CI = 0.69-1.12];
-coronary heart disease [RR = 1.03, 95% CI = 0.96-1.09];
-stroke [RR = 0.98, 95% CI = 0.93-1.03] and;
-colorectal cancer [RR = 1.05, 95% CI = 0.92-1.20].

The investigators found consumption of one daily/serving (150 g/day) of boiled/baked/mashed-potatoes was also not associated with risk of hypertension [RR = 1.08, 95% CI = 0.96-1.21].
No association because RR of 1 was found in the 95% CI of 0.96 to 1.21. RR of 1 means no risk/association.

The investigators found consumption of one daily/serving (150 g/day) of boiled/baked/mashed-potatoes significantly increased risk of type 2 diabetes with 8% [RR = 1.08, 95% CI = 1.01-1.18].
Significantly because RR of 1 was not found in the 95% CI of 1.01 to 1.18. RR of 1 means no risk/association.

The investigators found for each 150 g/day increase in French-fries consumption a significantly increased risk of type 2 diabetes with 66% [RR =1.66, 95% CI = 1.43-1.94].

The investigators found for each 150 g/day increase in French-fries consumption a significantly increased risk of hypertension with 37% [RR =1.37, 95% CI = 1.15-1.63].
Significantly means that there is an association with a 95% confidence.

The investigators concluded that 150 g/day increase in French-fries consumption is associated with an increased risk of type 2 diabetes and an increased risk of hypertension.

Original title:
Potatoes and risk of chronic disease: a systematic review and dose-response meta-analysis by Schwingshackl L, Schwedhelm C, […], Boeing H.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29987352

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10,000 steps a day do not decrease blood pressure in healthy adults

Afbeelding

Objectives:
Is there a relationship between step count and changes in blood pressure (BP) in healthy adults?

Study design:
This review article included 14 trials involving healthy adults and an intervention in the form of brisk walking with a pedometer.

Net changes in blood pressure and step count in each trial were calculated and pooled. In addition, the pooled net changes of two categories (trials that achieved walking 10,000 steps a day and those that did not) were compared.

Results and conclusions:
The investigators found that pooled net changes in blood pressure improved significantly [systolic blood pressure = -3.1 mmHg and diastolic blood pressure = -1.6 mmHg].

The investigators found, however, when the trials were categorized depending on whether they achieved walking 10,000 steps a day, the pooled net change in systolic blood pressure and diastolic blood pressure did not differ significantly between both groups of subjects.

The investigators found the meta-regression analyses indicated that net change in systolic blood pressure was significantly associated with an increased step count (e.g., systolic blood pressure is expected to decrease approximately 4 mmHg if increased step count by 2000 steps a day).
However, net change in systolic blood pressure was not associated with the step count in an intervention group following the intervention.

The investigators concluded that there is no evidence that walking 10,000 steps a day lowers the blood pressure to any marked degree in healthy adults. In order to reduce systolic blood pressure by walking with a pedometer, one should be mindful of increasing one's step count to 20,000 steps per day.

Original title:
The required step count for a reduction in blood pressure: a systematic review and meta-analysis by Igarashi Y, Akazawa N and Maeda S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30127487

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Walnut-enriched diet reduces cholesterol and triglyceride levels

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Objectives:
Intervention studies suggest that incorporating walnuts into the diet may improve blood lipids without promoting weight gain. Therefore, this review article has been conducted.

Does a diet with walnuts improve blood lipids profile (such as cholesterol and triglycerides) without promoting weight gain?

Study design:
This review article included 26 clinical trials with a total of 1,059 participants.
Weighted mean differences (WMDs) were used.

Results and conclusions:
The investigators found compared with control group, a walnut-enriched diet significantly reduced total blood cholestrerol level with 6.99 mg/dL [95% CI = -9.39 to -4.58 mg/dL, p 0.001; 3.25% greater reduction].

The investigators found compared with control group, a walnut-enriched diet significantly reduced low-density lipoprotein (LDL) cholesterol level with 5.51 mg/dL [95% CI = -7.72 to -3.29 mg/dL, p 0.001; 3.73% greater reduction].

The investigators found compared with control group, a walnut-enriched diet significantly reduced triglyceride concentrations with 4.69 mg/dL [WMD = -4.69 mg/dL, 95% CI = -8.93 to -0.45 mg/dL, p = 0.03; 5.52% greater reduction].  

The investigators found more pronounced reductions in blood lipids were observed when walnut interventions were compared with American and Western diets [WMD for total blood cholestrerol level = -12.30, 95% CI = -23.17 to -1.43] and for LDL blood cholestrerol level = -8.28, 95% CI = -13.04 to -3.51, p 0.001].

The investigators found apolipoprotein B was also reduced significantly more on walnut-enriched diet compared with control group [WMD = -3.74 mg/dL, 95% CI = -6.51 to -0.97 mg/dL, p = 0.008].

The investigators found a trend towards a reduction was observed for apolipoprotein A [WMD = -2.91, 95% CI = -5.98 to 0.08, p = 0.057].

The investigators found, however, walnut-enriched diet did not lead to significant differences in weight change compared with control diet [WMD = -0.12 kg, 95% CI = -2.12 to 1.88, p = 0.90], systolic blood pressure [WMD = -0.72 mmHg, 95% CI = -2.75 to 1.30, p = 0.48] or diastolic blood pressure [WMD = -0.10 mmHg, 95% CI = -1.49 to 1.30, p = 0.88].

The investigators concluded that walnut-enriched diet improves total and LDL cholesterol levels (bad cholesterol), apolipoprotein B levels and triglyceride levels without adversely affecting body weight or blood pressure.

Original title:
Effects of walnut consumption on blood lipids and other cardiovascular risk factors: an updated meta-analysis and systematic review of controlled trials by Guasch-Ferré M, Li J, […], Tobias DK.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29931130

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Persons with atherosclerosis often have an elevated total cholesterol level, an elevated LDL cholesterol level, an elevated triglyceride level and an elevated apolipoprotein B level.

Persons with atherosclerosis are advised to choose products/meals with maximum 30 En% fat, maximum 7 En% saturated fat, maximum 0.2 gram salt per 100 kcal and minimum 1.5 grams fiber per 100 kcal. Check here which products/meals are suitable for persons with atherosclerosis.
 

Higher sodium intake and higher dietary sodium-to-potassium ratio are associated with a higher risk of stroke

Afbeelding

Objectives:
The association of high sodium intake with risk of stroke has been accepted. But considering the proposed J/U-shaped association between sodium intake and risk of all-cause mortality, the shape of the dose-response relationship has not been determined yet. Therefore, this review article has been conducted.

Is there a dose-response association of dietary sodium and sodium-to-potassium ratio with risk of stroke in adults aged 18 years or older?

Study design:
This review article included 14 prospective cohort studies, 1 case-cohort study and 1 case-control study with a total of 261,732 participants, of which 10,150 cases of stroke.

Results and conclusions:
The investigators found a significantly increased risk of 6% [pooled RR = 1.06, 95% CI = 1.02 to 1.10, I2 = 60%, n = 14 studies] for stroke for a 1 gr/d increment in dietary sodium intake.

The investigators found a significantly increased risk of 22% [pooled RR = 1.22, 95% CI = 1.04 to 1.41, I2 = 60%, n = 5 studies] for stroke for a one-unit increment in dietary sodium-to-potassium ratio (mmol/mmol).

The investigators found the risk of stroke increased linearly with increasing dietary sodium intake and also along with the increase in dietary sodium-to-potassium ratio.

The investigators found no evidence of a J/U-shaped association in the analyses of total stroke, stroke incidence and stroke mortality.

The investigators found high sodium intake was associated with a somewhat worse prognosis among Asian countries as compared to westerns.

The investigators concluded that higher dietary sodium intake and higher dietary sodium-to-potassium ratio are associated with a higher risk of stroke in adults aged 18 years or older. Reducing dietary sodium-to-potassium ratio can be considered as a supplementary approach in parallel with the decrease in sodium intake in order to decrease stroke risk.

Original title:
Dietary sodium, sodium-to-potassium ratio, and risk of stroke: A systematic review and nonlinear dose-response meta-analysis by Jayedi A, Ghomashi F, […], Shab-Bidar S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29907351

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Sodium is a component of salt. Thus, a high sodium intake means a high salt intake.
A high salt diet means, practically, a diet with a lot of products with minimum 0.3 gram salt per 100 kcal.

A low salt diet means, practically, a diet with a lot of products with maximum 0.2 gram salt per 100 kcal. These products meet a low salt diet.


 

EPA/DHA ratio of < 1 reduces risk of postoperative atrial fibrillation after coronary artery bypass grafting

Afbeelding

Objectives:
N-3 polyunsaturated fatty acids (PUFA) have been postulated to have an anti-arrhythmic effect on postoperative atrial fibrillation (POAF), with conflicting results among studies. Therefore, this review article has been conducted.

Do n-3 polyunsaturated fatty acids reduce risk of postoperative atrial fibrillation among patients undergoing cardiac surgery?

Study design:
This review article included 4 studies with 3,570 patients.
The funnel plot and fail-safe number suggested insignificant publication bias.

Results and conclusions:
The investigators found n-3 polyunsaturated fatty acids significantly reduced risk of postoperative atrial fibrillation with 16% [RR = 0.84, 95% CI = 0.73-0.98, p = 0.03].
Significantly means it can be said with a 95% confidence that n-3 polyunsaturated fatty acids really reduced the risk of postoperative atrial fibrillation with 16%. 

The investigators found in subgroup analyses EPA:DHA 1 significantly reduced risk of postoperative atrial fibrillation with 49% [RR = 0.51, 95% CI = 0.36-0.73, p = 0.0003].

The investigators found in subgroup analyses, when placebo was usual care, n-3 polyunsaturated fatty acids significantly reduced risk of postoperative atrial fibrillation with 41% [RR = 0.59, 95% CI = 0.44-0.80, p = 0.0005].

The investigators found in subgroup analyses, n-3 polyunsaturated fatty acids significantly reduced risk of postoperative atrial fibrillation with 32% after coronary artery bypass grafting (CABG) [RR = 0.68, 95% CI = 0.47-0.97, p = 0.03].

The investigators concluded that n-3 polyunsaturated fatty acids (PUFA), particularly at EPA/DHA ratio of  1 reduce risk of postoperative atrial fibrillation after coronary artery bypass grafting (CABG). Further studies are needed to confirm the effect of PUFA on postoperative atrial fibrillation and to assess the proper use of PUFA against postoperative atrial fibrillation.

Original title:
N-3 polyunsaturated fatty acids for prevention of postoperative atrial fibrillation: updated meta-analysis and systematic review by Wang H, Chen J and Zhao L.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29380237

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Coenzyme Q10 supplementation reduces serum triglycerides levels of patients with metabolic disorders

Objectives:
Oxidative stress and inflammation are key parameters in developing metabolic disorders. Hence, antioxidant intake might be an appropriate approach. Several studies have evaluated the effect of coenzyme Q10 (CoQ10) supplementation on lipid profile among patients with metabolic diseases, though findings are controversial. Therefore, this review article has been conducted.

Does coenzyme Q10 supplementation improve lipid profile of patients with metabolic disorders?

Study design:
This review article included 21 RCTs with a total of 514 patients with metabolic disorders in the coenzyme Q10 supplementation group and 525 patients with metabolic disorders in the non-coenzyme Q10 supplementation group (control group).

Results and conclusions:
The investigators found coenzyme Q10 supplementation significantly reduced serum triglycerides levels of patients with metabolic disorders [SMD = -0.28, 95% CI = -0.56 to -0.005].

The investigators found coenzyme Q10 supplementation non-significantly reduced total-cholesterol levels of patients with metabolic disorders [SMD = -0.07, 95% CI = -0.45 to 0.31].

The investigators found coenzyme Q10 supplementation non-significantly increased LDL-cholesterol (bad cholesterol) levels of patients with metabolic disorders [SMD = 0.04, 95% CI = -0.27 to 0.36].

The investigators found coenzyme Q10 supplementation non-significantly increased HDL-cholesterol (good cholesterol) levels of patients with metabolic disorders [SMD = 0.10, 95% CI = -0.32 to 0.51].

The investigators concluded that coenzyme Q10 supplementation reduces serum triglycerides levels of patients with metabolic disorders. However, it has no effects on cholesterol levels.  

Original title:
The effects of coenzyme Q10 supplementation on lipid profiles among patients with metabolic diseases: a systematic review and meta-analysis of randomized controlled trials by Sharifi N, Tabrizi R, […], Asemi Z.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29623830

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A metabolic disorder occurs when the metabolism process fails and causes the body to have either too much or too little of the essential substances, namely carbohydrates, aminoacids, fatty acids and organic acids needed to stay healthy.

Metabolic disorders can take many forms. This includes:

  • a disease in the liver, pancreas, endocrine glands or other organs involved in metabolism
  • nutritional deficiencies
  • a missing enzyme or vitamin that’s necessary for an important chemical reaction
  • abnormal chemical reactions that hinder metabolic processes

Olive oil consumption decreases LDL cholesterol and triglyceride less than other plant oils

Afbeelding

Objectives:
What are the effects of olive oil consumption compared with other plant oils on blood lipids?

Study design:
This review article included 27 RCTs, comprising 1,089 participantes.

Results and conclusions:
The investigators found compared to other plant oils, HDL cholesterol levels (good cholesterol) increased significantly more for olive oil consumption [WMD = 1.37 mg/dL, 95% CI = 0.4 to 2.36].

The investigators found, however, olive oil consumption reduced total cholesterol levels [WMD = 6.27 mg/dL, 95% CI = 2.8 to 10.6], LDL cholesterol levels (bad cholesterol) [WMD = 4.2 mg/dL, 95% CI = 1.4 to 7.01] and triglyceride levels [WMD = 4.31 mg/dL, 95% CI = 0.5 to 8.12] significantly less than other plant oils.

The investigators found that there were no significant effects on Apo lipoprotein A1 and Apo lipoprotein B.

The investigators concluded that olive oil consumption decreases serum total cholesterol, LDL cholesterol and triglyceride levels less but increases HDL cholesterol levels more than other plant oils.

Original title:
Comparison of blood lipid-lowering effects of olive oil and other plant oils: A systematic review and meta-analysis of 27 randomized placebo-controlled clinical trials by Ghobadi S, Hassanzadeh-Rostami Z, […], Faghih S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29420053

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1 serving/week poultry intake reduces risk of stroke among US people

Afbeelding

Objectives:
Does poultry intake reduce risk of stroke?

Study design:
This review article included 7 prospective cohort studies involving 354,718 participants.

Results and conclusions:
The investigators found for the highest versus lowest categories of poultry intake a non-significantly reduced risk of 8% for total stroke [pooled RR = 0.92, 95% CI = 0.82-1.03, I2 = 19.8%, p = 0.28].

The investigators found in subgroup analysis for the highest versus lowest categories of poultry intake, a significantly reduced risk of 14% for total stroke among US people [RR = 0.86, 95% CI = 0.77-0.95, I2 = 0.0%, p = 0.38].

The investigators found in subgroup analysis for the highest versus lowest categories of poultry intake, a significantly reduced risk of 17% for total stroke among women [RR = 0.83, 95% CI = 0.72-0.93, I2 = 0.0%, p = 0.63].

The investigators found in subgroup analysis no association between the highest poultry intake and ischemic stroke risk [RR = 0.91, 95% CI = 0.79-1.02, I2 = 0.0%, p = 0.93].

The investigators found in subgroup analysis no association between the highest poultry intake and hemorrhagic stroke risk [RR = 0.82, 95% CI = 0.59-1.04, I2 = 20.5%, p = 0.28].

The investigators found one serving per week increment in poultry intake was not associated with the risk of stroke [RR = 1.00, 95% CI = 0.96-1.03, I2 = 69.0%, p = 0.004].

The investigators found nonlinear dose-response meta-analysis showed a lower risk of stroke at consumption of 1 serving/week.  

The investigators concluded that 1 serving/week poultry intake reduces risk of stroke, particularly among US people and women.

Original title:
Dietary poultry intake and the risk of stroke: A dose-response meta-analysis of prospective cohort studies by Mohammadi H, Jayedi A, […], Shab-Bidar S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29460808

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1 serving poultry corresponds to 100 gram raw poultry.
This meal provides 75 grams of poultry.
Poultry are chickens, turkeys, geese and ducks.

Resveratrol supplements do not reduce LDL-cholesterol levels

Objectives:
New studies indicate that resveratrol can significantly reduce plasma lipids, but the result of randomized clinical trials (RCTs) on resveratrol effect and the serum lipid profile are contradictory. Therefore, this review article (meta-analysis) has been conducted.  

Do resveratrol supplements reduce plasma lipids, like cholesterol levels?

Study design:
This review article included 21 RCTs.

Results and conclusions:
The investigators found resveratrol supplements had no significant effects on both:
-total cholesterol (TC) [WMD = 0.08 mmol/L, 95% CI = -0.23 to 0.08, p = 0.349, I2 = 87.8%];
-low-density lipoprotein (LDL-C or bad cholesterol) [WMD = -0.04 mmol/L, 95% CI = -0.21 to 0.12, p  = 0.620, I2 = 93.4%] and;
-high density lipoprotein (HDL-C or good cholesterol) [WMD = -0.01 mmol/L, 95% CI = -0.04 to 0.02, p = 0.269, I2 = 88.6%].

The investigators found resveratrol supplements had significant effects on
triacylglycerol (TG) [WMD = 0.58 mmol/L, 95% CI = 0.34 to 0.82, p 0.0001, I2 = 99.8%]. But after removing 1 study the significance was eliminated.

The investigators also found that sex, age, BMI, resveratrol dosage and intervention duration could not change the results.

The investigators concluded that resveratrol supplements do not change lipid profile concentration, like cholesterol levels. Confirmation of this conclusion will require more studies exclusively on dyslipidemic patients in which the intake of lipid lowering agents is among the exclusion criteria.

Original title:
Effect of resveratrol on lipid profile: An updated systematic review and meta-analysis on randomized clinical trials by Haghighatdoost F and Hariri M.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29305228

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20g/d of fish consumption reduce risk of CVD mortality

Afbeelding

Objectives:
There are some indications of regional differences in the association between fish consumption and clinical outcomes. Therefore, this review article (meta-analysis) has been conducted.  

Are there regional differences in the association between fish consumption and risk of all-cause mortality and cardiovascular (CVD) mortality?

Study design:
This review article included 14 prospective cohort studies (10 publications) with 911,348 participants, of which 75,451 incident deaths.

Results and conclusions:
The investigators found dose-response meta-analysis showed a 20 g/d increment in fish consumption significantly reduced risk of cardiovascular mortality with 4% [relative risk = 0.96, 95% CI = 0.94-0.98, I2 = 0%, n = 8]. However, subgroup analysis resulted in a significant association only in Asian studies and not in Western studies.

The investigators found dose-response meta-analysis showed a 20 g/d increment in fish consumption significantly reduced risk of all-cause mortality with 2% [relative risk = 0.98, 95% CI = 0.97-1.00, I2 = 81.9%, n = 14]. However, subgroup analysis resulted in a significant association only in Asian studies and not in Western studies.

The investigators found analysis of Western studies suggested a nearly U-shaped association, with a nadir at fish consumption of 20 g/d in analysis of both outcomes. Meanwhile, the associations appeared to be linear in Asian studies.

The investigators concluded that fish consumption, particularly 20 g/d reduces boh risk of cardiovascular mortality and all-cause mortality. Furthermore, there is potential evidence of regional differences in the association between fish consumption and mortality. Therefore, it may be helpful to examine the associations by considering types of fish consumed and methods of fish preparation.

Original title:
Fish consumption and risk of all-cause and cardiovascular mortality: a dose-response meta-analysis of prospective observational studies by Jayedi A, Shab-Bidar S, […], Djafarian K.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29317009

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