Nutritional Advice El Mondo

Nutritional advice

Overweight

Scientific studies (review articles) on the relationship between diet/nutrients and overweight prevention:
One swallow does not make a summer. A famous Dutch saying that could not be any more obvious. Just because one single scientific study about a certain topic makes certain claims, it does not necessarily mean it is true. On the other hand, a review article (a collection of scientific studies on a certain topic) of randomized, placebo-controlled double blind clinical trials (RCTs) will answer the following question:
"Do taking dietary supplements make sense?" Yes for a positive conclusion and no for a negative conclusion.

One swallow does not make a summer. A famous Dutch saying that could not be any more obvious. Just because one single scientific study about a certain topic makes certain claims, it does not necessarily mean it is true. On the other hand, a review article (a collection of scientific studies on a certain topic) of cohort studies or case-control studies will answer the following question:
"Should I change my diet?".

2023:

  1. Causal relationship between sugar-sweetened beverages consumption and higher BMI and body weight

2021:

  1. High protein diets causally have beneficial effect on body weight management
  2. High circulating vitamin C level reduces metabolic syndrome
  3. Carbohydrate intake increases metabolic syndrome
  4. Poultry consumption decreases metabolic syndrome
  5. Nut consumption does not increase adiposity
  6. Obesity increases colorectal cancer in men with Lynch Syndrome
  7. A diet with low GI increases metabolic syndrome
  8. Hyperlipidemia, obesity and high alcohol consumption are risk factors of early-onset colorectal cancer
  9. Obesity is a risk factor for mortality from primary liver cancer
  10. Insufficiency of serum carotenoids increases overweight and obesity
  11. Obesity increases atrial fibrillation recurrence in patients undergoing catheter ablation
  12. Brown rice has anti-obesity effects in comparison with white rice
  13. No effect of vitamin E supplementation on weight, BMI and waist circumference
  14. Mortality is more frequently in COVID-19 patients with chronic kidney diseases and cardiovascular disease
  15. Vitamin D supplementation during pregnancy or infancy reduces adiposity in childhood

2020:

  1. Dairy products reduce causal fat mass and BMI among overweight or obese adults
  2. Pistachio supplementation lowers BMI without increasing body weight
  3. Abdominal adiposity is a risk factor in COVID-19
  4. Alpha-lipoic acid supplementation reduces weight and BMI
  5. Obesity increases severe COVID-19
  6. Coenzyme Q10 supplementation does not decrease body weight and BMI
  7. Yogurt intake is associated with a reduced risk of type 2 diabetes
  8. Fish consumption reduces metabolic syndrome
  9. Waist circumference is a significant risk factor of liver cancer

2019:

  1. A higher serum copper level increases obesity
  2. 100 g/d fruit consumption reduces metabolic syndrome
  3. 150 mg/day quercetin supplementation reduces LDL-cholesterol in obese people
  4. <2 g/d L-carnitine decreases diastolic blood pressure in participants with obesity
  5. 280 mg/d dietary calcium intake may reduce metabolic syndrome
  6. Adults with overweight/obesity benefit from probiotics
  7. ≤400 μg/d chromium supplementation reduce BMI
  8. Whole grains, fruit, nut, legume consumption reduce adiposity risk
  9. Tree nuts reduce risk of metabolic syndrome

2018:

  1. ≥75 mg/day isoflavones reduce BMI
  2. <50 g/d carbohydrates increase good cholesterol in overweight/obese adults
  3. ≥30g chocolate per day during 4-8 weeks reduce BMI
  4. Carotenoids may reduce risk of metabolic syndrome
  5. Ginger intake reduces body weight and fasting glucose among overweight and obese subjects
  6. Vegetable and fruit consumption reduce metabolic syndrome

2017:

  1. A low-fat diet reduces cholesterol level in overweight or obese people
  2. A high dietary fiber intake may reduce risk of metabolic syndrome
  3. A high fruit and/or vegetable consumption reduce risk of metabolic syndrome among Asian
  4. A high relative adipose mass reduces bone mineral density in overweight and obese populations
  5. Higher sodium increases metabolic syndrome
  6. Metabolic syndrome increases risk of ischemic stroke
  7. A higher circulating DHA is associated with a lower metabolic syndrome risk
  8. Whole flaxseed supplementation in doses ≥30 g/d during ≥12 weeks has positive effects on body composition in overweight participants
  9. n-3 PUFA supplements reduce waist circumference in overweight and obese adults
  10. Green tea decreases LDL cholesterol level in overweight or obese people
  11. Decreased vitamin D levels and increased BMI increase pediatric-onset MS
  12. CLA does not reduce fasting blood glucose and waist circumference
  13. Abdominal adiposity and higher body fat mass increase risk of atrial fibrillation

2015:

  1. Green tea consumption decreases blood pressure among overweight and obese adults

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Overweight is an increasing problem in the world. It’s called overweight when the BMI is greater than 25 and obese when the BMI is greater than 30. A healthy weight has a BMI of 18.5-25. A woman with 65 kg and 1.57 meters has a BMI of 26.4 (65/(1.57x1.57)). BMI is weight divided by height squared (weight (kg)/height2 (m)).

The best way to determine overweight in children is to calculate the BMI. In adults, beside the BMI, waist circumference should also be measured.

Everybody who wants to lose weight, wants to burn more calorie at rest and more fat. How do you achieve these two goals?

Make sure the resting metabolic rate (RMR) does not decrease when following a diet (therefore, the recommendation of dietitians is no more than 0.5-1 kg of weight loss per week). A low resting metabolic rate will result in a low calorie burning at rest. But that is not what you want. You want, when following a diet, that the body will burn more calories (at rest).
A low resting metabolic rate is often the result of the insufficient intake of carbohydrate. When the body obtains insufficient quantities of carbohydrate, it’s been forced to get energy from protein, resulting in muscle degradation. Muscle degradation will in turn result in a lower resting metabolic rate. Muscle degradation can be observed when the upper arm and calf circumference become smaller. To prevent muscle degradation, when following a diet, is recommendable to choose product with 55-70 En% carbohydrates.

To prevent muscle degradation when following a diet, the diet must contain at least 1.6 g protein per kg body weight. For a person of 65 kg means 65x1.6 = 104 kg of protein per day. 1.6 g protein per kg body weight corresponds to a diet with 20 En% protein.

To prevent muscle degradation when following a diet, it is recommendable to choose products with 20-35 En% protein and/or products with 55-70 En% carbohydrates in combination with strength training. Strength training increases the resting metabolic rate. A declined resting metabolic rate is often the cause of the yo-yo effect.

Cardio-fitness is a good way to burn fat. To be able to burn fat efficiently, you should perform cardio-fitness with the heart rate between 75 and 90% of the maximum heart rate. The maximum heart rate is calculated by 220 minus age.
For example, you are 40 years old you have to perform cardio-fitness with a heart rate between 0.75-0.9x(220-40) = 135 and 162 heart beats per minute. Stop immediately  with the exercises when you are not feeling well or have pain in the chest!

In summary, it can be said the best way to lose weight is to perform strength training with cardio-fitness in combination with a diet containing products with 20-35 En% protein and/or products with 55-70 En% carbohydrates.

The main cause of overweight is the body gets more calories than it daily burns. Through physical activities, the body will burn more calories. To gain positive effects of physical exercises the body should burn at least 2000 calories (kcal) per week or at least 150 minutes of aerobic exercise of moderate intensity, accumulated over the week, which can be split into periods of at least 10 minutes. To prevent overweight, physical activities should account for 15-30% of the daily calorie intake.

The main consequences of overweight are:

  • Cardiovascular diseases.
  • Type 2 diabetes. The main effects of type 2 diabetes are cardiovascular diseases and kidney problems.

Belly fat is bad because it increases the risk of getting type 2 diabetes and cardiovascular disease. Therefore, aim for a waist circumference of 68-80 cm for women and 79-94 cm for men. A loss of 1 cm of belly fat (e.g. 95 to 94 cm) corresponds to a loss of 1 kg of fat. 1 kg of fat corresponds to 9000 calories.

Local fat loss, such as the backside or thighs is a scientific myth.

The human body will only burn fat when it meets the following two criteria:

  1. Increased oxygen uptake (only occurs during physical exercises).
  2. Increased energy demand (only occurs during physical exercises).

We like to eat fat but our body likes to use carbohydrates as energy source.

Overweight is the result of poor knowledge about nutrition in combination with hardly physical exercises.

It is not possible to lose more than 1.8 grams of fat per week. However, at more than 1 kg of fat loss per week, the body will also break down muscle, resulting in a low resting metabolic rate and yoyo-effect.

When following a diet is favorable to minimize fat through diet. But at least 7 grams of fat per day is necessary to ensure the intake of essential fatty acids and to stimulate the production of bile salts.
7 grams of fat per day corresponds to a daily diet with 4 En% fat. However, a diet with at least 20 En% fat (and up to 35 En% fat) is necessary to prevent a deficiency of essential fatty acids and fat-soluble vitamins on long-term.

A responsible breakfast contains up to 350 kcal.
A responsible lunch contains up to 450 kcal.
A responsible evening meal contains up to 750 kcal.

Good indicators for weight loss are a decreased body fat and an increased muscle mass. The body fat and muscle mass can be measured with a body composition analyzers scale.

Recommended daily energy intake by sex and age group
Age group (years)MenWomen
Kcal per dayKcal per day
616001500
1222002000
1729002300
30-3926002000
50-5925002000
70-7923001800
Others25002000

 

Recommended fat percentage by sex and age group
Age group (years)MenWomen
17-291525
30-3917.527.5
40-492030
50+2535
A healthy adult male has a body fat percentage around 15%.
A healthy adult woman has a body fat percentage around 25%.


Dietary guidelines for overweight prevention:

  • Choose products with 20-30 En% fat, products with maximum 7 En% saturated fat, products with 20-35% protein, products with maximum 10 En% sugars, products with minimum 1.5 grams of fiber per 100 kcal and products with a GI value of 55 or lower or in other words, your daily diet (=all meals/products that you eat on a daily basis) should on average contain 20-30 En% fat, maximum 7 En% saturated fat, 20-35% protein, maximum 10 En% sugars and minimum 1.5 grams of fiber per 100 kcal.
  • Products with 20-35 En% protein in combination with 10000 steps per day and 25-30 grams of fiber per day will reduce weight in a responsible manner.
    Products with 20-35 En% protein should contain maximum 30 En% fat and maximum 7 En% saturated fat!
  • No more than 0.5-1 kg of weight loss per week. 0.5 kg of weight loss per week corresponds to a decreased intake of 350 kcal per day through diet and 150 kcal extra through physical activities.
  • To prevent a deficiency of vitamins and essential fatty acids a diet should contain a minimum of 1700 kcal per day.
  • Increase the resting metabolic rate. Strength training is the best way to increase the resting metabolic rate.
  • Use the following guideline: total energy intake per day is 25-30 kcal per kg body weight.
  • Eat 300 grams of vegetables and five servings of fruit per day or 25-30 grams of fiber per day. Dietary fiber provides a longer satiety, resulting in less meal times during the day. Furthermore, the antioxidants from fruits and vegetables reduce inflammation.
    30 grams of fiber per day corresponds to a daily diet of minimum 1.5 grams of fiber per 100 kcal.
  • Eat no more than 19 grams of saturated fat per day at 2500 kcal and 15 grams of saturated fat at 2000 kcal. The WHO advises 2000 kcal per day for women and 2500 kcal for men.
  • Aim for a healthy weight. A healthy weight has a BMI of 18.5-25. BMI is weight divided by height squared (weight (kg)/height2 (m)).
  • Spend at least 90 minutes per day on physical exercises or at least 10000 steps per day.
  • Stop smoking because smoking causes atherosclerosis. Atherosclerosis is the most important cause of cardiovascular diseases.
  • Do not go shopping on an empty stomach.
  • Do not skip breakfast.
  • Put the meal on a small plate. So it looks like there is a lot of food on the plate!
  • Eat at least 2 times (100-150 g fish per time) a week oily fishes or take daily 250-500 mg EPA and DHA.
    Oily fishes are sardines, herring, salmon, anchovies, eel and mackerel.
  • Limit alcohol to 2 glasses for men and 1 glass for women per day.
  • Eat no more than 6 grams of salt per day, corresponding to 2400 mg of sodium.
    6 grams salt per day corresponds to a daily diet with <0.3 g salt per 100 kcal.
  • Do not take weight loss supplements. They do not what they claim.
Age (years)Recommended BMI for menRecommended BMI for women
414.40-17.5514.25-17.28
514.20-17.4214.05-17.15
614.04-17.5513.90-17.34
714.02-17.9213.94-17.75
814.10-18.4414.06-18.35
914.29-19.1014.26-19.07
1014.53-19.8414.57-19.86
1114.84-20.5514.99-20.74
1215.23-21.2215.52-21.68
1315.70-21.9116.13-22.58
1416.25-22.6216.73-23.34
1516.84-23.2917.28-23.94
1617.42-23.9017.75-24.37
1717.98-24.4618.16-24.70
18 and older18-50-25.0018.50-25.00

Chronic diseases

Scientific studies (review articles) on the relationship between diet/nutrients and chronic diseases:
One swallow does not make a summer. A famous Dutch saying that could not be any more obvious. Just because one single scientific study about a certain topic makes certain claims, it does not necessarily mean it is true. On the other hand, a review article (a collection of scientific studies on a certain topic) of randomized, placebo-controlled double blind clinical trials (RCTs) will answer the following question:
"Do taking dietary supplements make sense?" Yes for a positive conclusion and no for a negative conclusion.

One swallow does not make a summer. A famous Dutch saying that could not be any more obvious. Just because one single scientific study about a certain topic makes certain claims, it does not necessarily mean it is true. On the other hand, a review article (a collection of scientific studies on a certain topic) of cohort studies or case-control studies will answer the following question:
"Should I change my diet?".

2023:

  1. High β-carotene dietary intake reduces Parkinson's disease among women
  2. 50g/d legume dietary intake may reduce mortality from all causes

2022:

  1. Selenium supplementation reduces postpartum depression
  2. Tomato intake causally reduces TNF-α levels in adults
  3. 400 mg/day vitamin C supplementation improves lung function of COPD patients
  4. Vitamin E supplements enhance quality of life of rheumatoid arthritis patients
  5. Meat intake may increase kidney stones
  6. High-dose dietary intake of vitamins A and B reduces glaucoma
  7. Higher intake of antioxidant-rich foods reduces Parkinson's disease

2021:

  1. 0.8-10 mg/d folic acid supplements decrease CRP levels
  2. Low vitamin D level increases asthma in children
  3. Low vitamin D level increases acne
  4. Selenium supplementation decreases hs-CRP level among patients with metabolic diseases
  5. NAC supplementation could improve lung function in patients with acute exacerbation of chronic obstructive pulmonary disease
  6. Vitamin B1 supplementation reduces ICU delirium in critically ill patients
  7. Soy supplementation improves insulin resistance for nonalcoholic fatty liver disease
  8. 540 mg/d green tea catechins supplementation reduces UV-induced damage due to erythema inflammation
  9. Cardiovascular reserve is improved after kidney-transplantation
  10. Vitamin B1 + vitamin C supplementation does not reduce mortality in patients with sepsis or septic shock
  11. Grape products containing polyphenols supplementation improves status of oxidative stress
  12. Vitamin B supplementation is effective in treating mouth ulcers
  13. L-carnitine supplementation should be supported in hemodialysis patients
  14. Carotenoid supplements decrease inflammation
  15. Coenzyme Q10 supplementation reduces oxidative stress
  16. 400 mg/day vitamin B2 supplementation decrease migraine attacks
  17. A higher manganese level increases MS
  18. Peripheral neuropathy is associated with lowered plasma vitamin B12 levels
  19. Resistant starch type 2 improves residual renal function of patients under maintenance hemodialysis
  20. Intravenous NAC administration decreases serum creatinine levels
  21. Probiotic, prebiotic and synbiotic supplementation improve oxidative stress in patients with chronic kidney disease
  22. Ginger supplementation improves oxidative stress levels
  23. Serum albumin concentrations are lower in patients with stable COPD
  24. Melatonin supplements have positive effects on sleep quality in adults with metabolic disorders

2020:

  1. 0.5 to 6 g/d taurine supplementation reduces total cholesterol and triglyceride in patients with liver dysregulation
  2. Patients with diabetic kidney disease benefit from <0.8 g protein per kilogram body weight per day
  3. <100 mg/day isoflavones reduce IL-6 and TNF-α levels
  4. 0.5 servings of fish per week reduce multiple sclerosis
  5. A higher dietary intake of fruit, dietary fiber, fish and vitamine C reduce COPD in adults
  6. Higher selenium and lower zinc level increase risk of vitiligo
  7. Higher serum levels of homocysteine increase multiple sclerosis
  8. Physical exercise offers benefits to patients with chronic kidney disease
  9. 300 mg/day dietary anthocyanins reduce inflammation
  10. Pomegranate decreases inflammation in adults
  11. LDL cholesterol-lowering treatment reduce risk of major vascular events
  12. Hepatitis B virus infection increases chronic kidney disease
  13. Lead increases ALS
  14. Meat is not a risk factor for asthma in children

2019:

  1. Vitamin B12, D and E reduce eczema
  2. Higher levels of selenium in cerebrospinal fluid increase Parkinson's disease
  3. Omega-3 supplementation decreases CRP levels in patients on hemodialysis
  4. Low selenium and zinc levels increase rheumatoid arthritis
  5. 60-500 mg/day coenzyme Q10 supplements reduce inflammation
  6. Egg consumption does not increase inflammation
  7. Hypomagnesemia increases all-cause mortality in end-stage renal disease patients
  8. Vitamin D improves fasting glucose among patients with chronic kidney disease
  9. Dietary DHA, DPA and EPA are associated with higher lung function among current smokers
  10. Exercise intervention in kidney transplant recipients improves quality of life
  11. 200g vegetables per day reduce gallstone disease
  12. ≥12 weeks of L-carnitine supplements reduce inflammation
  13. Plasma creatinine seems to be a promising prognostic biomarker for ALS
  14. 10-40 g/day dietary fiber intake reduce diverticular disease risk
  15. Higher hemoglobin levels decrease transfusion risk in predialysis patients with CKD
  16. Magnesium deficiency increases risk of ADHD
  17. High prenatal vitamin D level reduces risk autism-related traits later in life
  18. 3 cups/d coffee consumption reduce risk of all-cause mortality
  19. Dietary n-3 PUFAs reduce ulcerative colitis
  20. 15 minutes/week sunlight exposure decreases risk of Parkinson's disease

2018:

  1. Dairy products, high purine vegetables, soy foods and coffee decrease gout
  2. Postherpetic neuralgia patients benefit from vitamin B12 supplementation
  3. 320 to 1500 mg/day magnesium supplementation decreases CRP levels
  4. 1 g/day salt reduction reduces blood pressure in end-stage renal disease
  5. Coffee consumption is associated with a higher circulating level of adiponectin in women
  6. Higher intakes of fruit and vegetables improve immune function
  7. Oral supplementation with chondroitin sulfate reduces pain in knee osteoarthritis
  8. Coffee consumption is associated with a lower level of serum CRP in humans
  9. Milk increases acne
  10. 1 time/week fish consumption from 6-9 months reduces asthma and wheeze in children up to 4.5 years old
  11. A high uric acid level plays a protective role in ALS
  12. Coenzyme Q10 supplementation reduces serum triglycerides levels of patients with metabolic disorders
  13. Zinc deficiency increases risk of autoimmune disorders

2017:

  1. Cranberry may be effective in preventing urinary tract infection recurrence in women
  2. High consumption of soft drinks increases ulcerative colitis
  3. Children and adolescents with ADHD have a deficiency in n-3 PUFAs levels
  4. Subjects with end-stage renal disease benefit from a diet with <5.5 En% protein
  5. Resveratrol supplementation ≥3 months has favorable effects on several risk factors of non-communicable diseases
  6. 500 mg/day quercetin reduce circulating C-reactive protein levels
  7. Asthma increases risk of cardiovascular disease and all-cause mortality in women
  8. Improving iron status decreases fatigue in patients with iron deficiency without anaemia
  9. High sucrose intake might increase the risk of Crohn’s disease
  10. Daily 1-2g L-carnitine supplementation reduce inflammation
  11. Decreased vitamin D levels and increased BMI increase pediatric-onset MS
  12. Lower serum zinc levels increase Parkinson's disease
  13. Decreased folate level is a risk factor for schizophrenia
  14. Coenzyme Q10 supplementation may decrease inflammation
  15. Marine oil supplements alleviate pain in rheumatoid arthritis patients
  16. Serum vitamin D ≥75 nmol/L reduces risk of allergic rhinitis in men

2016:

  1. Daily 3 cups of tea decrease risk of depression

2015:

  1. 500-1000 mg/day oral ginger intake reduce pain in osteoarthritis patients
  2. Ultrasound can detect active Crohn’s disease in adults

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Chronic diseases, also known as noncommunicable diseases (NCDs) are diseases caused by inflammation in the human body. Inflammation is caused by the actions of free radicals or eicosanoids, which are produced from the fatty acid arachidonic acid. While the eicosanoids produced from arachidonic acid are pro-inflammatory, are the eicosanoids produced from EPA anti-inflammatory.
Arachidonic acid is found in meat, eggs, dairy products, and fish. The WHO and the EFSA have not set nutritional recommendation for dietary arachidonic acid yet.

Chronic diseases generally cannot be prevented by vaccines or cured by medication nor do they just disappear. Chronic diseases tend to become more common with age.

Free radicals are caused by the inhalation of cigarette smoke, diseases, physical exercises, smog, fine particles, high-fat products and exhaust gases. Free radicals can be neutralized by antioxidants. But scientific studies showed that taking antioxidant supplements will cause more harm than good. Therefore, nutritionists recommend to get antioxidants from diet rather than from dietary supplements. Antioxidants are found in vegetables, fruits and nuts.

Scientific studies showed that an n3:n6 ratio of 1 to 5 or less possible prevents chronic diseases. However, the WHO and the EFSA have not set specific values for the n3:n6 ratio yet.

Chronic diseases are:

  • Autoimmune diseases (AID)
  • Diabetes
  • Brain disorders (epilepsy, Parkinson's disease)
  • Cancer
  • Joint disorders (rheumatism, gout and arthritis)
  • Heart diseases
  • Kidney diseases
  • Lung diseases (asthma and COPD)
  • Mental disorders

Dietary guidelines for chronic disease prevention:

  • Choose products with maximum 30-35 En% fat, products with maximum 7-10 En% saturated fat, products with maximum 0.3 gram of salt per 100 kcal, products with minimum 1.5 grams of fiber per 100 kcal, products with a GI-number of 55 or lower and fishes providing at least 2000 mg EPA and DHA per day or in other words, your daily diet (=all meals/products that you eat on a daily basis) should on average contain maximum 30-35 En% fat, maximum 7-10 En% saturated fat, maximum 0.3 gram of salt per 100 kcal and minimum 1.5 grams of fiber per 100 kcal.
  • Stop smoking because cigarette smoke contains/causes free radicals.
  • Aim for a healthy weight. A healthy weight has a BMI of 18.5-25. BMI is weight divided by height squared (weight (kg)/height2 (m)).
    Overweight is a risk factor for certain chronic diseases.
  • Spend at least 60-90 minutes of physical activities per day or at least 10000 steps per day.
  • Eat at least 3 times (100-150 g fish per time) a week oily fish. Oily fishes are sardines, herring, salmon, anchovies, eel and mackerel.
  • Eat 300 grams of vegetables and five servings of fruit a day or 30-40 grams of fiber per day.
    40 grams of fiber per dag corresponds to a daily diet of minimum 2 grams of fiber per 100 kcal.
  • Take when needed glucosamine supplements. Take supplements always after consultation with an expert!
  • Do not take antioxidant supplements because they do more harm than good!

Causal relationship between sugar-sweetened beverages consumption and higher BMI and body weight

Objectives:
Is there a causal relationship between sugar-sweetened beverages consumption and higher BMI and body weight in both children and adults?
 
Study design:
This review article included 85 studies with 48 in children (40 cohort studies with 91,713 participants and 8 RCTs with 2,783 participants) and 37 in adults (21 cohort studies with 448,661 participants and 16 RCTs with 1,343 participants).

Results and conclusions:
The investigators found among cohort studies, each serving/day increase in sugar-sweetened beverages intake was significantly associated with a 0.07 kg/m2 [95% CI = 0.04 to 0.10 kg/m2] higher BMI in children and a 0.42 kg [95% CI = 0.26 to 0.58 kg] higher body weight in adults.

The investigators found RCTs in children indicated less BMI gain with sugar-sweetened beverages reduction interventions compared with control [MD = -0.21 kg/m2, 95% CI = -0.40 to -0.01 kg/m2].

The investigators found RCTs in adults showed randomization to addition of sugar-sweetened beverages to the diet led to greater body weight gain [MD = 0.83 kg, 95% CI = 0.47 to 1.19 kg] and subtraction of sugar-sweetened beverages led to weight loss [MD = -0.49 kg, 95% CI = -0.66 to -0.32 kg] compared with the control groups.

The investigators found a positive linear dose-response association between sugar-sweetened beverages consumption and weight gain for all outcomes assessed.

The investigators concluded there is a causal relationship between sugar-sweetened beverages consumption and higher BMI and higher body weight in both children and adults.

Original title:
Sugar-sweetened beverage consumption and weight gain in children and adults: a systematic review and meta-analysis of prospective cohort studies and randomized controlled trials by Nguyen M, Jarvis SE, [...], Malik VS.

Link:
https://pubmed.ncbi.nlm.nih.gov/36789935/

Additional information of El Mondo:
Find more information/studies on sugar-sweetened beverages consumption and obesity/overweight right here.

High β-carotene dietary intake reduces Parkinson's disease among women

Objectives:
Does high-dose dietary intake of vitamin E, β-carotene or vitamin C reduce risk of Parkinson's disease?

Study design:
This review article included 13 observational studies.

Results and conclusions:
The investigators found no significant association between high-dose vitamin C dietary intake and the risk of Parkinson's disease compared with low-dose vitamin C dietary intake [RR = 0.98, 95% CI = 0.89 to 1.08].

The investigators found compared with low-dose dietary intake, high-dose dietary intake of vitamin E significantly reduced risk of Parkinson's disease with 13% [RR = 0.87, 95% CI = 0.77 to 0.99].

The investigators found compared with low-dose dietary intake, high-dose dietary intake of β-carotene significantly reduced risk of Parkinson's disease among women with 22% [RR = 0.78, 95% CI = 0.64 to 0.96].

The investigators concluded both high-dose dietary intake of vitamin E and β-carotene (beta-carotene) reduce risk of Parkinson's disease.

Original title:
Vitamin C, vitamin E, β-carotene and risk of Parkinson's disease: a systematic review and dose-response meta-analysis of observational studies by Niu F, Xie W, […], Yu X.

Link:
https://pubmed.ncbi.nlm.nih.gov/36961747/

Additional information of El Mondo:
Find here more information/studies about RCTs/significant, vitamin C, E, beta-carotene and Parkinson’s disease.
 

50g/d legume dietary intake may reduce mortality from all causes

Objectives:
There is an equivocal and inconsistent association between legume consumption and health outcomes and longevity. Therefore, this review article has been conducted.

Does a higher legume dietary intake reduce mortality and stroke risk?

Study design:
This review article included 32 cohort studies (31 publications) involving 1,141,793 participants and 93,373 deaths from all causes (all-cause mortality).

The certainty of evidence was judged from low to moderate.

Results and conclusions:
The investigators found higher dietary intakes of legumes, compared with lower dietary intakes, were significantly associated with a reduced risk of 6% for mortality from all causes [HR = 0.94, 95% CI = 0.91 to 0.98, n = 27].

The investigators found higher dietary intakes of legumes, compared with lower dietary intakes, were significantly associated with a reduced risk of 9% for stroke [HR = 0.91, 95% CI = 0.84 to 0.99, n = 5].

The investigators found no significant association for cardiovascular diseases mortality [HR = 0.99, 95% CI = 0.91 to 1.09, n =11], coronary heart disease mortality [HR = 0.93, 95% CI = 0.78 to 1.09, n = 5] or cancer mortality [HR = 0.85, 95% CI = 0.72 to 1.01, n = 5].

The investigators found in the linear dose-response analysis, a 50 g/d increase in legume dietary intake was significantly associated with a 6% reduction in the risk of all-cause mortality [HR = 0.94, 95% CI = 0.89 to 0.99, n = 19], but no significant association was observed for the remaining outcomes.

The investigators concluded a higher legume dietary intake may reduce mortality from all causes and stroke risk. May reduce because the certainty of evidence is low to moderate.

Original title:
Legume Consumption and Risk of All-Cause and Cause-Specific Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies by Zargarzadeh N, Mousavi SM, […], Esmaillzadeh A.

Link:
https://pubmed.ncbi.nlm.nih.gov/36811595/

Additional information of El Mondo:
Find here more information/studies about RCTs/significant, vegetable intake and stroke prevention.
 

Fish consumption reduces Alzheimer's disease

Objectives:
Current findings about the differential effects of various sources of dietary animal protein on the risk of neurodegenerative diseases are contradictory. Therefore, this review article has been conducted.

Is there an association between various sources of dietary animal protein and the risk of Parkinson's disease, Alzheimer's disease, dementia and cognitive impairment?

Study design:
This review article included 33 prospective cohort studies.

Results and conclusions:
The investigators found dietary fish consumption was significantly associated with a reduced risk of 25% for Alzheimer's disease [RR = 0.75, 95% CI = 0.57 to 0.97].

The investigators found dietary fish consumption was significantly associated with a reduced risk of 16% for dementia [RR = 0.84, 95% CI = 0.75 to 0.93].

The investigators found dietary fish consumption was significantly associated with a reduced risk of 15% for cognitive impairment [RR = 0.85, 95% CI = 0.81 to 0.95].

The investigators found compared to the lowest consumption, the highest total dairy products consumption was significantly associated with an increased risk of 49% for Parkinson's disease [RR = 1.49, 95% CI = 1.06 to 2.10].

The investigators found compared to the lowest consumption, the highest milk consumption was significantly associated with an increased risk of 40% for Parkinson's disease [RR = 1.40, 95% CI = 1.13 to 1.73].

The investigators found total dairy products consumption was significantly associated with a reduced risk of 11% for cognitive impairment [RR = 0.89, 95% CI = 0.80 to 0.99].

The investigators found total meat consumption was significantly associated with a reduced risk of 28% for cognitive impairment [RR = 0.72, 95% CI = 0.57 to 0.90].

The investigators found poultry consumption was significantly associated with a reduced risk of 18% for cognitive impairment [RR = 0.82, 95% CI = 0.68 to 0.99].

The investigators found linear dose-response meta-analysis revealed that each 200g/d increase in total dairy dietary intake was significantly associated with an 11% higher risk of Parkinson's disease and a 12% lower risk of cognitive impairment.

The investigators found a strong linear association between fish consumption and reduced risk of dementia.

The investigators concluded dairy consumption, particularly milk is associated with an increased risk of Parkinson's disease, while a higher intake of fish reduces Alzheimer's disease, dementia and cognitive impairment. Future well-controlled, randomized clinical trials are essential to validate the present findings.

Original title:
Association between animal protein sources and risk of neurodegenerative diseases: a systematic review and dose-response meta-analysis by Talebi S, Asoudeh F, […], Mohammadi H.

Link:
https://pubmed.ncbi.nlm.nih.gov/36647769/

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Selenium supplementation reduces postpartum depression

Objectives:
The results of human studies are inconsistent regarding selenium and depressive disorders. Therefore, this review article has been conducted.

Does high selenium intake (through diet or supplements) reduce risk of depression?

Study design:
This review article included 20 studies (4 RCTs, 9 cross-sectional studies, 4 case-control studies and 3 prospective cohort studies) with a total of 47,164 participants.
The age of participants ranged from 18.0 ± 1.2 to 82 years old.
12 studies included both men and women.
Confounding variables were adjusted in half of included studies.
All included randomized controlled trials (RCTs) had high quality.
There was no publication bias.

Results and conclusions:
The investigators found no significant differences in serum selenium levels between patients with depression and healthy subjects [WMD = 2.12 mg/L, 95% CI = -0.11 to 4.36, I2 = 98.0%, p 0.001].

The investigators found no significant differences between serum levels of selenium and depression scores [r = -0.12, 95% CI = -0.33 to 0.08, I2 = 73.5%, p = 0.010].

The investigators found high selenium supplementation significantly reduced the risk of postpartum depression with 3% [OR = 0.97, 95% CI = 0.95 to 0.99, I2 = 0.0%, p = 0.507].

The investigators found selenium supplementation significantly reduced depressive symptoms [WMD = -0.37, 95% CI = -0.56 to -0.18, I2 = 0.0%, p = 0.959].

The investigators concluded that high selenium supplementation has a protective role against postpartum depression. In addition, supplementation with selenium reduces depressive symptoms. Nevertheless, further studies are needed to draw definitive conclusions.

Original title:
The role of selenium in depression: a systematic review and meta-analysis of human observational and interventional studies by Sajjadi SS, Foshati S, […], Rouhani H.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8776795/

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Tomato intake causally reduces TNF-α levels in adults

Objectives:
Inflammation is a major cause of chronic diseases. Several studies have investigated the effects of tomato intake on inflammatory biomarkers; however, the results are equivocal. Therefore, this review article has been conducted.

Does tomato intake have positive impact on inflammatory biomarkers in adults?

Study design:
This review article included 7 RCTs (8 treatment arms) with a total of 465 subjects.

Results and conclusions:
The investigators found that pooled effect size of articles indicated that tomato intake was not significantly effective on CRP [WMD = 0.13 mg/dL, 95% CI = -0.09 to 0.36, p = 0.23, I2 = 83.9%] and IL-6 [Hedges' g = -0.12, 95% CI = -0.36 to 0.13, p = 0.34, I2 = 0.0%] levels compared to the control group.

The investigators found that pooled effect size of articles indicated that tomato intake significantly reduced TNF-α [Hedges' g = -0.45, 95% CI = -0.76 to -0.13, p = 0.005, I2 = 0.0%] levels in adults.

The investigators concluded that tomato intake causally reduces TNF-α levels in adults. However, additional well-designed studies that include more diverse populations and longer duration are warranted.

Original title:
Effect of tomato consumption on inflammatory markers in health and disease status: A systematic review and meta-analysis of clinical trials by Widjaja G, Doewes RI, […], Aravindhan S.

Link:
https://pubmed.ncbi.nlm.nih.gov/35871957/

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Tumor necrosis factor alpha (TNF-α) is an inflammatory cytokine that is elevated in heart failure.

400 mg/day vitamin C supplementation improves lung function of COPD patients

Objectives:
Do COPD patients benefit from vitamin C supplementation?

Study design:
This review article included 10 RCTs with a total of 487 patients.

Results and conclusions:
The investigators found that vitamin C supplementation (≥400 mg/day) significantly improved the forced expiratory volume in one second as a percentage (FEV1%) of COPD patients [SMD = 1.08, 95% CI = 0.03 to 2.12, p = 0.04].

The investigators found, moreover, vitamin C supplementation (≥400 mg/day) significantly improved the ratio of forced expiratory volume in 1 second and forced vital capacity (FEV1/FVC) [WMD = 0.66, 95% CI = 0.26 to 1.06, p = 0.001], vitamin C level in serum [SMD = 0.63, 95% CI = 0.02 to 1.24, p = 0.04] and glutathione (GSH) level in serum [SMD = 2.47, 95% CI = 1.06 to 3.89, p = 0.0006] of COPD patients.

The investigators found no statistically significant difference was observed in body mass index (BMI), fat-free mass index (FFMI), vitamin E level and superoxide dismutase (SOD) level in serum.

The investigators concluded vitamin C supplementation increases the levels of antioxidation in serum (vitamin C and GSH) and improves lung function (FEV1% and FEV1/FVC) of COPD patients, especially when treated with vitamin C supplementation greater than 400 mg/day. However, further prospective studies are needed to explore the role of vitamin C in improving nutritional status.

Original title:
Efficacy of Vitamin C Supplementation on Chronic Obstructive Pulmonary Disease (COPD): A Systematic Review and Meta-Analysis by Lei T, Lu T, […], Liu J.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9473551/

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Vitamin E supplements enhance quality of life of rheumatoid arthritis patients

Objectives:
Do rheumatoid arthritis patients benefit from vitamin E supplements?

Study design:
This review article included 9 RCTs with a total of 39,845 patients.

Results and conclusions:
The investigators found that vitamin E supplements were shown to be more effective in individuals with rheumatoid arthritis for sensitive joints [MD = -1.66, 95% CI = -6.32 to -2.99, I2 = 93%, p 0.00001] and swollen joints [MD = -0.46, 95% CI = -1.98 to 1.07, I2 = 56%, p = 0.08].

The investigators concluded vitamin E's ability to restore the intestinal barrier and improve the gastrointestinal tract may be linked to the prevention and treatment of rheumatoid arthritis. Vitamin E supplements used on a regular basis can help individuals with rheumatoid arthritis reduce joint discomfort, edema and stiffness, as well as enhance their overall quality of life.

Original title:
Effect of vitamin E supplementation in rheumatoid arthritis: a systematic review and meta-analysis by Kou H, Qing Z, […], Ma J.

Link:
https://pubmed.ncbi.nlm.nih.gov/35468933/

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Meat intake may increase kidney stones

Objectives:
What is the association of total protein, animal protein and animal protein sources with risk of kidney stones in the general population?

Study design:
This review article included 14 prospective cohort studies.
According to NutriGrade scoring system, the credibility of evidence for most of the exposures was rated as low.
Some kind of publication bias was found in the association of animal protein intake and risk of kidney stones, according to Egger's and Begg's tests.
Sensitivity analysis of processed meat as well as dairy consumption with risk of kidney stones showed one study changed the overall estimate.

Results and conclusions:
The investigators found that higher dietary intake of non-dairy animal protein significantly increased risk of kidney stones with 11% [RR = 1.11, 95% CI = 1.03 to 1.20, I2 = 0%, n = 4].
Significant means that there is an association with a 95% confidence.

The investigators found that higher dietary intake of total meat and meat products significantly increased risk of kidney stones with 22% [RR = 1.22, 95% CI = 1.09 to 1.38, I2 = 13%, n = 3].
Significant because RR of 1 was not found in the 95% CI of 1.09 to 1.38. RR of 1 means no risk/association.

The investigators found that higher dietary intake of processed meat significantly increased risk of kidney stones with 22% [RR = 1.22, 95% CI = 1.10 to 1.51, I2 = 0%, n = 2]. 

The investigators found that higher intake of dairy protein significantly decreased risk of kidney stones with 9% [RR = 0.91, 95% CI = 0.84 to 0.99, I2 = 0%, n = 4].

The investigators found, moreover, each 100 gram increment of red meat dietary intake was significantly associated with an increased risk of 39% for kidney stones [RR = 1.39, 95% CI = 1.13 to 1.71].

The investigators concluded that higher dietary intake of meat and meat products may increase the risk of kidney stones in the general population, while higher dietary intake of dairy proteins may decrease the risk of kidney stones in the general population. May because the credibility of evidence for most of the exposures was rated as low and there was publication bias. Therefore, further observational studies are needed to confirm present results.

Original title:
Associations of Total Protein or Animal Protein Intake and Animal Protein Sources with Risk of Kidney Stones: A Systematic Review and Dose-Response Meta-Analysis by Asoudeh F, Talebi S, […], Mohammadi H.

Link:
https://pubmed.ncbi.nlm.nih.gov/35179185/

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When the credibility of evidence of the studies in the review article is low and there is publication bias, the results will not be very reliable.
 

High-dose dietary intake of vitamins A and B reduces glaucoma

Objectives:
There is currently a lack of high-quality research on the best dietary recommendations for patients with early glaucoma or at high risk for glaucoma. Therefore, this review article has been conducted.

Does a high dietary vitamin intake reduce risk of glaucoma?

Study design:
This review article included 8 cohort studies, with a total of 262,189 patients.

There was no publication bias.

Results and conclusions:
The investigators found that high-dose dietary intake of vitamins A was significantly associated with a 27% low risk of glaucoma [OR = 0.63, 95% CI = 0.53 to 0.76 , p 001, I2 = 49%].

The investigators found that high-dose dietary intake of vitamins B (a combination of B1, B2, B3, B6 and B12) was significantly associated with a 29% low risk of glaucoma [OR = 0.71, 95% CI = 0.64 to 0.80, p 0.001, I2 = 29%].

The investigators found no association between high-dose dietary intake of vitamins C, D or E and lower risk of glaucoma.

The investigators concluded that high-dose dietary intake of vitamins A and B, but not vitamins C, D or E, is associated with a low prevalence of glaucoma. Overall, middle-aged and elderly people or patients with early glaucoma should consume vitamin-rich foods rich or take additional vitamin supplements.

Original title:
Vitamin intake and glaucoma risk: A systematic review and meta-analysis by Han FF and Fu XX.             

Link:
https://www.sciencedirect.com/science/article/pii/S0181551222000419?via%3Dihub

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Higher intake of antioxidant-rich foods reduces Parkinson's disease

Objectives:
Does a higher intake of dietary antioxidants (like vitamin C and E, β-carotene, zinc, anthocyanins, lutein) reduce risk of Parkinson's disease (PD)?

Study design:
This review article included 6 prospective cohort studies and 2 nested case-control studies (448,737 participants with 4,654 persons with Parkinson's disease) and 6 case-control studies (1,948 persons without Parkinson's disease and 1, 273 persons with Parkinson's disease).

Results and conclusions:
The investigators found comparded to the lowest dietary vitamine E intake, that the highest dietary vitamine E intake significantly reduced risk of Parkinson's disease with 16% [pooled RR = 0.84, 95% CI = 0.71 to 0.99, n = 7 cohort studies].
Significantly means that there is an association with a 95% confidence.

The investigators found compared to the lowest dietary anthocyanins intake, that the highest dietary anthocyanins intake significantly reduced risk of Parkinson's disease with 24% [pooled RR = 0.76, 95% CI = 0.61 to 0.96, n = 2 cohort studies].
Significantly because pooled RR of 1 was not found in the 95% CI of 0.61 to 0.96. RR of 1 means no risk/association.

The investigators found compared to the lowest dietary lutein intake, that the highest dietary lutein intake significantly increased risk of Parkinson's disease with 86% [pooled RR = 1.86, 95% CI = 1.20 to 2.88, n = 3 case-control studies].

The investigators found in dose-response meta-analyses that every increment of dietary vitamin C intake with 50 mg/d significantly reduced risk of Parkinson's disease with 6% [RR = 0.94, 95% CI = 0.88 to 0.99, n = 6].

The investigators found in dose-response meta-analyses that every increment of dietary vitamin E intake with 5 mg/d significantly reduced risk of Parkinson's disease with 16% [RR = 0.84, 95% CI = 0.70 to 0.99, n = 7].

The investigators found in dose-response meta-analyses that every increment of dietary β-carotene intake with 2 mg/d significantly reduced risk of Parkinson's disease with 6% [RR = 0.94, 95% CI = 0.89 to 0.99, n = 6].

The investigators found in dose-response meta-analyses that every increment of dietary zinc intake with 1 mg/d significantly reduced risk of Parkinson's disease with 35% [RR = 0.65, 95% CI = 0.49 to 0.86, n = 1].

The investigators concluded that higher intake of antioxidant-rich foods reduces risk of Parkinson's disease. Future, well-designed prospective studies are needed to validate the present findings.

Original title:
Dietary Antioxidants and Risk of Parkinson's Disease: A Systematic Review and Dose-response Meta-analysis of Observational Studies by Talebi S, Ghoreishy SM, […], Mohammadi H.

Link:
https://pubmed.ncbi.nlm.nih.gov/35030236/

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High protein diets causally have beneficial effect on body weight management

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

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

There was no publication bias.

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

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

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

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

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

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

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

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

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

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

 

High circulating vitamin C level reduces metabolic syndrome

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

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

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

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

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

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

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

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

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

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

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

 

Carbohydrate intake increases metabolic syndrome

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

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

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

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

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

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

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

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

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

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

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

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No difference in seroconversion between 3 doses of fIPV and 3 doses of full-dose poliovirus vaccine

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

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

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

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

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

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

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

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

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

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0.8-10 mg/d folic acid supplements decrease CRP levels

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

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

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

There was no publication bias.

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

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

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

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

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Poultry consumption decreases metabolic syndrome

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

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

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

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

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

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

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

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

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

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

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Low vitamin D level increases asthma in children

Objectives:
The association between serum 25-hydroxyvitamin D 25(OH)D level (vitamin D level in blood) and asthma occurrence in children was controversial. Therefore, this review article has been conducted.

Does a low vitamin D level increase risk of asthma occurrence in children?

Study design:
This review article included 35 studies with 5,711 children with asthma and 21,561 children without asthma. Among them, 24 studies were included for analyzing the association between 25(OH)D level and asthma and 12 studies evaluated the treatment effect of vitamin D.

Results and conclusions:
The investigators found that the children with asthma had significant lower 25(OH)D level than children without asthma [21.7 ng/mL versus 26.5 ng/mL, SMD = -1.36, 95% CI = -2.40 to -0.32, p = 0.010].

The investigators found, besides, children with asthma treated with vitamin D supplement had a significantly lower recurrence rate of 65% than the placebo group [18.4% versus 35.9%, RR = 0.35, 95% CI = 0.35 to 0.79, p = 0.002].

The investigators concluded that children with asthma have a lower 25(OH)D level than healthy children. Vitamin D supplement could decrease the asthma recurrence rate in the follow-up years.

Original title:
Vitamin D and asthma occurrence in children: A systematic review and meta-analysis by Wang Q, Ying Q, [...], Chen J.

Link:
https://pubmed.ncbi.nlm.nih.gov/34366195/

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Low vitamin D level increases acne

Objectives:
Vitamin D deficiency is frequently associated with several medical conditions. However, a comprehensive meta-analysis assessing the association between vitamin D level and acne is lacking. Therefore, this review article (meta-analysis) has been conducted.

Does a low vitamin D level (expressed as circulating 25(OH)D levels) increase risk of both acne and acne severity?

Study design:
This review article included 13 articles with a total of 1,362 acne patients and 1,081 healthy controls (persons without acne).

Results and conclusions:
The investigators found that the circulating 25(OH)D levels were significantly lower in patients with acne than in healthy controls [pooled MD = -9.02 ng/mL, 95% CI = -13.22 to -4.81, p 0.0001].

The investigators found that vitamin D deficiency was more prevalent in acne patients than in healthy controls [pooled OR = 2.97, 95% CI = 1.68 to 5.23, I2 = 72%].

The investigators found that vitamin D levels were negatively correlated with acne severity.

The investigators concluded that the vitamin D levels are low in acne patients. Also, there is evidence of an inverse association between vitamin D levels and acne severity. Therefore, vitamin D might be involved in the pathogenesis (the manner of development of a disease) of acne.

Original title:
Association between Vitamin D Level and Acne, and Correlation with Disease Severity: A Meta-Analysis by Hasamoh Y, Thadanipon K, […], Juntongjin P.

Link:
https://pubmed.ncbi.nlm.nih.gov/34348293/

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Nut consumption does not increase adiposity

Objectives:
Nuts are recommended for cardiovascular health, yet concerns remain that nuts may contribute to weight gain due to their high energy density. Therefore, this review article has been conducted.

Does nut consumption contribute to an increased adiposity risk?

Study design:
This review article included 6 prospective cohort studies with 569,910 participants and 86 RCTs with 114 comparisons and 5,873 participants.

Results and conclusions:
The investigators found nuts consumption was significantly associated with a lower risk of 7% for incidence of overweight/obesity [RR = 0.93, 95% CI = 0.88 to 0.98, p 0.001, moderate certainty of evidence] in prospective cohort studies.

The investigators found RCTs showed no adverse effect of nuts on body weight [MD = 0.09 kg, 95% CI = -0.09 to 0.27 kg, p 0.001, high certainty of evidence].

The investigators found meta-regression showed that higher nut intake was significantly associated with reductions in body weight and body fat.

The investigators concluded that current evidence demonstrates the concern that nut consumption contributes to increased adiposity appears unwarranted.

Original title:
Are fatty nuts a weighty concern? A systematic review and meta-analysis and dose-response meta-regression of prospective cohorts and randomized controlled trials by Nishi SK, Viguiliouk E, [...], Sievenpiper JL.

Link:
https://pubmed.ncbi.nlm.nih.gov/34494363/

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Selenium supplementation decreases hs-CRP level among patients with metabolic diseases

Objectives:
Selenium (Se) is a trace element having significant effects on human metabolism. Recent studies suggest that selenium supplementation have a pivotal effect on the inflammatory markers. Therefore, this review article has been conducted.

Does selenium supplementation reduce plasma inflammatory markers including C-reactive protein (CRP) and high-sensitivity C-reactive protein (hs-CRP) and nitric oxide (NO) as a stress oxidative index, among patients with metabolic diseases?

Study design:
This review article included 7 RCTs.

Results and conclusions:
The investigators found subgroup analysis of CRP type showed that selenium supplementation significantly decreased hs-CRP level [pooled SMD = -0.44, 95% CI = -0.67 to -0.21] among patients with metabolic diseases.

The investigators concluded that selenium supplementation decreases hs-CRP level among patients with metabolic diseases.

Original title:
The effects of dietary selenium supplementation on inflammatory markers among patients with metabolic diseases: a systematic review and meta-analysis of randomized controlled trials by Djalalinia S, Hasani M, […], Qorbani M.

Link:
https://pubmed.ncbi.nlm.nih.gov/34222098/

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NAC supplementation could improve lung function in patients with acute exacerbation of chronic obstructive pulmonary disease

Objectives:
Whether N-acetylcysteine (NAC) therapy can promote the improvement of clinical symptoms and lung function in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has not been verified by large-scale randomized controlled trials, only a few small sample studies. Therefore, this review article has been conducted.

Does n-acetylcysteine (NAC) supplementation improve clinical symptoms and lung function in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD)?

Study design:
This review article included 12 retrospective analyses and 3 randomized controlled trials (RCTs) with 1,605 patients.
The 15 included studies were small sample studies, with sample sizes ranging from 72 to 146.

9 studies had a Jadad score of 3-5 points and 6 studies had a Jadad score of 1-2 points.

Results and conclusions:
The investigators found the meta-analysis results of 10 studies (525 cases in the n-acetylcysteine group and 524 cases in the control group) showed that the forced expiratory volume in the first second (FEV1) of the n-acetylcysteine group was markedly higher than that of the control group; the mean difference was 30.63 [95% CI = 25.48 to 35.78, I2 = 92%] and the difference was statistically significant [z = 11.65 and p 0.0001].

The investigators found the meta-analysis results of 6 studies (347 cases in the n-acetylcysteine group and 350 cases in the control group) showed that forced expiratory volume in the first second/forced vital capacity (FEV1/FVC) of the n-acetylcysteine group was markedly higher than that of the control group; the mean difference was 30.42 [95% CI = 24.00 to 36.85, I2 = 93%] and the difference was statistically significant [z = 9.28 and p 0.0001].

The investigators found the meta-analysis results of 6 studies (323 cases in the n-acetylcysteine group and 322 cases in the control group) showed that the glutathione sulfur transferase (GSH-ST) activity of the n-acetylcysteine group was notably greater than that of the control group; the mean difference was 3.10 [95% CI = 1.38 to 4.82, I2 = 91%] and the difference was statistically significant [z = 3.63, p = 0.0004].

The investigators found the meta-analysis results of 4 studies (224 cases in the n-acetylcysteine group and 227 cases in the control group) showed that the ability of the n-acetylcysteine group to inhibit hydroxyl free radicals was higher than that of the control group; the mean difference was 77.52 [95% CI = 61.01 to 94.03, I2 = 44%] and the difference was statistically significant [z = 9.20 and p 0.0001]. 

The investigators found the meta-analysis results of 4 studies (224 cases in the n-acetylcysteine group and 227 cases in the control group) showed that the superoxide anion radical resistance ability of the n-acetylcysteine group was greater than the ability of the control group; the mean difference was 47.75 [95% CI = 36.26 to 59.25, I2 = 35%] and the difference was statistically significant [z = 8.14 and p 0.0001]. 

The investigators concluded n-acetylcysteine (NAC) supplementation could promote the symptom improvement rate of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), improve lung function in FEV1 and FEV1/FVC and enhance the body’s antioxidant capacity. Could because the sample size of the literature included in this review article was small. The sample size should be expanded in future randomized controlled trials to verify these findings. All in all, the results of this review article can provide a reliable theoretical basis for the clinical treatment of AECOPD, so that patients can benefit from NAC treatment.

Original title:
Systematic review and meta-analysis of the efficacy of N-acetylcysteine in the treatment of acute exacerbation of chronic obstructive pulmonary disease by Jiang C, Zou J, [...], Yang Y.

Link:
https://apm.amegroups.com/article/view/72787/html

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An acute exacerbation of chronic obstructive pulmonary disease is a sudden worsening of chronic obstructive pulmonary disease (COPD) symptoms including shortness of breath, quantity and color of phlegm that typically lasts for several days.
 

Zinc supplementation does not increase brain derived neurotrophic factor levels

Objectives:
Zinc in one of the most abundant trace minerals in human body which is involved in numerous biological pathways and has variety of roles in the nervous system. It has been assumed that zinc exerts its role in nervous system through increasing brain derived neurotrophic factor (BDNF) concentrations. Therefore, this review article has been conducted.

Does zinc supplementation increase brain derived neurotrophic factor (BDNF) levels?

Study design:
This review article included 5 studies with 238 participants. These studies enrolled subjects with premenstrual syndrome, diabetic retinopathy, major depression disorder, overweight/obese and obese with mild to moderate depressive disorders.

Funnel plot did not suggest publication bias.

Results and conclusions:
The investigators found zinc supplementation failed to increase blood brain derived neurotrophic factor concentrations with effect size of 0.30 [95% CI = -0.08 to 0.67, p = 0.119].

The investigators concluded zinc supplementation does not increase brain derived neurotrophic factor (BDNF) levels. However, the small number of included articles and significant heterogeneity between them can increase the risk of a false negative result; therefore, the results should be interpreted with caution.

Original title:
The effect of zinc supplementation on brain derived neurotrophic factor: A meta-analysis by Jafari F, Mohammadi H and Amani R.

Link:
https://pubmed.ncbi.nlm.nih.gov/33831797/

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Brain Derived Neurotrophic Factor (BDNF) plays an important role in neuronal survival and growth, serves as a neurotransmitter modulator and participates in neuronal plasticity, which is essential for learning and memory.
Decreased levels of BDNF are associated with neurodegenerative diseases with neuronal loss, such as Parkinson's disease, Alzheimer's disease, multiple sclerosis and Huntington's disease.