Nutritional advice

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Does mushroom consumption reduce all-cause mortality?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Objectives:
Findings on the link between dietary intakes of monounsaturated fatty acids (MUFA) and risk of mortality are conflicting. Therefore, this review article has been conducted.

Does monounsaturated fatty acids dietary intake reduce risk of mortality?

Study design:
This review article included 17 prospective cohort studies with a total of 1022,321 participants aged ≥ 20 years, of which 191,283 all-cause deaths, 55,437 cardiovascular diseases (CVD) deaths and 64,448 cancer deaths.

Results and conclusions:
The investigators found combining 15 effect sizes from 11 studies, monounsaturated fatty acids dietary intake was significantly associated with a reduced risk of 6% for all-cause mortality [RR = 0.94, 95% CI = 0.90 to 0.98, I2 = 55.5%, p = 0.005].
Significantly because RR of 1 was not found in the 95% CI of 0.90 to 0.98. RR of 1 means no risk/association.

The investigators found based on 17 effect sizes from 11 studies, no significant association between monounsaturated fatty acids dietary intake and risk of cardiovascular diseases mortality [RR = 0.95, 95% CI = 0.89 to 1.01, I2 =37.0%, p = 0.06].
No significant means that there is no association with a 95% confidence.

The investigators found when combining 10 effect sizes from 6 studies, monounsaturated fatty acids dietary intake was not significantly associated with cancer mortality [RR = 0.99, 95% CI = 0.96 to 1.03, I2 = 13.3%, p = 0.32].  
Not significantly because RR of 1 was found in the 95% CI of 0.96 to 1.03. RR of 1 means no risk/association.

The investigators found an additional 5% of energy (5 En%) from monounsaturated fatty acids was significantly associated with a 3% reduced risk of all-cause mortality [RR = 0.97, 95% CI = 0.96 to 0.98], but not with cardiovascular diseases [RR = 0.98, 95% CI = 0.95 to 1.01] and cancer mortality [RR = 0.99, 95% CI = 0.97 to 1.01].

The investigators concluded that monounsaturated fatty acids dietary intake reduces risk of all-cause mortality.

Original title:
Dietary intakes of monounsaturated fatty acids and risk of mortality from all causes, cardiovascular disease and cancer: A systematic review and dose-response meta-analysis of prospective cohort studies by Lotfi K, Salari-Moghaddam A, […], Esmaillzadeh A.

Link:
https://pubmed.ncbi.nlm.nih.gov/34560281/

Additional information of El Mondo:
Find more information/studies on fatty acids, cardiovascular disease and elderly right here.

Objectives:
Despite growing evidence that type 2 diabetes is associated with dementia, the question of whether intensive glucose control can prevent or arrest cognitive decline remains unanswered. Therefore, this review articles (meta-analysis) has been conducted.

Does intensive glucose control slow down cognitive decline in persons with type 2 diabetes?

Study design:
This review article included 5 cohort studies with 16,584 participants.
The mean follow-up duration ranged from 3.5 to 10 years.
The mean age of participants in the studies included in the current meta-analysis was 65.6 years at the initiation of the studies and the proportion of women was 40.8%.
All quality assessment scores fell in the range of 8 or 9, indicating high quality.
There was no publication bias.

Results and conclusions:
The investigators found a significantly poorer decline in cognitive function in the intensive glucose control group [β = -0.03, 95% CI = -0.05 to -0.02] than in the conventional glucose control group.

The investigators found, subgroup analysis showed a significant difference in the change in cognitive performance in composite cognitive function [β = -0.03, 95% CI = -0.05 to -0.01] and memory [β = -0.13, 95% CI = -0.25 to -0.02].

The investigators concluded that intensive glucose control in persons with type 2 diabetes slows down cognitive decline, especially the decline in composite and memory function. The impact of intensive glucose control on the brain structural abnormalities and risk of dementia needs further rigorously designed studies to validate these findings. Also, replicating and validating these findings is warranted.

Original title:
Impact of Intensive Glucose Control on Brain Health: Meta-Analysis of Cumulative Data from 16,584 Patients with Type 2 Diabetes Mellitus by Tang X, Cardoso MA, […], Simó R.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7947088/

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

Objectives:
Magnesium supplementation is often purported to improve sleep; however, as both an over-the-counter sleep aid and a complementary and alternative medicine, there is limited evidence to support this assertion. Therefore, this review article (meta-analysis) has been conducted.

Does magnesium supplementation improve sleep in older adults with insomnia?

Study design:
This review article included 3 randomized control trials (RCTs), comparing oral magnesium to placebo in 151 older adults in 3 countries.

All 3 RCTs were at moderate-to-high risk of bias and outcomes were supported by low to very low quality of evidence.

Daily elemental magnesium intake ranged from 320 mg to 729 mg taken 2 to 3 times per day using 2 formulations (magnesium oxide and magnesium citrate tablets).
Duration of follow-up for outcome assessment ranged from 20 days to 8 weeks.

Results and conclusions:
The investigators found pooled analysis showed that post-intervention sleep onset latency time was significantly 17.36 min less [95% CI = -27.27 to -7.44, p = 0.0006] after magnesium supplementation compared to placebo.
Significantly because the calculated p-value of = 0.0006 was less than the p-value of 0.05.

The investigators found pooled analysis showed that total sleep time improved by 16.06 min in the magnesium supplementation group but was statistically insignificant [95% CI = - 5.99 to 38.12, p = 0.15].
Insignificant because the calculated p-value of 0.15 was larger than the p-value of 0.05.

The investigators concluded that RCT evidence may support oral magnesium supplements (less than 1 g quantities given up to 3 times a day) for insomnia symptoms in older adults. May support because all 3 RCTs are at moderate-to-high risk of bias and outcomes are supported by low to very low quality of evidence.

Original title:
Oral magnesium supplementation for insomnia in older adults: a Systematic Review & Meta-Analysis by Mah J and Pitre T.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8053283/

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

Magnesium oxide contains 60% elemental magnesium and magnesium citrate contains 16% elemental magnesium.
So if you want to get 320 mg elemental magnesium from magnesium supplements, you have to take 534 mg magnesium oxide supplements or 2000 mg magnesium citrate.

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

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

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

The NOS score was 8.

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

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

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

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

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

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

Additional information of El Mondo:
Find more information/studies on alcohol, coffee and tea consumption and dementia right here.

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

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

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

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

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

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

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

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

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

Additional information of El Mondo:
Find more information/studies on magnesium consumption, cardiovascular disease and cancer right here.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Does alcohol consumption increase risk of fractures?

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

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

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

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

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

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

Additional information of El Mondo:
Find more information/studies on alcohol and osteoporosis right here.
 

Objectives:
Recent evidence suggests that diet can modify the risk of future cognitive impairment and dementia. A biologically plausible rationale and initial clinical data indicate that the antioxidant activities of dietary carotenoids may assist the preservation of cognitive function. Therefore, this review article has been conducted.

Does carotenoid supplementation improve cognitive performance among healthy adults?

Study design:
This review article included 9 RCTs, involving 2,228 subjects in the treated group (group with carotenoid supplementation) and 2,174 subjects in control group (group without carotenoid supplementation).
The age of all participants varied from 45 to 78 years.
The majority of clinical trials assessed the effect of xanthophylls such as lutein, zeaxanthin, and astaxanthin, whereas only 1 study determined the effects of β-carotene.
The duration of carotenoid supplementation ranged from 2 weeks to 12 months.
The dosage of carotenoids administered in the studies ranged from 0.5 mg/d to 50 mg/d.
There was no evidence of publication bias.

Results and conclusions:
The investigators found results of the pooled meta-analysis showed a significant effect of carotenoid intervention on cognitive outcomes [Hedge's g = 0.14, 95% CI = 0.08 to 0.20, p 0.0001, I2 = 0.00%].
The sensitivity analysis did not change the overall findings obtained from the primary analysis.

The investigators concluded that these results highlight the potential role of carotenoids (0.5 mg/d to 50 mg/d) in the protection of mental functions even in subjects (healthy participants aged 45-78 years) without cognitive impairment. This is particularly important because the population is aging and preservation of cognitive function is crucial for individual autonomy and quality of life, even in non-demented subjects. Further well-powered and long-term trials are required to determine treatment duration, type of carotenoid and optimal dosage.

Original title:
Carotenoids and Cognitive Outcomes: A Meta-Analysis of Randomized Intervention Trials by Davinelli S, Ali S, […], Corbi G.

Link:
https://www.mdpi.com/2076-3921/10/2/223/htm

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

Objectives:
Increasing macular pigment optical density (MPOD) as a result of increased macular concentration of lutein and zeaxanthin may reduce the risk of age-related macular degeneration (AMD). Therefore, this review article has been conducted.

Have daily egg consumption beneficial effects on macular pigment optical density and serum lutein levels?

Study design:
This review article included 5 RCTs with a total of 296 participants.
There was no heterogeneity between studies.

Results and conclusions:
The investigators found that egg consumption significantly increased macular pigment optical density [WMD = +0.037, 95% CI = 0.004 to 0.069, p = 0.027] and serum lutein levels [WMD = +0.150 μmol/L, 95% CI = 0.037 to 0.263, p = 0.009].

The investigators found subgroup analyses showed that egg consumption had a larger effect on macular pigment optical density in studies with a parallel design and increased serum lutein levels to a greater extent in a healthy population.

The investigators concluded daily egg consumption have beneficial effects on macular pigment optical density and serum lutein level is inversely associated with reduced age-related macular degeneration progression. Further clinical trials are required to confirm the results of this review article.

Original title:
A positive effect of egg consumption on macular pigment and healthy vision: a systematic review and meta-analysis of clinical trials by Sikaroudi MK, Saraf-Bank S, […], Soltani S.

Link:
https://pubmed.ncbi.nlm.nih.gov/33491232/

Additional information of El Mondo:
Find here more information/studies about review article/significant, egg consumption and elderly diseases.
 

Objectives:
Does a high dietary intake of β-cryptoxanthin reduce the risk of osteoporosis and hip fracture?

Study design:
This review article included 7 cohort studies, 4 case-control studies and 4 cross-sectional studies with a total of 100,496 individuals.
The methodological qualities of all studies were rated as “fair” to “good”.
The number of populations in each study ranged from 59 to 25,566.

Results and conclusions:
The investigators found that a high dietary intake of β-cryptoxanthin significantly reduced risk of osteoporosis with 24% [OR = 0.76, 95% CI = 0.66 to 0.88, p = 0.0002, I2 = 36%, p = 0.11].

The investigators found in subgroup analysis that a high dietary intake of β-cryptoxanthin significantly reduced risk of osteoporosis with 28% [OR = 0.72, 95% CI = 0.58 to 0.91, p = 0.005, I2 = 59%] among women.

The investigators found in subgroup analysis that a high dietary intake of β-cryptoxanthin significantly reduced risk of osteoporosis with 20% [OR = 0.80, 95% CI = 0.65 to 1.00, p = 0.005, I2 = 11%] among men.

The investigators found that a high dietary intake of β-cryptoxanthin significantly reduced risk of hip fracture with 28% [OR = 0.72, 95% CI = 0.60 to 0.87, p = 0.0008, I2 = 55%].

The investigators found in subgroup analysis that a high dietary intake of β-cryptoxanthin significantly reduced risk of hip fracture with 29% [OR = 0.71, 95% CI = 0.54 to 0.94, p = 0.02, I2 = 71%] among women. 

The investigators concluded that a high dietary intake of β-cryptoxanthin reduces the risk of osteoporosis and hip fracture. Further longitudinal studies are needed to validate the causality of current findings.

Original title:
Effects of β-Cryptoxanthin on Improvement in Osteoporosis Risk: A Systematic Review and Meta-Analysis of Observational Studies by Kim SJ, Anh NH, […], Kwon SW.

Link:
https://www.mdpi.com/2304-8158/10/2/296/htm

Additional information of El Mondo:
Find more information/studies on β-cryptoxanthin and osteoporosis right here.
 

Objectives:
Can the biomarker miRNAs predict Alzheimer's disease?

Study design:
This review article included 10 studies containing 770 Alzheimer's disease and 664 normal controls (persons without Alzheimer's disease).

Results and conclusions:
The investigators found miRNAs presented excellent diagnostic performance and the overall sensitivity was 0.80 [95% CI = 0.75-0.83], specificity was 0.83 [95% CI = 0.78-0.87] and diagnostic odds ratio was 14 [95% CI = 11-19].

The investigators found subgroup analysis suggested that the Caucasian group and blood group showed a better performance in Alzheimer's disease diagnosis and the diagnostic odds ratio was 42 and 34, respectively.

The investigators concluded that miRNAs may be a promising biomarker for Alzheimer's disease.

Original title:
Blood circulating miRNAs as biomarkers of Alzheimer's disease: a systematic review and meta-analysis by Zhang YH, Bai SF and Yan JQ.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31385521

Additional information of El Mondo:
Find more information/studies on dementia and elderly.

Objectives:
Does alcohol consumption increase of risk of osteoporosis?

Study design:
This review article included  3 case control studies, 2 cohort studies and 1 cross-sectional study.

Results and conclusions:
The investigators found no association between consuming 0.5-1 drinks per day and the risk of developing osteoporosis [adjusted RR = 1.38, 95% CI = 0.90-2.12].
No association because RR of 1 was found in the 95% CI of 0.90 to 2.12. RR of 1 means no risk/association.

The investigators found compared with abstainers of alcohol, persons consuming 1-2 drinks per day had 1.34 times the risk of developing osteoporosis [adjusted RR = 1.34, 95% CI = 1.11-1.62].

The investigators found compared with abstainers of alcohol, persons consuming 2 drinks or more per day had 1.63 times the risk of developing osteoporosis [adjusted RR = 1.63, 95% CI = 1.01-2.65].

The investigators found a positive association between alcohol consumption and osteoporosis in the case-control studies [adjusted OR = 2.95, 95% CI = 1.78-4.90].

The investigators concluded there is a positive relationship between alcohol consumption, particularly 1 drink or more per day and osteoporosis.

Original title:
The effect of alcohol on osteoporosis: A systematic review and meta-analysis by Cheraghi Z, Doosti-Irani A, Almasi-Hashiani A, […], Mansournia MA.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30844616

Additional information of El Mondo:
Find more information/studies on alcohol consumption and elderly.

Objectives:
Do older adults benefit from high protein intake (>0.8 g/kg body weight/day)?

Study design:
This review article included 12 cohort studies and 1 RCT.
Studies had an intervention duration of at least 6 months.

Results and conclusions:
The investigators found meta-analysis of the cohort studies showed that high vs low protein intake resulted in a statistically significant decrease of 11% for hip fractures [pooled HR = 0.89, 95% CI = 0.84 to 0.94, p 0.001, I2 = 0.0%, p = 0.614].
Sensitivity analyses showed that there was no single study affecting the overall estimate considerably.

The investigators concluded there is an association between a dietary protein intake above the current RDA of 0.8 g/kg body weight/day and a reduced hip fracture risk in older adults. In comparison with younger adults, the body of evidence from the included studies is not strong enough to increase the protein recommendation for older adults with respect to bone health.

Original title:
High Versus low Dietary Protein Intake and Bone Health in Older Adults: a Systematic Review and Meta-Analysis by Groenendijk I, den Boeft L , [...], de Groot LCPGM.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6704341/

Additional information of El Mondo:
Find more information/studies on protein and elderly.

A protein intake higher than 0.8 g/kg body weight/day corresponds to a diet with a minimum of 11 En% protein. The easiest way to follow a diet with at least 11 En% protein is to choose only products that contain at least 11 En% protein. These products from the supermarket contain at least 11% En% protein.
 

Objectives:
Do low folate levels and vitamin B12 levels increase risk of depression among the aged people?

Study design:
This review article included both gender data of 11 folate-related (7,949 individuals) and 9 B12-related studies (6,308 individuals) and gender-specific data of 4 folate-related (3,409 individuals) and 3 B12-related studies (1,934 individuals).

Results and conclusions:
The investigators found low folate levels significantly increased risk of depression among the aged people with 23% [OR =1.23, 95% CI =1.07-1.43]. 

The investigators found low vitamin B12 levels significantly increased risk of depression among the aged people with 20% [OR =1.20, 95% CI =1.02-1.42]. 

The investigators found in subgroup analysis low vitamin B12 levels significantly increased risk of depression among the aged women with 33% [OR =1.33, 95% CI =1.02-1.74]. 

The investigators concluded both low folate levels and low vitamin B12 levels increase risk of depression among the aged people.

Original title:
Folate and B12 serum levels in association with depression in the aged: a systematic review and meta-analysis by Petridou ET, Kousoulis AA, [...], Stefanadis C.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/26055921

Additional information of El Mondo:
Find more information/studies on vitamin B12, folate and elderly.
 

Objectives:
Findings from observational studies and clinical trials on the associations between vitamin E and dementia remain controversial. Therefore, this review article has been conducted.

Do low vitamin E levels increase risk of Alzheimer's disease (AD) or age-related cognitive deficits and mild cognitive impairment (MCI)?

Study design:
This review article included 31 studies.

Results and conclusions:
The investigators found individuals with Alzheimer's disease had lower circulatory concentrations of α-tocopherol (vitamin E) compared with healthy controls [SMD = -0.97, 95% CI = -1.27 to -0.68, p  0.00001].

The investigators found individuals with age-related cognitive deficits had lower circulatory concentrations of α-tocopherol (vitamin E) compared with healthy controls [SMD = -0.72, 95% CI = -1.12 to -0.32, p  0.0005].

The investigators found individuals with mild cognitive impairment had lower circulatory concentrations of α-tocopherol (vitamin E) compared with healthy controls [SMD = -0.72, 95% CI = -1.12 to -0.32, p  0.0005].

The investigators found levels of β-, γ- and δ-tocopherols did not significantly differ between groups of Alzheimer's disease and age-related cognitive deficits compared to controls.

The investigators concluded that lower α-tocopherol (vitamin E) levels have a strong association with Alzheimer's disease and mild cognitive impairment supporting evidence for the role of diet and vitamin E in Alzheimer's disease risk and age-related cognitive decline.

Original title:
A meta-analysis of peripheral tocopherol levels in age-related cognitive decline and Alzheimer's disease by Ashley S, Bradburn S and Murgatroyd C.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31661399

Additional information of El Mondo:
Find more information/studies on vitamin E and elderly.
 

Objectives:
Serum uric acid (SUA) accounts for about 50% of extracellular antioxidant activity, suggesting that hyperuricemia (an abnormally high level of uric acid in the blood) may have a protective role in diseases characterized by high levels of oxidative stress, such as osteoporosis. Therefore, this review article has been conducted.

Does a high serum uric acid level (also called hyperuricemia) increase bone mineral density (BMD)?

Study design:
This review article included 19 cross-sectional studies with a total of 55,859 participants.

Results and conclusions:
The investigators found in 6 studies that subjects with higher serum uric acid levels had significantly higher bone mineral density values for the spine [SMD = 0.29, 95% CI = 0.22-0.35, I2 = 47%].
Simple correlation analyses substantially confirmed this finding.

The investigators found in 7 studies that subjects with higher serum uric acid levels had significantly higher bone mineral density values for total hip [SMD = 0.29, 95% CI = 0.24-0.34, I2 = 33%].
Simple correlation analyses substantially confirmed this finding.

The investigators found in 6 studies that subjects with higher serum uric acid levels had significantly higher bone mineral density values for femoral neck [SMD = 0.25, 95% CI = 0.16-0.34, I2 = 71%].
Simple correlation analyses substantially confirmed this finding.

The investigators found in 3 studies that an increase of one standard deviation in serum uric acid levels significantly reduced risk of new fractures with 17% [HR = 0.83, 95% CI = 0.74-0.92, I2 = 0%].

The investigators found no significant differences between men and women, although data about women were limited.

The investigators concluded a high serum uric acid level is independently associated with higher bone mineral density values and a lower risk of fractures, supporting a protective role for uric acid in bone metabolism disorders.

Original title:
Hyperuricemia protects against low bone mineral density, osteoporosis and fractures: a systematic review and meta-analysis by Veronese N, Carraro S, […], Cereda E.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/27636234

Additional information of El Mondo:
Find more information/studies on elderly.
 

Objectives:
Do dietary intakes of soy, soy isoflavones and soy protein reduce risk of mortality from all causes, cancers and cardiovascular diseases?

Study design:
This review article included 23 prospective cohort studies with an overall sample size of 330,826 participants.

Results and conclusions:
The investigators found soy/soy products consumption significantly reduced risk of mortality from cancers with 12% [pooled relative risk = 0.88, 95% CI = 0.79 to 0.99, p = 0.03, I2 = 47.1%].

The investigators found soy/soy products consumption significantly reduced risk of mortality from cardiovascular diseases with 15% [pooled effect size = 0.85, 95% CI = 0.72 to 0.99, p = 0.04, I2 = 50.0%].

The investigators found such significant associations were also observed for all-cause mortality in some subgroups of the included studies, particularly those with higher quality.

The investigators found in addition, higher dietary intake of soy was associated with decreased risk of mortality from gastric, colorectal and lung cancers as well as ischemic cardiovascular diseases.

The investigators found participants in the highest category of dietary soy isoflavones intake had a 10% lower risk of all-cause mortality compared with those in the lowest category.

The investigators found that a 10-mg/day increase in dietary intake of soy isoflavones was associated with 7% and 9% decreased risk of mortality from all cancers and breast cancer, respectively.

The investigators found for each 5-g/day increase in consumption of soy protein a 12% reduction in breast cancer death.

The investigators found, however, dietary intake of soy protein was not significantly associated with all-cause and cardiovascular diseases mortality.

The investigators concluded that soy and its isoflavones consumption favorably influence risk of mortality. In addition, soy protein dietary intake is associated with a decreased risk in the mortality of breast cancer. These findings support the current recommendations to increase intake of soy for greater longevity.

Original title:
Soy, Soy Isoflavones, and Protein Intake in Relation to Mortality from All Causes, Cancers, and Cardiovascular Diseases: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies by Nachvak SM, Moradi S, […], Sadeghi O.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31278047

Additional information of El Mondo:
Find more information/studies on soy consumption, cardiovascular diseases and breast cancer right here.

 

Objectives:
Does a high blood homocysteine level increase risk of cognitive impairment, like Alzheimer's disease and vascular dementia?

Study design:
This review article included 28 prospective cohort studies with 2,557 cases (1,035 all-cause dementia, 530 Alzheimer's disease, 92 vascular dementia and >900 cognitive impairment without dementia (CIND)) among 28,257 participants.
 
The average follow-up period ranged from 2.7 to 35 years.

There was no clear evidence of publication bias with Begg's and Egger's tests for Alzheimer dementia [p = 0.806, 0.084, respectively].

Results and conclusions:
The investigators found there was a clear linear dose-response relationship between blood homocysteine concentration and risk of Alzheimer-type dementia [p > 0.05 for non-linearity].

The investigators found for every 5 μmol/L increase in blood homocysteine a significantly increased risk of 15% [pooled RR = 1.15, 95% CI = 1.04 to 1.26, I2 = 56.6%, n = 5] for Alzheimer-type dementia.
Sensitivity analysis showed similar results.

The investigators found due to the presence of publication bias and low statistical power, elevated levels of blood homocysteine were not appreciably associated with risk of all-cause, vascular dementia and cognitive impairment without dementia.

The investigators concluded every 5 μmol/L increase in blood homocysteine is linearly associated with a 15% increase in relative risk of Alzheimer-type dementia.

Original title:
Hyperhomocysteinemia and risk of incident cognitive outcomes: An updated dose-response meta-analysis of prospective cohort studies by Zhou F and Chen S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30826501

Additional information of El Mondo:
Find more information/studies on Alzheimer disease.
 

Objectives:
Although intake of fruits and vegetables seemed to have a protective effect on bone metabolism, its effect on fractures remains uncertain. Therefore, this review article has been conducted.

Does intake of fruits and vegetables reduce risk of fractures?

Study design:
This review article included 6 cohort studies and 4 RCTs.
6 cohort studies included 225,062 participants (134,365 women and 90,697 men) aged 50 years or older. The participants’ follow-up time ranged from 2.8 years to 20 years.

Validated food frequency questionnaires (FFQs), 24-hour food recall (24h-R) and 7-day food record were used to evaluate fruit and vegetable intake.

Results and conclusions:
The investigators found in 5 cohort studies that intake of at least one serving of fruits and vegetables per day significantly reduced risk of hip fractures with 8% [pooled HR = 0.92, 95% CI = 0.87 to 0.98, I2 = 55.7%, p = 0.060] among participants aged 50 years or older.

The investigators found in 2 cohort studies that intake of at least one serving of fruits and vegetables per day significantly reduced risk of any fractures with 10% [pooled HR = 0.90, 95% CI = 0.86 to 0.96, I2 = 24.9%, p = 0.249] among participants aged 50 years or older.

The investigators found no association between the bone resorption marker CTx and 3 months of fruit and vegetable intake evaluated by 4 RCTs.

The investigators concluded that at least one serving of fruits and vegetables per day is associated with a lower risk of fractures among participants aged 50 years or older.

Original title:
Fruit and vegetable intake and bones: A systematic review and meta-analysis by Brondani JE, Comim FV, […], Premaor MO.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6544223/

Additional information of El Mondo:
Find more information/studies on fruits and vegetables consumption and elderly.
 

Objectives:
Does a dietary low-ratio n-6/n-3 PUFA supplementation improve risk factors (such as fasting blood glucose, HbA1c) of diabetes?

Study design:
This review article included 11 RCTs.

No significant publication bias was observed for all blood glucose and other related indicators as suggested by Begg's test and Egger's test.

Results and conclusions:
The investigators found no significant effect of dietary low-ratio n-6/n-3 PUFA supplementation on:
-fasting blood glucose [WMD = 0.057 mmol/L, 95% CI = -0.090 to 0.204 mmol/L];
-insulin [WMD = -0.757 mIU/L, 95% CI = -2.419 to 0.904 mIU/L];
-insulin resistance index [WMD = -0.201, 95% CI = -0.566 to 0.165] and;
-glycosylated hemoglobin [WMD = -0.063%, 95% CI = -0.061 to 0.186%].

The investigators found subgroup analysis showed that the effect of dietary low-ratio n-6/n-3 PUFA on the reduction of the plasma insulin level in North America [WMD = -3.473 mIU/L, 95% CI = -5.760 to -1.185 mIU/L] was more obvious than that in Asian countries [WMD = -0.797 mIU/L, 95% CI = -2.497 to 0.902 mIU/L] and European countries [WMD = -0.063 mIU/L, 95% CI = -0.061 to 0.186 mIU/L].

The investigators found in the subgroup of diabetic subjects, dietary low-ratio n-6/n-3 PUFA supplementation significantly decreased plasma insulin level [WMD = -3.010 mIU/L, 95% CI = -5.371 to -0.648 mIU/L] and insulin resistance index [WMD = -0.460, 95% CI = -0.908 to -0.012].

The investigators found when the intervention period was longer than 8 weeks, dietary low-ratio n-6/n-3 PUFA supplementation significantly decreased the plasma insulin level [WMD = -2.782 mIU/L, 95% CI = -4.946 to -0.618 mIU/L].

The investigators concluded dietary low-ratio n-6/n-3 PUFA supplementation improves the glucose metabolism by reducing the insulin and insulin resistance in the diabetic patients. Dietary low-ratio n-6/n-3 PUFA supplementation also reduces the plasma insulin level when the supplementation duration is longer than 8 weeks.

Original title:
Effect of low-ratio n-6/n-3 PUFA on blood glucose: a meta-analysis by Li N, Yue H, […], Xu T.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31292599

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

Objectives:
The associations between dietary fat intake and cognitive function are inconsistent and inconclusive. Therefore, this review article has been conducted.

Is there a relationship between different types of fat intake and cognitive impairment?

Study design:
This review article included 9 prospective cohort studies covering a total of 23,402 participants.

Results and conclusions:
The investigators found compared with the lowest category of consumption, the highest category of saturated fat consumption significantly increased risk of cognitive impairment with 40% [RR = 1.40, 95% CI = 1.02-1.91].

The investigators found compared with the lowest category of consumption, the highest category of saturated fat consumption significantly increased risk of Alzheimer disease with 87% [RR = 1.87, 95% CI = 1.09-3.20].

The investigators found total and unsaturated fat dietary intakes were not statistically associated with cognitive outcomes with significant between-study heterogeneity.

The investigators concluded there is an increased risk between saturated fat consumption and both cognitive impairment and Alzheimer disease. Given the substantial heterogeneity in the sample size and methodology used across studies, the evidence presented here should be interpreted with caution.

Original title:
Dietary Fat Intake and Cognitive Function among Older Populations: A Systematic Review and Meta-Analysis by Cao GY, Li M, […], Xu B.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31062836

Additional information of El Mondo:
Find more information/studies on saturated fat intake, dementia and elderly right here.

A diet with a high saturated fat intake is a diet with >10 En% saturated fat.
>10 En% saturated fat means that the total amounts of saturated fat make up for >10% of the total kcal of the diet.
The easiest way to follow this diet is to choose only meals/products that also contain 10 En% saturated fat.
Check here which products contain >10 En% saturated fat.

A diet with a low saturated fat intake is a diet with 7 En% saturated fat.

Objectives:
No conclusive information is available about the association between dietary total antioxidant capacity (DTAC) and risk of mortality. Therefore, this review article has been conducted.

Does dietary total antioxidant capacity (DTAC) reduce risk of death from all-cause (all-cause mortality), cancer (cancer mortality) and cardiovascular diseases (CVDs mortality)?

Study design:
This review article included 5 prospective cohort studies with a follow-up period of 4.3-16.5 years. There were 38,449 deaths from all-cause, 4,470 from cancer and 2,841 from cardiovascular diseases among 226,297 individuals.

Results and conclusions:
The investigators found dietary total antioxidant capacity significantly reduced all-cause mortality with 38% [combined effect size = 0.62, 95% CI = 0.60-0.64].
Significant because combined effect size of 1 was not found in the 95% CI of 0.60 to 0.64. Combined effect size of 1 means no risk/association.

The investigators found dietary total antioxidant capacity significantly reduced cancer mortality with 19% [combined effect size = 0.81, 95% CI = 0.75-0.88].
Significant means that there is an association with a 95% confidence.

The investigators found dietary total antioxidant capacity significantly reduced cardiovascular diseases mortality with 29% [combined effect size = 0.71, 95% CI = 0.63-0.82].

The investigators found findings from linear dose-response meta-analysis revealed that a 5 mmol/day increment in dietary total antioxidant capacity based on ferric reducing antioxidant power (FRAP) and oxygen radical absorbance capacity (ORAC) was associated with 7% and 15% lower risk of all-cause mortality, respectively.

The investigators found findings from non-linear dose-response meta-analysis showed a significant reduction in risk of all-cause mortality when increasing ferric reducing antioxidant power (FRAP) from 2 to 12 mmol/day [p-nonlinearity = 0.002] and oxygen radical absorbance capacity (ORAC) from 5 to 11 mmol/day [p-nonlinearity  0.001].

The investigators concluded a diet with high total antioxidant capacity decreases risk of death from all-cause, cancer and cardiovascular diseases.

Original title:
Dietary total antioxidant capacity and mortality from all causes, cardiovascular disease and cancer: a systematic review and dose-response meta-analysis of prospective cohort studies by Parohan M, Anjom-Shoae J, […], Sadeghi O

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30756144

Additional information of El Mondo:
Find more information/studies on significantly/review article, antioxidant and cancer and cardiovascular diseases mortality right here.

The easiest way to get enough antioxidants from food is to eat at least 200 grams of vegetables and at least 200 grams of fruit per day.

There exist different methods to measure the antioxidant capacity of foods: Oxygen Radical Absorbance Capacity (ORAC), Ferric Ion Reducing Power (FRAP) and Trolox Equivalence Antioxidant Capacity (TEAC). The most popular method is the ORAC determination, which was developed by the National Institutes of Health in Baltimore.

The USDA recommends an ORAC unit ingestion of about 3000 to 5000 units daily.