Nutritional Advice El Mondo

Nutritional advice

Pregnancy

Scientific studies (review articles) on the relationship between diet/nutrients and pregnancy:
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 specific 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 specific topic) of cohort studies or case-control studies will answer the following question:
"Should I change my diet?".

2023:

  1. Probiotic/synbiotic supplements improve glucose and lipid metabolism in pregnant women with gestational diabetes mellitus
  2. Vitamin B6 supplements reduce nausea and vomiting during pregnancy

2022:

  1. Systolic blood pressure <130 mmHg prevents severe hypertension in pregnant women

2021:

  1. Oral magnesium supplementation does not reduce leg cramps during pregnancy
  2. Salt iodination alone is not sufficient to provide adequate iodine status to pregnant women
  3. Breastfeeding reduces ovarian cancer in women with BRCA1 or BRCA2 mutation
  4. Vitamin and mineral supplementation improves glycemic control in women with gestational diabetes mellitus
  5. Prenatal alcohol exposure increases placental abruption
  6. Preterm birth and low birthweight are strongest risk factors associated with increased case fatality of infants with spina bifida
  7. Enteral zinc supplementation enhances weight gain and linear growth in preterm infants
  8. >650 mg/day maternal or neonatal DHA and/or EPA supplements increase weight in childhood
  9. 400 μg folic acid during pregnancy reduce offspring's autism spectrum disorders
  10. Multiple-micronutrient supplementation improves birth outcomes among pregnant adolescents in low- and middle-income countries
  11. Vitamin A supplementation reduces bronchopulmonary dysplasia in premature infants
  12. CNS congenital abnormalities, intracranial calcifications, fetal loss, SGA, low birth weight and prematurity are associated with Zika virus infection
  13. A low maternal serum zinc level increases pre-eclampsia in African women
  14. Daily 100 mg cholesterol increase gestational diabetes mellitus

2020:

  1. Probiotic supplementation during pregnancy is beneficial for gestational age
  2. COVID-19 pandemic increases anxiety among women during pregnancy and perinatal period
  3. Coronavirus infection is more likely to affect pregnant women
  4. Rates of vaccine coverage immediately after birth are very low for BCG and HepB-BD in neonates in sub-Saharan Africa
  5. Artemisinin-based combination therapies should be treatment guidelines for uncomplicated falciparum malaria in pregnant women
  6. Higher levels of gestational vitamin D reduce multiple sclerosis in offspring
  7. Iron fortification increases haemoglobin concentration during pregnancy
  8. Probiotic supplementation has positive effects on outcomes of preterm infants in India
  9. No association between oral cholera vaccination and adverse pregnancy outcomes
  10. Influenza vaccination during pregnancy reduce infant influenza
  11. Probiotic supplementation improves outcomes of preterm infants in India
  12. Omega-3 fatty acids + vitamin E or D reduce gestational diabetes
  13. Maternal folic acid supplementation is associated with an increased birth weight
  14. Measles infection in pregnancy is dangerous for mother and fetus
  15. N-3 fatty acids supplementation reduces preeclampsia during pregnancy
  16. High maternal thyroid hormones during pregnancy increase neonatal birth weight

2019:

  1. 75 mg daily DHEA supplements increase fertility in women
  2. Higher plasma levels of free fatty acids increase gestational diabetes mellitus
  3. Pregnancy-associated malaria increases preterm birth and low birth weight
  4. HPV vaccination during pregnancy does not increase adverse pregnancy outcomes
  5. Maternal folic acid supplementation reduces childhood acute lymphoblastic leukaemia
  6. Multiple micronutrient supplementation generates positive health outcomes for both infants and pregnant women
  7. 0.6-2 gram calcium supplement reduce gestational hypertension
  8. Maternal vitamin D deficiency during pregnancy increases low birth weight
  9. Mother-infant skin to skin contact immediately after birth increases breastfeeding
  10. Steady-state red blood cell folate concentrations can be reached with 375-570 µg folic acid/day
  11. Breastfeeding can be improved by a combination of professional and laypersons
  12. High prenatal vitamin D level reduces risk autism-related traits later in life

2018:

  1. Probiotic supplementation during both prenatal and postnatal period reduces atopic dermatitis
  2. 2g inositol twice daily reduce preterm delivery rate
  3. Antioxidant supplements could increase sperm quality
  4. Egg into an infant’s diet between 3 and 6 months of age reduces egg allergy risk
  5. PUFA supplements do not improve intelligence in low birth weight children
  6. Kangaroo mother care increases breastfeeding
  7. Antenatal care and institutional delivery increase exclusive breastfeeding practices in Ethiopia
  8. Asian vegetarian mothers have an increased risk to deliver babies with low birth weight
  9. Low maternal iodine status in early pregnancy gives lower IQ
  10. Myo-inositol supplementation reduces risk of gestational diabetes and preterm delivery in pregnant women
  11. Anemia at the beginning of pregnancy increases a SGA baby
  12. Maternal probiotic supplements during pregnancy and lactation reduce eczema during childhood

2017:

  1. First-trimester use of artemisinin derivatives is not associated with an increased risk of miscarriage or stillbirth compared to quinine
  2. ABT results in higher efficacy than QBT in the second and third trimester of pregnancy with uncomplicated falciparum malaria
  3. Women’s groups practising participatory learning and action improve key behaviours on the pathway to neonatal mortality
  4. Breastfeeding during 6-9 months reduces risk of endometrial cancer
  5. Antenatal multiple micronutrient supplements provide greater birth-outcome benefits for infants born to undernourished and anaemic pregnant women
  6. Plasmodium falciparum malaria in pregnancy increases stillbirth risk
  7. Daily 1mg heme iron increases risk of gestational diabetes mellitus in pregnant women
  8. Childhood nutritional supplementation with ≥5 nutrients improves cognitive development of children in developing countries
  9. Pregnant women with malnutrition and malaria infection are at increased risk of having a low birthweight compared to women with only 1 risk factor or none
  10. Severe vitamin D deficiency (<20 ng/mL) increases risk of early spontaneous pregnancy loss
  11. Serum ceruloplasmin may be a useful screening and follow-up tool for developing preeclampsia
  12. High serum copper level increase risk of preeclampsia in Asian pregnant women
  13. Zinc sulfate supplementation does not reduce neonatal jaundice
  14. Fish consumption during pregnancy is not associated with risk of asthma and other allergy-related diseases from infancy to mid childhood
  15. Routine supplementation of full-term infant milk formula with LCPUFA cannot be recommended
  16. Vitamin D supplementation alone during pregnancy reduces risk of preterm birth
  17. Maternal vitamin B12 deficiency increases low birth weight in newborns

2013:

  1. Daily 10 to 66 mg iron supplementation during pregnancy improve maternal haematological status and birth weight

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Childbirth usually occurs about 38 weeks after conception; in women who have a menstrual cycle length of four weeks, this is approximately 40 weeks from the start of the last normal menstrual period. A pregnancy of 37 to 42 weeks is considered full-term. A pregnancy less than 37 weeks is considered pre-term, which is dangerous due to underdevelopment. Over 42 weeks is also dangerous due to septic poisoning.
Women generally don't begin to feel the baby moves until sometime between 16 and 22 weeks or later. In general, the gender can be determined with certainty after the fourteenth week. After 30 weeks of gestation, the baby is able to recognize a language.

The pregnancy is divided into 3 periods:

  1. The first 3 months. During these months all organs of the fetus are developed.
  2. The second three months, in which the organs further develop.
  3. The last 3 months. During these 3 months the emphasis is put on growth and the unborn child gets per day 67 mg of DHA from the mother.

A woman with a BMI of 18.5-25 will gain during pregnancy about 12 kg, of which about one third is the weight of the child.

BMI before pregnancyDesired weight gain during pregnancy
<19.8

12

.5-18

19.8-2611.5-16
26-297-11.5
>296
A woman with 65 kg and 1.57 meters has a BMI of 26.4 (65/(1.57x1.57)). BMI is kg/m2.

 

Energy requirements during pregnancy
The duration of pregnancyExtra kcal per day
The first 3 months70
The second three months260
The last 3 months500


During breastfeeding mothers need on average 500 extra calories per day. Most women need 6 months to a year after childbirth to get back to their pre-pregnancy weight.

It is not desirable to lose weight during pregnancy.

The World Health Organization shows that optimal birth weight of 3.1-3.6 kg is associated with maternal weight gains of 10-14 kg.

Dietary guidelines during pregnancy:

  • A balanced diet during pregnancy contains 18-24 kJ (4.3-5.7 kcal) per kg body weight. This diet has a low GI value and includes whole grains, fruits, beans and vegetables.
  • Your daily diet (=all meals/products that you eat on a daily basis) should on average contain maximum 30 En% fat, maximum 7-10 En% saturated fat, 15-20 En% protein, 50-55 En% carbohydrates, maximum 25 En% simple sugars, maximum 0.3 gram salt per 100 kcal, minimum 1.3 grams of fiber per 100 kcal and fish providing 500 mg of EPA and DHA (with 200 mg DHA) per day.
  • Do not drink alcohol.
  • Stop smoking.
  • Take daily 400 micrograms (mcg) of folic acid supplement for a period of at least four weeks prior to the first eight weeks of pregnancy.
    400 mcg of folic acid per day reduces the risk of getting a spina bifida and cleft palate in the unborn child.
  • Eat no more than 3000 micrograms of vitamin A per day.
  • Aim for a BMI of 18.5-25 before entering the pregnancy. Research has shown that the healthiest pregnancy is associated with a pre-pregnancy BMI of 23.
  • Eat fish, providing at least 200 mg of DHA per day. DHA is needed for the development of the brain and vision of the fetus.  
  • Do not eat raw or undercooked (pink fried) meat because the mother can be infected with toxoplasmosis. Toxoplasmosis can cause permanent damage to the brains and eyes of the unborn child. Feces of cats and sandboxes are also sources of toxoplasmosis.
  • Do not eat cheeses made from raw milk (lait au cu).The listeria bacteria are found in raw milk. Listeria can be harmful to the unborn child and can even cause miscarriage.
  • Take a multivitamin supplement.
  • Take fish oil supplements (250-500 mg of EPA and DHA per tablet) if you do not eat fish. Take only dietary supplements after consulting an expert!

Dietary guidelines during breastfeeding:

  • Do not drink alcohol.
  • Stop smoking.
  • Do not drink more than 3 cups of coffee or 3 cups of tea per day. Too much caffeine (found in coffee and tea) can make the baby restless.
  • Give 4-6 months exclusively breastfeeding because breast milk is the healthiest nutrition for the baby. After 4-6 months the baby should receive supplementary feeding because breastfeeding no longer covers the daily nutritional requirements of the growing baby.
  • Do not lose more than 0.5 kg weight per week, otherwise your baby will get through breastfeeding too much toxins. Toxins in the human body are stored in fatty tissues.

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

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.

Probiotic/synbiotic supplements improve glucose and lipid metabolism in pregnant women with gestational diabetes mellitus

Objectives:
The effect of probiotic/synbiotic supplementation on gestational diabetes mellitus (GDM) is controversial. Therefore, this review article has been conducted.

Do probiotic/synbiotic supplements improve glucose and lipid metabolism in pregnant women with gestational diabetes mellitus?

Study design:
This review article included 11 RCTs with a total of 390 women with gestational diabetes mellitus in probiotics/synbiotics group and 389 women with gestational diabetes mellitus in placebo group.

The mean age of those participants ranged from 26.4 years to 33.5 years.
The duration of intervention ranged from 4 weeks to 8 weeks.

Results and conclusions:
The investigators found compared with the placebo, probiotics/synbiotics supplements were associated with a statistically significant improvement in fasting plasma glucose (FPG) [MD = -2.33, 95% CI = -4.27 to -0.40, p = 0.02, I2 = 74%].  

The investigators found compared with the placebo, probiotics/synbiotics supplements were associated with a statistically significant improvement in the homoeostatic model assessment for insulin resistance (HOMA-IR) [MD = -0.40, 95% CI = -0.74 to -0.06, p = 0.02, I2 = 76%].  

The investigators found compared with the placebo, probiotics/synbiotics supplements were associated with a statistically significant improvement in fasting serum insulin (FSI) [MD = -2.47, 95% CI = -3.82 to -1.12, p = 0.0003, I2 =73%].  

The investigators found compared with the placebo, probiotics/synbiotics supplements were associated with a statistically significant improvement in total cholesterol (TC) [MD = -6.59, 95% CI = -12.23 to -0.95, p = 0.02].  

The investigators found subgroup analysis revealed that the kind of supplement led to heterogeneity for FPG and FSI, while heterogeneity was not found for others.

The investigators concluded probiotic/synbiotic supplements improve glucose and lipid metabolism in pregnant women with gestational diabetes mellitus. The use of specific probiotic supplementations containing Lactobacillus acidophilus and Bifidobacterium bifidum (>1 × 106 CFU/g) may be a promising prevention and therapeutic strategy for gestational diabetes mellitus, as they could directly act on the intestinal mucosal barrier and restore the gut flora balance. However, due to the heterogeneity among existing studies, further studies are warranted to address the limitations of existing evidence and better inform the management of gestational diabetes mellitus.

Original title:
The Effects of Probiotics/Synbiotics on Glucose and Lipid Metabolism in Women with Gestational Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trials by Mu J, Xian Guo X, […], Cao G.

Link:
https://www.mdpi.com/2072-6643/15/6/1375

Additional information of El Mondo:
Find more information/studies on probiotic, diabetes mellitus and pregnancy right here.

 

 Vitamin B6 supplements reduce nausea and vomiting during pregnancy

Objectives:
Nausea and vomiting during pregnancy (NVP) are common symptoms in pregnancy. Although no definitive treatment option for NVP, pyridoxine (vitamin B6) supplementation has been used widely. Therefore, this review article has been conducted.

Does supplementation of pyridoxine alone as well as combined treatment of pyridoxine with an active ingredient as the intervention reduce nausea and vomiting during pregnancy?

Study design:
This review article included 8 RCTs.

Results and conclusions:
The investigators found 8 studies showed beneficial effects with pyridoxine alone as the supplementation, while 6 others found that the supplementation of pyridoxine in combination with another active substance had favourable effects.

The investigators found supplementation of pyridoxine alone as well as combined treatment of pyridoxine with an active ingredient as the intervention significantly improved the symptoms of nausea according to Rhode's score [0.78, 95% CI= 0.26 to 1.31, p = 0.003, I2 = 57%, p = 0.10] and PUQE score [0.75, 95% CI = 0.28 to 1.22, p = 0.002, I2 = 0%, p = 0.51], respectively.

The investigators concluded supplementation of pyridoxine (vitamin B6) alone as well as combined treatment of pyridoxine with an active ingredient as the intervention reduces nausea and vomiting during pregnancy.

Original title:
The effects of pyridoxine (vitamin B6) supplementation in nausea and vomiting during pregnancy: a systematic review and meta-analysis by Jayawardena R, Majeed S, […], Ranaweera P.

Link:
https://pubmed.ncbi.nlm.nih.gov/36719452/

Additional information of El Mondo:
Find more information/studies on vitamin B6 and pregnancy right here.
 

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/

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

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

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

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

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

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

 

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/

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

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

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

 

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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Oral magnesium supplementation does not reduce leg cramps during pregnancy

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

Does oral magnesium supplementation reduce leg cramps during pregnancy?

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

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

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

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

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

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

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

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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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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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Vitamin and mineral supplementation improves glycemic control in women with gestational diabetes mellitus

Objectives:
The effects of vitamin and mineral supplementation on women with gestational diabetes mellitus (GDM) have not been well established. Therefore, this review article has been conducted.

Does vitamin and mineral supplementation improve glycemic control (like, fasting plasma glucose, serum insulin, homeostasis model assessment-insulin resistance and homeostasis model of assessment for β cell function) and decrease risk of inflammation and oxidative stress in women with gestational diabetes mellitus?

Study design:
This review article included 12 RCTs with 698 patients.

Patients included were in the age range of 18-40 years and all reported gestational diabetes mellitus screening was conducted between 24 weeks and 28 weeks gestation.

All trials gave vitamin and mineral supplementation orally.

Types, doses, dose regimens and duration of vitamin and mineral supplementation were as follows: magnesium (100-250 mg), zinc (4-233 mg), selenium (200 μg), calcium (400-1000 mg) and vitamin E (400 IU) every day for 6 weeks, vitamin D (200-50000 IU) every day or every 2 or 3 weeks for 6 weeks. Magnesium, zinc, selenium, calcium, vitamin D or E was given separately or in different combinations: magnesium and vitamin E; zinc and vitamin E; calcium and vitamin D; magnesium, zinc, calcium and vitamin D.

All trials used placebo as control intervention.

Among the 12 trials, 8 were judged to be at low risk of bias and 4 as being at unclear risk of bias. Unclear risks were related to attrition bias and other bias.

No significant publication bias was found for the effect of vitamin and mineral supplementation on all 8 outcomes.

Results and conclusions:
The investigators found magnesium, zinc, selenium, calcium, vitamin D and E (alone or in combination) supplementation significantly improved glycemic control in women with gestational diabetes mellitus compared to those receiving placebos:
-fasting plasma glucose (FPG) [MD = - 9.02, 95% CI = -12.09 to -5.96, p   0.00001];
-serum insulin [MD = -4.33, 95% CI = -5.35 to -3.32, p  0.00001];
-homeostasis model assessment-insulin resistance (HOMA-IR) [MD = -1.34, 95% CI = -1.60 to -1.07, p  0.00001] and;
-homeostasis model of assessment for β cell function (HOMA-B) [MD = - 15.58, 95% CI = -23.70 to -7.46, p = 0.0002].
Significantly because the calculated p-value of 0.0002 was less than the p-value of 0.05.

The investigators found vitamin and mineral supplementation (magnesium, zinc, selenium, calcium, vitamin D and E (alone or in combination)) significantly decreased risk of inflammation and oxidative stress through decreasing high-sensitivity C-reactive protein (hs-CRP) [MD = -1.29, 95% CI = -1.82 to -0.76, p  0.00001], malondialdehyde (MDA) [MD = -0.71, 95% CI = -0.97 to -0.45, p  0.00001] and increasing total antioxidant capacity (TAC) [MD = 45.55, 95% CI = 22.02 to 69.08, p = 0.0001].

The investigators concluded that vitamin and mineral supplementation improves glycemic control and decreases risk of inflammation and oxidative stress in women with gestational diabetes mellitus.

Original title:
The effects of vitamin and mineral supplementation on women with gestational diabetes mellitus by Li D, Cai Z, [...], Zhang J.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8145819/

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A diet with low GI increases metabolic syndrome

Objectives:
Diets with high glycemic index (GI) or high glycemic load (GL) have been linked to important risk factors associated with the development of metabolic syndrome (MetS), such as dyslipidemia, higher blood glucose and insulin concentrations. However, the role of GI and GL in relation to metabolic syndrome is still understudied and controversial. Therefore, this review article has been conducted.

Does high dietary GI or GL increase risk of metabolic syndrome?

Study design:
This review article included 1 cohort study and 11 cross-sectional studies with a total sample size of 36,295 subjects.

Results and conclusions:
The investigators found, the pooled effect sizes from the 9 studies indicated high versus low dietary GI was significantly associated with increased risk of 5% for metabolic syndrome [OR = 1.05, 95% CI = 1.01 to 1.09, I2 = 58.1%, p = 0.004].
This finding was supported by all subgroup analyses except where studies used 24-h recalls for dietary assessment.

The investigators found, additionally, a linear dose-response investigation revealed that each 5-point increment in GI was associated with 2% increase in the risk of metabolic syndrome [OR = 1.02, 95% CI = 1.01 to 1.02].
Howver, non-linear pattern was insignificant [p-nonlinearity = 0.63].

The investigators found, moreover, pooled effect sizes from 10 studies suggested that no association was found between the GL and metabolic syndrome with results remaining consistent in all subgroup analyses.

The investigators concluded that high dietary GI increases risk of metabolic syndrome. Nutrition policy and clinical practices should encourage a diet with low GI. Future studies should include both GI and GL and different criteria of metabolic syndrome to provide a better comparison.

Original title:
Glycemic index, but not glycemic load, is associated with an increased risk of metabolic syndrome: Meta-analysis of observational studies by Askari M, Dehghani A, […], Alizadeh S.

Link:
https://pubmed.ncbi.nlm.nih.gov/33928722/

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A diet with low GI is a diet with GI of 55 or lower.

Insufficiency of serum carotenoids increases overweight and obesity

Objectives:
Excess body weight, including overweight and obesity, is one of the major factors influencing human health and plays an important role in the global burden of disease. Carotenoids serve as precursors of vitamin A-related retinoids and are considered to have potential effects on many diseases. However, the influence of carotenoids on people with excess body weight is unclear. Therefore, this review article has been conducted.

Does carotenoid supplementation reduce risk of overweight and obesity in overweight or obese subjects?

Study design:
This review article included 7 randomized controlled trials (RCTs) and 8 observational studies with 28,944 subjects and data on multiple carotenoid subgroups, including lycopene, astaxanthin, cryptoxanthin, α-carotene, and β-carotene.

In all included RCTs, the intervention duration was 20 days at the shortest and 16 weeks at the longest and the range of intervention doses was 1.2-60 mg/d.

Results and conclusions:
The investigators found that the insufficiency of serum carotenoids significantly increased risk of overweight and obesity with 73% [OR = 1.73, 95% CI = 1.57 to 1.91, p 0.001].

The investigators found, moreover, carotenoid supplementation was significantly associated with body weight reductions [SMD = -2.34 kg, 95% CI = -3.80 to -0.87 kg, p 0.001], body mass index decrease [SMD = -0.95 kg/cm2, 95% CI = -1.88 to -0.01 kg/cm2, p 0.001] and waist circumference losses [SMD = -1.84 cm, 95% CI = -3.14 to -0.54 cm, p 0.001].

The investigators concluded that 1.2-60 mg/d carotenoid supplementation reduces risk of overweight and obesity in overweight or obese subjects. Furthermore, an insufficiency of serum carotenoids is a risk factor for overweight and obesity. Additional data from large clinical trials are needed.

Original title:
The association between carotenoids and subjects with overweight or obesity: a systematic review and meta-analysis by Yao N, Yan S, […], Cui W.

Link:
https://pubmed.ncbi.nlm.nih.gov/33977977/

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Am I overweight?
 

Obesity increases atrial fibrillation recurrence in patients undergoing catheter ablation

Objectives:
The evidence on the association between obesity and atrial fibrillation (AF) recurrence was equivocal. Therefore, this review article (meta-analysis) has been conducted.

Does obesity increase risk of atrial fibrillation recurrence in patients undergoing catheter ablation?

Study design:
This review article included 20 studies with 52,771 patients.

Results and conclusions:
The investigators found that obesity was significantly associated with higher atrial fibrillation recurrence [OR = 1.30, 95% C = 1.16 to 1.47, p 0.001, I2 = 72.7%] and similar rate of adverse events [OR = 1.21, 95% CI = 0.87 to 1.67, p = 0.264, I2 = 23.9%] in patients undergoing catheter ablation.

The investigators found meta-regression showed that the association varied by age [coefficient = -0.03, p = 0.024].

The investigators found meta-analysis of highest versus lowest BMI showed that the highest group had higher atrial fibrillation recurrence [OR = 1.37, 95% CI = 1.18 to 1.58, p 0.001, I2 = 64.9%] and adverse events [OR = 2.02, 95% CI = 1.08 to 3.76, p = 0.028, I2 = 49.5%] in patients undergoing catheter ablation.

The investigators found the dose-response relationship for BMI and atrial fibrillation recurrence was nonlinear [p nonlinearity 0.001], the curve became steeper at 30-35 kg/m2.

The investigators found for adverse events, an increase of 1% for every 1 kg/m2 increase in BMI [OR = 1.01, 95% CI = 1.00 to 1.02, p = 0.001], the relationship was nonlinear [p nonlinearity = 0.001].

The investigators concluded that obesity is associated with higher atrial fibrillation recurrence in patients undergoing catheter ablation. High BMI is associated with a higher risk for adverse events.

Original title:
BMI and atrial fibrillation recurrence post catheter ablation: A dose-response meta-analysis by Pranata R, Henrina J, […], Munawar M.

Link:
https://pubmed.ncbi.nlm.nih.gov/33544873/

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Catheter ablation is a procedure that uses radiofrequency energy (similar to microwave heat) to destroy a small area of heart tissue that is causing rapid and irregular heartbeats. Destroying this tissue helps restore your heart’s regular rhythm. Catheter ablation is also called radiofrequency ablation.

Am I overweight?
 

Brown rice has anti-obesity effects in comparison with white rice

Objectives:
A few randomized controlled trials (RCTs) have assessed the effect of brown rice consumption on metabolic parameters (such as, weight, height, waist circumference, fasting glucose, LDL, HDL, total cholesterol, triglycerides and blood pressure) compared to white rice, with inconsistent findings. Therefore, this review article has been conducted.

Is the effect of brown rice on adiposity indices (such as, weight, height and waist circumference), lipid profile (such as, LDL, HDL, total cholesterol and triglycerides) and glycemic markers (such as, fasting blood glucose) higher compared to white rice in adult subjects?

Study design:
This review article included 13 RCTs.
In accordance with Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, the certainly of the included evidence was low and very low.

Results and conclusions:
The investigators found brown rice significantly reduced:
weight by -1.63 kg [95% CI = -2.15 to -1.11, I2 = 97%, n = 6];
body mass index (BMI) by -0.58 kg/m2 [95% CI = -0.78 to -0.37, I2 = 96%, n = 6] and;
waist circumference by -2.56 cm [95% CI = -4.86 to -0.26, I2 = 88%, n = 5] compared with white rice.

The investigators found, moreover, brown rice had no significant effect on lipid profile and glycemic markers.

The investigators found pre-germinated brown rice significantly declined:
weight by -1.75 kg [95% CI = -2.70 to -0.81, I2 = 99%, n = 4];
total cholesterol by -24.22 mg/dL [95% CI = -33.03 to -15.41, I2 = 78%, n = 5];
triglyceride (TG) by -43.28 mg/dL [95% CI = -74.05 to -12.50, I2 = 90%, n = 5];
low-density lipoprotein (LDL or bad cholesterol) by -20.05 mg/dL [95% CI = -29.57 to -10.52, I2 = 71%, n = 5] and;
fasting blood glucose (FBG) by -15.83 mg/dL [95% CI = -25.20 to -6.46, I2 = 91%, n = 5] compared to white rice.

The investigators concluded brown rice has anti-obesity effects in comparison with white rice. However, it has no beneficial effects on lipid profile and glycemic markers. Furthermore, pre-germinated brown rice has better functional effects on promoting lipid profile and fasting blood glucose compared to brown rice.

Original title:
The effect of brown rice compared to white rice on adiposity indices, lipid profile, and glycemic markers: a systematic review and meta-analysis of randomized controlled trials by Golzarand M, Toolabi K, […], Mirmiran P.

Link:
https://pubmed.ncbi.nlm.nih.gov/33905269

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>650 mg/day maternal or neonatal DHA and/or EPA supplements increase weight in childhood

Objectives:
Do high maternal or neonatal DHA and/or EPA levels increase offspring birth weight and weight in childhood?

Study design:
This review article included 27 RCTs with 6,408 infants and 14 observational studies.

Results and conclusions:
The investigators found in RCTs that >650 mg/day DHA and/or EPA supplementation significantly increased birth weight [MD = 87.5g, 95% CI = 52.3 to 122.6, n = 3,831 participants, moderate quality].

The investigators found in RCTs that >650 mg/day DHA and/or EPA supplementation significantly increased combined BMI and BMI z score at 5-10 years [SMD = 0.11, 95% CI = 0.04 to 0.18, n = 3,220 participant, moderate quality].

The investigators found results from the observational studies were generally inconsistent. High trans fatty acids levels during pregnancy seemed to be associated with lower birth weight.

The investigators concluded this review and meta-analysis support a relationship between high maternal or neonatal DHA and/or EPA levels and higher offspring birth weight and weight in childhood. More high-quality long-term studies are still needed.

Original title:
Systematic Literature Review and Meta-Analysis of the Relationship Between Polyunsaturated and Trans Fatty Acids During Pregnancy and Offspring Weight Development by Ren X, Vilhjálmsdóttir BL, […], Specht  IO.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8027310/

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

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

Does vitamin E supplementation reduce overweight?

Study design:
This review article included 24 RCTs.

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

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

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

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

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

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

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

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

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

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

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

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

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

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Vitamin A supplementation reduces bronchopulmonary dysplasia in premature infants

Objectives:
Does vitamin A supplementation reduce risk of bronchopulmonary dysplasia (BPD) in premature infants?

Study design:
This review article included 9 RCTs with 709 infants received vitamin A treatment (intervention group) and 700 infants did not receive vitamin A treatment (control group).
The dose of vitamin A regimens varied from 1500 to 10,000 IU (450 to 3,003 micrograms) and the treatment durations generally lasted for 4 weeks.

The funnel plots for all synthesized outcomes remained symmetrical, indicating that there was no significant publication bias.

Results and conclusions:
The investigators found when compared to the control group, vitamin A supplementation significantly reduced the incidence of bronchopulmonary dysplasia in premature infants with 33% [OR  =  0.67, 95% CI = 0.52 to 0.88].
The sensitivity analyses were performed by excluding single RCT one by one. The results of sensitivity analysis of all outcomes had indicated no substantial result changes among the overall estimates.

The investigators concluded that vitamin A supplementation is beneficial to reduce bronchopulmonary dysplasia in premature infants.  

Original title:
Vitamin A supplementation prevents the bronchopulmonary dysplasia in premature infants: A systematic review and meta-analysis by Ding Y, Chen Z and Lu Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7837939/

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Bronchopulmonary dysplasia is a form of chronic lung disease that develops in preterm neonates treated with oxygen and positive-pressure ventilation.
 

Daily 700-1000 mg dietary calcium intake increases cardiovascular disease in healthy postmenopausal women

Objectives:
Recent systematic reviews and meta-analyses of randomized, double-blind, placebo-controlled trials (double-blind, placebo-controlled RCTs) have reported controversial findings regarding the associations between calcium supplements on the risk of cardiovascular disease (CVD). Therefore, this review article has been conducted.

Do calcium supplements increase risk of cardiovascular disease (CVD)?

Study design:
This review article included 13 RCTs with 28,935 participants in an intervention group (group with calcium supplements) and 14,243 in a control group (group without calcium supplements).

The mean age of the study participants was 66.3 years (range: 35 to 97 years) and 92.8% of those were women.
Publication bias was not observed.

Results and conclusions:
The investigators found calcium supplements significantly increased the risk of cardiovascular disease with 15% in healthy postmenopausal women [RR = 1.15, 95% CI = 1.06 to 1.25, I2 = 0.0%, n = 14].

The investigators found calcium supplements significantly increased the risk of coronary heart disease with 16% in healthy postmenopausal women [RR = 1.16, 95% CI = 1.05 to 1.28, I2 = 0.0%, n = 9].

The investigators found in the subgroup meta-analysis, dietary calcium intake of 700-1000 mg per day or supplementary calcium intake of 1000 mg per day significantly increased the risk of cardiovascular disease and coronary heart disease.

The investigators concluded that the use of calcium supplements (1000 mg per day) is significantly associated with the increased risk of cardiovascular disease and coronary heart disease by 15%, specifically in postmenopausal women. These findings should be explicitly confirmed by conducting further RCTs with cardiovascular disease outcome measures as well as the incidence of osteoporosis or fractures as the primary endpoints.

Original title:
Calcium Supplements and Risk of Cardiovascular Disease: A Meta-Analysis of Clinical Trials by Myung SK, Kim HB, […], Oh SW.

Link:
https://pubmed.ncbi.nlm.nih.gov/33530332/

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Vitamin D supplementation during pregnancy or infancy reduces adiposity in childhood

Objectives:
Vitamin D deficiency during pregnancy or infancy is associated with adverse growth in children. No systematic review has been conducted to summarize available evidence on the effect of vitamin D supplementation in pregnancy and infancy on growth and body composition in children. Therefore, this review article has been conducted.

Does vitamin D supplementation during pregnancy or infancy increase adiposity (severe or morbid overweight) risk in childhood?

Study design:
This review article included 12 RCTs with a total of 4,583 participants.
The doses of vitamin D in the intervention group (group with vitamin D supplements) were 60,000 IU/4 weeks (1,500 mcg/4 weeks) or 60,000 IU/8 weeks and in the control group (group without vitamin D supplements) was 400 IU/day.

Results and conclusions:
The investigators found vitamin D supplementation during pregnancy was associated with higher triceps skinfold thickness (mm) [MD = 0.33, 95% CI = 0.12 to 0.54, I2 = 34%] in neonates.

The investigators found vitamin D supplementation during pregnancy or infancy was associated with significantly increased length for age z-score in infants at 1 year of age [MD = 0.29, 95% CI = 0.03 to 0.54, I2 = 0%].

The investigators found vitamin D supplementation during pregnancy or infancy was associated with lower body mass index (BMI) (kg/m2) [MD = -0.19, 95% CI = -0.34 to -0.04, I2 = 0%] and body mass index z-score (BMIZ) [MD = -0.12, 95% CI = -0.21 to -0.04, I2 = 0%] in offspring at 3-6 years of age.

The investigators found vitamin D supplementation during early life was not observed to be associated with children’s bone, lean or fat mass.

The investigators concluded vitamin D supplementation during pregnancy or infancy is associated with reduced adiposity (severe or morbid overweight) in childhood. Future large well-designed double blinded RCTs are needed to assess the effectiveness of vitamin D supplementation in early life on children’s bone health, lean mass and adiposity.

Original title:
Effect of Vitamin D Supplementation in Early Life on Children's Growth and Body Composition: A Systematic Review and Meta-Analysis of Randomized Controlled Trials by Ma K, Wei SQ, [...], Wen SW.

Link:
https://www.mdpi.com/2072-6643/13/2/524/htm

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Daily 100 mg cholesterol increase gestational diabetes mellitus

Objectives:
Does a high dietary cholesterol intake increase risk of gestational diabetes mellitus?

Study design:
This review article included 3 cohort studies, 4 cross-sectional studies and 2 case-control studies involving 30,123 participants and 3,237 women with gestational diabetes mellitus (diabetes mellitus in pregnancy).

Results and conclusions:
The investigators found comparing highest versus lowest category of dietary cholesterol intake, that the highest dietary cholesterol intake significantly increased risk of gestational diabetes mellitus with 49% [pooled RR = 1.49, 95% CI = 1.18 to 1.88].

The investigators found in dose-response analysis that the risk of gestational diabetes mellitus significantly increased by 32% [RR = 1.32, 95% CI = 1.20 to 1.45] for every increase of 100 mg per day in dietary cholesterol intake.

The investigators concluded a high dietary cholesterol intake (at least 100 mg per day) increases risk of gestational diabetes mellitus.

Original title:
Dietary Cholesterol Intake and Risk of Gestational Diabetes Mellitus: A Meta-Analysis of Observational Studies by Gao F and Cui CY.

Link:
https://pubmed.ncbi.nlm.nih.gov/33416437/

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Dairy products reduce causal fat mass and BMI among overweight or obese adults

Objectives:
Is there a causal relationship between dairy products or calcium supplements and the reduction in fat mass and BMI among overweight or obese adults?

Study design:
This review article included 10 and 14 RCTs with ≥ 12 weeks interventions of calcium supplements and dairy products among overweight (BMI>25) or obese (BMI>30) adults aged ≥18.

Results and conclusions:
The investigators found that dairy products significantly reduced fat mass among overweight or obese adults [SMD = -0.40, 95% CI = -0.77 to -0.02].
This reduction was also significant in the analysis of RCTs with low risk of bias scores.

The investigators found that dairy products significantly reduced BMI among overweight or obese adults [SMD = -0.46 kg/m2, 95% CI = -0.67 to -0.26].
This reduction was also significant in the analysis of RCTs with low risk of bias scores.

The investigators found that calcium supplements significantly reduced fat mass among overweight or obese adults [SMD = -0.15, 95% CI = -0.28 to -0.02].
However, this reduction was not significant in the analysis of RCTs with low risk of bias scores.

The investigators concluded there is a causal relationship between dairy products without distinction of fat percentage and the reduction in fat mass and BMI among overweight or obese adults.

Original title:
Meta-analysis of randomized controlled trials on calcium supplements and dairy products for changes in body weight and obesity indices by Hong JY, Lee JS, [...], Kim MK.

Link:
https://pubmed.ncbi.nlm.nih.gov/33292017/

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Pistachio supplementation lowers BMI without increasing body weight

Objectives:
Does pistachio supplementation reduce obesity risk?

Study design:
This review article included 11 randomized controlled trials (RCTs) with 1,593 subjects.

The assigned pistachio intake was below 50 g/d in 3 studies.
Intervention times were shorter than 12 weeks in 4 studies.
There was no significant publication bias.

Results and conclusions:
The investigators found compared to the control diet group, the pistachio supplementation regimen significantly decreased BMI [-0.18 kg/m2, 95% CI = -0.26 to -0.11 kg/m2, p 0.001, I2 = 29.8%, p = 0.180].

The investigators found compared to the control diet group, the pistachio supplementation regimen did not significantly change waist circumference [net change = 0.76 cm, 95% CI = -0.11 to 1.63 cm, p = 0.087, I2 = 7.0%, p = 0.340].

The investigators found compared to the control diet group, the pistachio supplementation regimen had no effect on body weight [net change = 0.22 kg, 95% CI = -0.50 to 0.07 kg, p = 0.141, I2 = 0.0%, p = 0.962].

The investigators concluded compared to a controlled dietary intake, an adequate amount of pistachio supplementation lowers BMI without increasing body weight, which supports the view that pistachio consumption is beneficial for human health.

Original title:
The relationship between pistachio (Pistacia vera L) intake and adiposity: A systematic review and meta-analysis of randomized controlled trials by Xia K, Yang T, […], Chen XZ.

Link:
https://journals.lww.com/md-journal/Fulltext/2020/08210/The_relationship_between_pistachio__Pistacia_vera.7.aspx

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