Nutritional advice

Objectives:
Women have a 50% risk of urinary tract infection (UTI) over their lifetime and 20-30% experience a subsequent urinary tract infection recurrence. Cranberry (Vaccinium spp.) has been advocated for treatment of urinary tract infection; however, its efficacy is controversial. Therefore, this review article (meta-analysis) has been conducted.

Does cranberry reduce the risk of urinary tract infection recurrence in healthy women?

Study design:
This review article included 7 RCTs conducted in healthy nonpregnant women aged ≥18 years with a history of urinary tract infection (n = 1498 participants).
Risk of bias indicated that 2 studies had high loss to follow-up or selective outcome reporting. Overall, the studies were relatively small, with only 2 having >300 participants.

Results and conclusions:
The investigators found that cranberry significantly reduced the risk of urinary tract infection by 26% [pooled risk ratio = 0.74, 95% CI = 0.55-0.98, I2 = 54%].

The investigators concluded that cranberry may be effective in preventing urinary tract infection recurrence in generally healthy women. May be effective because the studies were relatively small, with only 2 having >300 participants. Therefore, larger high-quality studies are needed to confirm these findings.

Original title:
Cranberry Reduces the Risk of Urinary Tract Infection Recurrence in Otherwise Healthy Women: A Systematic Review and Meta-Analysis by Zhuxuan Fu, DeAnn Liska, […], Mei Chung.

Link:
http://jn.nutrition.org/content/147/12/2282.abstract

Additional information of El Mondo:
Find more information/studies on chronic disease and fruit right here.
 

Objectives:
Previous studies have shown that fish consumption and dietary intake of n-3 polyunsaturated fatty acids (n-3 PUFAs) are associated with hip fracture; however, findings were conflicting. Therefore, this review article (meta-analysis) has been conducted.

Do both dietary intake of fish and n-3 polyunsaturated fatty acids decrease hip fracture risk?

Study design:
This review article included 7 prospective cohort studies and 3 case-control studies with a total sample size of 29,2657 participants. The age of participants was 20 years or older.

Results and conclusions:
The investigators found combining 8 effect sizes from 4 prospective cohort studies and 2 case-control studies revealed a significant inverse association between fish consumption and risk of hip fracture [pooled effect size = 0.88, 95% CI = 0.79-0.98, p = 0.02].
Although this relationship became non-significant in prospective cohort studies, a significant inverse association was found in prospective cohort studies with sample size of 10,000 individuals or more and studies that considered body mass index as a covariate.

The investigators also found dietary intake of n-3 PUFAs significantly reduced risk of hip fracture with 12% [pooled effect size = 0.88, 95% CI = 0.80-0.98, p = 0.02].

The investigators concluded that both fish consumption and dietary intake of n-3 PUFAs have protective effects on bone health and decline the risk of hip fracture.

Original title:
Dietary intake of fish, n-3 polyunsaturated fatty acids and risk of hip fracture: A systematic review and meta-analysis on observational studies by Sadeghi O, Djafarian K, […], Shab-Bidar S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29244536

Additional information of El Mondo:
Find more information/studies on fish consumption, n-3 PUFAs and elderly right here.

Fatty acids in fish are all n-3 PUFAs.
 

Objectives:
Although there is an overall reduction in underfive mortality rate, the progress in reducing neonatal mortality rate has been very slow. Over the last 20 years, preterm births have steadily increased in low-income and medium-income countries (LMICs) particularly in sub-Saharan Africa and South Asia. Preterm birth is associated with increased mortality and morbidity, particularly in LMICs. Based on systematic reviews of randomised controlled trials (RCTs), many neonatal units in high-income countries have adopted probiotics as standard of care for preterm neonates. Therefore, this review article (meta-analysis) has been conducted.

Do probiotics reduce mortality and morbidity in preterm neonates (born 37 weeks) in low-income and medium-income countries?

Study design:
This review article included 23 RCTs (n = 4783) conducted in 10 different low-income and medium-income countries in 4 continents with preterm neonates born at a gestational age (GA) 37 weeks or LBW (2500 g) or both.

Out of the 23 included studies, single-strain probiotics were used in 11 studies, whereas 12 used multiple strains. Lactobacillus was part of the supplementation in 13 studies; Bifidobacterium was part of the supplementation in 11 studies and Saccharomyces in 3 studies.

The results were significant on random effects model analysis and after excluding studies with high risk of bias. No significant adverse effects were reported.

Results and conclusions:
The investigators found in 20 trials (n = 4022), a significantly reduced risk of 54% [risk ratio = 0.46, 95% CI = 0.34 to 0.61, p 0.00001, I2 = 19%, p = 0.22] for the risk of necrotising enterocolitis (NEC greater than or equal to stage II) for probiotic supplemented neonates.
The numbers needed to treat (NNT) with probiotics to prevent one case of necrotising enterocolitis was 25 [95% CI = 20 to 50].

The investigators found in 18 trials (n = 4062), a significantly reduced risk of 20% [risk ratio = 0.80, 95% CI= 0.71 to 0.91, p = 0.0009, I2 = 25%, p = 0.16] for the risk of late-onset sepsis (LOS) for probiotic supplemented neonates.
The numbers needed to treat (NNT) with probiotics to prevent one case of late-onset sepsis was 25 [95% CI = 17 to 50].

The investigators found in 19 trials (n = 4196), a significantly reduced risk of 27% [risk ratio = 0.73, 95% CI = 0.59 to 0.90, p = 0.003, I2 = 0%, p = 0.67] for the risk of all-cause mortality for probiotic supplemented neonates.
The numbers needed to treat (NNT) to prevent one death by probiotic supplement was 50 [95% CI = 25 to 100].

The investigators concluded that probiotics have significant potential to reduce mortality and morbidity (eg, NEC, LOS) in preterm neonates (born 37 weeks) in low-income and medium-income countries. Considering the burden of death, disease (NEC, LOS) and suboptimal nutrition in preterm neonates in LMICs, cooperation between various stake holders (eg, industry, scientists, regulatory agencies) is warranted to either develop or to improve access to high-quality safe and effective probiotics in such set-ups. Support from organisations such as the WHO is important in providing access to probiotics for the countries (eg, sub-Saharan Africa) where most prematurity related deaths occur. Whether probiotics could be used for research and/or routine use in preterm neonates in LMICs will depend on the national health priorities, resources and ethics.

Original title:
Benefits of probiotics in preterm neonates in low-income and medium-income countries: a systematic review of randomised controlled trials by Deshpande G, Jape G, […],Patole S.

Link:
http://bmjopen.bmj.com/content/7/12/e017638

Additional information of El Mondo:
Find more information/studies on food fortification/malnutrition, probiotics and study design/meta-analysis/significant right here.

Objectives:
Randomised controlled trials comparing low- versus high-fat diets on cardiometabolic risk factors in people with overweight or obesity have shown inconsistent results, which may be due to the mixed metabolic status of people with excess adiposity. The role of dietary fat manipulation in modifying cardiometabolic indicators in people with overweight or obese without metabolic disturbance is unclear. Therefore, this review article (meta-analysis) has been conducted.

Does a low-fat diet modify cardiometabolic indicators in people who are overweight (BMI>25) or obese (BMI>30) without metabolic disturbance?

Study design:
This review article included 20 RCTs with 2,106 participants.

Results and conclusions:
The investigators found total cholesterol levels in people who are overweight or obese without metabolic disturbance were significantly lower following low-fat diet compared with high-fat diet [WMD = -7.05 mg/dL, 95% CI = -11.30 to -2.80, p = 0.001].  

The investigators found LDL-cholesterol levels (bad cholesterol) in people who are overweight or obese without metabolic disturbance were significantly lower following low-fat diet compared with high-fat diet [WMD = -4.41 mg/dL, 95% CI = -7.81 to -1.00, p = 0.011].  

The investigators found HDL-cholesterol levels (good cholesterol) in people who are overweight or obese without metabolic disturbance were significantly lower following low-fat diet compared with high-fat diet [WMD = -2.57 mg/dL, 95% CI = -3.85 to -1.28, p 0.001].  

The investigators found TAG levels (blood fat levels) in people who are overweight or obese without metabolic disturbance were significantly higher following low-fat diet compared with high-fat diet [WMD = -11.68 mg/dL, 95% CI = 5.90 to 17.45, p 0.001].  

The investigators concluded a low-fat diet reduces cholesterol and TAG levels in people with overweight or obesity without metabolic disturbances.

Original title:
Effects of low-fat compared with high-fat diet on cardiometabolic indicators in people with overweight and obesity without overt metabolic disturbance: a systematic review and meta-analysis of randomised controlled trials by Lu M, Wan Y, [...], Li D.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29212558

Additional information of El Mondo:
Find more information/studies on fat, cholesterol and overweight right here.

A triglyceride (TG, triacylglycerol, TAG or triacylglyceride) is an ester derived from glycerol and three fatty acids. Triglycerides are the main constituents of body fat in humans.

Those with overweight or obesity are advised to follow a diet with maximum 30 En% fat, of which maximum 7 En% saturated fat and minimum 1.5 grams fiber per 100 kcal.
The most easy way to follow a diet with maximum 30 En% fat, of which maximum 7 En% saturated fat and minimum 1.5 grams fiber per 100 kcal is to choose meals/products with maximum 30 En% fat, of which maximum 7 En% saturated fat and minimum 1.5 grams fiber per 100 kcal.
However, the most practical way to follow a diet with maximum 30 En% fat, of which maximum 7 En% saturated fat and minimum 1.5 grams fiber per 100 kcal is all meals/products that you eat on a daily basis should on average contain maximum 30 En% fat, of which maximum 7 En% saturated fat and minimum 1.5 grams fiber per 100 kcal.

Objectives:
There is considerable evidence of the favourable role of more physical activity (PA) in fighting against dementia. However, the shape of the dose-response relationship is still unclear. Therefore, this review article (meta-analysis) has been conducted.

Does leisure time physical activity reduce risk of all-cause dementia (ACD), Alzheimer’s disease (AD) and vascular dementia (VD) in dose-response manner?

Study design:
This review article included 15 cohort studies with 37,436 participants for all-cause dementia, with 25,031 participants for Alzheimer’s disease and with 16,797 participants for vascular dementia.
During follow-up (3-31.6 years for all-cause dementia, 3.9-31.6 years for Alzheimer’s disease and 4-11.9 years for vascular dementia), at least 2,665, 1,337 and 343 participants who were not suffering from dementia at baseline (=at the beginning of the study) were diagnosed with all-cause dementia, Alzheimer’s disease and vascular dementia, respectively.

There was no publication bias.

Results and conclusions:
The investigators found in the dose-response analysis, either all-cause dementia [p trend 0.005 and p non-linearity = 0.87] or Alzheimer’s disease [p trend 0.005 and p non-linearity = 0.10] exhibited a linear relationship with leisure time physical activity over the observed range (0-2000 kcal/week or 0-45 metabolic equivalent of task hours per week (MET-h/week)).

The investigators found for every 500 kcal or 10 MET-h increase per week, a significantly 10% [95% CI = 0.85-0.97] and 13% [95% CI = 0.79-0.96] decrease in the risk of all-cause dementia and Alzheimer’s disease, respectively.

The investigators concluded leisure time physical activity over a specific range (0-2000 kcal/week or 0-45 MET-h/week) is associated with a risk of dementia and Alzheimer’s disease in an inverse linear dose-response manner; with for every 500 kcal (calories) or 10 MET-h increase per week, a 10% and 13% decrease in the risk of all-cause dementia and Alzheimer’s disease, respectively.

Original title:
Leisure time physical activity and dementia risk: a dose-response meta-analysis of prospective studies by Xu W, Wang HF, [...], Tan L.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5665289/

Additional information of El Mondo:
Find more information/studies on physical activities and dementia here.

If you do a 4 MET activity for 30 minutes, you have done 4 x 30 = 120 MET-minutes or 2.0 MET-hours of physical activity.
 

Objectives:
The aim of this meta-analysis (review article) is to evaluate the influence of dietary intake and blood level of vitamin A (total vitamin A, retinol or β-carotene) on total and hip fracture risk?

Study design:
This review article included 11 prospective cohort studies and 2 nested case-control studies, involving a total of 319,077 participants over the age of 20 years (109,056 post-menopausal women).

Results and conclusions:
The investigators found higher dietary intake of retinol significantly decreased total fracture risk with 5% [RR = 0.95, 95% CI = 0.91 to 1.00, I2 = 64.64%, p = 0.04].

The investigators found higher dietary intake of retinol significantly increased hip fracture risk with 40% [RR = 1.40, 95% CI = 1.02 to 1.91, I2 = 30.01%, p = 0.40].

The investigators found higher dietary intake of vitamin A significantly decreased total fracture risk with 6% [RR = 0.94, 95% CI = 0.88 to 0.99, I2 = 35.18%, p = 0.20].

The investigators found higher dietary intake of vitamin A significantly increased hip fracture risk with 29% [RR = 1.29, 95% CI = 1.06 to 1.57, I2 = 0.00%, p = 0.60].

The investigators found lower blood level of retinol significantly increased hip fracture risk with 27% [RR = 1.27, 95% CI = 1.05 to 1.53, I2 = 0.00%, p = 0.62].

The investigators concluded that higher dietary intake of total vitamin A or retinol increases the risk of hip fracture but decreases total fracture risk. Clinical trials are warranted to confirm these results and assess the clinical applicability.

Original title:
The Effect of Vitamin A on Fracture Risk: A Meta-Analysis of Cohort Studies by Zhang X, Zhang R, [...], Chen G.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5615580/

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

Vitamin A is a generic term for compounds with the biological activity of retinol. Preformed vitamin A (mainly retinol and retinyl esters) is usually found in foods derived from animal products and provitamin A (mainly β-carotene and carotenoids) is usually found in foods derived from plant products.
 

Objectives:
Vitamin A deficiency (VAD), a leading cause of preventable childhood blindness, has been recognized as an important public health problem in many developing countries. Therefore, this review article (meta-analysis) has been conducted.

The aim of this review article is to identify all population-based studies of vitamin A deficiency and marginal vitamin A deficiency (MVAD) in Chinese children published from 1990 onwards.

Study design:
This review article included 54 studies.

Results and conclusions:
The investigators found the prevalence of vitamin A deficiency and marginal vitamin A deficiency both decreased with increasing age and rural children had a higher prevalence of vitamin A deficiency and marginal vitamin A deficiency than urban children.

The investigators found in 2015, the prevalence of vitamin A deficiency was 5.16% [95% credible interval = 1.95-12.64] and that of marginal vitamin A deficiency was 24.29% [95% credible interval = 12.69-41.27] in Chinese children aged 12 years and under.

The investigators concluded that vitamin A deficiency remains a public health problem in China. Efforts to reduce vitamin A deficiency in younger children are needed, especially for those in rural areas.

Original title:
The Prevalence of Vitamin A Deficiency in Chinese Children: A Systematic Review and Bayesian Meta-Analysis by Song P, Wang J, […], An L.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29186832

Additional information of El Mondo:
Find more information/studies on food fortification/malnutrition, vitamin A and study design/meta-analysis/significant right here.

Objectives:
Epidemiological studies have provided controversial evidence between beverage consumption and the risk of ulcerative colitis (UC). Therefore, this review article (meta-analysis) has been conducted.

Is there a relationship between beverage consumption and risk of ulcerative colitis?

Study design:
This review article included 13 case-control studies and 3 prospective cohort studies, with a total of 3,689 cases (subjects with ulcerative colitis) and 335,339 controls (subjects without ulcerative colitis).

Egger test detected no significant publication bias.

Results and conclusions:
The investigators found high intake of soft drinks versus low intake, significantly increased risk of ulcerative colitis with 69% [pooled RR = 1.69, 95% CI = 1.24-2.30, I2  =  12.9%, p  = 0 .332].
In subgroup analysis, no substantial changes of the primary result were found between subgroups.

The investigators found high tea consumption versus low consumption, significantly decreased risk of ulcerative colitis with 31% [pooled RR = 0.69, 95% CI = 0.58-0.83, I2  =  0.0%, p  = 0 .697].
In subgroup analysis, no substantial changes of the primary result were found between subgroups.

The investigators found no significant association between alcohol [pooled RR = 1.08, 95% CI = 0.66-1.51] or coffee consumption [pooled RR = 0.58, 95% CI = 0.33-1.05, I2  =  87.5%, p    0.001] and risk of ulcerative colitis. No significant association because RR of 1 was found in the 95% CI of 0.66 to 1.51. RR of 1 means no risk/association.

The investigators concluded high consumption of soft drinks increases the risk of ulcerative colitis, while high tea consumption decreases the risk.

Original title:
Beverage consumption and risk of ulcerative colitis. Systematic review and meta-analysis of epidemiological studies by Nie JY and Zhao Q.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5728934/

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

Objectives:
Over the last 7 years there has been intense debate about the advice to reduce saturated fat and increase polyunsaturated fat to reduce cardiovascular (CVD) risk. Therefore, this review article (meta-analysis) has been conducted.

Does replacement of saturated fat with carbohydrate, polyunsaturated fatty acid (PUFA) or monounsaturated fatty acid (MUFA) reduce cardiovascular risk?

Study design:
This review article included cohort studies and intervention studies.

Results and conclusions:
The investigators found replacement of saturated fat with any carbohydrate, polyunsaturated fatty acid (PUFA) and monounsaturated fatty acid (MUFA) is associated with lower mortality with PUFA being more effective than MUFA [19% reduction versus 11%].

The investigators found per 5% of energy (5 En%) replacement of saturated fat with polyunsaturated fatty acid and fish oil significantly lowered risk of cardiovascular mortality with 28%.  

The investigators found replacing saturated fat with PUFA or MUFA was equally effective at reducing coronary heart disease (CHD) events

The investigators found replacement of saturated fat with whole grains significantly lowered coronary heart disease events while replacement with sugar and starch significantly increased coronary heart disease events.

The investigators found replacement of saturated fat with carbohydrate had no effect on coronary heart disease events or death.

The investigators found only PUFA replacement of saturated fat significantly lowered coronary heart disease events and cardiovascular and total mortality.

The investigators concluded reducing saturated fat and replacing it with carbohydrate will not lower coronary heart disease events or cardiovascular mortality although it will reduce total mortality. Replacing saturated fat with PUFA, MUFA or high-quality carbohydrate will lower coronary heart disease events.

Original title:
A systematic review of the effect of dietary saturated and polyunsaturated fat on heart disease by Clifton PM and Keogh JB.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29174025

Additional information of El Mondo:
Find more information/studies on fat, carbohydrates and cardiovascular diseases right here.

Objectives:
Dietary fiber intake may provide beneficial effects on the components of metabolic syndrome (MetS); however, observational studies reported inconsistent results for the relationship between dietary fiber intake and metabolic syndrome risk. Therefore, this review article (meta-analysis) has been conducted.

Does dietary fiber intake reduce risk of metabolic syndrome?

Study design:
This review article included 11 cross-sectional studies and 3 cohort studies.
There was evidence of publication bias in cross-sectional studies.

Results and conclusions:
The investigators found in cross-sectional studies when comparing the highest with lowest categories of dietary fiber intake, a significantly reduced risk of 33% [OR = 0.67, 95% CI = 0.58-0.78, I2 = 32.4%, p = 0.181] for metabolic syndrome. However, this reduced risk was not significant in cohort studies [pooled RR = 0.86, 95% CI = 0.70-1.06]. Not significant because RR of 1 was found in the 95% CI of 0.70 to 1.06. RR of 1 means no risk/association.

The investigators concluded that a high dietary intake of fiber may reduce risk of metabolic syndrome. May reduce because there was evidence of publication bias in cross-sectional studies and the reduced risk was not significant in cohort studies. Therefore, more prospective cohort studies are needed to further verify the association between dietary fiber intake and the risk of metabolic syndrome.

Original title:
Fruit and vegetable consumption and risk of the metabolic syndrome: a meta-analysis by Tian Y, Su L, [...], Jiang X.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29151369

Additional information of El Mondo:
Find more information/studies on publication bias/cohort studies/significant, fiber consumption and overweight right here.  

Find out whether you are overweight or not right here.

Those with metabolic syndrome are advised to follow a diet with maximum 30 En% fat, of which maximum 7 En% saturated fat and minimum 1.5 grams fiber per 100 kcal.
The most easy way to follow a diet with maximum 30 En% fat, of which maximum 7 En% saturated fat and minimum 1.5 grams fiber per 100 kcal is to choose meals/products with maximum 30 En% fat, of which maximum 7 En% saturated fat and minimum 1.5 grams fiber per 100 kcal.
However, the most practical way to follow a diet with maximum 30 En% fat, of which maximum 7 En% saturated fat and minimum 1.5 grams fiber per 100 kcal is all meals/products that you eat on a daily basis should on average contain maximum 30 En% fat, of which maximum 7 En% saturated fat and minimum 1.5 grams fiber per 100 kcal.

Objectives:
Several epidemiological studies have been performed to evaluate the association of fruit and vegetable consumption with risk of the metabolic syndrome (MetS), but the results remain controversial. Therefore, this review article (meta-analysis) has been conducted.

Does consumption of vegetables or fruit reduce risk of metabolic syndrome?

Study design:
This review article included a total of 9 studies for fruit consumption, 9 studies for vegetable consumption and 7 studies for fruit and vegetable consumption.

There was no evidence of small-study effect (publication bias)

Results and conclusions:
The investigators found a significantly reduced risk of 13% [pooled RR = 0.87, 95% CI = 0.82-0.92, I2 = 46.7%] for metabolic syndrome when comparing the highest fruit consumption versus the lowest consumption.

The investigators found a significantly reduced risk of 15% [pooled RR = 0.85, 95% CI = 0.80-0.91, I2 = 0.0%] for metabolic syndrome when comparing the highest vegetable consumption versus the lowest consumption.

The investigators found a significantly reduced risk of 24% [pooled RR = 0.76, 95% CI = 0.62-0.93, I2 = 83.5%] for metabolic syndrome when comparing the highest fruit and vegetable consumption versus the lowest consumption.

The investigators found in subgroup analyses stratified by continent, the inverse association of fruit consumption [RR = 0.86, 95% CI = 0.77-0.96] and vegetable consumption [RR = 0.86, 95% CI = 0.80-0.92] with risk of metabolic syndrome remained significant in Asia.

The investigators concluded that a high fruit or/and vegetable consumption reduce risk of metabolic syndrome, particularly among Asian. Therefore, people should consume more fruits and vegetables to reduce risk of metabolic syndrome.

Original title:
Fruit and vegetable consumption and risk of the metabolic syndrome: a meta-analysis by Tian Y, Su L, [...], Jiang X.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29151369

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

Find out whether you are overweight or not right here.

Those with metabolic syndrome are advised to follow a diet with maximum 30 En% fat, of which maximum 7 En% saturated fat and minimum 1.5 grams fiber per 100 kcal.
The most easy way to follow a diet with maximum 30 En% fat, of which maximum 7 En% saturated fat and minimum 1.5 grams fiber per 100 kcal is to choose meals/products with maximum 30 En% fat, of which maximum 7 En% saturated fat and minimum 1.5 grams fiber per 100 kcal.
However, the most practical way to follow a diet with maximum 30 En% fat, of which maximum 7 En% saturated fat and minimum 1.5 grams fiber per 100 kcal is all meals/products that you eat on a daily basis should on average contain maximum 30 En% fat, of which maximum 7 En% saturated fat and minimum 1.5 grams fiber per 100 kcal.

Objectives:
The role of omega-3 polyunsaturated fatty acids (omega-3 or n-3 PUFAs) in the pathogenesis and treatment of children and adolescents with attention deficit hyperactivity disorder (ADHD) is unclear. Therefore, this review article (meta-analysis) has been conducted.

Do children and adolescents with attention deficit hyperactivity disorder (ADHD) benefit from n-3 PUFA supplementation?

Study design:
This review article included 7 RCTs and 7 case-control studies.

Results and conclusions:
The investigators found in 7 RCTs (n = 534 randomised youth with ADHD) n-3 PUFAs supplementation significantly improved ADHD clinical symptom scores [g = 0.38, p 0.0001].

The investigators found in 3 RCTs (n = 214 randomised youth with ADHD) n-3 PUFAs supplementation significantly improved cognitive measures associated with attention [g = 1.09, p = 0.001].

The investigators found children and adolescents with ADHD had lower levels of DHA [7 case-control studies, n = 412, g = -0.76, p = 0.0002], EPA (7 case-control studies, n = 468, g = -0.38, p = 0.0008] and total n-3 PUFAs [6 case-control studies, n = 396, g = -0.58, p = 0.0001].

The investigators concluded there is evidence that n-3 PUFAs supplementation monotherapy improves clinical symptoms and cognitive performances in children and adolescents with ADHD and that these youth have a deficiency in n-3 PUFAs levels. These findings provide further support to the rationale for using n-3 PUFAs as a treatment option for ADHD.

Original title:
Omega-3 Polyunsaturated Fatty Acids in Youths with Attention Deficit Hyperactivity Disorder (ADHD): A Systematic Review and Meta-Analysis of Clinical Trials and Biological Studies by Chang JC, Su KP, [...], Pariante CM.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28741625

Additional information of El Mondo:
Find more information/studies on chronic disease, n-3 PUFA right here.
EPA and DHA are n-3 PUFA.

Objectives:
What are the cardiovascular benefits of indiscriminate supplementation of omega-3 supplementation?

Study design:
This review article included 8 RCTs.

Results and conclusions:
The investigators found omega-3 supplementation significantly resulted in a 8% decrease of the risk of cardiac death, unless the patients are treated by statins.

The investigators found omega-3 supplementation prolonged quality adjusted life years by about a month. Old people gained less, whereas diabetes mellitus type 2 patients and people with history of cardiovascular events gained more.

The investigators concluded omega-3 supplementation decreases risk of cardiac death, unless the patients are treated by statins.

Original title:
The cardiovascular benefits of indiscriminate supplementation of omega-3 fatty acids; meta-analysis and decision-making approach by Leshno M, Goldbourt U, [...], Lichtenberg D.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29171335

Additional information of El Mondo:
Find more information/studies on omega-3 fatty acids and cardiovascular diseases right here.

Objectives:
What is the relationship between dietary intake of 12 major food groups, including whole grains, refined grains, vegetables, fruit, nuts, legumes, eggs, dairy, fish, red meat, processed meat and sugar-sweetened beverages and colorectal cancer (CRC) risk?

Study design:
This review article included cohort studies.

Results and conclusions:
The investigators found in the linear dose-response meta-analysis, that every 30 g/d whole grains significantly reduced risk of colorectal cancer with 5% [RR = 0.95, 95% CI = 0.93 to 0.97, n = 9 cohort studies].

The investigators found in the linear dose-response meta-analysis, that every 100 g/d vegetables significantly reduced risk of colorectal cancer with 3% [RR = 0.97, 95% CI = 0.96 to 0.98, n = 15 cohort studies].

The investigators found in the linear dose-response meta-analysis, that every 100 g/d fruit significantly reduced risk of colorectal cancer with 3% [RR = 0.97, 95% CI = 0.95 to 0.99, n = 16 cohort studies]. 

The investigators found in the linear dose-response meta-analysis, that every 200 g/d dairy products significantly reduced risk of colorectal cancer with 7% [RR = 0.93, 95% CI = 0.91 to 0.94, n = 15 cohort studies]. 

The investigators found in the linear dose-response meta-analysis, that every 100 g/d red meat significantly increased risk of colorectal cancer with 12% [RR = 1.12, 95% CI = 1.06 to 1.19, n = 21 cohort studies].

The investigators found in the linear dose-response meta-analysis, that every 50 g/d processed meat significantly increased risk of colorectal cancer with 17% [RR = 1.17, 95% CI = 1.10 to 1.23, n = 16 cohort studies].

The investigators found some evidence for a nonlinear relationship between dietary intake of vegetables, fruit and dairy products and risk of colorectal cancer.

The investigators concluded that daily dietary intake of 30g whole grains, 100g vegetables,100g fruit and 200g dairy products reduce risk of colorectal cancer, while daily dietary intake of 100g red meat and 50g processed meat increase risk of colorectal cancer.

Original title:
Food groups and risk of colorectal cancer by Schwingshackl L, Schwedhelm C, [...], Schlesinger S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29210053

Additional information of El Mondo:
Find more information/studies on different food groups and colorectal cancer right here.

Objectives:
Undernutrition is the outcome of insufficient food intake and recurrent infectious diseases. The baseline levels of undernutrition remain so high that Ethiopia still needs to continue substantial investment in nutrition. Therefore, this review article (meta-analysis) has been conducted.

The aim of this review article is to obtain estimates of over-time trends in the prevalence of undernutrition in Ethiopia and to determine risk factors for undernutrition among children of under five years of age.

Study design:
This review article included 18 cross-sectional studies published in English from 1997 to 2015 focusing the prevalence of stunting, wasting and underweight in children aged 0-5 years (n = 39,585) in Ethiopia.
Sample size ranged from 100 to 10,449 participants. The majority (14/18) of the studies were conducted in rural and urban areas.

There was no publication bias.

Results and conclusions:
The investigators found the overall pooled prevalence estimate of stunting, underweight and wasting in Ethiopia was 42.0% [95% CI = 37.0 to 46.0], 33.0% [95% CI = 27.0 to 39.0] and 15.0% [95% CI = 12.0 to 19.0], respectively. The heterogeneity between studies was very high [I2 = 98.5% and p = 0.433].

The investigators found the highest prevalence of stunting was reported in East Ethiopia 67.8% and the least was in North Ethiopia 14.6%. The highest prevalence of underweight was reported in country level studies (DHS) (47.2%) and the least was in South Ethiopian studies (12%). Similarly, the highest prevalence of wasting was reported in country level studies (DHS) 42% and the least was reported in North Ethiopian studies (4.5%).

The investigators found that sensitivity analyses showed a prevalence of stunting of 40% [95% CI = 32.0 to 48.0, I2 = 99.19%], a prevalence of underweight of 33% [95% CI = 24.0 to 42.0, I2 = 99.34%] and wasting rate equal to 19% [95% CI = 14.0 to 24.0, I2 = 99.19%].

The investigators found cumulative analysis revealed a stabilization trend of stunting and underweight (1996-2010) followed by an upward trend (2010-2014).

The investigators found child age, child sex, complementary food, poor dietary diversity, diarrheal diseases, maternal education, maternal height, residential area and socio- economic status were significant risk factors for undernutrition in Ethiopia.

The investigators concluded that the trend of undernutrition in Ethiopia indicates that there is an increment of chronic malnutrition cases in recent years and the prevalence of undernutrition remains extremely high. Thus, the implementation of policies to reverse child undernutrition should get maximum emphasis.

Original title:
Nutritional Status of Under Five Children in Ethiopia: A Systematic Review and Meta-Analysis by Abdulahi A, Shab-Bidar S, […], Djafarian K.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5440832/

Additional information of El Mondo:
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Objectives:
Vitamin D is involved in musculoskeletal health. There is no consensus on a possible association between circulating 25-hydroxyvitamin D (25OHD) concentrations and walking speed, a “vital sign” in older adults. Therefore, this meta-analysis (review article) has been conducted.

Does a high vitamin D level (expressed as circulating 25-hydroxyvitamin D (25OHD) concentrations) increase walking speed in older adults?

Study design:
This review article included 22 observational studies (17 cross-sectional and 5 longitudinal). The number of participants ranged between 54 and 4,100 (0-100% female).

Results and conclusions:
The investigators found usual walking speed was slower among participants with hypovitaminosis D, with a clinically relevant difference compared with normal vitamin D (>75 nmol/L) of -0.18m/s for severe vitamin D deficiency (≤25 nmol/L), -0.08m/s for vitamin D deficiency (≤50 nmol/L) and -0.12m/s for vitamin D insufficiency (≤75 nmol/L).

The investigators found similar results regarding the fast walking speed [mean differences = -0.04m/s for vitamin D deficiency (≤50 nmol/L) and vitamin D insufficiency (≤75 nmol/L) compared with normal vitamin D (>75 nmol/L) and Timed Up and Go test (TUG) [mean difference = 0.48s for severe vitamin D deficiency (≤25 nmol/L) compared with normal vitamin D (>75 nmol/L).

The investigators found a slow usual walking speed was positively associated with:
-severe vitamin D deficiency (≤25 nmol/L) [summary OR = 2.17, 95% CI = 1.52-3.10];
-vitamin D deficiency (≤50 nmol/L) [OR = 1.38, 95% CI = 1.01-1.89] and;
-vitamin D insufficiency (≤75nmol/L) [OR = 1.38, 95% CI = 1.04-1.83], using normal vitamin D (>75 nmol/L) as the reference.

The investigators concluded that robust evidence shows a high 25OHD concentration (vitamin D level of >75 nmol/L) increases walking speed among older adults.

Original title:
Vitamin D and walking speed in older adults: Systematic review and meta-analysis by Annweiler C, Henni S, [...], Duval GT.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29150169

Additional information of El Mondo:
Find more information/studies on review article/observational studies, vitamin D and elderly right here.

A vitamin D level of >75 nmol/L can be achieved by taking 800-1200 IU/d (800-1200 mcg/d) vitamin D3 supplements.
 

Objectives:
No quantitative assessment has been performed to specifically link the consumption of fruit and vegetables with the incident risk of cognitive disorders. Therefore, this meta-analysis (review article) has been conducted.

Does consumption of fruit and vegetables reduce risk of cognitive disorders?

Study design:
This review article included 6 cohort studies involving a total of 21,175 participants.

Results and conclusions:
The investigators found in pooled analysis that consumption of fruit and vegetables significantly reduced risk of cognitive disorders with 26% [pooled RR = 0.74, 95% BI = 0.62-0.88, I2 = 68%; the significant heterogeneity might be attributed to the ethnic difference].

The investigators concluded that consumption of fruit and vegetables reduces risk of cognitive disorders. However, further large prospective studies should be performed to quantify the potential dose-response patterns of fruit and/or vegetables intake and to explore the role of fruit or vegetables consumption separately on cognitive disorders in different populations.

Original title:
Intake of Fruit and Vegetables and the Incident Risk of Cognitive Disorders: A Systematic Review and Meta-Analysis of Cohort Studies by Wu L, Sun D and Tan Y.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29188891

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

Objectives:
Beetroot is considered a complementary treatment for hypertension because of its high content of inorganic NO3.

The aim of this meta-analysis (review article) is to clarify several aspects of beetroot juice supplementation on systolic blood pressure (SBP) and diastolic blood pressure (DBP).

Study design:
This review article included 22 RCTs with a total of 47 intervention (n = 650) and 43 control (n = 598) groups.

Results and conclusions:
The investigators found overall, systolic blood pressure [-3.55 mmHg, 95% CI = -4.55 to -2.54 mmHg] and diastolic blood pressure [-1.32 mmHg, 95% CI = -1.97 to -0.68 mmHg] were significantly lower in the beetroot juice-supplemented groups than in the control groups.

The investigators found the mean difference of systolic blood pressure was larger between beetroot juice-supplemented and control groups in the longer than in the shorter (≥14 compared with 14 days) study durations [-5.11 compared with -2.67 mmHg].

The investigators found the mean difference of systolic blood pressure was larger between beetroot juice-supplemented and control groups in the highest compared with the lowest (500 compared with 70 and 140 mL/d] doses of beetroot juice [-4.78 compared with -2.37 mmHg].

The investigators found a positive correlation between beetroot juice doses and the mean differences of blood pressures.

The investigators found a smaller effect size of blood pressures after supplementation with higher NO3 (milligrams per 100 mL beetroot juice).

The investigators found a weak effect size in a meta-analysis of trials that used NO3-depleted beetroot juice as a placebo compared with other interventions [-3.09 compared with -4.51 mmHg for systolic blood pressure and -0.81 compared with -2.01 mmHg for diastolic blood pressure].

The investigators concluded beetroot juice supplementation, particularly 500 mL/d beetroot juice during at least 14 days, reduces blood pressure.

Original title:
The Nitrate-Independent Blood Pressure-Lowering Effect of Beetroot Juice: A Systematic Review and Meta-Analysis by Bahadoran Z, Mirmiran P, […], Ghasemi A.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29141968

Additional information of El Mondo:
Find more information/studies on fruit, hypertension prevention and cardiovascular diseases right here.

Objectives:
Carnitine deficiency has been implicated as a potential pathway for cancer-related fatigue that could be treated with carnitine supplementation. Therefore, this review article (meta-analysis) has been conducted.

Does carnitine supplementation reduce cancer-related fatigue?

Study design:
This review article included 3 RCTs involving a total of 659 participants.

There were not enough studies to conduct sensitivity analyses to isolate potential sources of heterogeneity and test the robustness of findings.

Results and conclusions:
The investigators found in 3 RCTs involving a total of 659 participants that carnitine supplementation did not significantly reduce cancer-related fatigue [SMD = 0.06 points, 95% CI = -0.09 to 0.21, p = 0.45, I2 = 0%].
Clinical heterogeneity was evident from these studies in regards to the dose (2-4 g of carnitine per day), patient demographics (40-100% females included) and carnitine status.

The investigators concluded there is no evidence to support the use of carnitine supplementation (2-4 g of carnitine per day) for cancer-related fatigue.

Original title:
Efficacy and Effectiveness of Carnitine Supplementation for Cancer-Related Fatigue: A Systematic Literature Review and Meta-Analysis by Marx W, Teleni L, [...], Isenring E.

Link:
http://www.mdpi.com/2072-6643/9/11/1224/htm

Additional information of El Mondo:
Find more information/studies on carnitine, randomized controlled trials/cohort studies/subgroup analysis and cancer right here.

Objectives:
Malaria risk can vary markedly between households in the same village or between villages, but the determinants of this “micro-epidemiological” variation in malaria risk remain poorly understood. Therefore, this review article (meta-analysis) has been conducted.

What are the risk factors for variation in malaria infection between individuals, households, clusters, hotspots or villages in any malaria-endemic setting?

Study design:
This review article included 51 studies (case-control, cross-sectional and cohort studies), representing populations comprising over 160,000 individuals in 21 countries, in high- and low-endemicity settings. 65 risk factors were identified and meta-analyses were conducted for 11 risk factors.

9 studies considered at low risk of bias (scored eight or nine stars), 24 studies at moderate risk of bias (scored six or seven stars) and 8 studies at high risk of bias (scored two to five stars).

Results and conclusions:
The investigators found in 10 studies that increasing distance from a breeding site significantly reduced malaria risk per 100 m with 11% [unadjusted OR = 0.89, 95% CI = 0.86-0.92].

The investigators found in 12 studies that individual bed net use resulted in a significantly reduced risk of 37% [unadjusted OR = 0.63, 95% CI = 0.52-0.77] for malaria.
However, household bed net ownership was not associated with a reduced risk of malaria [unadjusted OR = 0.91, 95% CI = 0.66-1.25, 6 studies] nor was a household ratio of one to two bed nets per person [unadjusted OR = 0.73, 95% CI = 0.48-1.09, 5 studies].

The investigators found in 4 studies that increasing household size resulted in a significantly increased risk of 8% [unadjusted OR = 1.08, 95% CI = 1.01-1.15] for malaria.

The investigators found in 4 studies that household crowding resulted in a significantly increased risk of 79% [unadjusted OR = 1.79, 95% CI = 1.48-2.16] for malaria. However, this increased risk was no longer significant when adjustments were applied [adjusted OR = 1.12, 95% = 0.93-1.35]. Significant because RR of 1 was not found in the 95% CI of 1.48 to 2.16. RR of 1 means no risk/association.

The investigators found in 8 studies that keeping animals in or near the house was not associated with malaria risk [unadjusted OR = 1.27, 95% CI 0.93-1.73].

The investigators concluded that several variables associated with individual-level malaria infection were identified, but there was limited evidence that these factors explain variation in malaria risk at village or hotspot level. Social, population and other factors may confound estimates of environmental risk factors, yet these variables are not included in many studies (e.g. ORs were not adjusted). Therefore, a structured framework of malaria risk factors is proposed to improve study design and quality of evidence in future micro-epidemiological studies.

Original title:
Defining micro-epidemiology for malaria elimination: systematic review and meta-analysis by Bannister-Tyrrell M, Kristien Verdonck K, [...], Grietens KP.

Link:
https://malariajournal.biomedcentral.com/articles/10.1186/s12936-017-1792-1

Additional information of El Mondo:
Find more information/studies on food fortification/malnutrition and study design/meta-analysis/significant right here.

Objectives:
Currently, dementia is considered untreatable and there are many factors that cause dementia. However, previous studies were unable to identify the factors that affect directly. Therefore, this meta-analysis (review article) has been conducted.

What are the risk factors for prognostic dementia in stroke patients?

Study design:
This review article included 7 hospital-based cohorts of consecutive patients with stroke and 1 population-based cross-sectional study.

Results and conclusions:
The investigators found:
a significantly increased risk of 68% [pooled relative ratio = 1.68, 95% CI = 1.28 to 2.22, I2 = 72%] for atrial fibrillation;
a significantly increased risk of 59% [pooled relative ratio = 1.59, 95% CI = 1.33 to 1.91] for previous stroke;
a significantly increased risk of 40% [pooled relative ratio = 1.40, 95% CI = 1.23 to 1.59, I2% = 14%] for myocardial infarction;
a significantly increased risk of 36% [pooled relative ratio = 1.36, 95% CI = 1.20 to 1.53, I2 = 46%] for hypertension;
a significantly increased risk of 25% [pooled relative ratio = 1.25, 95% CI = 1.11 to 1.41, I2 = 0%] for diabetes mellitus and;
a significantly increased risk of 25% [pooled relative ratio = 1.25, 95% CI = 1.08 to 1.45, I2 = 16%] for previous transient ischemic attack (TIA).

The investigators concluded that strongly risk factors associated with increased risk of post-stroke dementia are atrial fibrillation, previous stroke, myocardial infarction, hypertension, diabetes and previous TIA. However, there are other risk factors related to dementia. Therefore, further studies are needed to investigate and develop the risk score value to forecast the dementia incident in stroke patients.

Original title:
Risk factors associated with post-stroke dementia: a systematic review and meta-analysis by Surawan J, Areemit S, […], Saensak S.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5641826/

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

Objectives:
The scientific literature shows conflicting evidence about the relationship between adiposity and bone mass in overweight and obese populations. Therefore, this review article (meta-analysis) has been conducted.

Does a high adipose mass reduce bone mineral density in overweight and obese populations?

Study design:
This review article included a total of 16 studies, comprising 2587 participants and 75 correlation coefficients.

Results and conclusions:
The investigators found strong evidence supported a negative relationship between relative (%) adipose mass and bone mineral density (BMD) in men [R = -0.37, 95% CI = -0.57 to -0.12] and in those aged less than 25 years [R = -0.28, 95% CI = -0.45 to -0.08].

The investigators concluded that a high relative (%) adipose mass reduces bone mineral density in overweight (BMI = 25-30) and obese populations (BMI > 30), particularly in men and those aged less than 25 years. Therefore, to prevent bone loss in overweight and obese populations, nutrition- and exercise-based interventions that focus on a controlled reduction of adipose mass with concomitant preservation of lean mass are recommended.

Original title:
Influence of adipose tissue mass on bone mass in an overweight or obese population: systematic review and meta-analysis by Dolan E, Swinton PA, […], O'Reilly J.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29028271

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

Find out whether you are overweight or not right here.

Those with overweight (BMI = 25-30) or obesity (BMI > 30) are advised to follow a diet with maximum 30 En% fat, of which maximum 7 En% saturated fat and minimum 1.5 grams fiber per 100 kcal.
The most easy way to follow a diet with maximum 30 En% fat, of which maximum 7 En% saturated fat and minimum 1.5 grams fiber per 100 kcal is to choose meals/products with maximum 30 En% fat, of which maximum 7 En% saturated fat and minimum 1.5 grams fiber per 100 kcal.
However, the most practical way to follow a diet with maximum 30 En% fat, of which maximum 7 En% saturated fat and minimum 1.5 grams fiber per 100 kcal is all meals/products that you eat on a daily basis should on average contain maximum 30 En% fat, of which maximum 7 En% saturated fat and minimum 1.5 grams fiber per 100 kcal.

Strength exercise is the best way to reduce adipose mass while preserving lean mass.

Objectives:
What is the relationship of the intake of whole grains, refined grains, vegetables, fruits, nuts, legumes, eggs, dairy, fish, red meat, processed meat and sugar-sweetened beverages (SSBs) and the risk of hypertension?

Study design:
This review article included 28 prospective cohort studies.

Results and conclusions:
The investigators found in dose-response meta-analysis of 4 studies with 28,069 incident hypertension cases, a significantly reduced risk of 8% [RR = 0.92, 95% CI = 0.87-0.98, I2 = 88%, p 0.0001] for hypertension for 30 g/day whole grains. Significant means that there is an association with a 95% confidence.
The reduced risk was highest (15%) at 90 g/day whole grains.

The investigators found in dose-response meta-analysis of 6 studies, a significantly reduced risk of 3% [RR = 0.97, 95% CI = 0.96-0.99, I2 = 64%, p = 0.02] for hypertension for 100 g/day fruits.
The strongest risk reduction was 7% at 300 g/day fruits.

The investigators found in dose-response meta-analysis of 9 studies with 31,509 incident hypertension cases, a significantly reduced risk of 5% [RR = 0.95, 95% CI = 0.94-0.97, I2 = 0%, p = 0.50] for hypertension for 200 g/day dairy products.
The strongest risk reduction was 15% at 800 g/day dairy products.

The investigators found in dose-response meta-analysis of 7 studies with 97,745 incident hypertension cases, a significantly increased risk of 14% [RR = 1.14, 95% CI = 1.02-1.28, I2 = 88%, p 0.001] for hypertension for 100 g/day red meat.
The increased risk was highest (40%) at 200 g/day red meat.

The investigators found in dose-response meta-analysis of 4 studies, a significantly increased risk of 12% [RR = 1.12, 95% CI = 1.00-1.26, I2 = 82%, p 0.001] for hypertension for 50 g/day processed meat.

The investigators found in dose-response meta-analysis of 4 studies, a significantly increased risk of 7% [RR = 1.07, 95% CI = 1.04-1.10, I2 = 64%, p = 0.04] for hypertension for 250 mL/day sugar-sweetened beverages.
The increased risk was highest (13%) at 450 mL/day sugar-sweetened beverages.

The investigators found compared with nonconsumption, an intake of 2 servings red meat/d [170g, RR = 1.35], 1 serving processed meat/d [35g, RR = 1.07], 1 serving fish/d [100g, RR = 1.08] and 2 servings sugar-sweetened beverages/d [500mL, RR = 1.14 was associated with a 78% increased risk of hypertension. On the other hand, a risk reduction by 44% would be achieved by not consuming these foods (red meat, processed meat, fish and sugar-sweetened beverages).

The investigators concluded a daily dietary intake of 30g whole grains, 100g fruits, 200g dairy products reduce risk of hypertension, whereas a daily dietary intake of 100g red meat, 50g processed meat, and 250mL sugar-sweetened beverages increase risk of hypertension. These findings need to be seen under the light of very-low to low credibility of meta-evidence. However, the findings support the current dietary recommendations in the primary prevention of hypertension.

Original title:
Food Groups and Risk of Hypertension: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies by Schwingshackl L, Schwedhelm C, […], Boeing H.

Link:
http://advances.nutrition.org/content/8/6/793.long

Additional information of El Mondo:
Find more information/studies on different food groups, hypertension prevention and cardiovascular diseases right here.

Objectives:
Whole grains are rich source of nutrients and have shown beneficial effects on human health. Therefore, this meta-analysis (review article) has been conducted.

Do taking whole grains reduce mortality risk?

Study design:
This review article included 19 cohort studies with in total 1,041,692 participants and 96,710 deaths.

Results and conclusions:
The investigators found when comparing the highest versus the lowest categories of whole grain, a significantly reduced risk of 16% [RR = 0.84, 95% CI = 0.81-0.88, n = 9] for total mortality.

The investigators found when comparing the highest versus the lowest categories of whole grain, a significantly reduced risk of 17% [RR = 0.83, 95% CI = 0.79-0.86, n = 8] for cardiovascular mortality.

The investigators found when comparing the highest versus the lowest categories of whole grain, a non-significantly reduced risk of 6% [RR = 0.94, 95% CI = 0.87-1.01, n = 14] for cancer mortality.

The investigators found a nonlinear relationship of whole grain intake with risk of total, cardiovascular and cancer mortality.

The investigators found each 28 g/d intake of whole grains was associated with a 9% [pooled RR = 0.91, 95% CI = 0.90-0.93] lower risk for total mortality.

The investigators found each 28 g/d intake of whole grains was associated with a 14% [pooled RR = 0.86, 95% CI = 0.83-0.89] lower risk for cardiovascular mortality.

The investigators found each 28 g/d intake of whole grains was associated with a 3% [pooled RR = 0.97, 95% CI = 0.95-0.99] lower risk for cancer mortality.

The investigators concluded that a higher whole grain intake (at least 28 g/d) reduces risk of total, cardiovascular and cancer mortality. These findings support current dietary guidelines to increase the intake of whole grains. Government officials, scientists and medical staff should take actions to promote whole grains intake.
 
Original title:
Association of whole grain intake with all-cause, cardiovascular, and cancer mortality: a systematic review and dose-response meta-analysis from prospective cohort studies by Zhang B, Zhao Q, [...], Wang X.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29091078

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

Objectives:
As Ethiopia is one of the sub-Saharan countries with a great burden of malaria the effectiveness of first line anti-malarial drugs is the major concern. Therefore, this review article (meta-analysis) has been conducted.

What is the efficacy of artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria in Ethiopia?

Study design:
This review article included 10 prospective single-arm cohort studies involving 1,179 patients with a mean age of 15.8 years.

In the majority (80%) of the studies, subjects were followed for 28 days, while in the remaining (20%) studies; the follow-up period was 42 days.
In each study, anywhere from 66 to 384 patients with P. falciparum mono-infection were included.
Most (70%) of the studies followed patients who were older than six months.
All of the included studies were deemed to be of high quality.

Heterogeneity between the studies was minimal (I2 = 38.8%).

At recruitment, the average parasite count per patient was 12,981/μL of blood and gametocytes were found in 7.7% of patients.

The mean temperature of patients on the day of enrolment was 38.2 ± 0.35 °C.

Results and conclusions:
The investigators found on the third day of treatment, 96.7% and 98.5% of study subjects become fever-free and parasite-free, respectively.

The investigators also found a significant decrease in gametocyte carriage from 7.7% at baseline to 0.4% on the 28th day of treatment.

The investigators found based on the per protocol analysis, the cure rate after use of artemether-lumefantrine was 98.2% (polymerase chain reaction corrected) and 97.01% (polymerase chain reaction uncorrected) after 28 days of follow-up. The reinfection rate within 28 days was 1.1% and the recrudescence rate was 1.9%.

The investigators concluded that the cure rate for uncomplicated P. falciparum malaria using artemether-lumefantrine in Ethiopia is still high enough to recommend the drug as a first-line agent. There should be careful periodic monitoring of the efficacy of this drug, as treatment failure may occur due to resistance, sub-therapeutic levels that may occur due to non-adherence or inadequate absorption.

Original title:
Therapeutic efficacy of artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria in Ethiopia: a systematic review and meta-analysis by Ayalew MB.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5686809/

Additional information of El Mondo:
Find more information/studies on food fortification/malnutrition and study design/meta-analysis/significant right here.