Nutritional advice

High maternal thyroid hormones during pregnancy increase neonatal birth weight

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Objectives:
Are growth parameters at birth associated with maternal urinary iodine concentration (UIC) or normal ranges of thyroid hormones during pregnancy?

Study design:
This review article included 11 studies.

The pooled mean birth weight, length and head circumference values and 95% confidence intervals were estimated in newborns born to women with UIC  150 μg/L and UIC ≥150 μg/L during pregnancy.

Results and conclusions:
The investigators found pooled mean birth weight, length and head circumference in newborns whose mothers had UIC  150 μg/L vs UIC ≥150 μg/L were 2,898g vs 2,900g [p = 0.970], 49.6 cm vs 49.4 cm [p = 0.880] and 34.0 cm vs 34.1 cm [p = 0.933], respectively.

The investigators found dose-response meta-analyses revealed no significant linear or nonlinear associations between maternal urinary iodine concentration during pregnancy and anthropometric measures at birth.

The investigators found high vs normal values of maternal free thyroxine and thyrotropin during pregnancy were inversely associated with neonatal birth weight.

The investigators concluded that birth weight is affected by even mild variations in the normal concentrations of maternal thyroid hormones. However, in the current meta-analysis, birth anthropometric measures are not associated with maternal urinary iodine concentration during pregnancy.

Original title:
Do maternal urinary iodine concentration or thyroid hormones within the normal range during pregnancy affect growth parameters at birth? A systematic review and meta-analysis by Nazeri P, Shab-Bidar S, […], Shariat M.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31923312

Additional information of El Mondo:
Find more information/studies on food fortification/malnutrition and pregnancy right here.

Lead increases ALS

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Objectives:
Lead is a known risk factor for amyotrophic lateral sclerosis (ALS). However, the results of studies exploring the relationship between lead exposure and the occurrence of ALS are inconsistent. Therefore, this review article has been conducted.

Does a high lead exposure increase risk of ALS?

Study design:
This review article included 11 case-control studies.

Results and conclusions:
The investigators found a high lead exposure significantly increased risk of ALS with 28% [OR = 1.28, 95% CI = 1.02 to 1.63].
Subgroup and sensitivity analyses showed stable results.

The investigators concluded a high lead exposure increases risk of ALS.

Original title:
Population-based study of environmental/occupational lead exposure and amyotrophic lateral sclerosis: a systematic review and meta-analysis by Meng E, Mao Y, […], Jin W.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31578652

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Low-carbohydrate diet reduces cardiovascular disease

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Objectives:
Low-carbohydrate diets are associated with cardiovascular risk factors; however, the results of different studies are inconsistent. Therefore, this review article has been conducted.

Do low-carbohydrate diets (diets with less than 40 En% carbohydrates) reduce cardiovascular risk factors?

Study design:
This review article included 12 RCTs with a total of 820 in the observation group (intervention group or low carbohydrate group) and 820 in the control group. The largest sample size was 403 cases and the smallest was 42 cases. The patients’ ages ranged from 31 to 65 years old.
The intervention was a diet with less than 40 En% carbohydrates in the observation group and a diet with 45 En% to 55 En% carbohydrates in the control group.

Results and conclusions:
The investigators found compared with the control group, the triglyceride levels of the low-carbohydrate group (less than 40 En% carbohydrates) significantly decreased by 0.15 mmol/L [95% CI = -0.23 to -0.07, I2 = 75%, p = 0.001].
The results remained unchanged in the sensitivity analysis (after subtracting each of the included studies individually).

The results of the publication bias analysis showed that the funnel plot was not symmetric. The asymmetry of the funnel plot may have been caused by publication bias and other issues.

The investigators found in subgroup analyses, low-carbohydrate diet interventions lasting less than 6 months significantly decreased the triglyceride levels by 0.23 mmol/L [95% CI = -0.32 to -0.15] and those of 12-23 months decreased the levels by 0.17 mmol/L [95% CI = -0.32 to -0.01].

The investigators found compared with the control group, the plasma HDL-cholesterol level (good cholesterol) of the low-carbohydrate group significantly increased by 0.1 mmol/L [95% CI = 0.08 to 0.12, I2 = 41%, p = 0.02].
The results remained unchanged in the sensitivity analysis (after subtracting each of the included studies individually).

The investigators found in subgroup analyses, the increase in plasma HDL-cholesterol levels was 0.08 mmol/L [95% CI = 0.27 to 0.57] for interventions lasting less than 6 months, 0.12 mmol/L [95% CI = 0.09 to 0.15] for those lasting 6-11 months, 0.12 mmol/L [95% CI = 0.08 to 0.15] for those lasting 12-23 months and 0.08 mmol/L [95% CI = 0.04 to 0.12] for those lasting 24 months. 

The investigators found compared with the control group, the serum total cholesterol level of the low-carbohydrate group significantly increased by 0.13 mmol/L [95% CI = 0.08 to 0.19].
The results remained unchanged in the sensitivity analysis (after subtracting each of the included studies individually).

The investigators found compared with the control group, the plasma LDL-cholesterol level (bad cholesterol) of the low-carbohydrate group significantly increased by 0.11 mmol/L [95% CI = 0.02 to 0.19, I2 = 71%, p = 0.0001].
The results remained unchanged in the sensitivity analysis (after subtracting each of the included studies individually).

The investigators found compared with the control group, the body weight of the low-carbohydrate group significantly decreased by 1.58 kg [95% CI = -1.58 to -0.75, I2 = 49%, p = 0.01].
The results remained unchanged in the sensitivity analysis (after subtracting each of the included studies individually).

The investigators found in subgroup analyses, the decrease in body weight was 1.14 kg [95% CI = -1.65 to -0.63] for interventions lasting less than 6 months and 1.73 kg [95% CI = -2.7 to -0.76] for those lasting 6-11 months.

The investigators found compared with the control group, the overall systolic blood pressure of the low-carbohydrate group significantly decreased by 1.41 mmHg [95% CI = -2.26 to -0.56, I2 = 0%, p = 0.84].
The results remained unchanged in the sensitivity analysis (after subtracting each of the included studies individually).

The investigators found in subgroup analyses, the overall systolic blood pressure significantly decreased by 2.97 mmHg [95% CI = -4.62 to -1.31] in the group that received interventions lasting less than 6 months.

The investigators found compared with the control group, the diastolic blood pressure of the low-carbohydrate group significantly decreased by 1.71 mmHg [95% CI = -2.36 to -1.06, I2 = 14%, p = 0.29].
The results remained unchanged in the sensitivity analysis (after subtracting each of the included studies individually).

The investigators found in subgroup analyses, the diastolic blood pressure significantly decreased by 2.76 mmHg [95% CI = -4.07 to -1.46] in the group that received interventions lasting less than 6 months and 2.11 mmHg [95% CI = -3.28 to -0.93] for those lasting 6-11 months.

The investigators concluded low-carbohydrate diets (diets less than 40 En% carbohydrates) have beneficial effects on cardiovascular risk factors at less than 6 months and 6-11 months, but after 2 years of a low-carbohydrate diet, there is no significant effect on cardiovascular risk factors.

Original title:
The effects of low-carbohydrate diets on cardiovascular risk factors: A meta-analysis by Dong T, Guo M, [...], Chen B.

Link:
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0225348

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40 En% carbohydrates means that the total amounts of carbohydrate make up for a 40% of the total kcal of the diet. The easiest way to follow this diet is to choose only meals/products that also contain 40 En% carbohydrates. These products in the supermarket contain 40 En% carbohydrates.

 

Soy protein dietary intake reduces type 2 diabetes

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Objectives:
Previous findings on the associations of legume and soy intake with the risk of type 2 diabetes are conflicting. Therefore, this review article (meta-analysis) has been conducted.

Does legume or soy dietary intake reduce risk of type 2 diabetes?

Study design:
This review article included 15 unique cohort studies with a total of 565,810 individuals and 32,093 incident cases (persons with type 2 diabetes).

Overall quality of evidence was rated as moderate for total legumes and low for total soy and soy subtypes.

Results and conclusions:
The investigators found no association between total legumes dietary intake and risk of type 2 diabetes [summary RR = 0.95, 95% CI = 0.79 to 1.14, I2 = 84.8%].
No association because RR of 1 was found in the 95% CI of 0.79 to 1.14. RR of 1 means no risk/association.

The investigators found no association between total soy dietary intake and risk of type 2 diabetes [summary RR = 0.83, 95% CI = 0.68 to 1.01, I2 = 90.8%].

The investigators found no association between soy milk dietary intake and risk of type 2 diabetes [summary RR = 0.89, 95% CI = 0.71 to 1.11, I2 = 91.7%].

The investigators found tofu dietary intake significantly reduced risk of type 2 diabetes with 8% [summary RR = 0.92, 95% CI = 0.84 to 0.99].
Significantly because RR of 1 was not found in the 95% CI of 0.84 to 0.99. RR of 1 means no risk/association.

The investigators found soy protein dietary intake significantly reduced risk of type 2 diabetes with 16% [summary RR = 0.84, 95% CI = 0.75 to 0.95].

The investigators found soy isoflavones dietary intake significantly reduced risk of type 2 diabetes with 12% [summary RR = 0.88, 95% CI = 0.81 to 0.96].

The investigators found in dose-response analysis, significant linear inverse associations for tofu, soy protein and soy isoflavones [all p 0.05].

The investigators concluded dietary intakes of tofu, soy protein and soy isoflavones reduce incident type 2 diabetes. These findings support recommendations to increase intakes of certain soy products for the prevention of type 2 diabetes. However, the overall quality of evidence was low and more high-quality evidence from prospective studies is needed.

Original title:
Legume and soy intake and risk of type 2 diabetes: a systematic review and meta-analysis of prospective cohort studies by Tang J, Wan Y, […], Feng F.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31915830

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Middle-aged people with diabetes are at higher risk of developing dementia

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Objectives:
Which factors increase risk of dementia?

Study design:
This review article included 34 prospective cohort studies, among which 24 were eligible for meta-analysis. A total of 159,594 non-demented adults were enrolled at baseline before 65 years and 13,540 people were diagnosed with dementia after follow-up.

Results and conclusions:
The investigators found obesity significantly increased risk of dementia with 78% [RR = 1.78, 95% CI = 1.31-2.41].

The investigators found diabetes mellitus significantly increased risk of dementia with 69% [RR = 1.69, 95% CI = 1.38-2.07].

The investigators found current smoking significantly increased risk of dementia with 61% [RR = 1.61, 95% CI = 1.32-1.95].

The investigators found hypercholesterolemia significantly increased risk of dementia with 57% [RR = 1.57, 95% CI = 1.19-2.07].
However, the sensitivity analyses showed that the result of hypercholesterolemia was not reliable, which need to be confirmed by more high-quality studies.

The investigators found hypertension significantly increased risk of dementia with 41% [RR = 1.41, 95% CI = 1.23-1.62] for borderline blood pressure.

The investigators found hypertension significantly increased risk of dementia with 72% [RR = 1.72, 95% CI = 1.25-2.37] for high systolic blood pressure.
However, the sensitivity analyses showed that the result of high systolic blood pressure was not reliable, which need to be confirmed by more high-quality studies.

The investigators found hyperhomocysteinemia, psychological stress and heavy drinking were also associated with elevated dementia risk.

The investigators found, in addition, physical exercise, a healthy diet and hormone therapy in middle age were associated with the reduction of dementia risk.

The investigators concluded middle-aged people with obesity or diabetes and current smokers in midlife are at higher risk of developing dementia later in life.

Original title:
Midlife Modifiable Risk Factors for Dementia: A Systematic Review and Meta-analysis of 34 Prospective Cohort Studies by Li XY, Zhang M, [...], Tan L.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31902364

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Find more information/studies on obesity, diabetes, hypertension and dementia right here.
 

Meat is not a risk factor for asthma in children

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Objectives:
Many studies have been reported that dietary meat intake may be associated with the risk of asthma in children, but the results are inconsistent. Therefore, this review article has been conducted.

Does dietary meat intake increase asthma in children?

Study design:
This review article included a total of 9 articles.

No publication bias was detected.

Results and conclusions:
The investigators found dietary meat intake 3 or more times per week compared with never/occasionally intake had no significant association with asthma risk among children [OR = 1.27, 95% CI  =  0.80-2.01, p =  0.308].
Not significant because OR of 1 was found in the 95% CI of 0.80 to 2.01. OR of 1 means no risk/association.

The investigators found, similarly, daily dietary intake of meat did not affect the risk of asthma in children when compared with never/occasionally intake [OR  =  1.13, 95% CI  =  0.93-1.37, p  =  0.234].

The investigators concluded dietary meat intake is not a risk factor for asthma in children. Due to some limitations that exist in this review article, more studies are needed to further assess the association between dietary meat intake and asthma risk in children.

Original title:
Dietary meat intake and risk of asthma in children: evidence from a meta-analysis by Zhang D, Cao L, [...], Wang Z.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31895767

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Garlic could reduce risk of colorectal cancer

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Objectives:
Does dietary intake of garlic reduce risk of colorectal cancer?

Study design:
This review article included 11 studies involving 12,558 cases (persons with colorectal cancer).

There was no notable evidence of publication bias.

Results and conclusions:
The investigators found for the highest versus the lowest garlic consumption categories, a significantly reduced risk of 20% [integrated relative risk = 0.80, 95% CI = 0.69 to 0.91] for colorectal cancer.
The sensitivity analysis revealed no notable alterations of the integrated results.
Significant means that there is an association with a 95% confidence.

The investigators found in case-control studies for the highest versus the lowest garlic consumption categories, a significantly reduced risk of 29% [relative risk = 0.71, 95% CI = 0.60 to 0.84] for colorectal cancer.
Significant because relative risk of 1 was not found in the 95% CI of 0.60 to 0.84. Relative risk of 1 means no risk/association.

The investigators found in cohort studies for the highest versus the lowest garlic consumption categories, a non-significantly reduced risk of 1% [relative risk = 0.99, 95% CI = 0.80 to 1.23] for colorectal cancer.
Non-significantly because relative risk of 1 was found in the 95% CI of 0.80 to 1.23. Relative risk of 1 means no risk/association.

The investigators concluded that dietary intake of garlic could reduce risk of colorectal cancer. Could reduce because the risk was not significant in cohort studies.

Original title:
Garlic intake and the risk of colorectal cancer: A meta-analysis by Zhou X, Qian H, […], Zeng L.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31895803

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Physical activity reduces lung cancer among smokers

Objectives:
Epidemiological evidences regarding the association between physical activity and the risk of lung cancer are still controversial. Therefore, this review article has been conducted.

Does physical activity reduce risk of lung cancer?

Study design:
This review article included 20 cohort studies with a total of 2,965,811 participants and 31,807 lung cancer cases.

The study population were adults with age of >18 years.
Most studies were adjusted for major confounders including age, sex, smoking status and body mass index, etc.

The quality scores ranged from 5 to 9 with a median score of 8.
3 studies were evaluated with a score of 7 and others with a score of ≥7. Thus, the majority of the studies included in the meta-analysis were assessed as high-quality studies.

There might be little indication of publication bias in this meta-analysis.

Results and conclusions:
The investigators found compared with the low level of physical activity, the high level of physical activity significantly reduced risk of lung cancer with 17% [pooled RR = 0.83, 95% CI = 0.77 to 0.90, I2 = 62.6%, p heterogeneity 0.001].

The investigators found in subgroup analyses, compared with the low level of physical activity, the high level of physical activity significantly reduced risk of lung cancer among women with 10% [pooled RR = 0.90, 95% CI = 0.82 to 0.99].

The investigators found in subgroup analyses compared with the low level of physical activity, the high level of physical activity significantly reduced risk of lung cancer among men with 19% [pooled RR = 0.81, 95% CI = 0.73 to 0.90].

The investigators found smokers with a high level of physical activity were associated with a 10% lower risk for lung cancer [RR = 0.90, 95% CI = 0.84 to 0.97], while the association was not significant among non-smokers [RR = 0.95, 95% CI = 0.88 to 1.03].

Subgroups analysis stratified by whether the studies adjusted for smoking intensity and durations yielded the same magnitude of RR.

However, the RR for subgroups without adjustment for dietary factors was 0.74 [95% CI = 0.71 to 0.77], which was significantly lower than that with dietary factors adjusted [RR = 0.89, 95% CI = 0.84 to 0.95].

The investigators found in sensitivity analyses, the pooled RRs ranged from 0.82 [95% CI = 0.76 to 0.89] to 0.86 [95% CI = 0.81 to 0.92]. The trend was generally similar with the overall analysis.

The investigators concluded a high level of physical activity reduces risk of lung cancer among smokers. Large interventional studies are expected to further verify these findings. If the inverse association, as well as the effect modification by smoking status, reflects a causal relation, future precision prevention of lung cancer by increased physical activity may be more effective when targeting to smokers rather than non-smokers.

Original title:
Association Between Physical Activity and Lower Risk of Lung Cancer: A Meta-Analysis of Cohort Studies by Liu Y, Li Y, […], Fan XX.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6349707/

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Probiotic supplementation during both prenatal and postnatal period reduces atopic dermatitis

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Objectives:
Probiotic supplementation in early life may be effective in preventing atopic dermatitis (AD); however, results regarding efficacy have been controversial. Therefore, this meta-analysis (systematic review) has been conducted.

Does probiotic supplementation in early life prevent atopic dermatitis in infants and children?

Study design:
This review article included 28 RCTs.

Results and conclusions:
The investigators found compared with controls, probiotic supplementation of mother was associated with a significantly reduced risk of 31% for atopic dermatitis in infants and children [OR = 0.69, 95% CI = 0.58-0.82, p  0.0001].

The investigators found compared with controls, the use of probiotics of mother during both the prenatal and the postnatal period significantly reduced the incidence of atopic dermatitis in infants and children with 33% [OR = 0.67, 95% CI = 0.54-0.82].
However, analysis of studies of probiotics given prenatally only or postnatally only did not reach statistical significance.

The investigators concluded that probiotic supplementation of mother during both the prenatal and the postnatal period reduces the incidence of atopic dermatitis in infants and children. These findings suggest that starting probiotic treatment during gestation and continuing through the first 6 months of the infant's life may be of benefit in the prevention of atopic dermatitis.

Original title:
Probiotic Supplementation for Prevention of Atopic Dermatitis in Infants and Children: A Systematic Review and Meta-analysis by Li L, Han Z, […], He C.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30465329

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2g inositol twice daily reduce preterm delivery rate

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Objectives:
Inositol (ISL) embraces a family of simple carbohydrates with insulin-sensitizing properties, whose most common isoforms are Myo-inositol (MYO) and D-chiro inositol (DCI). Therefore, this meta-analysis (systematic review) has been conducted.

Does inositol supplementation reduce gestational diabetes (GDM)?

Study design:
This review article included 5 RCTs with a total of  965 participants.
The primary outcome was the preventive effect on gestational diabetes, defined as the rate of gestational diabetes in women without a prior diagnosis of gestational diabetes.
Pooled results were expressed as odds ratio (OR) with a 95% confidence interval (95% CI).
No adverse effects were reported for inositol supplementation.

Results and conclusions:
The investigators found inositol supplementation significantly reduced risk of gestational diabetes with 51% [OR = 0.49, p = 0.01]. However, this reduced risk was only significant in patients receiving 2g inositol twice daily.

The investigators found inositol supplementation significantly reduced risk of preterm delivery with 65% [OR = 0.35, 95% CI = 0.17-0.74, p = 0.006]. However, this reduced risk was only significant in patients receiving 2g inositol twice daily.

The investigators concluded double administration of inositol 2g per day reduces gestational diabetes rate and preterm delivery rate. Therefore, inositol supplementation may represent a novel strategy for gestational diabetes prevention.

Original title:
Inositol for the prevention of gestational diabetes: a systematic review and meta-analysis of randomized controlled trials by Vitagliano A, Saccone G, […], Berghella V.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30564926

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Mass deworming has no effect on anaemia and iron-deficiency

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Objectives:
The impact of deworming on parasite load, nutritional status and other health outcomes of non-pregnant adolescent girls and adult women is uncertain. Therefore, this review article has been conducted.

Have deworming beneficial effects on health outcomes of non-pregnant adolescent girls and adult women 10 to 49 years old?

Study design:
This review article included 4 RCTs of mass deworming involving 1,086 participants.
Outcomes of interest included parasite load, reinfection, anaemia, severe anaemia, iron deficiency, diarrhoea or all-cause morbidity.
Risk of bias was assessed using the Cochrane risk of bias tool.

The WHO guideline was used for severe anaemia, defined by haemoglobin levels  80 g/L.
None of the included studies assessed screen and treat deworming or reported reinfection, diarrhoea or adverse events.

Results and conclusions:
The investigators found compared to the control group, mass deworming significantly reduced risk of roundworm infection with 71% [RR = 0.29, 95% CI = 0.14 to 0.62, 2 trials, 1,498 participants, moderate certainty evidence].
Significantly because RR of 1 was not found in the 95% CI of 0.14 to 0.62. RR of 1 means no risk/association.

The investigators found compared to the control group, mass deworming significantly reduced risk of hookworm infection with 68% [RR = 0.32, 95% CI = 0.18 to 0.59, 2 trials, 1,498 participants, moderate certainty evidence].
Significantly means that there is an association with a 95% confidence.

The investigators found compared to the control group, mass deworming significantly reduced risk of whipworm infection with 23% [RR = 0.77, 95% CI = 0.65 to 0.91, 2 trials, 1,498 participants, moderate certainty evidence].

The investigators found compared to the control group, mass deworming non-significantly reduced risk of anaemia with 18% [RR = 0.82, 95% CI = 0.60 to 1.11, 3 studies, 683 participants, low certainty evidence].
Non-significantly because RR of 1 was found in the 95% CI of 0.60 to 1.11. RR of 1 means no risk/association.

The investigators found compared to the control group, mass deworming non-significantly reduced risk of iron-deficiency with 11% [RR = 0.89, 95% CI = 0.64 to 1.23, 1 study, 186 participants, low certainty evidence].
Non-significantly means that there is no association with a 95% confidence.

The investigators found there was uncertainty whether deworming reduced the prevalence of severe anaemia compared to control as the certainty of evidence was very low.

The investigators concluded mass deworming reduces the prevalence of soil-transmitted helminth infections but has no effect on anaemia and iron-deficiency in adolescent girls and non-pregnant women 10 to 49 years old.

Original title:
Deworming in non-pregnant adolescent girls and adult women: a systematic review and meta-analysis by Tanjong Ghogomu E, Suresh S, […], Welch V.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6300900/

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1-6g/d taurine supplementation improves human endurance performance

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Objectives:
Taurine is central to many physiological processes, some of which are augmented by exogenous supply and have the potential to facilitate endurance performance; however, its independent effects on performance have not been systematically analyzed. Therefore, this review article has been conducted.

Does supplementation of taurine improve human endurance performance?

Study design:
This review article included 10 peer-reviewed articles. A sub-analysis of time-to-exhaustion (TTE) trials (n = 7) was also performed.

The doses of taurine ranged from 1 to 6 g/day and were provided in single doses and for up to 2 weeks among a range of subjects.

Results and conclusions:
The investigators found that taurine supplementation significantly improved overall endurance performance [Hedges' g = 0.40, 95% CI = 0.12-0.67, p = 0.004], which was similar in TTE trials [Hedges' g = 0.43, 95% CI = 0.12-0.75, p = 0.007].

The investigators found no differences between acute or chronic supplementation for the full sample [p = 0.897] or the TTE group [p = 0.896].

The investigators found that the dose of taurine did not moderate its effect on endurance performance [p > 0.05].

The investigators concluded that human endurance performance can be improved by orally ingesting a single dose of taurine in varying amounts (1-6 g).

Original title:
The Effects of an Oral Taurine Dose and Supplementation Period on Endurance Exercise Performance in Humans: A Meta-Analysis by Waldron M, Patterson SD, […], Jeffries O.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29546641

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Stunting has negative effects on child development

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Objectives:
Stunting (length-for-age z score -2) before 2 years of age has shown associations with poor child developmental indicators, but information at the population level is scarce in South Asia, the region with the highest burden of stunting. Therefore, this review article has been conducted.

Does undernutrition (i.e., stunting [HAZ -2], wasting [WHZ -2] and underweight [WAZ -2]) associate with poor learning/cognition and social-emotional development among children 36-59 months of age in South Asia?

Study design:
This review article included data from Multiple Indicator Cluster Surveys in Bangladesh (n = 8,659), Bhutan (n = 2,038), Nepal (n = 2,253), and Pakistan (Punjab n = 11,369 and Sindh n = 6,718).
Children were considered developmentally "on-track" in learning/cognition or social-emotional domains if they met specific early child development criteria.
Meta-analysis was conducted to examine regional associations, adjusting for socio-economic status, early childhood education and quality of care.

Results and conclusions:
The investigators found in pooled analysis, that on-track learning/cognition development was positively associated with HAZ [OR = 1.17, 95% CI =1.07 to 1.27] and WAZ [OR = 1.18, 95% CI = 1.07 to 1.31].

The investigators found in pooled analysis, that on-track learning/cognition development significantly reduced risk of stunting with 28% [OR = 0.72, 95% CI = 0.60 to 0.86].
Significantly means that there is an association with a 95% confidence.

The investigators found in pooled analysis, that on-track learning/cognition development significantly reduced risk of underweight with 25% [OR = 0.75, 95% CI = 0.66 to 0.86].

The investigators found in pooled analysis, that on-track learning/cognition development was not associated with WHZ or wasting.

The investigators found in pooled analysis on-track development of social-emotional domain was not associated with any z scores or undernutrition indicators.

The investigators found that across several countries of South Asia, stunted children were less likely to be developmentally "on track" for learning/cognition.

The investigators concluded that interventions that prevent stunting have benefit effects on child development, leading to significant individual and societal gains given the large burden of child stunting in regions like South Asia.

Original title:
Association between stunting and early childhood development among children aged 36-59 months in South Asia by Kang Y, Aguayo VM, […], West KP Jr.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30499257

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Alzheimer's disease patients have a low plasma vitamin E level

Objectives:
Is there a relationship between the levels of vitamin C, vitamin E and β-carotene in the plasma and Alzheimer's disease risk?

Study design:
This review article included studies with data of levels of vitamin C, vitamin E and β-carotene in the plasma of Alzheimer's disease patients.

Results and conclusions:
The investigators found meta-analysis showed that, compared with the control group, the level of vitamin E in the plasma of Alzheimer's disease patients declined significantly [SMD = -1.49 μmol/L, 95% CI = -2.08 to -0.89 μmol/L, p 0.001].

However, no differences were determined in the levels of the plasma vitamin C and β-carotene between the two groups [vitamin C: SMD = -1.43 μmol/L, 95% CI = -3.05 to 0.19 μmol/L, p = 0.083 and β-carotene: SMD = -0.61 μmol/L, 95% CI = -1.40 to 0.18 μmol/L, p = 0.131].

The investigators concluded increasing vitamin E level in the plasma through vitamin E riched diet is useful to prevent Alzheimer's disease. However, it is not yet believed the beneficial role on Alzheimer's disease to increase vitamin C and β-carotene.

Original title:
Meta-analysis of vitamin C, vitamin E and β-carotene levels in the plasma of Alzheimer's disease patients by Dong R, Yang Q, […], Zhao H.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30081996  

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Dietary intake of vitamin A, C and green leafy vegetables reduce glaucoma risk

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Objectives:
Although several studies have been conducted on the association of vitamins with glaucoma, it is often noticed that the results are conflicting leaving physicians and patients in doubt about the effect of vitamins on glaucoma. Therefore, this review article has been conducted.

Does dietary vitamin intake reduce risk of the eye disease glaucoma? 

Study design:
This review article included 5 cohort studies with a total of 940 open-angle glaucoma (OAG) cases and 123,697 controls (persons without open-angle glaucoma).

Results and conclusions:
The investigators found a significantly reduced risk of 55% [pooled OR = 0.45, 95% CI = 0.30-0.68, I2 = 0%] for open-angle glaucoma for dietary intake of vitamin A.

The investigators found a significantly reduced risk of 61% [pooled OR = 0.39, 95% CI = 0.23-0.67, I2 = 0%] for open-angle glaucoma for dietary intake of vitamin C.

The investigators found a significantly reduced risk of 61% [pooled OR = 0.39, 95% CI = 0.22-0.70, I2 = 0%] for open-angle glaucoma for dietary intake of green leafy vegetables (a source for vitamin A, C and nitrate).

The investigators concluded dietary intake of vitamin A, C and green leafy vegetables show a beneficial association with the eye disease open-angle glaucoma.

Original title:
The Effect of Vitamins on Glaucoma: A Systematic Review and Meta-Analysis by Ramdas WD, Schouten JSAG and Webers CAB.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5872777/

Additional information of El Mondo:
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Malnutrition among older adults living in South-East Asia is 25%

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Objectives:
Protein-energy malnutrition is a major health concern in home-dwelling older adults, particularly in the context of an ageing population. Therefore, this review article has been conducted.

What is the prevalence of malnutrition among older adults living independently in the community according to geographical region, sampling frame, rurality and sex?

Study design:
This review article included 111 studies from 38 countries (n = 69,702 participants, with a mean age of ≥65 years).
Meta-regression was used to explore predictors of malnutrition prevalence in pooled statistics with high heterogeneity.

Results and conclusions:
The investigators found the pooled prevalence of malnutrition in the older community setting ranged from 0.8% [95% CI = 0.2-1.7%] in Northern Europe to 24.6% [95% CI = 0.0-67.9%] in South-East Asia.

The investigators found of all sampling frames, participants receiving homecare services had the highest prevalence at 14.6% [95% CI = 9.9-20.0%].

The investigators found malnutrition prevalence in rural communities [9.9%, 95% CI = 4.5-16.8%] was double that in urban communities [5.7%, 95% CI = 4.2-7.3%] and higher among females than males [odds ratio = 1.45, 95% CI = 1.27-1.66, p 0.00001].

The investigators concluded that the prevalence of malnutrition among older adults living in South-East Asia is very high (24.6%), particularly among rural communities and females. These findings provide strategic insight to develop public and community health priorities for preventing malnutrition and associated poor health outcomes.

Original title:
A systematic review, meta-analysis and meta-regression of the prevalence of protein-energy malnutrition: associations with geographical region and sex by Crichton M, Craven D, […], Marshall S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30188972

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88 µg/d vitamin D supplementation reduces type 2 diabetes

Objectives:
Diabetes prevention is a public health priority. Vitamin D supplementation may help prevent the development of diabetes in persons at increased risk. Therefore, this review article has been conducted.

Does vitamin D supplementation reduce risk of type 2 diabetes?

Study design:
This review article included 28 RCTs with 3,848 participants.

The sample size varied from 23 to 511.
The mean age of participants ranged from 26 years to 71 years.
The duration of follow-up across studies ranged from 2 months to 5 years, with a median follow-up of 22 weeks [interquartile range (IQR): 14 to 48 weeks], a duration long enough to detect changes in measured outcomes.

The average vitamin D supplementation dose of 88 µg/d (3500 IU/d).
All included trials measured the effect of vitamin D supplementation on serum 25(OH)D concentrations.

Results and conclusions:
The investigators found overall, serum 25(OH)D concentrations in the treated arms (vitamin D-supplemented groups) significantly improved by 45.1 nmol/L [95% CI = 41.3 to 48.9, p 0.001, I2 = 97.4%].

The investigators found compared with the control group, vitamin D supplementation significantly reduced HbA1c level by -0.48% [95% CI = -0.79 to -0.18, p = 0.002, I2 = 92.1%].
However, after adjusting the effect size for potential publication bias using the “trim and fill” method, 4 potentially missing studies were imputed in the funnel plot and the effect size increased from -0.48% [95% CI = -0.79 to -0.18] to -0.71% [95% CI = -1.02 to -0.39].

The investigators found compared with the control group, vitamin D supplementation significantly reduced fasting plasma glucose level by -0.46 mmol/L [95% CI = -0.74 to -0.19, p = 0.001, I2 = 92.4%].  
However, after adjusting the effect size for potential publication bias using the “trim and fill” method, 6 potentially missing studies were imputed in the funnel plot and the effect size increased -0.46 mmol/L [95% CI = -0.74 to ­0.19] to -0.72 mmol/L [95% CI =-1.02 to -0.42].

The investigators found compared with the control group, vitamin D supplementation significantly reduced HOMA-IR level by -0.39 [95% CI = -0.68 to -0.11, p = 0.007, I2 = 91.3%].
However, after adjusting the effect size for potential publication bias using the “trim and fill” method, 5 potentially missing studies were imputed in the funnel plot and the effect size increased from -0.39 [95% CI = -0.68 to -0.11] to -0.62 [95% CI = -0.92 to -0.32].

The investigators found in subgroup analysis both HbA1c and HOMA-IR showed a greater reduction over time among overweight/obese individuals compared with prediabetics [HbA1c = -0.98 ± 0.45 vs -0.29 ± 0.14, p = 0.1 and HOMA-IR = -0.62 ± 0.23 vs -0.07 ± 0.16, p = 0.05].

The investigators found in subgroup analysis vitamin D supplementation significantly decreased HbA1c [p = 0.05], fasting plasma glucose level [p = 0.05] and HOMA-IR [p = 0.1] to a greater extent when serum 25(OH)D concentration achieved was above 86 nmol/L.

The investigators found in subgroup analysis vitamin D supplementation for less than 6 months provided a larger effect size on HbA1c in comparison with long durations [-0.75 ± 0.33 vs -0.25 ± 0.11, p = 0.1].

The investigators found in subgroup analysis HbA1c showed greater improvement in populations with a mean age younger than 45 years in comparison with older populations [-1.15 ± 0.6 vs -0.30 ± 0.1, p = 0.05].

The investigators found in subgroup analysis greater reductions were found within HbA1c and fasting plasma glucose levels when baseline (at the beginning of the study) mean serum 25(OH)D concentration was ≥50 nmol/L, whereas the lowering effect was significantly less in the subgroup with baseline mean 25(OH)D 50 nmol/L [HbA1c = -0.79 ± 0.25 vs -0.14 ± 0.13, p = 0.04 and fasting plasma glucose level = -0.69 ± 0.21 vs -0.11 ± 0.10, p = 0.05].

The investigators concluded 88 µg/d vitamin D supplementation during 22 weeks improves glycemic measures and insulin sensitivity and may be useful as part of a preventive strategy for type 2 diabetes, particularly among overweight/obese individuals younger than 45 years.

Original title:
Vitamin D Supplementation, Glycemic Control, and Insulin Resistance in Prediabetics: A Meta-Analysis by Mirhosseini N, Vatanparast H, [...], Kimball SM.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6016617/

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HbA1c, FPG, HOMA-IR and plasma glucose after 2-hour oral glucose tolerance test (2HPG) are different parameters associated with (pre)diabetes.

 

≥75 mg/day isoflavones reduce BMI

Afbeelding

Objectives:
Has flavonoid supplementation potential against obesity?

Study design:
This review article included 58 RCTs.
Analysis endpoints were calculated as the mean difference between baseline and post-treatment.
Flavonoids were in subclasses of flavanols, flavonols, isoflavones, flavanones, anthocyanins and proanthocyanidins. They were mostly in the form of supplements and dosages varying from 40 to 1300 mg/day.

Results and conclusions:
The investigators found among flavonoid subclasses, flavanols showed potential for decreasing BMI, in the overall population [MD = -0.28 kg/m2, p = 0.04, n = 21] and in the subgroups of Asians [MD = -0.42 kg/m2, p = 0.046, n = 13], ages 50 years [MD = -0.50 kg/m2, p = 0.008, n = 14], BMI ≥25 kg/m2 [MD = -0.30 kg/m2, p = 0.049, n = 15] and at doses ≥500 mg/day [MD = -0.36 kg/m2, p = 0.049, n = 12].

The investigators found among flavonoid subclasses, isoflavones also significantly decreased BMI of non-Asian populations [MD = -0.26 kg/m2, p = 0.035, n = 13] and doses ≥75 mg/day [MD = -0.34 kg/m2, p = 0.027, n = 8].

The investigators found in the overall assessment, flavanols also significantly decreased waist circumference [MD = -0.60 cm, p = 0.02, n = 18] but had no significant effect on body fat percentage.

The investigators found the available trials did not reveal significant effects from flavonols, flavanones and anthocyanins on the specified anthropometric measures.

The investigators concluded that flavanols, particularly ≥500 mg/day and isoflavones, particularly ≥75 mg/day have potential against obesity.

Original title:
Flavanols are potential anti-obesity agents, a systematic review and meta-analysis of controlled clinical trials by Akhlaghi M, Ghobadi S, […], Mohammadian F.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29759310

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High dietary vitamin E intake reduces risk of stroke

Afbeelding

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

Does dietary vitamin E intake reduce risk of stroke?

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

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

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

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

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

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

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

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No correlation between autoimmune disease and HPV vaccine

Afbeelding

Objectives:
In the literature conflicting opinions are detectable on the onset of adverse events as autoimmune disease post HPV vaccine and often case reports describes the onset of one of these events, but don’t emerge a clear relationship and we don’t have data to support it. Therefore, this review article has been conducted.

Does HPV vaccine increase risk of autoimmune diseases/disorders?

Study design:
This review article included 6 RCT’s (3 used a bivalent vaccine and 3 a quadrivalent vaccine), comprising 243,289 in vaccine group and 248,820 in control group.

The age of the enrolled subjects in the studies varied from 9 to 26 years and all studies reported the number of subjects who experienced a specific autoimmune disease.

4 of the 6 trials had a Jadad score of 3 or 4 indicating an adequate trial quality.

The most frequent autoimmune diseases observed across the 6 studies were musculoskeletal, CNS conditions and endocrinological conditions.

Results and conclusions:
The investigators found no correlation between autoimmune disorders and HPV vaccines [pooled OR = 1.038, 95% CI = 0.689-1.562].

The investigators concluded there is no correlation between autoimmune disorders and bivalent and quadrivalent HPV vaccines. It's therefore essential to correctly inform the general population in order to try to increase both Italian and international vaccination coverage.

Original title:
HPV vaccine and autoimmune diseases: systematic review and meta-analysis of the literature by Genovese C, LA Fauci V, […], Squeri R.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196376/

Additional information of El Mondo:
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Antioxidant supplements could increase sperm quality

Objectives:
Infertility, which affects ∼15% of the world's population, is a global public health issue recognized by the WHO. Therefore, it is of major clinical and public health importance to investigate whether modifiable lifestyle factors,such as stress, drug use, smoking, alcohol intake and diet may influence human fertility. Therefore, this meta-analysis (systematic review) has been conducted.

What is the effect of supplementation of nutrients on sperm quality parameters?

Study design:
This review article included 28 articles (RCTs) for qualitative analysis and 15 for quantitative meta-analysis.

Results and conclusions:
The investigators found total sperm concentrations were significantly increased by:
-selenium [MD = 3.91 × 106 spz/mL, 95% CI = 3.08 to 4.73 spz/mL];
-zinc [MD = 1.48 × 106 spz/mL, 95% CI = 0.69 to 2.27 spz/mL];
-omega 3 fatty acids [MD = 10.98 × 106 spz/mL, 95% CI = 10.25 to 11.72 spz/mL] and
-coenzyme Q10 [MD = 5.93 × 106 spz/mL, 95% CI = 5.36 to 6.51 spz/mL].

The investigators found sperm counts were significantly increased by:
-omega 3 fatty acids [MD = 18.70 × 106 spz/mL, 95% CI = 16.89 to 20.51 spz/mL] and
-coenzyme Q10 [MD = 10.15 × 106 spz/mL, 95% CI = 8.34 to 11.97 spz/mL].

The investigators found sperm total motility was significantly increased by:
-selenium [MD = 3.30%, 95% CI = 2.95% to 3.65%];
-zinc [MD = 7.03%, 95% CI = 6.03% to 8.03%];
-omega 3 fatty acids [MD = 7.55%, 95% CI = 7.09% to 8.01%];
-coenzyme Q10 [MD = 5.30%, 95% CI = 4.98% to 5.62%] and
-carnitines [MD = 7.84%, 95% CI = 6.54% to 9.13%].

The investigators found sperm progressive motility significantly increased by supplementation with carnitines [MD = 7.45%, 95% CI = 6.24% to 8.67%].

The investigators found sperm morphology was significantly enhanced by:
-selenium [MD = 1.87%, 95% CI = 1.50% to 2.24%];
-omega 3 fatty acid [MD = 0.91%, 95% CI = 0.69% to 1.13%];
-coenzyme Q10 [MD = 1.06%, 95% CI = 0.72% to 1.41%] and
-carnitine [MD = 4.91%, 95% CI = 3.68% to 6.15%].

The investigators concluded evidence from RCTs shows that some dietary supplements beneficially modulate sperm quality parameters and affect male fertility. However, results must be cautiously interpreted due to the limited sample size of the meta-analyzed studies and the considerable observed interstudy heterogeneity.

Original title:
The Effect of Nutrients and Dietary Supplements on Sperm Quality Parameters: A Systematic Review and Meta-Analysis of Randomized Clinical Trials by Salas-Huetos A, Rosique-Esteban N, […], Salas-Salvadó J.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30462179

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<50 g/d carbohydrates increase good cholesterol in overweight/obese adults

Afbeelding

Objectives:
Carbohydrate-restricted diets may increase low-density lipoprotein cholesterol (LDL-cholesterol or bad cholesterol) and thereby cardiovascular risk. Therefore, this review article has been conducted.

Do carbohydrate restriction diets increase cholesterol and triglycerides levels in overweight/obese adults?

Study design:
This review article included 8 RCTs with a total of 1,633 participants, of which 818 in carbohydrate-restricted diet group (intervention group) and 815 low-fat diet group (control group).

All RCTs had more than 100 participants with duration of at least 6 months.

Results and conclusions:
The investigators found when compared with low-fat diets, carbohydrate-restricted diets showed no significant difference in LDL-cholesterol levels after 6, 12 and 24 months.
Although an overall pooled analysis statistically favoured low-fat diets [0.07 mmol/L, 95% CI = 0.02-0.13, p = 0.009], this was clinically insignificant.

The investigators found when compared with low-fat diets, carbohydrate-restricted diets significant increased HDL-cholesterol (good cholesterol) levels [0.08 mmol/L, 95% CI = 0.06-0.11, p 0.00001] after 6 and 12 months.
These favourable changes were more marked in the subgroup with very-low carbohydrate content [50 g/d: 0.12 mmol/L, 95% CI = 0.10-0.14, p  0.00001].

The investigators found when compared with low-fat diets, carbohydrate-restricted diets significant reduced plasma triglycerides levels [-0.13 mmol/L, 95% CI = -0.19 to -0.08, p  0.00001 after 6 and 12 months.
These favourable changes were more marked in the subgroup with very-low carbohydrate content [50 g/d: -0.19 mmol/L, 95% CI = -0.26 to -0.12, p = 0.02].

The investigators concluded large randomized controlled trials (RCTs) of at least 6 months duration with carbohydrate restriction, particularly 50 g/d carbohydrates, is superior in improving HDL-cholesterol and triglycerides levels in overweight/obese adults when compared with low-fat diets. Dietary guidelines should consider carbohydrate restriction as an alternative dietary strategy for the prevention/management of dyslipidemia for populations with cardiometabolic risk.

Original title:
Effects of carbohydrate-restricted diets on low-density lipoprotein cholesterol levels in overweight and obese adults: a systematic review and meta-analysis by Gjuladin-Hellon T, Davies IG, […], Amiri Baghbadorani R.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30544168

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50 grams of carbohydrates per day corresponds to a diet with 10 En% carbohydrates.
The easiest way to follow a diet with 10 En% carbohydrates is to choose only meals/products with 10 En% carbohydrates.
However, the most practical way to follow a diet with 10 En% carbohydrates is all meals/products that you eat on a daily basis should contain on average 10 En% carbohydrates. Check here which products contain 10 En% carbohydrates.

Dairy products, high purine vegetables, soy foods and coffee decrease gout

Afbeelding

Objectives:
Is there an association between dietary factors and the risk of gout and hyperuricemia?
 
Study design:
This review article included 10 prospective cohort studies (the follow-up duration ranged from 6 years to 26 year) and 9 cross-sectional studies.

Based on the Newcastle-Ottawa Scale (NOS), the quality assessment of included studies yielded a mean NOS score of 7.1, suggesting the presence of high methodologic quality.

Results and conclusions:
The investigators found in meta-analysis that the risk of getting gout significantly increased with:
29% [OR = 1.29, 95% CI = 1.16-1.44] for dietary red meat intake;
31% [OR = 1.31, 95% CI = 1.01-1.68] for dietary seafoods intake;
158% [OR = 2.58, 95% CI = 1.81-3.66] for dietary alcohol intake;
114% [OR = 2.14, 95% CI = 1.65-2.78] for dietary fructose intake.

The investigators found in meta-analysis that the risk of getting gout significantly decreased with:
44% [OR = 0.56, 95% CI = 0.44-0.70] for dietary dairy products intake;
15% [OR = 0.85, 95% CI = 0.76-0.96] for dietary soy foods intake;
14% [OR = 0.86, 95% CI = 0.75-0.98] for dietary high-purine vegetables intake;
53% [OR = 0.47, 95% CI = 0.37-0.59] for dietary coffee intake.

The investigators found in meta-analysis that the risk of getting hyperuricemia (an excess of uric acid in the blood) significantly increased with:
24% [OR = 1.24, 95% CI = 1.04-1.48] for dietary red meat intake;
47% [OR = 1.47, 95% CI = 1.16-1.86] for dietary seafoods intake;
106% [OR = 2.06, 95% CI = 1.60-2.67] for dietary alcohol intake;
85% [OR = 1.85, 95% CI = 1.66-2.07] for dietary fructose intake.

The investigators found in meta-analysis that the risk of getting hyperuricemia (an excess of uric acid in the blood) significantly decreased with:
50% [OR = 0.50, 95% CI = 0.37-0.66] for dietary dairy products intake;
30% [OR = 0.70, 95% CI = 0.56-0.88] for dietary soy foods intake.

The investigators found in meta-analysis that the risk of getting hyperuricemia (an excess of uric acid in the blood) non-significantly increase with:
10% [OR = 1.10, 95% CI = 0.88-1.39] for dietary high-purine vegetables intake.

The investigators found in meta-analysis that the risk of getting hyperuricemia (an excess of uric acid in the blood) non-significantly decreased with 24% [OR = 0.76, 95% CI = 0.55-1.06] for dietary coffee intake in men.
Non-significantly because OR of 1 was found in the 95% CI of 0.55 to 1.06. OR of 1 means no risk/association.

The investigators found in meta-analysis that the risk of getting hyperuricemia (an excess of uric acid in the blood) significantly increased with 58% [OR = 1.58, 95% CI = 1.16-2.16] for dietary coffee intake in women.
Significant because OR of 1 was not found in the 95% CI of 1.16 to 2.16. OR of 1 means no risk/association.

The investigators concluded that the risk of hyperuricemia and gout is positively correlated with the dietary intake of red meat, seafoods, alcohol or fructose and negatively with dairy products or soy foods. High-purine vegetables show no association with hyperuricemia, but negative association with gout. Coffee intake is negatively associated with gout risk, whereas it is positively associated with hyperuricemia risk in women.

Original title:
Dietary factors and risk of gout and hyperuricemia: a meta-analysis and systematic review by Li R, Yu K and Li C.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30485934

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Postherpetic neuralgia patients benefit from vitamin B12 supplementation

Afbeelding

Objectives:
Postherpetic neuralgia (PHN) is the most distressful complication of herpes zoster. Postherpetic neuralgia results in an impaired quality of life and higher healthcare utilization. Vitamin B12 has been proven to be effective in pain relief for various conditions. Therefore, this review article has been conducted.

Do postherpetic neuralgia patients benefit from vitamin B12 supplementation?

Study design:
This review article included 4 RCTs (published between 2013 and 2016) including 383 participants.

Results and conclusions:
The investigators found compared with the placebo group, the vitamin B12 group exhibited a significant decrease in the Numeric Rating Scale score, with a mean difference of -4.01 [95% CI = -4.70 to -3.33].

The investigators found compared with the placebo group, vitamin B12 administration improved the quality of life of postherpetic neuralgia patients with moderate quality evidence and significantly decreased the number of patients using analgesics.

The investigators concluded that vitamin B12 appears to be an attractive complementary therapy for postherpetic neuralgia patients. However, further investigation is needed before conclusive recommendations can be made.

Original title:
Vitamin B12 for herpetic neuralgia: A meta-analysis of randomised controlled trials by Wang JY, Wu YH, [...], Lu PH.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30477853

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Postherpetic neuralgia (PHN) is a nerve pain (neuralgia) that persists after a shingles rash has cleared. Postherpetic neuralgia is caused by the chickenpox (varicella-zoster) virus.
 

Serum selenium is lower in tuberculosis patients

Afbeelding

Objectives:
Tuberculosis (TB) is associated with increased mortality. The high risk of micronutrients deficiency, including selenium, in tuberculosis patients is of great concern because it increases the risk of death. However, it is not clear whether selenium supplementation could improve the treatment outcomes in tuberculosis patients. Therefore, this review article has been conducted.

Have tuberculosis patients a low serum selenium concentration?

Study design:
This review article included 6 observational studies. Of them, 4 were carried out in Asia and one each in Africa and South America.

Potential sources of heterogeneity included study design and selenium measurement methods.

Results and conclusions:
The investigators found the random pooled effect size was 1.6 [95% CI = 0.9 to 2.4, I2 = 95.1%]. This means that the probability is 160% for an individual with tuberculosis to have low levels of selenium as compared to an individual without tuberculosis.

The investigators concluded that serum selenium is lower in tuberculosis patients as compared with individuals without tuberculosis. Therefore, it is advisable to individually assess selenium status in tuberculosis patients and decide whether selenium supplement is needed or not.

Original title:
Serum selenium levels in tuberculosis patients: A systematic review and meta-analysis by Muzembo BA, Mbendi NC, […], Ikeda S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30262288

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