Nutritional advice

Objectives:
Is there an association between poultry and egg consumption and brain cancer risk?

Study design:
This review article included a total of 10 articles (6 articles for poultry consumption and 5 articles for egg consumption).

Results and conclusions:
The investigators found no association between poultry consumption and reduced risk of brain cancer [summarized relative risk = 0.901, 95% CI = 0.703-1.154, I2 = 60.7%, p = 0.018].
No association because RR of 1 was found in the 95% CI of 0.703 to 1.154. RR of 1 means no risk/association.

The investigators found in 4 studies no association between poultry consumption and reduced risk of brain cancer glioma [summarized relative risk = 0.873, 95% CI = 0.737-1.034, I2 = 0.0%, p = 0.838].

The investigators found no association between egg consumption and reduced risk of brain cancer [summarized relative risk = 0.998, 95% CI = 0.552-1.805, I2 = 82.6%, p = 0.001].

The investigators found no association between egg consumption and increased risk of brain cancer glioma [summarized relative risk = 1.472, 95% CI = 0.935-2.316].

The investigators concluded that poultry and egg consumption are not associated with the risk of brain cancer. Due to the limited quality of evidence currently available, more studies related to poultry and egg consumption for brain cancer is necessary.

Original title:
A meta-analysis of the association between poultry and egg consumption and the risk of brain cancer by Luo H, Sun P, [...], Guo Y.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30782302

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Find more information/studies on poultry and egg consumption, review article/significantly and cancer right here.

Objectives:
Intermittent preventive treatment (IPT) with sulphadoxine-pyrimethamine (SP) is recommended for preventing maternal and fetal effects of malaria in pregnancy. Increasing parasite resistance to sulphadoxine-pyrimethamine has necessitated the search for an alternative medication. Therefore, this review article has been conducted.

What is the magnitude of effects of dihydroartemisinin‐piperaquine (DP) and sulphadoxine‐pyrimethamine (SP) in preventing malaria during pregnancy?

Study design:
This review article included 3 RCTs involving 3,719 participants.
The trials commenced in 2011, 2012 and 2014 in Malawi, Kenya and Uganda, respectively. The included studies involved pregnant women who were given DP (as routine IPT, a three‐dose regimen, monthly regimen or as IST) and compared with those given SP.

Results and conclusions:
The investigators found compared with intermittent preventive treatment with sulphadoxine-pyrimethamine (IPT-SP), moderate certainty evidence indicated that women who received intermittent preventive treatment with a three‐dose regimen of dihydroartemisinin-piperaquine (IPT-DP) had a significantly lower risk of 83% [OR = 0.17, 95% CI = 0.10-0.29, 1171 participants] of clinical malaria during pregnancy.

The investigators found high certainty evidence showed intermittent screening and treatment with dihydroartemisinin-piperaquine did not reduce placental malaria [OR = 1.29, 95% CI = 1.10-1.50, 2 studies, 2,903 participants] or maternal parasitemia at delivery [OR = 1.39, 95% CI = 1.14-1.69, 2 studies, 2,903 participants].  

The investigators found compared with intermittent preventive treatment with sulphadoxine-pyrimethamine (IPT-SP), moderate certainty evidence indicated that women who received intermittent preventive treatment with a monthly regimen of dihydroartemisinin-piperaquine (IPT-DP) had a significantly lower risk of 99% [OR 0.01, 95% CI = 0.00-0.19, 1 study, 206 participants] of clinical malaria during pregnancy.

The investigators found effect of dihydroartemisinin-piperaquine on low birth weight and adverse birth outcomes was minimal.

The investigators concluded the efficacy of DP as a potential agent for IPT for malaria in pregnancy reported in this review is limited by few studies and moderate certainty of the evidence. Although also limited by few studies, there is moderate to high certainty of evidence that the use of DP for intermittent screening and treatment (IST) of malaria is not superior to IPT‐SP. The findings from the studies included in this review indicate that further high‐quality research with large numbers of participants, in settings endemic for malaria infection, is needed to provide reliable evidence for policy and practice recommendations.

Original title:
A systematic review and meta-analysis of dihydroartemisinin-piperaquine versus sulphadoxine-pyrimethamine for malaria prevention in pregnancy by Olaleye A, Okusanya BO, […], Meremikwu M.

Link:
https://obgyn.onlinelibrary.wiley.com/doi/full/10.1002/ijgo.12835

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Find more information/studies on food fortification/malnutrition and malaria right here.

Objectives:
The role of chromium as a weight loss agent remains questionable and although previous meta-analyses findings have reported small reductions in body weight in individuals with overweight/obesity following chromium supplementation, there have been significant limitations with these findings. Therefore, this review article has been conducted.

Do individuals with overweight/obesity benefit from chromium supplementation?

Study design:
This review article included 21 RCTs with a total of 1,316 participants.

Results and conclusions:
The investigators found pooled analysis showed significant reductions in anthropometric indices associated with body composition for:
-weight loss [WMD = -0.75 kg, 95% CI = -1.04 to -0.45, p  0.001];
-body mass index (BMI) [WMD = -0.40, 95% CI = -0.66 to -0.13, p = 0.003] and;
-body fat percentage [WMD = -0.68%, 95% CI = -1.32 to -0.03, p = 0.04] in individuals with overweight/obesity following chromium supplementation. No changes were detected in controls.

The investigators found subgroup analysis showed significant improvements in weight loss and body fat percentage, particularly for study durations ≤12 weeks and doses ≤400 μg/d chromium.

The investigators concluded ≤400 μg/d chromium supplementation during ≤12 weeks is associated with some improvements in body composition in subjects with obesity/overweight. The effect size was medium and the clinical relevance of chromium as a weight loss aid remains uncertain. Therefore, further investigation from larger and well-designed randomized controlled studies, especially in patients with diabetes, is warranted.

Original title:
A meta-analysis of the effect of chromium supplementation on anthropometric indices of subjects with overweight or obesity by Tsang C, Taghizadeh M, […], Jafarnejad S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31115179

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Find more information/studies on chromium and obesity/overweight right here.

Objectives:
Does coenzyme Q10 (CoQ10) supplementation improve biomarkers of inflammation and oxidative stress among patients with coronary artery disease (CAD)?

Study design:
This review article included 13 RCTs.

Given the presence of heterogeneity, random-effects model or fixed-effect model were used to pool standardized mean differences (SMDs) as summary effect sizes.

Results and conclusions:
The investigators found pooled findings for biomarkers of inflammation and oxidative stress demonstrated that coenzyme Q10 supplementation significantly increased superoxide dismutase (SOD) [SMD = 2.63, 95% CI = 1.17 to 4.09, p  0.001, I2 = 94.5%] and catalase (CAT) levels [SMD = 1.00, 95% CI = 0.57 to 1.43, p  0.001, I2 = 24.5%] among patients with coronary artery disease.

The investigators found pooled findings for biomarkers of inflammation and oxidative stress demonstrated that coenzyme Q10 supplementation significantly reduced malondialdehyde (MDA) [SMD = -4.29, 95% CI = -6.72 to -1.86, p = 0.001, I2 = 97.6%] and diene levels [SMD = -2.40, 95% CI = -3.11 to -1.68, p  0.001, I2 = 72.6%] among patients with coronary artery disease.

The investigators found among patients with coronary artery disease no significant effect of coenzyme Q10 supplementation on:
-C-reactive protein (CRP) [SMD = -0.62, 95% CI = -1.31 to 0.08, p = 0.08, I2 = 87.9%];
-tumor necrosis factor alpha (TNF-α) [SMD = 0.22, 95% CI = -1.07 to 1.51, p = 0.73, I2 = 89.7%];
-interleukin-6 (IL-6) [SMD = -1.63, 95% CI = -3.43 to 0.17, p = 0.07, I2 = 95.2%] and;
-glutathione peroxidase (GPx) levels [SMD = 0.14, 95% CI = -0.77 to 1.04, p = 0.76, I2 = 78.7%].
No significant because the calculated p-values were larger than the p-value of 0.05.

The investigators concluded coenzyme Q10 supplementation increases superoxide dismutase and catalase and decreases malondialdehyde and diene levels, but has no affect on C-reactive protein, tumor necrosis factor alpha, interleukin-6 and glutathione peroxidase levels among patients with coronary artery disease.

Original title:
The effects of coenzyme Q10 supplementation on biomarkers of inflammation and oxidative stress in among coronary artery disease: a systematic review and meta-analysis of randomized controlled trials by Jorat MV, Tabrizi R, […], Asemi Z.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30758695

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Malondialdehyde and diene are biomarkers of oxidative stress. Oxidative stress can arise when human cells cannot adequately destroy the excess of free radicals formed.

Free radicals can be rendered harmless by antioxidants such as vitamins C and E and by antioxidative enzymes such as superoxide dismutase and catalase.

Objectives:
Breastfeeding initiation within the first half hour after birth is one of the World Health Organization recommendations. However, in most hospitals, mother-infant contact and breastfeeding initiation are delayed due to routine mother and infant care. Therefore, this review article has been conducted.

Does mother-infant skin to skin contact (SSC) immediately after birth increase the success rate and duration of first breastfeeding?

Study design:
This review article included a total of 9 RCTs with 597 participants were assigned to the intervention group and 553 participants were assigned to the comparison group.

Results and conclusions:
The investigators found quantitative analysis based on mean differences or odds ratio showed that mother-infant skin to skin contact had a significantly positive effect on success in first breastfeeding [MD =1.90, 95% CI = 0.958 to 2.856, p = 0.00; OR = 2.771, 95% CI = 1.587 to 4.838, p = 0.00] and first breastfeeding duration [MD = 26.627, 95% CI = 1.070 to 52.184, p = 0.041].

The investigators concluded mother-infant skin to skin contact immediately after birth has beneficial effects on breastfeeding and can increase the success rate and duration of the first lactation. Therefore, these findings can be used by healthcare providers in evidence-based decision-making about ways to increase breastfeeding rates.

Original title:
The effect of mother-infant skin to skin contact on success and duration of first breastfeeding: A systematic review and meta-analysis by Karimi FZ, Sadeghi R, […], Khadivzadeh T.

Link:
https://www.sciencedirect.com/science/article/pii/S1028455918302766?via%3Dihub

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Objectives:
Plasma creatinine has been described as a prognostic biomarker for Amyotrophic Lateral Sclerosis (ALS), but with conflicting results in the literature. Therefore, this review article (meta-analysis) has been conducted.

Does a high plasma creatinine concentration reduce risk of ALS?

Study design:
This review article included 14 distinct cohorts (19 studies).

The overall quality of the studies was low mainly due to potential attrition bias and several studies did not report analyzable results raising concern regarding a potential reporting bias.

Results and conclusions:
The investigators found for baseline plasma creatinine, mortality risk was 28% lower when creatinine was higher than 88.4 µmol/L [HR = 0.72, 95% CI = 0.58 to 0.88, p = 0.0003] and was 25% lower if creatinine was above versus below the median [HR = 0.75, 95% CI = 0.63 to 0.89, p = 0.0008].

The investigators found a significant positive correlation between plasma creatinine at baseline and functional score and between creatinine decline and functional score decline [p  0.0001 for both].

The investigators found, however, a negative correlation between plasma creatinine and functional score decline [p = 0.033].

The investigators concluded plasma creatinine seems to be a promising prognostic biomarker for ALS. However, new studies with sound methodology and standardized criteria for the evaluation of ALS progression should be conducted to validate plasma creatinine as a clinical biomarker for ALS prognosis.

Original title:
Plasma creatinine and amyotrophic lateral sclerosis prognosis: a systematic review and meta-analysis by Lanznaster D, Bejan-Angoulvant T, […], Blasco H.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30961401

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Objectives:
Previous studies had demonstrated some associations between coffee and tea consumption and brain cancer risk resulted in an inconsistent relationship. Therefore, this review article has been conducted.

Does coffee or tea consumption reduce brain cancer risk?

Study design:
This review article included 8 cohort studies and 3 case-control studies, involving 2,583 cases (persons with brain cancer) among 1,684,262 participants.

Based on Egger’s test and funnel plot, there existed no publication bias.

Results and conclusions:
The investigators found highest category of coffee consumption significantly reduced risk of brain cancer with 21.5% [RR = 0.785, 95% CI = 0.580-0.984, I2 = 65.6%, p for heterogeneity = 0.001], when compared with the lowest category.

The investigators found in supgroup analysis highest category of coffee consumption significantly reduced risk of glioma with 24% [RR = 0.760, 95% CI = 0.548-0.972], when compared with the lowest category.

The investigators found in cohort studies highest category of coffee consumption significantly reduced risk of brain cancer with 14.2% [RR = 0.858, 95% CI = 0.700-0.992], when compared with the lowest category. However, this reduced risk was not significant in case-control studies.

The investigators found highest category of coffee consumption significantly reduced risk of brain cancer with 88.3% in Asian populations [RR = 0.217, 95% CI = 0.042-0.896], when compared with the lowest category. However, this reduced risk was not significant in other populations.

The investigators found sensitivity analysis showed pooled RR of coffee consumption ranged from 0.738 [95% CI = 0.542-0.961) to 0.905 [95% CI = 0.754-1.088].

The investigators found highest category of tea consumption significantly reduced risk of brain cancer with 20.2% in American populations [RR = 0.798, 95% CI = 0.646-0.986], when compared with the lowest category.

The investigators found sensitivity analysis showed pooled RR of tea consumption ranged from 0.863 [95% CI = 0.699-1.067] to 0.947 [95% CI = 0.763-1.176].

The investigators found highest category of coffee plus tea consumption significantly reduced risk of brain cancer with 31.6% [RR = 0.684, 95% CI = 0.481-0.975], when compared with the lowest category.

The investigators concluded higher consumption of coffee reduces risk of brain cancer in Asian populations and higher consumption of tea reduces risk of brain cancer in American population. However, future studies with detailed information about sex, lifestyle and some other related factors are warranted to further explore the association between coffee or tea consumption and risk of brain cancer.

Original title:
Association between tea and coffee consumption and brain cancer risk: an updated meta-analysis by Song Y, Wang Z, [....], Guo J.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419842/

Additional information of El Mondo:
Find more information/studies on coffee and tea consumption, review article/significantly and cancer right here.
 

Objectives:
Micronutrient malnutrition is highly prevalent in low- and middle-income countries (LMICs) and disproportionately affects women and children. Although the effectiveness of large-scale food fortification (LSFF) of staple foods to prevent micronutrient deficiencies in high-income settings has been demonstrated, its effectiveness in LMICs is less well characterized. Therefore, this review article has been conducted.

Does large-scale food fortification (LSFF) of staple foods prevent micronutrient deficiencies in low- and middle-income countries (LMICs)?

Study design:
This review article included 50 studies.

4 studies for vitamin A fortification with a mean intervention duration of 14 months (12 to 24 months). Geographic locations included Indonesia, South Africa, Guatemala and Nicaragua and food vehicles included sugar, maize flour and oil.

11 studies for iodine fortification. Study populations consisted mostly of school-age children and adolescents (aged 5-18 years) in Asian and African locations. Iodine fortificants were varied and included potassium iodate, sodium iodide and multiple fortificants. Intervention duration ranged from 10 months to 14 years, with a mean of 5.7 years.

19 studies for iron fortification. The study populations consisted of women and children of varying age groups, including 2 studies pertaining specifically to pregnant women and 1 looking at the effects of fortification on anaemic children.
The food vehicles were varied and included maize flour, wheat flour, rice, soy sauce, fish sauce and milk.
Several fortificants were used, including sodium iron ethylenediaminetetraacetate (NaFeEDTA), ferrous sulfate, ferrous fumarate, ferrous bisglycinate, electrolytic iron and ferric orthophosphate.
The studies were geographically diverse, with the majority coming from Asia and South America. One was a multicountry study, reporting on anemia prevalence in 12 different countries.
Intervention duration ranged from 18 months to 16 years, with a mean of 5.3 years.

17 studies for folic acid fortification. The vast majority of studies took place in Central and South America and food vehicles included wheat and maize flour.
Intervention duration ranged from 12 months to 11 years, with a mean of 4.2 years.

The range of each age group was children (1-4 years), school-age children (5-9 years), adolescents (10-19 years) and women of reproductive age (WRA).

Results and conclusions:
The investigators found in pooled analysis that vitamin A fortification was associated with a significant increase in serum retinol [SMD = 0.31, 95% CI = 0.18 to 0.45].
The effect was significant for each of the age groups assessed and particularly for older [children SMD = 0.50, 95% CI = 0.16 to 0.85].
Single studies examining the effect of vitamin A fortification in children aged 1 y and women of reproductive age also signaled improvements in serum retinol (vitamin A level in blood).  

The investigators found that serum retinol levels of children aged 0-9 years significantly improved by 0.28 μg/dL [95% CI = 0.14 to 0.43 μg/dL] following large-scale food fortification with vitamin A for an average of 14 months.
Today, the global prevalence of vitamin A deficiency (VAD; defined as a serum retinol concentration 0.70 μmol/L) for children aged 5 y is 33.3%, equating to 190 million children. When considering the impact of these findings on a population curve, this global deficiency would shift to 32.82%, indicating an approximate reduction in vitamin A deficiency for 2.7 million children [95% CI = 1.3 to 4.1 million children] in just over 1 year.

The investigators found large-scale food fortification with iodine was associated with a significant increase in urinary iodine [SMD = 1.02, 95% CI = 0.63 to 1.42].
Subgroup analysis revealed a statistically significant impact for school-age children [SMD = 1.12, 95% CI = 0.57 to 1.67]. Accordingly, the prevalence of iodine deficiency was reduced for this age group as well [RR = 0.25, 95% CI = 0.21 to 0.29].

The investigators found large-scale food fortification with iodine significantly reduced goiter prevalence (grade 1-2) among school-age children with 74% [OR = 0.26, 95% CI = 0.16 to 0.43], a finding that was indicative of the long-term impact of salt iodization programs.

The investigators found large-scale food fortification with iron was associated with a small, but significant, increase in the hemoglobin concentration for combined populations (preschool children, school-age children and WRA only). However, when disaggregating by age and status (pregnant and anaemic populations at baseline) the effect remained significant for pregnant women only [SMD = 0.12, 95% CI = 0.01 to 0.23].

The investigators found large-scale food fortification with iron was associated with a 34% decline in anemia prevalence for combined age groups [RR = 0.66, 95% CI = 0.59 to 0.74], with the greatest impact noted for women of reproductive age [RR = 0.66, 95% CI = 0.58, 0.76], followed by school-age children (1-4 years) [RR = 0.68, 95% CI = 0.52, 0.90].

The investigators found in 3 studies looked at the impact of iron fortification in pregnant women specifically that, although anemia prevalence was significantly reduced [RR = 0.73, 95% CI = 0.64 to 0.84], the decline was less than it was for nonpregnant women.

The investigators found large-scale food fortification with iron significantly increased serum ferritin increased by 0.39 μg/L [95% CI = 0.34 to 0.44 μg/L], indicating a significant improvement in iron stores for combined age groups following iron fortification.
Variability around the point estimates for serum ferritin was largest for the youngest children [SMD = 0.47, 95% CI = 0.35 to 0.59].

The investigators found large-scale food fortification with iron significantly decreased prevalence of iron deficiency by 58% among all population subsets [RR = 0.42, 95% CI = 0.32 to 0.56].  

The investigators found large-scale food fortification with folic acid significantly reduced prevalence of total neural tube defects with 41% [OR = 0.59, 95% CI = 0.49 to 0.70] and neural tube defect subtype, including spina bifida with 34% [OR = 0.66, 95% CI = 0.53 to 0.82], anencephaly with 51% [RR = 0.49, 95% CI = 0.40 to 0.60] and cephalocele with 36% [OR = 0.64, 95% CI = 0.47 to 0.88].

The investigators found among women of reproductive age, folic acid fortification of flour was associated with a significant decline of 80% in the prevalence of folate deficiency [RR = 0.20, 95% CI = 0.15 to 0.25], as well as improvements in serum/plasma folate levels [SMD = 1.25, 95% CI = 0.50 to 1.99].

The investigators concluded that large-scale food fortification has a positive impact on some functional health outcomes, including goiter, anemia and neural tube defects prevalence. Large-scale food fortification also increases relevant micronutrient biomarker concentrations, and improves iron stores and reduces iron deficiency prevalence in both women and children.

Original title:
Improved micronutrient status and health outcomes in low- and middle-income countries following large-scale fortification: evidence from a systematic review and meta-analysis by Keats EC, Neufeld LM, […], Bhutta ZA.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6537942/

Additional information of El Mondo:
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Objectives:
The role of gut microbiota in the management of diabetes has been shown. Several current trials are investigating the effect of probiotics and prebiotics, which are widely used to modulate intestinal microbiota, on inflammatory factors and biomarkers of oxidative stress in diabetic patient. However, their findings are controversial. Therefore, this review article (meta-analysis) has been conducted.

Do probiotic and synbiotic supplementation improve biomarkers of inflammation and oxidative stress in diabetic patients?

Study design:
This review article included 16 RCTs (n = 1,060).

Randomized controlled trials (RCTs) reported the effect of probiotics or synbiotics on circulating (serum and plasma) inflammatory marker (hs-CRP) and oxidative stress indicators (malondialdehyde [MDA], glutathione [GSH], nitric oxide [NO] and total antioxidant capacity [TAC]) among patients with diabetes.

The methodological quality varied across these trials.

Results and conclusions:
The investigators found probiotic and synbiotic supplementation significantly decreased hs-CRP level [SMD = -0.38, 95% CI = -0.51 to -0.24, p = 0.000] and the oxidative stress indicator malondialdehyde [SMD = -0.61, 95% CI = -0.89 to -0.32, p = 0.000] in diabetic patients compared to those in subjects receiving placebos.

The investigators found, in addition, probiotic and synbiotic supplementation significantly increased total antioxidant capacity [SMD = 0.31, 95% CI = 0.09 to 0.52, p = 0.006], nitric oxide [SMD = 0.62, 95% CI = 0.25 to 0.99, p = 0.001] and glutathione [SMD = 0.41, 95% CI = 0.26, 0.55, p = 0.000] levels.

The investigators concluded that probiotic and synbiotic supplementation improve biomarkers of inflammation and oxidative stress in diabetic patients. Further studies are needed to develop clinical practice guidelines for the management of inflammation and oxidative stress in these patients.

Original title:
The effect of probiotic and synbiotic supplementation on biomarkers of inflammation and oxidative stress in diabetic patients: A systematic review and meta-analysis of randomized controlled trials by Zheng HJ, Guo J, [...], Wang Y.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30794924

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Oxidative stress is an imbalance between free radicals and antioxidants in your body. Antioxidants can reduce oxidative stress.
 

Objectives:
Does kiwifruit improve metabolic health in participants with cardiovascular risk factors, including hypercholesterolemia, hypertension, diabetes type 2 and smokers?

Study design:
This review article included 5 RCTs involving 489 participants.

Results and conclusions:
The investigators found no significant effect of kiwifruit on:
-systolic blood pressure (SBP) [MD = -1.72 mmHg, 95% CI = -4.27 to 0.84];
-diastolic blood pressure (DBP) [MD = -2.35 mmHg, 95% CI = -5.10 to 0.41];
-total cholesterol (TC) [MD = -0.14 mmol/L, 95% CI = -0.71 to 0.43];
-triglyceride (TG) [MD = -0.23 mmol/L, 95% CI = -0.66 to 0.20];
-low-density lipoprotein cholesterol (bad cholesterol or LDL) [MD = -0.41 mmol/L, 95% CI = -0.99 to 0.18];
-high-density lipoprotein cholesterol (good cholesterol or HDL) [MD = 0.15 mmol/L, 95% CI = -0.18 to 0.48];
-fasting plasma glucose (FPG) [MD = -0.08 mmol/L, 95% CI = -0.37 to 0.21];
-homeostasis model assessment of insulin resistance (HOMA-IR) [MD = -0.29, 95% CI = -0.61 to 0.02] and;
-body weight (BW) [MD = 1.08 kg, 95% CI = -4.22 to 2.05].

The investigators found subgroup analysis limiting to studies of whole kiwifruit and duration of intervention of at least 8 weeks again revealed no such effect of kiwifruit on total cholesterol, triglyceride, LDL cholesterol and HDL cholesterol.

The investigators concluded kiwifruit has no effect on metabolic health, as measured by systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides, LDL cholesterol and HDL cholesterol, fasting plasma glucose, homeostasis model assessment of insulin resistance (HOMA-IR) and body weight in participants with cardiovascular risk factors including hypercholesterolemia, hypertension, diabetes type 2 and smokers. Due to limited evidence and high heterogeneity of the study results, the potential of kiwifruit as a nonpharmaceutical alternative for metabolic health should be further evaluated in well-defined, well-controlled trials with larger sample size and standardized preparation.

Original title:
Effect of kiwifruit on metabolic health in patients with cardiovascular risk factors: a systematic review and meta-analysis by Suksomboon N, Poolsup N and Lin W.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6350646/

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Objectives:
The objective of this review article is to determine the effectiveness and harms of vaccination in patients with any sexual history to prevent the prevalence of papillomavirus infection.

Study design:
This review article included 29 studies described in 35 publications.

Results and conclusions:
The investigators found bivalent HPV vaccine offered protection against:
-HPV16 [RD = -0.05, 95% CI = -0.098 to -0.0032, I2 = 99%];
-HPV18 [RD = -0.03, 95% CI = -0.062 to -0.0004, I2 = 98%] and;
-HPV16/18 genotypes [RD = -0.1, 95% CI = -0.16 to -0.04, I2 = 99%].
It was consistent with 4 years for HPV16 and HPV18 genotypes.

The investigators found tetravalent HPV vaccine offered protection against:
-HPV6 [RD = -0.0500, 95% CI = -0.0963 to -0.0230, I2 = 66.8%];
-HPV11 [RD = -0.0198, 95% CI = -0.0310 to -0.0085, I2 = 0%].
-HPV16 [RD = -0.0608, 95% CI = -0.1126 to -0.0091, I2 = 76.4%] and;
-HPV18 [RD = -0.0200, 95% CI = -0.0408 to -0.0123, I2 = 34%].
It was consistent at 4 years for HPV6, HPV11, HPV16 and HPV18.

The investigators concluded there is a reduction in the prevalence of HPV16, 18 and 16/18 genotypes when applying the bivalent HPV vaccine, with no increase in adverse effects. Regarding the tetravalent HPV vaccine, there is a reduction in the prevalence of HPV6, 11, 16 and 18 genotypes, with no increase in adverse effects.

Original title:
The effectiveness of vaccination to prevent the papillomavirus infection: a systematic review and meta-analysis by García-Perdomo HA, Osorio JC, […], Castillo A.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6518793/

Additional information of El Mondo:
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Papillomaviruses (HPVs) are double-stranded DNA viruses that affect epithelial cells. More than 100 strains of HPV have been detected. Approximately 40 strains are known to infect genital mucosa, of which about 15 strains are known to cause cancer. HPV types 16 and 18 are the most common cancer-causing strains, leading to about 70% of all cervical cancer cases worldwide. HPV types 6 and 11 are associated with about 90% of all cases of genital warts.

Objectives:
A high intake of dietary fibre has been associated with a reduced risk of diverticular disease in several studies. However, the dose-response relationship between fibre intake and diverticular disease risk has varied and the available studies have not been summarised in a meta-analysis yet. Therefore, this review article (meta-analysis) has been conducted.

Is there a dose-response relationship between fibre intake and reduced risk of diverticular disease?

Study design:
This review article included 5 prospective cohort studies with 19,282 cases (persons with a diverticular disease) and 865,829 participants.

There was no evidence of publication bias with Egger's test, p = 0.58.

Results and conclusions:
The investigators found every 10 g/day increase of dietary fibre intake significantly reduced risk of diverticular disease with 26% [summary RR = 0.74, 95% CI = 0.71-0.78, I2 = 0%]. This significantly reduced risk persisted in subgroup and sensitivity analyses.

The investigators found no evidence of a nonlinear association between dietary fibre intake and diverticular disease risk [p nonlinearity = 0.35].

The investigators found compared to 7.5 g/day, 20 g/day of dietary fibre intake significantly reduced risk of diverticular disease with 23%.

The investigators found compared to 7.5 g/day, 30 g/day of dietary fibre intake significantly reduced risk of diverticular disease with 41%.

The investigators found compared to 7.5 g/day, 40 g/day of dietary fibre intake significantly reduced risk of diverticular disease with 58%.

The investigators found every 10 g/day increase of dietary cereal fibre intake significantly reduced risk of diverticular disease with 26% [summary RR = 0.74, 95% CI = 0.67-0.81, I2 = 60%, n = 4].

The investigators found every 10 g/day increase of dietary fruit fibre intake significantly reduced risk of diverticular disease with 44% [summary RR = 0.56, 95% CI = 0.37-0.84, I2 = 73%, n = 2].

The investigators found every 10 g/day increase of dietary vegetable fibre intake non-significantly reduced risk of diverticular disease with 20% [summary RR = 0.80, 95% CI = 0.45-0.1.44, I2 = 87%, n = 2].

The investigators concluded that 10-40 g/day dietary fiber intake, particularly cereal and fruit fibre reduces risk of diverticular disease. However, further studies are needed on fibre types and risk of diverticular disease and diverticulitis.

Original title:
Dietary fibre intake and the risk of diverticular disease: a systematic review and meta-analysis of prospective studies by Aune D, Sen A, […], Riboli E.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31037341

Additional information of El Mondo:
Find here more information/studies about chronic disease and fibre intake.

40 grams of fiber per day corresponds to a diet with 2 grams of fiber per 100 kcal. The easiest way to follow a diet with 2 grams of fiber per 100 kcal is to choose only products/meals with 2 grams of fiber per 100 kcal. Check here which products/meals provide 2 grams of fiber per 100 kcal.

Diverticular disease is the general name for a common condition that causes small bulges (diverticula) or sacs to form in the wall of the large intestine (colon). Although these sacs can form anywhere in the colon, they are most common in the sigmoid colon (part of the large intestine closest to the rectum). The recent literature does not identify diverticular disease as a long-term risk factor for colorectal cancer.
 

Objectives:
Anemia is one of the major complications in predialysis patients with chronic kidney disease (CKD). A clearer cognition of the prognostic impact of hemoglobin (Hb) or hematocrit (Hct) target on the outcomes of predialysis patients with CKD is significant. Therefore, this review article (meta-analysis) has been conducted.

Does higher hemoglobin levels decrease transfusion risk in predialysis patients with CKD?

Study design:
This review article included 13 RCTs involving 7,606 patients.

Results and conclusions:
The investigators found compared to lower hemoglobin levels, predialysis patients with chronic kidney disease with higher hemoglobin levels had a significantly lower risk of 49% for transfusion [risk ratio = 0.59, 95% CI = 0.52 to 0.67, p 0.00001].

The investigators found, however, no significant difference in all-cause mortality [RR = 1.10, 95% CI = 0.98 to 1.23, p = 0.11], stroke [RR = 1.32, 95% CI = 0.82 to 2.10, p = 0.25] and treatment of renal replacement including hemodialysis, peritoneal dialysis and renal transplant [RR = 1.08, 95% CI = 0.95 to 1.22, p = 0.23] between the higher hemoglobin group and the lower one.

The investigators concluded higher hemoglobin levels when treating predialysis patients with chronic kidney disease decrease the risk of transfusion without increasing the risk of death, stroke and treatment of renal replacement.

Original title:
Therapeutic targets for the anemia of predialysis chronic kidney disease: a meta-analysis of randomized, controlled trials by Liu H, Ye Y, […], Liu X.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30755495

Additional information of El Mondo:
Find here more information/studies about chronic diseases.
 

Objectives:
Human papillomavirus (HPV) vaccination has been proven to effectively protect against HPV infection and infection-associated cancer. However, there are concerns about the relationship between HPV vaccination and the risk of autoimmune disorders (ADs). Therefore, this review article has been conducted.  

Does human papillomavirus vaccination increase risk of autoimmune disorders?

Study design:
This review article included in total 12 cohort studies, 6 case-control studies and 2 randomized controlled trials (RCTs) involving more than 169,000 autoimmune disorders events.

Results and conclusions:
The investigators found that human papillomavirus vaccination was not associated with an increased risk of subsequent autoimmune disorders [OR = 1.003, 95% CI = 0.95-1.06],
Most of the subgroup analysis results based on the location or type of autoimmune disorders were consistent with the overall results.

The investigators found, however, that human papillomavirus vaccination significantly reduced risk of autoimmune disorders with 18% [OR = 0.82, 95% CI = 0.7-0.96] among those with prior autoimmune disorders.

The investigators concluded that human papillomavirus vaccination is not associated with an increased risk of autoimmune disorders. However, given the low number of estimates for individual autoimmune disorder, additional and larger observational studies are needed to verify these findings.

Original title:
Human papillomavirus vaccination and the risk of autoimmune disorders: A systematic review and meta-analysis by Jiang HY, Shi YD, […], Ruan B.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31036452

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

Objectives:
Results from earlier publications on the association of coffee and caffeine and risk of ovarian cancer are inconsistent. Therefore, this review article has been conducted.

Is there an association between coffee and caffeine consumption and risk of ovarian cancer among women?

Study design:
This review article included 22 case-control studies with a total of 40,140 participants, of which 8,568 patients with ovarian cancer. The participants were ≥ 17 years.

Results and conclusions:
The investigators found combining 21 effect sizes from 18 studies, no significant association was observed between total coffee consumption and risk of ovarian cancer [OR = 1.09, 95% CI = 0.94 to 1.26].

The investigators found no significant association between total caffeine intake and ovarian cancer risk [OR = 0.89, 95% CI = 0.55 to 1.45].

The investigators found, in addition, caffeinated coffee intake was not significantly associated with ovarian cancer risk [OR = 1.05, 95% CI = 0.87 to 1.28].

The investigators found, however, combining effect sizes from 5 studies, an inverse significant association between decaffeinated coffee intake and risk of ovarian cancer [OR = 0.72, 95% CI = 0.58 to 0.90].

The investigators concluded decaffeinated coffee consumption could reduce risk of ovarian cancer among women. Could reduce because this review article only included case-control studies and no cohort studies.

Original title:
Coffee and caffeine intake and risk of ovarian cancer: a systematic review and meta-analysis by Shafiei F, Salari-Moghaddam A , […], Esmaillzadeh A.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30833443

Additional information of El Mondo:
Find more information/studies on coffee consumption, review article/significantly and cancer right here.
 

Objectives:
Several epidemiological studies have investigated the association between dietary fat intake and cardiovascular disease. However, dietary recommendations based on systematic review and meta-analysis might be more credible. Therefore, this review article has been conducted.

Does dietary fat intake increase cardiovascular disease risk?

Study design:
This review article included 56 cohort studies.
Egger test showed no evidence of significant publication bias.

Results and conclusions:
The investigators found highest versus lowest levels of total dietary fat were not associated with cardiovascular disease risk [RR = 0.97, 95% CI = 0.93-1.01, I2 = 54.0%].
Sensitivity analysis showed that no individual study had an excessive influence on the pooled effect.
In addition, the analysis was repeated stratified according to each covariate. The results were consistent with that observed in meta-regression.

The investigators found highest versus lowest levels of dietary trans fatty acids intake were associated with a 14% increase of the risk of cardiovascular disease [RR = 1.14, 95% CI = 1.08-1.21, I2 = 26.1%].
Sensitivity analysis showed that no individual study had an excessive influence on the pooled effect.

The investigators found dose-response analysis showed the risk of cardiovascular disease significantly increased with 16% [RR = 1.16, 95% CI = 1.07-1.25, p-linearity = 0.033] for an increment of 2% energy/day (2 En%/day) of dietary trans fatty acids intake.

The investigators found highest versus lowest levels of dietary saturated fatty acids intake were not associated with the risk of cardiovascular disease [RR = 0.97, 95% CI = 0.93-1.02, I2 = 56.8%].
Sensitivity analysis showed that no individual study had an excessive influence on the pooled effect
In addition, the analysis was repeated stratified according to each covariate. The results were consistent with that observed in meta-regression.

The investigators found highest versus lowest levels of dietary monounsaturated fatty acids intake were not associated with the risk of cardiovascular disease [RR = 0.97, 95% CI = 0.93-1.01, I2 = 50.3%].
Sensitivity analysis showed that no individual study had an excessive influence on the pooled effect.
In addition, the analysis was repeated stratified according to each covariate. The results were consistent with that observed in meta-regression.

The investigators found highest versus lowest levels of dietary polyunsaturated fatty acids intake were not associated with the risk of cardiovascular disease [RR = 0.97, 95% CI = 0.93-1.004, I2 = 55.8%].
Sensitivity analysis showed that no individual study had an excessive influence on the pooled effect.
In addition, the analysis was repeated stratified according to each covariate. The results were consistent with that observed in meta-regression.

The investigators found in studies that has been followed up more than 10 years, that dietary polyunsaturated fatty acids intake significantly reduced cardiovascular disease risk with 5% [RR = 0.95, 95% CI = 0.91-0.99, I2 = 62.4%].

The investigators concluded there is a cardio-protective effect of dietary polyunsaturated fatty acids intake in studies that has been followed up more than 10 years. While, an increment of 2% energy/day (2 En%/day) of dietary trans fatty acids intake increases risk of cardiovascular disease.

Original title:
Dietary total fat, fatty acids intake, and risk of cardiovascular disease: a dose-response meta-analysis of cohort studies by Zhu Y, Bo Y and Liu Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6451787/

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

Objectives:
The goal of this review article is to identify as well as quantify the effect of vitamin A fortified food on serum vitamin A concentration among children under 10 year.

Study design:
This review article included 14 RCTs covering 6,153 children with duration of feeding for the fortified foods ranged between 3 and 12 months.  
A random effects model was applied to compute the pooled effect size of effect of serum retinol.
Meta regression was performed to detect the sources of heterogeneity and moderator variables on the study effect.

Results and conclusions:
The investigators found consumption of vitamin A fortified foods resulted in an increased concentration of retinol in children [SMD = 0.47, 95% CI = 0.16 to 0.78, I2 = 97%, p 0.01].

The investigators concluded that consumption of vitamin A fortified foods results in an increased concentration of retinol and thereby results in reduction of vitamin A deficiency among children under 10 year.

Original title:
Systematic review and meta-analysis approach on vitamin A fortified foods and its effect on retinol concentration in under 10 year children by Mendu VVR, Nair KPM and Athe R.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30904212

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

Objectives:
Various mechanisms link higher total homocysteine to higher insulin resistance and risk of type 2 diabetes (T2D). Folate supplementation is recognized as a way to lower homocysteine. However, randomized controlled trials (RCTs) show inconsistent results on insulin resistance and type 2 diabetes outcomes. Therefore, this review article (meta-analysis) has been conducted.

Does folate supplementation improve insulin resistance and type 2 diabetes outcomes?

Study design:
This review article included 29 RCTs (22,250 participants) that assessed the effect of placebo-controlled folate supplementation alone or in combination with other B vitamins on fasting glucose, insulin, homeostasis model assessment for insulin resistance (HOMA-IR), glycated hemoglobin (HbA1c) or risk of type 2 diabetes.

The meta-analysis was conducted using both random- and fixed-effects models to calculate weighted mean differences (WMDs) or risk ratios with 95% CIs.
Heterogeneity was low in all meta-analyses.

Results and conclusions:
The investigators found when compared with placebo, folate supplementation significantly lowered fasting insulin [WMD = -13.47 pmol/L, 95% CI = -21.41 to -5.53 pmol/L, p 0.001] and HOMA-IR [WMD = -0.57 units, 95% CI = -0.76 to -0.37 units, p 0.0001], but no overall effects were observed for fasting glucose or HbA1c.

The investigators found subgroup analysis showed no signs of effect modification except for change in homocysteine, with the most pronounced effects in trials with a change of >2.5 µmol/L.
Changes in homocysteine after folate supplementation correlated with changes in fasting glucose [β = 0.07, 95% CI = 0.01 to 0.14, p = 0.025] and HbA1c [β = 0.46, 95% CI = 0.06 to 0.85, p = 0.02].

The investigators found only 2 studies examined folate supplementation on risk of type 2 diabetes and they found no change in RR [pooled RR = 0.91, 95% CI = 0.80 to 1.04, p = 0.16].

The investigators concluded that folate supplementation lowers fasting insulin and HOMA-IR. However, folate supplementation does not reduce risk of type 2 diabetes.

Original title:
Effect of folate supplementation on insulin sensitivity and type 2 diabetes: a meta-analysis of randomized controlled trials by Lind MV, Lauritzen L, [...], Eriksen JN.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30615110

Additional information of El Mondo:
Find more information/studies on diabetes and folate (also called folic acid) right here.
 

Objectives:
Is there a relationship between the intake of foods (whole grains, refined grains, vegetables, fruit, nuts, legumes, eggs, dairy, fish, red meat, processed meat and sugar-sweetened beverages) and risk of general overweight/obesity, abdominal obesity and weight gain?

Study design:
This review article included 25 prospective cohort studies until August 2018.
In detail, 6 prospective cohort studies were included in the meta-analysis for consumption of whole grains, 4 studies for refined grains, 7 for vegetables, 6 for fruit, 4 for nuts, 2 for legumes, 2 for eggs, 11 for dairy products, 4 for fish, 4 for red meat, 2 for processed meat and 9 for sugar-sweetened beverages.

Results and conclusions:
The investigators found in the dose-response meta-analysis a significantly reduced risk of 7% per each increase of 30g/d whole-grain products [RR overweight/obesity = 0.93, 95% CI = 0.89 to 0.96, I2 = 0%].
There was no indication for a nonlinear association between whole-grain intake and risk of overweight/obesity [p-nonlinearity = 0.16].

The investigators found in the dose-response meta-analysis a significantly reduced risk of 7-9% per each increase of 100g/d fruit consumption [RR overweight/obesity = 0.93, 95% CI = 0.86 to 1.00, I2 = 89% and RR weight gain = 0.91, 95% CI = 0.86 to 0.97, I2 =7%].
There was no indication of a nonlinear relation [p-nonlinearity = 0.17, p-nonlinearity = 0.14, respectively].

The investigators found in the dose-response meta-analysis a significantly reduced risk of 58% per each increase of 28g/d nut consumption [RR abdominal obesity = 0.42, 95% CI = 0.31 to 0.57].

The investigators found in the dose-response meta-analysis a significantly reduced risk of 12% per each increase of 50g/d legume consumption [RR overweight/obesity = 0.88, 95% CI = 0.84 to 0.93].

The investigators found in the dose-response meta-analysis a significantly reduced risk of 17% per each increase of 100g/d fish consumption [RR abdominal obesity = 0.83, 95% CI = 0.71 to 0.97, I2 = 0%].
There was no indication of nonlinearity [p-nonlinearity = 0.07], but the graph indicated a stronger risk reduction at lower levels of fish intake and the curve reached a plateau at ∼40 g/d.

The investigators found in the dose-response meta-analysis a significantly increased risk of 5% per each increase of 30g/d refined grains consumption [RR overweight/obesity = 1.05, 95% CI = 1.00 to 1.10, I2 = 61%].
However, the nonlinear dose-response meta-analysis indicated that the association had a J-shape curve and a higher risk of overweight/obesity was identified for an intake of refined grains >90 g/d [p-nonlinearity 0.001].

The investigators found in the dose-response meta-analysis a significantly increased risk of 10-14% per each increase of 30g/d red meat consumption [RR abdominal obesity = 1.10, 95% CI = 1.04 to 1.16, I2 = 0% and RR weight gain = 1.14, 95% CI = 1.03 to 1.26].

The investigators found in the dose-response meta-analysis a significantly increased risk of 5-12% with each increase of 250 mL sugar-sweetened beverages per day consumption [RR overweight/obesity = 1.05, 95% CI = 1.00 to 1.11 and RR abdominal obesity = 1.12, 95% CI = 1.04 to 1.20, I2 = 38%].  
The increase in risk was stronger at lower amounts of sugar-sweetened beverages intake (until ∼300 mL/d), but an increase at higher intakes was still present [p-nonlinearity = 0.03].

The investigators found the intake of 5 servings of whole grains/d, 3 servings of vegetables/d and 3 servings of fruit/d significantly resulted in a 38% reduction in risk of overweight/obesity compared with non-consumption of these food groups.

The investigators found the intake of 5 servings of refined grains/d and 3 servings of sugar-sweetened beverages/d significantly resulted in a 59% increased risk of overweight/obesity.

The investigators concluded that high intakes of whole grains, vegetables, fruit and probably fish as well as a low intake of refined grains, red meat and sugar-sweetened beverages are associated with a reduced risk of measures of adiposity, including overweight/obesity, abdominal obesity or weight gain, respectively. These findings are in line with current public health recommendations regarding a health-promoting diet. However, with the current evidence rated as very low to low, findings should be interpreted with caution and better-designed observational studies, more evidence from intervention trials and use of novel statistical methods (e.g., substitution analyses or network meta-analyses) are needed.

Original title:
Food Groups and Risk of Overweight, Obesity, and Weight Gain: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies by Schlesinger S, Neuenschwander M, […], Schwingshackl BH.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6416048/

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

Objectives:
Current research suggests conflicting evidence surrounding the association between serum magnesium levels and the diagnosis of attention deficit hyperactivity disorder (ADHD). Therefore, this review article (meta-analysis) has been conducted.

Does serum magnesium deficiency increase risk of ADHD?

Study design:
This review article included 7 observational studies, which reported the mean and standard deviation (SD) of magnesium concentration in both ADHD and control groups.

Results and conclusions:
The investigators found random-effects meta-analysis showed that subjects with ADHD had 0.105 mmol/L [95% CI = -0.188 to -0.022, p 0.013, I2 = 96.2%, p = 0.0103] lower serum magnesium levels compared with to their healthy controls.

The investigators concluded this meta-analysis supports the theory that an inverse relationship between serum magnesium deficiency and ADHD exists. High heterogeneity amongst the included studies suggests that there is a residual need for observational and community-based studies to further investigate this issue.

Original title:
Magnesium status and attention deficit hyperactivity disorder (ADHD): A meta-analysis by Effatpanah M, Rezaei M, […], Hashemi R.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30807974

Additional information of El Mondo:
Find here more information/studies about random-effects meta-analysis and magnesium.
 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Objectives:
Do omega-3 fatty acids in fish consumption reduce risk of breast cancer in Asian patients?

Study design:
This review article included 4 cohort studies and 7 case-control studies with a total of 130,365 Asian patients.

There was not any study with significant publication bias included.

Results and conclusions:
The investigators found omega-3 fatty acids in fish consumption significantly reduced risk of  breast cancer in Asian patients with 20% [OR = 0.80, 95% CI = 0.73-0.87, p 0.00001].
Significant because OR of 1 was not found in the 95% CI of 0.73 to 0.87. OR of 1 means no risk/association.

The investigators concluded omega-3 fatty acids in fish consumption reduce breast cancer risk in Asian patients.

Original title:
Protective Effect of Omega-3 Fatty Acids in Fish Consumption Against Breast Cancer in Asian Patients: A Meta-Analysis by Nindrea RD, Aryandono T, […], Dwiprahasto I.

Link:
http://journal.waocp.org/?sid=Entrez:PubMed&id=pmid:30803190&key=2019.20.2.327

Additional information of El Mondo:
Find more information/studies on fish consumption, review article/significantly and breastcancer right here.

Fish containing omega-3 fatty acids are salmon, mackerel, herring, lake trout, bluefin tuna, sturgeon, sablefish, anchovy, albacore tuna, whitefish, arctic char, sardines, bluefish, mullet, halibut, striped bass, mahi mahi, pollock, rockfish, rainbow trout, shark, catfish, carp, cod, flounder, grouper, haddock, ocean perch, red snapper, swordfish, pike, sole and tilapia.

Objectives:
Several studies have been conducted on the effects of peanut consumption on cardiovascular diseases (CVD) risk factors. However, the findings are conflicting and appear inconsistent. Therefore, this review article has been conducted.

Does peanut consumption reduce cardiovascular disease risk?

Study design:
This review article included 13 RCTs.

Results and conclusions:
The investigators found peanuts consumption had no significant effect on:
-weight [WMD = -0.11 kg, p = 0.773];
-waist circumference [WMD = -1.41 cm, p = 0.139];
-body mass index [WMD = -0.14 kg/m², p = 0.428];

-systolic and diastolic blood pressure [WMD = -0.09 mmHg, p = 0.939 and WMD = 0.60 mmHg, p = 0.652, respectively];
-low-density lipoprotein (LDL or bad) cholesterol [WMD = -3.31 mg/dL, p = 0.472];
-triglyceride [WMD = -7.59 mg/dL, p = 0.180];
-total cholesterol [WMD = 3.15 mg/dL, p = 0.171];
-fasting blood sugar [WMD = 0.57 mg/dL, p = 0.604] and;
-serum insulin [WMD = -0.40, p = 0.582].

The investigators found peanuts consumption had a positive significant effect on high-density lipoprotein (HDL or good) cholesterol [WMD = 2.72 mg/dL, p = 0.001].
Significant because the calculated p-value of 0.001 was smaller than the p-value of 0.05.

The investigators found peanut consumption had a positive significant effect on HDL cholesterol, especially at the type of peanut oil, high-oleic peanut and peanut sprout and in healthy subjects and for consumption more than 12 weeks, while had no significant effect on other cardiovascular diseases risk factors.

The investigators concluded both high-oleic peanut and peanut sprout consumption during at least 12 weeks increases HDL cholesterol (good cholesterol) in healthy subjects.

Original title:
Peanut and cardiovascular disease risk factors: A systematic review and meta-analysis by Jafari Azad B, Daneshzad E and Azadbakht L.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30638042

Additional information of El Mondo:
Find more information/studies on nut consumption, cholesterol and cardiovascular diseases right here.

Objectives:
Without pregnancy-specific protection, an estimated 45% of 32 million pregnancies in malaria-endemic sub-Saharan Africa are exposed to Plasmodium falciparum malaria yearly, leading to 900,000 malaria-associated low birthweight deliveries and associated consequences for infant health. In these areas, WHO recommends intermittent preventive treatment in pregnancy (IPTp) with antimalarials. IPTp with sulfadoxine-pyrimethamine, the only antimalarial currently recommended for this strategy, is associated with major reductions in maternal anaemia, low birthweight and neonatal mortality. However, the effectiveness of sulfadoxine-pyrimethamine IPTp is threatened by resistance to this drug combination, particularly in east and southern Africa. Therefore, this review article has been conducted.

The goal of this review article is to assess the associations between markers of sulfadoxine-pyrimethamine resistance in P falciparum and the effectiveness of sulfadoxine-pyrimethamine intermittent preventive treatment during pregnancy (IPTp) for malaria-associated outcomes in sub-Saharan Africa.

Study design:
This review article included 57 clinical studies, with a total of 59,457 births.

A random-effects meta-analysis (clinical studies) or multivariate log-binomial regression (surveys) was carried out to obtain summarised dose-response data (relative risk reduction (RRR) [RRR = 100 × [1 – relative risk]) and multivariate meta-regression was carried out to explore the modifying effects of sulfadoxine-pyrimethamine resistance (as indicated by Ala437Gly, Lys540Glu and Ala581Gly substitutions in the dhps gene).

Results and conclusions:
The investigators found relative risk reduction for low birthweight (2.5 kg) declined with increasing prevalence of dhps Lys540Glu [p trend = 0.0060] but not Ala437Gly [p trend = 0.35].

The investigators found relative risk reduction was:
7% [95% CI = 0 to 13] in areas of high resistance to sulfadoxine-pyrimethamine (Lys540Glu ≥90% in east and southern Africa, n = 11];
21% [95% CI = 14 to 29] in moderate-resistance areas (Ala437Gly ≥90% [central and west Africa] or Lys540Glu ≥30% to 90% [east and southern Africa], n = 16) and 27% (21 to 33) in low-resistance areas (Ala437Gly 90% [central and west Africa] or Lys540Glu 30% [east and southern Africa],  n = 30, p trend = 0.0054 [univariate], I2 = 69.5%].

The investigators found overall relative risk reduction in all resistance strata was 21% [95% CI = 17 to 25].

The investigators found in the analysis of individual participant data from 13 surveys (42,394 births) sulfadoxine-pyrimethamine intermittent preventive treatment during pregnancy (IPTp) was associated with reduced prevalence of low birthweight in areas with a Lys540Glu prevalence of more than 90% and Ala581Gly prevalence of less than 10% [relative risk reduction = 10%, 95% CI = 7 to 12].
However, not in those with an Ala581Gly prevalence of 10% or higher [pooled Ala581Gly prevalence 37%, 95% CI = 29 to 46, relative risk reduction = 0.5%, 95% CI = -16 to 14; 2,326 births].

The investigators concluded the effectiveness of sulfadoxine-pyrimethamine intermittent preventive treatment during pregnancy (IPTp) is reduced in areas with high resistance to sulfadoxine-pyrimethamine among P falciparum parasites, but remains associated with reductions in low birthweight even in areas where dhps Lys540Glu prevalence exceeds 90% but where the sextuple-mutant parasite (harbouring the additional dhps Ala581Gly mutation) is uncommon.
However, sulfadoxine-pyrimethamine intermittent preventive treatment during pregnancy (IPTp) is not likely to reduce malaria and malaria-associated low birthweight in areas where the prevalence of sextuple-mutant parasites, with the dhps Ala581Gly mutation, exceed 37% (the pooled estimate in the high-resistance areas). For these areas, the search for alternative strategies or drugs to replace sulfadoxine-pyrimethamine IPTp is a pressing research priority for the control of malaria in pregnancy.

Original title:
Effect of Plasmodium falciparum sulfadoxine-pyrimethamine resistance on the effectiveness of intermittent preventive therapy for malaria in pregnancy in Africa: a systematic review and meta-analysis by van Eijk AM, Larsen DA, […], Ter Kuile FO.

Link:
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(18)30732-1/fulltext

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

Intermittent preventive therapy or intermittent preventive treatment (IPT) is a public health intervention aimed at treating and preventing malaria episodes in infants (IPTi), children (IPTc), schoolchildren (IPTsc) and pregnant women (IPTp).

Objectives:
Studies have shown that creatine supplementation increases intramuscular creatine concentrations, favoring the energy system of phosphagens, which may help explain the observed improvements in high-intensity exercise performance. However, research on physical performance in soccer has shown controversial results, in part because the energy system used is not taken into account. Therefore, this review article (meta-analysis) has been conducted.

Does creatine supplementation improve physical performance in soccer players?

Study design:
This review article included 9 RCTs with a total sample of 168 soccer players (118 males, 50 females) with an average age of 20.3 ± 2.0 years (from 15 to 30 years, as an average for the experimental sample).

The meta-analysis was performed using the random effects model and pooled standardized mean differences (SMD) (Hedges's g).

Results and conclusions:
The investigators found that creatine supplementation did not present beneficial effects on aerobic performance tests [SMD = -0.05, 95% CI = -0.37 to 0.28, p = 0.78] and phosphagen metabolism performance tests (strength, single jump, single sprint and agility tests: SMD = 0.21, 95% CI = -0.03 to 0.45, p = 0.08].

The investigators found, however, creatine supplementation showed beneficial effects on anaerobic performance tests [SMD = 1.23, 95% CI = 0.55 to 1.91, p 0.001].
Concretely, creatine supplementation demonstrated a large and significant effect on Wingate test performance [SMD = 2.26, 95% CI = 1.40 to 3.11, p 0.001].

The investigators concluded creatine supplementation with a loading dose of 20-30 g/day, divided 3-4 times per day, ingested for 6 to 7 days and followed by 5 g/day for 9 weeks or with a low dose of 3 mg/kg/day for 14 days presents positive effects on improving physical performance tests related to anaerobic metabolism, especially anaerobic power, in soccer players.

Original title:
Effects of Creatine Supplementation on Athletic Performance in Soccer Players: A Systematic Review and Meta-Analysis by Mielgo-Ayuso J, Calleja-Gonzalez J, […], Fernández-Lázaro D.

Link:
https://www.mdpi.com/2072-6643/11/4/757/htm

Additional information of El Mondo:
Find here more information/studies about sport nutrition and creatine.