Nutritional advice

Objectives:
Epidemiological studies on the impact of fish consumption on coronary heart disease (CHD) incidence have shown inconsistent results. Therefore, this review article has been conducted.

Does dietary intake of fish reduce coronary heart disease incidence and mortality?

Study design:
This review article included 40 prospective cohort studies (22 studies investigated the association between fish consumption and coronary heart disease incidence (28,261 persons with coronary heart disease and 918,783 participants) and 27 studies investigated the association between fish consumption and coronary heart disease mortality (10,568 events and 1,139,553 participants)).

No evidence of publication bias was found.

Results and conclusions:
The investigators found higher fish consumption was significantly associated with a 9%-lower coronary heart disease risk [RR = 0.91, 95% CI = 0.84 to 0.97, I2 = 47.4%].

The investigators found a significant correlation between fish consumption and coronary heart disease risk in the female subgroup [RR = 0.85, 95% CI = 0.78 to 0.92, I2 = 5.6%], the subgroup with a follow-up period of ≥10 years [RR = 0.91, 95% CI = 0.84 to 0.99, I2 = 51.5%] and the subgroup with an article quality of ≥7 points [RR = 0.90, 95% CI = 0.83 to 0.98, I2 = 50.6%].
However, it was not found in the male subgroup, the subgroup with a follow-up period of 10 years and the subgroup with an article quality of 7 points.

The investigators found higher fish intake was significantly associated with a 15%-lower coronary heart disease mortality risk [RR = 0.85, 95% CI = 0.77 to 0.94, I2 = 51.3%].

The investigators found the summary results did not change significantly in sensitivity analysis.

The investigators found dose-response analysis showed that the coronary heart disease incidence and mortality were reduced by 4%, respectively, with a 20 g/day increment in fish consumption.

The investigators concluded that a higher dietary intake of fish reduces coronary heart disease incidence and mortality. This finding has important public health implications in terms of the prevention of coronary heart disease. Since most of the research was conducted in male groups and Western countries, further research needs to be performed in female groups and other regions.

Original title:
Fish Consumption and Coronary Heart Disease: A Meta-Analysis by Zhang B, Xiong K, […], Ma A.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7468748

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In practice, higher fish consumption means at least twice a week of fish consumption (150 grams of fish at a time).

Objectives:
Since licensure in 2006, rotavirus vaccines have been introduced in more than 100 countries. However, the efficacy of rotavirus vaccines is variable in settings with different child mortality levels. Therefore, this review article has been conducted.

What is the efficacy of rotavirus vaccines in settings with different child mortality levels?

Study design:
This review article included 60 studies from 32 countries. 31 studies were from countries with low child mortality, 8 were from medium-mortality countries and 21 were from high-mortality countries.

There was no substantial heterogeneity [I2 range: 0-36%].

Results and conclusions:
The investigators found rotarix vaccine effectiveness against laboratory-confirmed rotavirus among children younger than 12 months old was 86% [95% CI = 81% to 90%] in low-mortality countries, 77% [95% CI = 66% to 85%] in medium-mortality countries and 63% [95% CI = 54% to 70%] in high-mortality countries.

The investigators found rotarix vaccine effectiveness among children aged 12-23 months was 86% [95% CI = 81% to 90%] in low-mortality countries, 54% [95% CI = 23% to 73%] in medium-mortality countries and 58% [95% CI = 38% to 72%] in high-mortality countries.

The investigators found rotateq vaccine effectiveness among children younger than 12 months was 86% [95% CI = 76% to 92%] in low-mortality countries and 66% [95% CI = 51% to 76%] in high-mortality countries.

The investigators found rotateq vaccine effectiveness among children aged 12-23 months was 84% [95% CI = 79% to 89%] in low-mortality countries.

The investigators found median vaccine effectiveness in low-mortality countries was similar for rotarix [83%, IQR = 78% to 91%], rotateq [85%, IQR = 81% to 92%], mixed series [86%, IQR = 70% to 91%] and non-product-specific [89%, IQR = 75% to 91%] vaccination.

The investigators concluded rotavirus vaccines are effective in preventing rotavirus diarrhoea, with higher performance in countries with lower child mortality.
 
Original title:
Real-world effectiveness of rotavirus vaccines, 2006-19: a literature review and meta-analysis by Burnett E, Parashar UD and Tate JE.

Link:
https://pubmed.ncbi.nlm.nih.gov/32827481/

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Find more information/studies on vaccination and malnutrition right here.

Objectives:
Malnutrition underlies 45% of under-5 deaths globally. Severe acute malnutrition (SAM) is the most serious form of undernutrition, characterized by wasting with or without edema. Mortality remains high (10%-40%) among children requiring hospitalization for complicated SAM. Therefore, this review article has been conducted.

What are the risk factors of inpatient mortality in children with severe acute malnutrition?

Study design:
This review article included 28 studies, of which 19 studies included all children with severe acute malnutrition and 9 evaluated subgroups of children with SAM [diarrhea (n = 4), pneumonia (n = 2), kwashiorkor (n = 1), shigellosis (n = 1) and those with blood cultures (n = 1)].

All 19 main studies were from 8 countries across Africa, with a median of 400 children per study. The majority (15 of 19; 79%) were single-center studies.

9 factors were included in the meta-analysis, stratified by HR and OR.

Results and conclusions:
The investigators found the mean inpatient mortality rate was 15.7% [95% CI = 10.4% to 21.0%] and HIV prevalence ranged from 2.1% to 51%.

The investigators found HIV infection significantly increased risk of inpatient mortality in children with severe acute malnutrition with 332% [HR = 4.32, 95% CI = 2.31 to 8.08].  

The investigators found weight-for-height z score (WHZ) significantly decreased risk of inpatient mortality in children with severe acute malnutrition with 56% [OR = 0.44, 95% CI = 0.24 to 0.80].  

The investigators found diarrhea significantly increased risk of inpatient mortality in children with severe acute malnutrition with 184% [HR = 2.84, 95% CI = 1.40 to 5.75].  

The investigators found pneumonia significantly increased risk of inpatient mortality in children with severe acute malnutrition with 89% [HR = 1.89, 95% CI = 1.19 to 3.02].  

The investigators found presence of shock significantly increased risk of inpatient mortality in children with severe acute malnutrition with 267% [HR = 3.67, 95% CI = 2.24 to 6.03].  

The investigators found lack of appetite significantly increased risk of inpatient mortality in children with severe acute malnutrition with 116% [HR = 2.16, 95% CI = 1.48 to 3.16].  

The investigators found no association between both child age and sex and risk of inpatient mortality in children with severe acute malnutrition.  

The investigators concluded HIV infection, diarrhea, pneumonia, shock, lack of appetite and lower weight-for-height z score (WHZ) are independent predictors of inpatient mortality in children with severe acute malnutrition. These factors may help to risk-stratify children being hospitalized with complicated severe acute malnutrition.
 
Original title:
Predictors of inpatient mortality among children hospitalized for severe acute malnutrition: a systematic review and meta-analysis by Karunaratne R, Sturgeon JP, […], Prendergast AJ.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7528552/

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Objectives:
There are numerous trials reported the effect of alpha-lipoic acid (ALA) on obesity measurements; while no summarised dose-response meta-analysis is available to address the effects of dose and duration of ALA supplementation on obesity measurements. Therefore, this review article has been conducted.

Does alpha-lipoic acid supplementation improve obesity measurements including weight, body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) and fat mass (FM)?

Study design:
This review article included 18, 21 and 8 RCTs of ALA-weight, ALA-BMI, ALA-WC, respectively.

Results and conclusions:
The investigators found in two-class meta-analysis, alpha-lipoic acid supplementation significantly reduced weight [WMD = -2.29 kg, 95% CI = -2.98 to -1.60, p 0.01] and BMI [WMD = -0.49 g/m², 95% CI = -0.83 to -0.15, p = 0.005] but had no effect on waist circumference [WMD = -2.57 cm, 95% CI = -8.91 to 3.76, p = 0.426].

The investigators found while the dose-response meta-analysis revealed that the duration of alpha-lipoic acid supplementation was a significant factor affecting waist circumference reduction [p non-linearity = 0.047].
While no evidence of departure from linearity was observed for other variables; moreover, subgrouping also revealed that gender could be an important factor affecting the alpha-lipoic acid impact on waist circumference, which was significant among women [WMD = -4.099, 95%CI = -7.837 to -0.361, p = 0.032].

The investigators concluded that alpha-lipoic acid supplementation reduces BMI, weight in a two-class meta-analysis without evidence of departure from linearity in terms of dose or duration. While the association of alpha-lipoic acid supplementation on waist circumference is dependent to the duration of the study. Although further trials evaluating the other obesity measurements specially central obesity will be helpful to infer a more reliable result.

Original title:
Alpha-lipoic acid supplementation significantly reduces the risk of obesity in an updated systematic review and dose response meta-analysis of randomised placebo-controlled clinical trials by Vajdi M and Farhangi MA.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32091656

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Objectives:
Despite the universal use of the two-dose trivalent measles-mumps-rubella (MMR) vaccine in the past two decades, outbreaks of these diseases still occur in countries with high vaccine uptake, giving rise to concerns about primary and secondary failure of MMR vaccine components. Therefore, this review article has been conducted.

What is the seroconversion and waning rate estimates for the measles, mumps and rubella components of MMR vaccines?

Study design:
This review article included 62 studies.

Results and conclusions:
The investigators found estimated overall seroconversion rates were 96.0% [95% CI = 94.5 to 97.4, I2 = 91.1%] for measles, 93.3% [95% CI = 91.1 to 95.2, I2 = 94.9%] for mumps when excluding the Rubini strain, 91.1% [95% CI = 87.4   to 94.1, I2 = 96.6%] for mumps when including the Rubini strain and 98.3% [95% CI = 97.3 to 99.2, I2 = 93.0%] for rubella.

The investigators found estimated overall annual waning rates were 0.009 [95% CI = 0.005 to 0.016, I2 = 85.2%] for measles, 0.024 [95% CI = 0.016 to 0.039, I2 = 94.7%] for mumps, and 0.012 [95% CI = 0.010 to 0.014, I2 = 93.3%] for rubella.

The investigators concluded this meta-analysis provides estimates of primary and secondary vaccine failure, which are essential to improve the accuracy of mathematical and statistical modelling to understand and predict the occurrence of future measles, mumps and rubella outbreaks in countries with high vaccine uptake.

Original title:
Immunogenicity and persistence of trivalent measles, mumps, and rubella vaccines: a systematic review and meta-analysis by Schenk J, Abrams S, [...], Hens N.

Link:
https://pubmed.ncbi.nlm.nih.gov/32888410/

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Objectives:
The number of cancer survivors is growing rapidly worldwide, especially long-term survivors. Although a healthy diet with a high vegetable and fruit consumption is a key factor in primary cancer prevention, there is a lack of specific dietary recommendations for cancer survivors, except in the case of breast cancer [World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) report]. Therefore, this review article (meta-analysis) has been conducted.

Does the general recommendation to consume ≥5 servings of vegetables and fruit per day (400 g/d) meet the needs of cancer survivors?

Study design:
This review article included 28 cohort studies.

Results and conclusions:
The investigators found a high vegetable intake before diagnosis significantly reduced overall mortality in survivors of head and neck cancer with 25% [HR = 0.75, 95% CI = 0.65 to 0.87].  

The investigators found a high vegetable intake before diagnosis significantly reduced overall mortality in survivors of ovarian cancer with 22% [HR = 0.78, 95% CI = 0.66 to 0.91].  

The investigators found a high fruit intake before diagnosis significantly reduced overall mortality in survivors of ovarian cancer with 18% [HR = 0.82, 95% CI = 0.70 to 0.96].  

The investigators found the evidence was insufficient for survivors of other cancers, although these associations generally tended to be protective. Therefore, more studies are needed to clarify the association between vegetable and fruit consumption and the prognosis of these different types of cancer.

The investigators concluded the general recommendation to consume ≥5 servings of vegetables and fruit per day (400 g/d) could underestimate the needs of cancer survivors, particularly those with ovarian tumors, in which the recommendation could increase to 600 g/d (i.e., 300 g/d of vegetables and 300 g/d of fruit).

Original title:
Vegetable and Fruit Consumption and Prognosis Among Cancer Survivors: A Systematic Review and Meta-Analysis of Cohort Studies by Hurtado-Barroso S, Trius-Soler M, […], Zamora-Ros R.

Link:
https://pubmed.ncbi.nlm.nih.gov/32717747/

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Objectives:
Hookworm is an intestinal parasite that infects nearly 230 million people, with another 5.1 billion at risk, especially in poverty-stricken tropical and subtropical regions. Pregnancy is an especially vulnerable time for hookworm infection because of its effect on both maternal and subsequently fetal health. Therefore, this review article has been conducted.

Does maternal hookworm infection increase risk of maternal anemia and coinfection with malaria?

Study design:
This review article included 62 studies, conducted in sub-Saharan Africa.

There was substantial heterogeneity in the magnitude of association across the studies.

Results and conclusions:
The investigators found the prevalence of hookworm ranged from 1% to 78% in pregnant women, whereas malaria prevalence ranged from 11% to 81%.

The investigators found pregnant women with hookworm infection had a significantly increased risk of 155% for anemia [combined odds ratio = 2.55, 95% CI = 2.20 to 2.96, p 0.001].

The investigators found pregnant women with hookworm infection had a significantly increased risk of 60% for malaria coinfection [combined odds ratio = 1.60, 95% CI = 1.38 to 1.86, p 0.001].

The investigators concluded maternal hookworm infection increases risk of maternal anemia and coinfection with malaria.

Original title:
Maternal Hookworm Infection and Its Effects on Maternal Health: A Systematic Review and Meta-Analysis by Ness TE, Agrawal V, […], Weatherhead JE.

Link:
https://pubmed.ncbi.nlm.nih.gov/32840198/

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Objectives:
Does niacin (vitamin B3) supplementation improve lipid profiles and glycemic control in patients with type 2 diabetes mellitus?

Study design:
This review article included 8 RCTs comprised a total of 2,110 patients with type 2 diabetes mellitus.
Studies published ranged from 1990 to 2016 and 15 to 1,053 patients were included in each individual trial.

The follow-up duration ranged from 8.0 weeks to 12.0 months.

The study quality was assessed using the Jadad scale. 4 studies had 3 scores and the remaining 4 studies had 2 scores.

There was no significant publication bias.

Results and conclusions:
The investigators found patients’ niacin supplementation was associated with lower levels of total cholesterol [WMD = -0.28, 95% CI = -0.44 to -0.12, p =  0.001], triglyceride [WMD = -0.37, 95% CI = -0.52 to -0.21, p   0 .001] and low-density lipoprotein cholesterol (bad cholesterol) [WMD = -0.42, 95% CI = -0.50 to -0.34, p    0.001].

The investigators found, moreover, the level of high-density lipoprotein cholesterol (good cholesterol) was significantly increased when niacin supplementation [WMD = 0.33, 95% CI = 0.21 to 0.44, p 0 .001] was provided.

The investigators found, however, niacin supplementation produced no significant effects on plasma glucose [WMD = 0.18, 95% CI = -0.14 to 0.50, p = 0 .275] and hemoglobin A1c (HbA1c) levels [WMD = 0.39, 95% CI = -0.15 to 0.94, p = 0 .158].

The investigators concluded that niacin (vitamin B3) supplementation improves lipid profiles, including total cholesterol, LDL and HDL cholesterol without affecting the glycemic levels for patients with type 2 diabetes mellitus. Additional large-scale RCTs should be conducted to evaluate the long-term effectiveness of niacin supplementation.

Original title:
Effectiveness of niacin supplementation for patients with type 2 diabetes: A meta-analysis of randomized controlled trials by Xiang D, Zhang Q and Wang YT.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7373507/

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Objectives:
By sustaining transmission or causing malaria outbreaks, imported malaria undermines malaria elimination efforts. Few studies have examined the impact of travel on malaria epidemiology. Therefore, this review article has been conducted.

Is travel an important risk factor for malaria infection in sub-Saharan Africa?

Study design:
This review article included 22 studies, conducted in sub-Saharan Africa.

There was substantial heterogeneity in the magnitude of association across the studies.

Results and conclusions:
The investigators found travel significantly increased risk of malaria infection with 277% [OR = 3.77, 95% CI = 2.49 to 5.70].
Odds ratios were particularly high in urban locations when travel was to rural areas, to more endemic/high transmission areas and in young children.

The investigators concluded travel is an important risk factor for malaria infection in sub-Saharan Africa.

Original title:
Travel Is a Key Risk Factor for Malaria Transmission in Pre-Elimination Settings in Sub-Saharan Africa: A Review of the Literature and Meta-Analysis by Ahmed S, Reithinger R and Ngondi JM.

Link:
https://pubmed.ncbi.nlm.nih.gov/32815497/

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Objectives:
Observational studies regarding the putative associations between dietary intake of homocysteine metabolism-related B-vitamins (vitamin B6, folate and vitamin B12) and stroke risk have yielded inconsistent results. Therefore, this review article has been conducted.

Does dietary intake of vitamin B6, folate or vitamin B12 reduce stroke risk?

Study design:
This review article included 1 nested case-control study and 11 prospective cohort studies comprising 389,938 participants and 10,749 cases (persons with stroke).

The studies were published from 2002 through to 2019 and the follow-up period ranged from 4.2 to 19 years.

All 12 studies provided risk estimates adjusted for cigarette smoking and most studies also adjusted for other conventional risk factors, including BMI, energy intake, alcohol consumption, hypertension and/or physical activity.

Study quality scores ranged from 5 to 9; the mean quality score was 7.4.

There was no evidence of publication bias.

Results and conclusions:
The investigators found for the highest versus the lowest category of dietary vitamin B6 intake, a significantly reduced risk of 16% for stroke [RR = 0.84, 95% CI = 0.73 to 0.97, I2 = 48.8%].

The investigators found in dose-response analysis that each 0.5 mg/d increment in vitamin B6 dietary intake was associated with a 6% reduction in the risk of stroke [RR = 0.94, 95% CI = 0.89 to 0.99, I2 = 77.0%].

The investigators found for the highest versus the lowest category of dietary folate intake, a significantly reduced risk of 15% for stroke [RR = 0.85, 95% CI = 0.78 to 0.94, I2 = 11.5%].

The investigators found in dose-response analysis that each 100 μg/d increase in dietary folate intake was associated with a 6% reduction in the risk of stroke [RR = 0.94, 95% CI = 0.90 to 0.98, I2 = 46.8%].

The investigators found, in contrast, no significant association between dietary vitamin B12 intake and the risk of stroke, with an RR of 1.01 [95% CI = 0.97 to 1.06] per 3 μg/d increase.

The investigators concluded increased dietary intake of vitamin B6 (at least 0.5 mg/d) and dietary folate intake (at least 100 μg/d) is associated with a reduced risk of stroke, supporting the notion that increasing habitual folate and vitamin B6 intake may provide a small but beneficial effect with respect to stroke.

Original title:
Dietary Intake of Homocysteine Metabolism-Related B-Vitamins and the Risk of Stroke: A Dose-Response Meta-Analysis of Prospective Studies by Chen L, Li Q, [...], Wang F.

Link:
https://academic.oup.com/advances/advance-article/doi/10.1093/advances/nmaa061/5854025

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Objectives:
Prevention of mother-to-child transmission (MTCT) of hepatitis B virus (HBV) involves neonatal immunoprophylaxis, with a birth dose of hepatitis B vaccine and immune globulin, and provision of peripartum antiviral prophylaxis in highly viraemic women. However, access to assays to quantify HBV DNA levels remains inadequate in resource-poor settings. Therefore, this review article has been conducted.

The aims of this review article are to identify the HBV DNA threshold for MTCT, to assess the sensitivity and specificity of hepatitis B e antigen (HBeAg) testing to identify pregnant women with HBV DNA levels above this threshold and to predict MTCT of HBV infection on the basis of HBeAg testing?

Study design:
This review article included 66 studies.

Results and conclusions:
The investigators found the risk of mother-to-child transmission (MTCT) despite infant immunoprophylaxis was negligible [0.04%, 95% CI = 0.00 to 0.25] below a maternal HBV DNA level of 5.30 log10 IU/mL (200,000 IU/mL) and increased above this threshold.

The investigators found the pooled sensitivity of HBeAg testing to identify HBV DNA levels of 5.30 log10 IU/mL or greater in pregnant women was 88.2% [95% CI = 83.9 to 91.5] and pooled specificity was 92.6% [95% CI = 90.0 to 94.5].

The investigators found the pooled sensitivity of HBeAg testing in predicting MTCT of HBV infection despite infant immunoprophylaxis was 99.5% [95% CI = 91.7-100] and pooled specificity was 62.2% [95% CI = 55.2 to 68.7].

The investigators concluded maternal HBV DNA of 5.30 log10 IU/mL or greater appears to be the optimal threshold for MTCT of HBV infection despite infant immunoprophylaxis. HBeAg is accurate to identify women with HBV DNA levels above this threshold and has high sensitivity to predict cases of immunoprophylaxis failure. In areas where HBV DNA assays are unavailable, HBeAg can be used as an alternative to assess eligibility for antiviral prophylaxis.

Original title:
Accuracy of HBeAg to identify pregnant women at risk of transmitting hepatitis B virus to their neonates: a systematic review and meta-analysis by Boucheron P, Lu Y, […], Shimakawa Y.

Link:
https://pubmed.ncbi.nlm.nih.gov/32805201/

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Objectives:
Hypertension is regarded as a major and independent risk factor of cardiovascular diseases and numerous studies observed an inverse correlation between vitamin C intake and blood pressure. Therefore, this review article has been conducted.

Does a high serum vitamin C reduce blood pressure?

Study design:
This review article included 11 cross-sectional studies and 7 case-control studies. These studies comprised 22,200 observational subjects and were conducted from the year 1990 to 2017. Of the 18 articles, 14 were published in the English language and 4 were in Chinese.

Assessed with NOS, all the case-control studies yield a high quality averaging with 7.143 scores. And the result of AHRQ indicates a moderate quality with all cross-sectional studies scoring between 4 and 7.

Results and conclusions:
The investigators found random-effects model showed serum level of vitamin C of hypertensive subjects was 15.13 μmol/L lower than the normotensives [MD = -15.13, 95% CI = -24.19 to -6.06, p = 0.001, I2 = 98%].

The investigators found subgroup analysis showed that hypertensive subjects who took antihypertensive drugs had a 15.97 μmol/L lower serum vitamin C compared with normotensive ones.

The investigators found serum vitamin C had a significant inverse relation with both systolic blood pressure [Fisher′s Z = -0.17, 95% CI = -0.20 to -0.15, p 0.00001] and diastolic blood pressure [Fisher′s Z = -0.15, 95% CI = -0.20 to -0.10, p 0.00001].

The investigators concluded people with hypertension have a relatively low serum vitamin C and vitamin C is inversely associated with both systolic blood pressure and diastolic blood pressure.

Original title:
Association between Serum Vitamin C and the Blood Pressure: A Systematic Review and Meta-Analysis of Observational Studies by Ran L, Zhao W, […], Bu H.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7211237/

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Objectives:
Since the World Health Organization recommended single low-dose (0.25mg/kg) primaquine (PQ) in combination with artemisinin-based combination therapies (ACTs) in areas of low transmission or artemisinin-resistant P. falciparum, several single-site studies have been conducted to assess its efficacy. Therefore, this review article has been conducted.

What is the efficacy of primaquine (PQ) in combination with artemisinin-based combination therapies (ACTs) in areas of low transmission or artemisinin-resistant P. falciparum?

Study design:
This review article included 14 studies with 2,574 participants.

Results and conclusions:
The investigators found primaquine significantly reduced PCR-determined gametocyte carriage on days 7 and 14, most apparently in patients presenting with gametocytaemia on day 0 [OR = 0.22, 95% CI = 0.17 to 0.28 and OR = 0.12, 95% CI = 0.08 to 0.16, respectively].

The investigators found the rate of decline in gametocyte carriage was faster when primaquine was combined with artemether-lumefantrine (AL) compared to dihydroartemisinin-piperaquine (DP) [p = 0.010 for day 7].
Addition of 0.25mg/kg primaquine was associated with near complete prevention of transmission to mosquitoes.

The investigators concluded primaquine's transmission-blocking effects are achieved with 0.25 mg/kg primaquine. Gametocyte persistence and infectivity are lower when primaquine is combined with artemether-lumefantrine compared to dihydroartemisinin-piperaquine.

Original title:
Efficacy of single dose primaquine with artemisinin combination therapy on P. falciparum gametocytes and transmission: A WWARN individual patient meta-analysis by Stepniewska K, Humphreys GS, […], Bousema T.

Link:
https://pubmed.ncbi.nlm.nih.gov/32778875/

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Objectives:
Isoflavones have a structure similar to 17β-estradiol, so they may be useful to postmenopausal women in preventing bone loss related to estrogen deficiency. Therefore, this review article has been conducted.

Do isoflavone supplements increase bone mineral density (BMD) in postmenopausal women?

Study design:
This review article included 63 RCTs, involving 6,427 postmenopausal women.

Isoflavone interventions were generally safe and well tolerated.

Results and conclusions:
The investigators found statistically significant differences in bone mineral density at the last follow-up visit between the two groups (isoflavones vs. control) at the lumbar spine [MD = 21.34 mg/cm², 95% CI = 8.21 to 34.47 mg/cm², p = 0.001], the femoral neck [MD = 28.88 mg/cm², 95% CI = 15.05 to 42.71 mg/cm², p 0.0001] and the distal radius [MD = 19.27 mg/cm², 95% CI = 5.65 to 32.89 mg/cm², p = 0.006].
This improved bone mineral density was found for genistein 54 mg/day and ipriflavone (a synthetic isoflavone) 600 mg/day.

The investigators concluded isoflavone interventions, genistein (54 mg/day) and ipriflavone (600 mg/day) in particular, have beneficial effects on bone mineral density outcomes and are safe in postmenopausal women. They may be considered as a complementary or alternative option in the prevention and treatment of menopause-related osteoporosis.

Original title:
Effects of Isoflavone Interventions on Bone Mineral Density in Postmenopausal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials by Sansai K, Takuathung MN, [...], Koonrungsesomboon N.

Link:
https://pubmed.ncbi.nlm.nih.gov/32524173/

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Objectives:
Type 2 diabetes mellitus is a chronic disease that occurs among the general population. The insulin-lowering and homeostasis model assessment of insulin resistance-improving effects of inulin are unconfirmed. Therefore, this review article has been conducted.

Do inulin supplements improve HOMA-IR, fasting plasma glucose and HbA1c in patients with type 2 diabetes mellitus?

Study design:
This review article included 9 RCTs with a total of 661 participants.

The duration of the interventions ranged from 6 weeks to 12 weeks and the dosage of inulin supplementation ranged from 8.4 g to 10 g per day.

Results and conclusions:
The investigators found inulin supplementation significantly improved fasting plasma glucose [SMD = -0.55, 95% CI = -0.73 to -0.36, p = 0.0], HOMA-IR [SMD = -0.81, 95% CI = -1.59 to -0.03, p = 0.042] and HbA1c [SMD = -0.69, 95% CI = -0.92 to -0.46, p = 0.0] in patients with type 2 diabetes mellitus.

The investigators found, further subgroup analyses revealed a significant role of inulin supplementation for treatment durations ≥8 weeks [p = 0.038 for insulin, p = 0.002 for HOMA-IR, p = 0.032 for fasting plasma glucose, p = 0 for HbA1c] in patients with type 2 diabetes mellitus.

The investigators concluded that daily 8.4-10 grams of inulin supplements for at least 8 weeks improve HOMA-IR, fasting plasma glucose and HbA1c in patients with type 2 diabetes mellitus.

Original title:
Efficacy of inulin supplementation in improving insulin control, HbA1c and HOMA-IR in patients with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials by Zhang W, Tang Y, […], Hu H.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7263925/

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Inulin is a type of fiber that's found in certain plant foods. Chicory root is the main source of inulin in supplement form.

Objectives:
The relationship between dietary pattern and the risk of chronic obstructive pulmonary disease (COPD) has been described; however, the exclusive role of dietary factors remains controversial. Therefore, this review article has been conducted.

Does a dietary intake of fruits and vegetables, dietary fiber, fish, n-3 or n-6 fatty acids and antioxidant vitamins reduce risk of COPD in adults?

Study design:
This review article included 10 cohort, 6 case-control and 20 cross-sectional studies.

To assess usual dietary intake, 28 studies had used food frequency questionnaires (FFQ), of which 2 studies had used FFQ and a 24-hour recall, 3 studies had used the crosscheck dietary method, 1 study had assessed with only 24-hour recall and 1 study had used weighted household food records.

Results and conclusions:
The investigators found a significantly reduced risk of 26% [relative risk = 0.74, 95% CI = 0.65 to 0.85] for COPD for the highest fruit intake group compared with the lowest intake group.
This significantly reduced risk was 29% in cohort studies [RR = 0.71, 95% CI = 0.63 to 0.79, I2 = 0.0%].

The investigators found a significantly reduced risk of 47% [relative risk = 0.53, 95% CI = 0.39 to 0.74, I2 = 0.0%, p = 0.65] for COPD mortality for the highest fruit intake group compared with the lowest intake group.

The investigators found a significantly reduced risk of 35% [relative risk = 0.65, 95% CI = 0.55 to 0.78] for COPD for the highest dietary fiber intake group compared with the lowest intake group.
This significantly reduced risk was 39% in cohort studies [RR = 0.61, 95% CI = 0.54 to 0.68, I2 = 0.0%, p = 0.9].

The investigators found a significantly reduced risk of 29% [relative risk = 0.71, 95% CI = 0.58 to 0.85] for COPD for the highest fish intake group compared with the lowest intake group.

The investigators found a significantly reduced risk of 11% [relative risk = 0.89, 95% CI = 0.76 to 0.99] for COPD for the highest vitamin C dietary intake group compared with the lowest intake group.

The investigators found no association between the risk of COPD and the intake of vegetables, n-3 fatty acids, vitamin E and β-carotene.

The investigators concluded that a higher dietary intake of fruit, dietary fiber, fish and vitamine C reduce the risk of COPD in adults.

Original title:
Dietary Factors and Risk of Chronic Obstructive Pulmonary Disease: A Systemic Review and Meta-Analysis by Seyedrezazadeh E, Moghaddam MP, […], Kolahdooz F.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7309892/

Additional information of El Mondo:
Find here more information/studies about fruit, dietary fiber, fish and vitamine C.

Objectives:
Depending on the epidemiological context of each country, three vaccines are recommended by the World Health Organization (WHO) to be administered as soon as possible after birth (birth vaccines); namely, BCG, zero dose of oral polio vaccine (OPV0) and birth dose of hepatitis B vaccine (HepB-BD). The timely administration of these vaccines immediately after birth might pose significant challenges in sub-Saharan Africa, where about half of childbirths occur outside health facilities. Therefore, this review article has been conducted.

What is the coverage rate of BCG, zero dose of oral polio vaccine (OPV0) and birth dose of hepatitis B vaccine (HepB-BD) vaccines at a specific timing in neonates in sub-Saharan Africa?

Study design:
This review article included 20 cross-sectional studies, 7 prospective cohort studies and 4 retrospective cohort studies with 204,111 infants.
The number of studies assessing BCG, OPV0 and HepB-BD was 23, 15 and 8, respectively

Results and conclusions:
The investigators found the pooled coverage rates at day 0-1 after birth were 14.2% [95% CI = 10.1 to 18.9] for BCG and 1.3% [95% CI = 0.0 to 4.5] for HepB-BD. No data were available for OPV0 at day 0-1.

The investigators found the coverage at day 28 was 71.7% [95% CI = 63.7 to 79.2)] for BCG, 60.8% [95% CI = 45.8 to 74.7] for HepB-BD and 76.1% [95% CI = 67.1 to 84.0] for OPV0.

The investigators found no significant difference in the vaccine coverage between infants born in healthcare facilities and those born outside facilities.

The investigators concluded the rates of vaccine coverage immediately after birth are very low for BCG and HepB-BD and no data for OPV0 in neonates in sub-Saharan Africa. Additional data are needed to better define barriers and facilitators for the timely administration of the birth vaccines in sub-Saharan Africa, since the delay in its provision may increase the burden of these vaccine-preventable diseases.

Original title:
Coverage and Timeliness of Birth Dose Vaccination in Sub-Saharan Africa: A Systematic Review and Meta-Analysis by Bassoum O, Kimura M, […], Shimakawa Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7350240/

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

Objectives:
It is unclear how dietary intake influences the ovarian cancer. Therefore, this review article (meta-analysis) has been conducted.

Is there a relationship between dietary intake of different nutrients/food groups and ovarian cancer risk?

Study design:
This review article included 97 cohort studies.

Results and conclusions:
The investigators found no significant association between dietary intake and risk of ovarian cancer.

The investigators found in subgroup analyses that dietary intake of green leafy vegetables significantly reduced risk of ovarian cancer with 9% [RR = 0.91, 95% CI = 0.85 to 0.98].

The investigators found in subgroup analyses that dietary intake of allium vegetables significantly reduced risk of ovarian cancer with 21% [RR = 0.79, 95% CI = 0.64 to 0.96].

The investigators found in subgroup analyses that dietary intake of fiber significantly reduced risk of ovarian cancer with 11% [RR = 0.89, 95% CI = 0.81 to 0.98].

The investigators found in subgroup analyses that dietary intake of flavonoids significantly reduced risk of ovarian cancer with 17% [RR = 0.83, 95% CI = 0.78 to 0.89].

The investigators found in subgroup analyses that dietary intake of green tea significantly reduced risk of ovarian cancer with 39% [RR = 0.61, 95% CI = 0.49 to 0.76].

The investigators found in subgroup analyses that dietary intake of tota fat significantly increased risk of ovarian cancer with 10% [RR = 1.10, 95% CI = 1.02 to 1.18].

The investigators found in subgroup analyses that dietary intake of saturated fat significantly increased risk of ovarian cancer with 11% [RR = 1.11, 95% CI = 1.01 to 1.22].

The investigators found in subgroup analyses that dietary intake of saturated fatty acid significantly increased risk of ovarian cancer with 19% [RR = 1.19, 95% CI = 1.04 to 1.36].

The investigators found in subgroup analyses that dietary intake of cholesterol significantly increased risk of ovarian cancer with 13% [RR = 1.13, 95% CI = 1.04 to 1.22].

The investigators found in subgroup analyses that dietary intake of retinol (vitamin A) significantly increased risk of ovarian cancer with 14% [RR = 1.14, 95% CI = 1.00 to 1.30].

The investigators found, in addition, acrylamide, nitrate, water disinfectants and polychlorinated biphenyls were significantly associated with an increased risk of ovarian cancer.

The investigators concluded that dietary intakes of green leafy vegetables, allium vegetables, fiber, flavonoids and green tea reduce ovarian cancer.

Original title:
Association between dietary intake and risk of ovarian cancer: a systematic review and meta-analysis by Khodavandi A, Alizadeh F and Razis AFA.

Link:
https://pubmed.ncbi.nlm.nih.gov/32661683/

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

Objectives:
Antioxidant status is considered as important factor in the pathogenesis (the manner of development of a disease) of vitiligo. However, there are controversial findings about serum status of antioxidants in vitiligo patients. Therefore, this review article has been conducted.

Is there a relationship between serum antioxidant level (e.g. vitamin C, E, zinc and selenium) and risk of vitiligo?

Study design:
This review article included 11 studies including 570 vitiligo cases and 580 controls (people without vitiligo).

Serum vitamin A and copper level in vitiligo patients were only evaluated in single studies and not included in meta-analysis.

Results and conclusions:
The investigators found based on fixed effect model, there were no statistical difference between two groups regarding serum vitamin C levels [OR = 1.17, 95% CI = 0.74 to 1.84, p = 0.495] and serum vitamin E levels [OR = 0.61, 95% CI = 0.30 to 1.25, p = 0.180].

The investigators found in sensitivity analysis, higher serum zinc levels significantly decreased risk of vitiligo with 71% [OR = 0.29, 95% CI = 0.15 to 0.54, p 0.001].

The investigators found in sensitivity analysis, higher serum selenium level significantly increased risk of vitiligo with 331% [OR = 4.31, 95% CI = 2.72 to 6.81, p 0.001].

The investigators concluded that higher serum selenium and lower zinc level increase risk of vitiligo. Potential mechanism associated with preventive effects of zinc and the depigmentation effect of selenium should be more elucidated in further studies.

Original title:
Serum Level of Antioxidant Vitamins and Minerals in Patients With Vitiligo, a Systematic Review and Meta-Analysis by Huo J, Liu T, [...], Wang R.

Link:
https://pubmed.ncbi.nlm.nih.gov/32593085/

Additional information of El Mondo:
Find here more information/studies about antioxidants, selenium and zinc.

Vitiligo is a long-term condition where pale white patches develop on the skin. It's caused by the lack of melanin, which is the pigment in skin. Vitiligo can affect any area of skin, but it commonly happens on the face, neck and hands and in skin creases.

Objectives:
Some evidence indicates that carotenoids may reduce the risk of bladder cancer (BC), but the association is unclear. Therefore, this review article (meta-analysis) has been conducted.

Do dietary carotenoid (β-cryptoxanthin, α-carotene, β-carotene and lutein and zeaxanthin) intakes or circulating carotenoid concentrations reduce bladder cancer risk in men and women?

Study design:
This review article included 22 studies (case-control and cohort studies), involving 516,740 adults.

Results and conclusions:
The investigators found no association for the highest compared with the lowest category of carotenoid dietary intake and reduced risk of bladder cancer [RR = 0.88, 95% CI = 0.76 to 1.03].
No association because RR of 1 was found in the 95% CI of 0.76 to 1.03. RR of 1 means no risk/association.

The investigators found no association for the highest compared with the lowest category of circulating carotenoid concentrations and reduced risk of bladder cancer [RR = 0.36, 95% CI = 0.12 to 1.07].

The investigators found for the highest compared with the lowest category of circulating lutein and zeaxanthin concentrations a significantly reduced risk of 47% for bladder cancer [RR = 0.53, 95% CI = 0.33 to 0.84].
Significant because RR of 1 was not found in the 95% CI of 0.33 to 0.84. RR of 1 means no risk/association.

The investigators found dose-response analysis showed that bladder cancer risk significantly decreased by 42% [RR = 0.58, 95% CI = 0.36 to 0.94] for every 1 mg increase in daily dietary β-cryptoxanthin intake.

The investigators found dose-response analysis showed that bladder cancer risk significantly decreased by 76% [RR = 0.24, 95% CI = 0.08 to 0.67] for every 1 μmol/L increase in circulating concentration of α-carotene.

The investigators found dose-response analysis showed that bladder cancer risk significantly decreased by 27% [RR = 0.73, 95% CI = 0.57 to 0.94] for every 1 μmol/L increase in circulating concentration of β-carotene.

The investigators found dose-response analysis showed that bladder cancer risk significantly decreased by 56% [RR = 0.44, 95% CI = 0.28 to 0.67] for every 1 μmol/L increase in circulating concentrations of lutein and zeaxanthin.

The investigators concluded dietary β-cryptoxanthin intake and circulating concentrations of α-carotene, β-carotene and lutein and zeaxanthin reduce risk of bladder cancer.

Original title:
Carotenoid Intake and Circulating Carotenoids Are Inversely Associated With the Risk of Bladder Cancer: A Dose-Response Meta-analysis by Wu S, Liu Y, […], Ramirez AG.

Link:
https://pubmed.ncbi.nlm.nih.gov/31800007/

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

Objectives:
Are declined circulating vitamin D levels associated with severity of hepatitis C virus (HCV) infection?

Study design:
This review article included 28 studies, consisting of 7,736 HCV-infected patients and 14,061 control subjects without liver diseases.

Results and conclusions:
The investigators found compared to controls, circulating vitamin D levels were significantly lessened in HCV-infected patients [MD = -14.15, 95% CI = -20.51 to -7.80].

The investigators found remarkably decreased circulating vitamin D in patients with severe fibrosis [MD = -3.38, 95% CI = -4.51 to -2.25], non-achieving sustained virologic response (SVR) [MD = -2.99, 95% CI = -5.55 to -0.42] and advanced inflammation [MD = -4.68, 95% CI = -8.50 to -0.86].

The investigators found low vitamin D status (20 ng/mL) significantly increased HCV infection with 141% [pooled OR = 2.41, 95% CI = 1.48 to 3.95].

The investigators found a significantly increased risk of 70% [pooled OR = 1.70, 95% CI = 1.27 to 2.26] for severe fibrosis among HCV-infected patients with low vitamin D status.

The investigators found a significantly increased risk of 104% [pooled OR = 2.04, 95% CI = 1.62 to 2.57] for non-achieving SVR among HCV-infected patients with low vitamin D status.

The investigators concluded hepatitis C virus (HCV)-infected patients with declined circulating vitamin D levels are associated with severe fibrosis, non-achieving sustained virologic response (SVR) and advanced inflammation.

Original title:
Decreased Circulating Vitamin D Reflects Adverse Outcomes of Hepatitis C Virus Infection: A Systematic Review and Meta-Analysis by Udomsinprasert W, Jittikoon J, […], Chaikledkaew U.

Link:
https://pubmed.ncbi.nlm.nih.gov/32553842/

Additional information of El Mondo:
Find more information/studies vitamin D and malnutrition right here.

Virologic response means that the hepatitis C virus is not detected in the blood during treatment. When the hepatitis C virus continues to be undetectable 12 weeks or more after completing treatment, a “sustained” virologic response (SVR) has been achieved.

Objectives:
Is there a causal relationship between black or green tea consumption and lowering blood pressure in subjects with elevated blood pressure (BP) or hypertension?
 
Study design:
This review article included 5 RCTs with 408 individuals.

None of the studies reported any side effects.

Results and conclusions:
The investigators found regular tea consumption significantly reduced systolic blood pressure [WMD = -4.81 mmHg, 95% CI = -8.40 to -1.58, p = 0.004] in subjects with elevated blood pressure (BP) or hypertension.

The investigators found regular tea consumption significantly reduced diastolic blood pressure [WMD = -1.98 mmHg, 95% CI = -3.77 to -0.20, p = 0.029] in subjects with elevated blood pressure (BP) or hypertension.

The investigators found, however, excluding the most heterogeneous trials showed that regular tea intake significantly reduced systolic blood pressure and diastolic blood pressure by about -3.53 and -0.99 mmHg, respectively.

The investigators found based on meta-regression findings, the longer the duration of tea intake (≥3 months), the higher the decrease in both systolic blood pressure and diastolic blood pressure.

The investigators found categorized studies, according to the tea type, revealed that the hypotensive effects of green tea were more pronounced compared to black tea.

The investigators concluded regular tea consumption, particularly green tea during ≥3 months reduces systolic blood pressure and diastolic blood pressure in subjects with elevated blood pressure (BP) or hypertension. Hence, it may be applicable to physicians, health care providers and particularly hypertension patients.

Original title:
The Effects of Regular Consumption of Green or Black Tea Beverage on Blood Pressure in Those With Elevated Blood Pressure or Hypertension: A Systematic Review and Meta-Analysis by Mahdavi-Roshan M, Salari A, […], Ashouri A.

Link:
https://www.sciencedirect.com/science/article/abs/pii/S0965229919316899?via%3Dihub

Additional information of El Mondo:
Find more information/studies on green tea consumption and lowering of blood pressure right here.

Objectives:
A growing number of epidemiological studies have suggested a possible association between long-chain omega-3 polyunsaturated fatty acid (PUFA) intake and the risk of cancers, but the results have been inconsistent. Therefore, this review article (meta-analysis) has been conducted.

Does dietary intake of omega-3 PUFAs reduce digestive system cancers?

Study design:
This review article included 8 case-control studies and 17 cohort studies, involving 1,247,271 participants and 23,173 patients with digestive system cancers.

Visual inspection of funnel plots and the Begg's and Egger's tests revealed no evidence of publication bias.

Results and conclusions:
The investigators found the risk of digestive system cancers significantly decreased by 17% in individuals who consumed omega-3 PUFAs [RR = 0.83, 95% CI = 0.76 to 0.91].

The investigators found the risk estimates of digestive system cancers varied by cancer sites, study location, study design, type of omega-3 PUFAs and other confounders (smoking, alcohol consumption, body mass index and physical activity).

The investigators concluded omega-3 PUFA is a healthy dietary component for the prevention of digestive system cancers. Cancer incidence decreases with increasing omega-3 PUFAs intake for most digestive system cancer sites. The relation between omega-3 PUFAs and digestive system cancers RR is similar among different populations.

Original title:
Omega-3 PUFA Intake and the Risk of Digestive System Cancers: A Meta-Analysis of Observational Studies by Jian J, Zhang and Zhao L.

Link:
https://pubmed.ncbi.nlm.nih.gov/32384489/

Additional information of El Mondo:
Find more information/studies on omega-3 PUFAs and cancer right here.

Objectives:
Lymphoma etiology remains ill-defined, but immune factors seem to play a major role. The Bacillus Calmette-Guérin (BCG) vaccine, a non-specific stimulator of the cellular immune response, could influence lymphoma risk. Previous studies addressing this issue showed conflicting results. Therefore, this review article has been conducted.

Does BCG vaccination increase lymphoma risk?

Study design:
This review article included 11 studies.

Results and conclusions:
The investigators found BCG vaccination was not associated with Hodgkin's lymphoma [FE summary OR = 1.10, 95% CI = 0.93 to 1.30], but positively associated with non-Hodgkin's lymphoma [RE summary OR = 1.20, 95% CI = 1.01 to 1.43].

The investigators found, however, when restricting to higher quality studies, no association was found between BCG vaccination and either Hodgkin's lymphoma (RE summary OR = 0.97, 95% CI = 0.67 to 1.43] or non-Hodgkin's lymphoma [RE summary OR = 1.15, 95% CI = 0.84 to 1.59].

The investigators concluded, overall, these findings do not support that BCG vaccination is associated with lymphoma risk. Yet, lack of statistical power and relatively high heterogeneity among studies prevent from making definitive conclusions. Future studies investigating this issue are needed, using robust methodology.

Original title:
Association Between Bacillus Calmette-Guerin (BCG) Vaccination and Lymphoma Risk: A Systematic Review and Meta-Analysis by Salmon C, Conus F, […], Rousseau MC.

Link:
https://pubmed.ncbi.nlm.nih.gov/32203929/

Additional information of El Mondo:
Find more information/studies vaccination and maltnutrition right here.

Objectives:
Has oral supplementation of vitamin B (vitamins B1, B6, B12 and folic acid alone or combined) preventive effect on cognitive decline in cognitively unimpaired individuals?

Study design:
This review article included 20 RCTs, ranging from 23 to 2,919 participants per study, with a total of 12,697 participants.
8 of these 20 RCTs were deemed appropriate for the meta-analysis.

Results and conclusions:
The investigators found meta-analysis did not yield a significant overall effect of supplementation with vitamin B on cognitive function [SMD = 0.02, 95% CI = -0.034 to 0.08]. A sensitivity analysis focusing on specific risk factors did not alter this result.
Some studies reported isolated significant effects of the intervention on secondary outcomes. However, these findings were outnumbered by the number of cognitive tests that did not yield significant effects.

The investigators concluded there is no overall evidence that oral vitamin B supplementation prevent cognitive decline in cognitively unimpaired individuals. The results of this review do not provide evidence that population groups with certain risk factors would profit more from the intervention than others.

Original title:
Vitamin B-Can It Prevent Cognitive Decline? A Systematic Review and Meta-Analysis by Behrens A, Graessel E, [...], Donath C.

Link:
https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-020-01378-7

Additional information of El Mondo:
Find more information/studies on vitamins B1, B6, B12 and folic acid and dementia right here.