Nutritional advice

Objectives:
Epidemiologic studies, including trials, suggest an association between potassium intake and blood pressure (BP). However, the strength and shape of this relationship is uncertain. Therefore, this review article has been conducted.

What is the strength and shape of the relationship between potassium intake and blood pressure (BP)?
 
Study design:
This review article included 32 RCTs with a duration ≥4 weeks using the recently developed 1‐stage cubic spline regression model. This model allows use of trials with at least 2 exposure categories.
Most trials were conducted in adults with hypertension using a crossover design and potassium supplementation doses that ranged from 30 to 140 mmol (1173 and 5474 mg) per day.

Results and conclusions:
The investigators found a U‐shaped relationship between 24‐hour active and control arm differences in potassium excretion and blood pressure (BP) levels, with weakening of the blood pressure reduction effect above differences of 30 mmol/d and a blood pressure increase above differences ≈80 mmol/d.

The investigators found achieved potassium excretion analysis also identified a U‐shaped relationship. The blood pressure lowering effects of potassium supplementation were stronger in participants with hypertension and at higher levels of sodium intake.

The investigators found blood pressure increased with high potassium excretion in participants with antihypertensive drug‐treated hypertension but not in their untreated counterparts.

The investigators concluded that an adequate intake of potassium (≤30 mmol (1173 mg) per day) is desirable to achieve a lower blood pressure level but excessive potassium supplementation (>80 mmol (3128 mg) per day) should be avoided, particularly in specific subgroups.

Original title:
Potassium Intake and Blood Pressure: A Dose‐Response Meta‐Analysis of Randomized Controlled Trials by Filippini T, Naska A, […], Whelton PK.

Link:
https://www.ahajournals.org/doi/full/10.1161/JAHA.119.015719?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed&

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

Objectives:
The prevalence of co-infection of hepatitis B virus (HBV) and human immunodeficiency virus (HIV) is high and increases risk of hepatitis B chronicity and mortality. Despite guidelines for HIV-infected patients to be immunized against HBV, the immunogenicity of the HBV vaccination in HIV-infected patients is lower than that in the HIV-seronegative population. Therefore, this review article has been conducted.

What will be the response rate to an increased dose of HBV vaccination in HIV-infected patients?

Study design:
This review article included 9 RCTs, involving 970 HIV-positive vaccine recipients.
A fixed-effects model, with heterogeneity and sensitivity analyses, was used.
No heterogeneity was found.

Results and conclusions:
The investigators found results showed a significant increase in response rates among patients who received a double dose of the HBV vaccine versus the standard dose in both subgroups [pooled OR = 1.76, 95% CI = 1.36 to 2.29 and pooled OR = 2.28, 95% CI = 1.73 to 3.01] for the rate that was measured 4-6 weeks and >12 months after completion of vaccination, respectively.
The total OR was 1.99 [95% CI = 1.64 to 2.41].

The investigators concluded a double dose of the HBV vaccine improves the immune response in HIV-infected patients. Higher immunogenicity was observed, when it was measured 4-6 weeks and >12 months after completion of the vaccination.

Original title:
Systematic Review and Meta-Analysis of Immune Response of Double Dose of Hepatitis B Vaccination in HIV-infected Patients by Lee JH, Hong S, […], Kwon HY.

Link:
https://pubmed.ncbi.nlm.nih.gov/32334887/

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Find more information/studies vaccination and malnutriton right here.

Objectives:
Does barberry (Berberis vulgaris L.) supplementation improve glycemic markers including fasting blood sugar (FBS) concentrations, insulin levels, homeostatic model assessment for insulin resistance (HOMA-IR) and glycosylated hemoglobin (HbA1c) percentage?

Study design:
This review article included 7 RCTs, comprising 452 participants.

Results and conclusions:
The investigators found the meta-analysis revealed that barberry supplementation significantly reduced insulin levels [Hedges’s = -0.67, 95% CI = -1.31 to -0.03, p = 0.04, I2 = 73.3%].
However, no significant positive effect was observed for fasting blood sugar levels [WMD = -8.06 mg/dL, 95% CI = -20.46 to 4.33, p = 0.23, I2 = 96.1%], HbA1c percentage [WMD = -0.83%, 95% CI = -2.33 to 0.67, p = 0.27, I2 = 88.3%] and HOMA-IR index [WMD = -0.55, 95% CI = -1.60 to 0.50, p = 0.30, I2 = 99.4%].

The investigators concluded barberry supplementation improves insulin levels.

Original title:
The Effect of Barberry (Berberis Vulgaris L.) on Glycemic Indices: A Systematic Review and Meta-Analysis of Randomized Controlled Trials by Safari Z, Farrokhzad A, […], Askari G.

Link:
https://www.sciencedirect.com/science/article/abs/pii/S0965229920302235?via%3Dihub

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Find more information/studies on diabetes and fruit right here.

Objectives:
Vitamin D deficiency has been related to the risk of sepsis. However, previous studies showed inconsistent results regarding the association between serum 25-hydroxyvitamin D (25 (OH)D) and mortality risk in septic patients. Therefore, this review article has been conducted.

Does a low serum 25-hydroxyvitamin D (vitamin D level in blood) increase mortality risk in septic patients?

Study design:
This review article included 8 follow-up studies (4 were prospective and the other 4 were retrospective) with 1,736 septic patients.

The sample sizes of the included studies varied from 57 to 610.
The mean ages of the patients included in each study ranged from 57 to 75 years and the proportions of male patients varied from 43% to 71%.

Optimal vitamin D level, vitamin D insufficiency, vitamin D deficiency and severe vitamin D deficiency are defined as serum 25 (OH)D > 30 ng/mL, 21-29 ng/mL and  20 ng/mL, 10 ng/mL, respectively.

There was no publication bias.

Results and conclusions:
The investigators found meta-analysis with a random-effect model showed that septic patients with lower serum 25 (OH)D ( 30 ng/ml) at admission was associated with a significantly increased mortality risk of 93% [adjusted RR = 1.93, 95% CI = 1.41 to 2.63, p  0.001, I2 = 63%, p = 0.003].
Sensitivity analysis by excluding one study at a time did not significantly change the results.

The investigators found subgroup analyses according to the severity of vitamin D deficiency showed that patients with severe vitamin D deficiency ( 10 ng/mL) was significantly associated with a 92% higher mortality risk [adjusted RR = 1.92, 95% CI = 1.09 to 2.55, p  0.001].
But the associations were not significant for vitamin D insufficiency (25 (OH)D = 20-30 ng/mL) or deficiency (25 (OH)D = 10-20 ng/mL).

The investigators found further analyses showed that the association between lower serum 25(OH) D and higher mortality risk were consistent in studies applied different diagnostic criteria for sepsis (SIRS, Sepsis-2.0 or Sepsis-3.0), short-term (within 1 month) and long-term studies (3-12 months) and in prospective and retrospective studies.

The investigators concluded that severe vitamin D deficiency ( 10 ng/mL) is independently associated with increased mortality in patients with sepsis. Large-scale prospective studies are needed to validate these findings.

Original title:
Serum 25-Hydroxyvitamin D and the risk of mortality in adult patients with Sepsis: a meta-analysis by Li Y and Ding S.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7057612/

Additional information of El Mondo:
Find here more information/studies about vitamin D.

Objectives:
Malaria in pregnancy affects both the mother and the fetus. However, evidence supporting treatment guidelines for uncomplicated (including asymptomatic) falciparum malaria in pregnant women is scarce and assessed in varied ways. Therefore, this review article has been conducted.

What should be the treatment guidelines for uncomplicated (including asymptomatic) falciparum malaria in pregnant women?

Study design:
This review article included 19 interventional or observational cohort studies assessing the efficacy of artemisinin-based or quinine-based treatments in pregnancy; representing 92% of patients in the literature (4,968 of 5,360 episodes).

The included studies were done between 1995 and 2014 in 10 different countries; 9 studies (comprising 3,813 episodes) were done in sub-Saharan Africa and 10 (comprising 1,155 episodes) in Asia.

Results and conclusions:
The investigators found risk of PCR-corrected treatment failure was higher for the quinine monotherapy [n = 244, adjusted hazard ratio = 6.11, 95% CI = 2.57 to 14.54, p 0.0001] but lower for artesunate-amodiaquine [n = 840, adjusted hazard ratio = 0.27, 95% = 0.14 to 0.52, p 0.0001], artesunate-mefloquine [n = 1028, adjusted hazard ratio = 0.56, 95% = 0.34 to 0.94, p = 0.03] and dihydroartemisinin-piperaquine [n = 872, adjusted hazard ratio = 0.35 to 95% CI = 0.18 to 0.68, p = 0.002] than artemether-lumefantrine (n = 1,278) after adjustment for baseline asexual parasitaemia and parity.

The investigators found the risk of gametocyte carriage on day 7 was higher after quinine-based therapy than artemisinin-based treatment [adjusted odds ratio = 7.38, 95% CI = 2.29 to 23.82].

The investigators concluded efficacy and tolerability of artemisinin-based combination therapies (ACTs) in pregnant women are better than quinine. The lower efficacy of artemether-lumefantrine compared with other ACTs might require dose optimisation.

Original title:
Efficacy and Tolerability of Artemisinin-Based and Quinine-Based Treatments for Uncomplicated Falciparum Malaria in Pregnancy: A Systematic Review and Individual Patient Data Meta-Analysis by Saito M, Mansoor R, […], Guérin PJ.

Link:
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30064-5/fulltext

Additional information of El Mondo:
Find more information/studies malaria and pregnancy right here.

Objectives:
Nitric oxide related ergogenic aids such as arginine (Arg) have shown to impact positively on sport performance through several physiological and metabolic mechanisms. However, research results have shown to be controversial. Therefore, this review article has been conducted.

Do both acute and chronic arginine supplementation increase aerobic (≤VO2max) and anaerobic (>VO2max) performance?

Study design:
This review article included 15 RCTs with 386 males and 8 females.

Arginine supplementation was ingested by participants in both acute and chronic protocols.
Acute arginine protocol was 0.15 g/kg (≈10-11 g) ingested between 60-90 minutes before physical exercises.

Chronic arginine protocol was 1.5-2 g/day during 4-7 weeks or 10-12 g/day during 8 weeks.

Random effects model and pooled standardized mean differences (SMD) were used according to Hedges’ g.

Egger’s analyses did not find publication bias in anaerobic performance [z = 0.786, p = 0.432]. However, funnel plot showed publication bias in aerobic performance data [z = 2.873, p 0.05].

Results and conclusions:
The investigators found both acute and chronic arginine supplementation significantly improved anaerobic performance [SMD = 0.24, 95% CI = 0.05 to 0.43, p = 0.01, I2 = 0%, p = 0.85].

The investigators found both acute and chronic arginine supplementation significantly improved aerobic performance [SMD = 0.84, 95% CI = 0.12 to 1.56, p = 0.02, I2 = 89%, p 0.001].

The investigators concluded both acute and chronic arginine supplementation improve (anaerobic/aerobic) performance.

Original title:
Effects of Arginine Supplementation on Athletic Performance Based on Energy Metabolism: A Systematic Review and Meta-Analysis by Viribay A, Burgos J, […], Mielgo-Ayuso J.

Link:
https://www.mdpi.com/2072-6643/12/5/1300/htm

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Find here more information/studies about arginine and sport nutrition.

Objectives:
Vitamin D (vitD) deficiency is a global childhood health problem. Food fortification is a promising strategy to curb vitamin D deficiency. Therefore, this review article has been conducted.

Does vitamin D fortification reduce vitamin D deficiency in healthy children aged 1-18 years?

Study design:
This review article included 20 parallel RCTs (n = 4,044), including 15 parallel RCTs and 5 cluster RCTs.
All RCTs, except for three, had a low risk of bias.

The included children ranged in age from 1.4 to 18 years old.

The interventions included the fortification of a single food item such as milk, cereal, juice, and bread and two items of food such as yogurt and cheese or milk and bread.
All fortified food products were compared with unfortified food, different food products or no food.
The median intervention duration was 5 months (range 2-24 months).
The mean 25(OH)D concentration at baseline was 24.02 nmol/L and the prevalence of vitD deficiency was 46.6%.

No publication bias was detected by Egger’s test [p value = 0.24].

The overall evidence quality was high.

Results and conclusions:
The investigators found vitamin D food fortification significantly improved 25(OH)D concentration by a mean difference (MD) of 15.51 nmol/L [95% CI = 6.28 to 24.74, I2 = 99%], which resulted in a mean increase of 3 nmol/L for every 100 IU of vitamin D, when adjusted for baseline 25(OH)D concentration and country latitude.

The investigators found, additionally, the prevalence of vitamin D deficiency significantly decreased by a risk ratio of 0.53 [95% CI = 0.41 to 0.69, I2 = 95%] and cognitive function improved by a MD of 1.22 intelligence quotient (IQ) points [95% CI = 0.65 to 1.79, I2 = 0%].

The investigators concluded high-quality evidence from 20 RCTs shows improved 25(OH)D concentration by 15.51 nmol/L and reduces vitamin D deficiency prevalence by one child for every 6.3 children receiving a vitamin D fortified food product.

Original title:
The Impact of Vitamin D Food Fortification and Health Outcomes in Children: A Systematic Review and Meta-Regression by Al Khalifah R, Alsheikh R, [...], Backer N.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298752/

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

Objectives:
Does coenzyme Q10 supplementation reduce body weight and body mass index (BMI) of patients in randomized controlled clinical trial studies (RCTs)?

Study design:
This review article included 17 RCTs.

Results and conclusions:
The investigators found results of random-effect size meta-analysis showed that supplementation with coenzyme Q10 had no significant decreasing effects on body weight [WMD = 0.28 kg, 95% CI = -0.91 to 1.47, p = 0.64] and BMI [WMD = -0.03, 95% CI = -0.4 to 0.34, p = 0.86] of study participants.
No significant because the calculated p-value of 0.64 was larger than the p-value of 0.05.
Subgroup analysis revealed that dosage of Q10 and trial duration could not differ the results of Q10 supplementation.

The investigators concluded that coenzyme Q10 supplementation has no decreasing effects on body weight and BMI.

Original title:
Effect of Q10 supplementation on body weight and body mass index: A systematic review and meta-analysis of randomized controlled clinical trials by Saboori S, Rad EY, […], Falahi E.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31336462

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Objectives:
Do higher gestational vitamin D levels (vitamin D levels of the mother during pregnancy) decrease risk of multiple sclerosis (MS) in offspring?

Study design:
This review article included 4 case-control studies of moderate to low risk of bias.

Factors identified as determinants of heterogeneity were the definitions of vitamin D deficiency, the characteristics of study participants and the quality of the study.

Results and conclusions:
The investigators found that higher levels of gestational vitamin D significantly reduced risk of multiple sclerosis in offspring with 37% [OR = 0.63, 95% CI = 0.47 to 0.84] in random effects models and in a stratified analysis based on study quality.

The investigators concluded higher levels of gestational vitamin D reduce risk of multiple sclerosis in offspring.

Original title:
Gestational vitamin D and offspring risk of multiple sclerosis: a systematic review and meta-analysis by Jasper EA, Nidey NL, […], Ryckman KK.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32014337

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

 

Objectives:
Micronutrients’ deficiency is a common phenomenon among a majority of the population residing in the low- and middle-income countries (LMICs) especially among women and children. Given the widespread prevalence of micronutrients’ deficiency in LMICs, iron-fortified foods could be of potential benefits for both the mother and the development of fetus. Therefore, this review article has been conducted.

Does iron fortification increase hemoglobin (Hb) concentration during pregnancy and have iron fortification positive effects on specific maternal and pregnancy outcomes?

Study design:
This review article included 12 RCTs (n = 3,872).

The weighted mean difference (WMD) and relative risk (RR) were calculated using random-effects models. Sources of heterogeneity were explored through meta-regression.

The funnel plot was symmetrical, indicating that there was absence of any publication bias which was confirmed using Egger's weighted regression method [Egger test, ρ = 0.69].

Results and conclusions:
The investigators found the mean change in hemoglobin concentration was significantly higher in the group of mothers with iron fortification when compared with the control group [WMD = 4.45 g/L, 95% CI = 2.73 to 6.17 g/L, I2 = 83%, ρ 0.00001].

The investigators found in meta-regression analysis that the duration of feeding was positively associated with the effect size.

The investigators concluded iron fortification increases hemoglobin (Hb) concentration during pregnancy. Further research is required to explore the benefits of iron fortification on maternal and neonatal health outcomes during pregnancy.

Original title:
Meta-analysis Approach on Iron Fortification and Its Effect on Pregnancy and Its Outcome Through Randomized, Controlled Trials by Athe R, Dwivedi R, […], Banset U.  

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7114015/

Additional information of El Mondo:
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Objectives:
A low insulin-like growth factor 1 (IGF-1) level is known to be associated with many disorders. Several studies have shown that soy consumption may influence IGF-1, but the findings remain inconclusive. Therefore, this review article (meta-analysis) has been conducted.

Does soy consumption increase insulin-like growth factor 1 (IGF-1) level?

Study design:
This review article included 8 clinical trials.

Results and conclusions:
The investigators found, overall, a significant increment in plasma IGF-1 was observed following soy intervention [WMD = 13.5 ng/mL, 95% CI = 5.2 to 21.8, I2 = 97%].

The investigators found, subgroup analyses demonstrated a significantly greater increase in IGF-1, when soy was administered at a dosage of ≤40 g/day [WMD = 11.7 ng/mL, 95% CI = 10.9 to 12.6, I2 = 98%] and when the intervention duration was 12 weeks [WMD = 26.6 ng/mL, 95% CI = 9.1 to 44.1, I2 = 0.0%].

The investigators found, in addition, soy intervention resulted in a greater increase in IGF-1 among non-healthy subjects [WMD = 36 ng/mL, 95% CI = 32.7 to 39.4, I2 = 84%] than healthy subjects [WMD = 9.8 ng/mL, 95% CI = 8.9 to 10.7, I2 = 90%].

The investigators concluded ≤40 grams of soy consumption per day during 12 weeks increase the IGF-1 level.

Original title:
The Effect of Soy Intervention on Insulin-Like Growth Factor 1 Levels: A Meta-Analysis of Clinical Trials by Jiawei Zeng J, Feng Y, […], Chen X.

Link:
https://pubmed.ncbi.nlm.nih.gov/32072706/

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Objectives:
Is intralesional injection of mumps-measles-rubella (MMR) vaccine associated with a higher complete response in cutaneous warts?

Study design:
This review article included 5 RCTs with a total of 425 subjects.

Funnel plot analysis for complete response was asymmetrical, indicating the risk of publication bias.
There were statistically significant small-study effects for intralesional MMR on complete response upon analysis using Harbord's test (p = 0.047).
Grading of Recommendations Assessment, Development and Evaluation (GRADE) assessment showed that intralesional MMR injection has high level of certainty (quality of evidence) for complete response in warts with an absolute increase of 505 per 1000.

Results and conclusions:
The investigators found intralesional injection of mumps-measles-rubella (MMR) vaccine was associated with an increased complete response [OR = 9.43, 95% CI = 5.78 to 15.37, p 0.001, I2 = 5%, p = 0.38].

The investigators found subgroup analysis on patients receiving injection of mumps-measles-rubella (MMR) vaccine for every 2 weeks for a maximum of five injections revealed an OR of 11.70 [95% CI = 6.40, 21.38, p 0.001, I2 = 20%, p = 0.29].

The investigators found patients receiving intralesional mumps-measles-rubella (MMR) vaccine were associated with a lower partial response [OR = 0.54, 95% CI = 0.33 to 0.88, p = 0.01, I2 = 0%, p = 0.66].

The investigators found intralesional mumps-measles-rubella (MMR) vaccine was associated with a reduced no-response [OR = 0.16, 95% CI = 0.06 to 0.43, p 0.001, I2 = 69%, p = 0.01].

The investigators concluded intralesional MMR injection is associated with a higher complete response and lower no-response with a high level of certainty.

Original title:
Intralesional Measles-Mumps-Rubella Is Associated With a Higher Complete Response in Cutaneous Warts: A Systematic Review and Meta-Analysis of Randomized Controlled Trial Including GRADE Qualification by Vania R, Raymond Pranata R and Tan ST.

Link:
https://pubmed.ncbi.nlm.nih.gov/31985307/

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Find more information/studies food fortification right here.

Objectives:
An increased risk of gastric cancer for pickled vegetable and salted fish intake has been suggested, yet the lack of a dose-response association warrants a quantitative analysis. Therefore, this review article (meta-analysis) has been conducted.

Do pickled vegetable and salted fish intakes increase risk of gastric cancer?

Study design:
This review article included 21 cohort studies with a total of 195,624 participants for the analysis of pickled vegetable intake and 16 cohort studies with a total of

196,384 participants for the analysis of salted fish intake.

Results and conclusions:
The investigators found in a dose-response meta-analysis of 6 studies, a significantly increased risk of 15% [combined RR = 1.15, 95% CI = 1.07 to 1.23, p for heterogeneity = 0.14] for gastric cancer incidence for a 40 g/day increment in pickled vegetable intake.

The investigators found in the categorical meta-analysis of 6 studies, a marginally significant increase in the risk of gastric cancer incidence, comparing the highest to the lowest intake of salted fish [RR = 1.17, 95% CI = 0.99 to 1.38, p for heterogeneity = 0.26].

The investigators concluded intake of 40 g/day of pickled vegetable increases risk of gastric cancer incidence.

Original title:
Pickled Vegetable and Salted Fish Intake and the Risk of Gastric Cancer: Two Prospective Cohort Studies and a Meta-Analysis by Yoo JY, Cho HJ, […], Park SK.

Link:
https://www.mdpi.com/2072-6694/12/4/996/htm

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Objectives:
Is there a causal relationship between tomato consumption and lowering effects on cholesterol, triglycerides or fasting blood sugar levels?
 
Study design:
This review article included 6 RCTs.

Results and conclusions:
The investigators found tomato consumption significantly reduced total plasma cholesterol levels [WMD = -4.39 mg/dL, 95% CI = -7.09 to -1.68, I2 = 48%, p = 0.05].

The investigators found tomato consumption significantly reduced plasma triglyceride (TG) levels [WMD = -3.94 mg/dL, 95% CI = -7.67 to -0.21, I2 = 90%, p = 0.001].
A higher reduction effect was found on younger participants.

The investigators found tomato consumption significantly reduced plasma LDL cholesterol (bad cholesterol) levels [WMD = -2.09 mg/dL, 95% CI = -3.73 to -0.81, I2 = 78%, p = 0.001].
A higher reduction effect was found on younger participants.

The investigators found tomato consumption significantly increased plasma HDL cholesterol (good cholesterol) levels [WMD = 2.25 mg/dL, 95% CI = 0.41 to 4.10, I2 = 97%, p = 0.001].

The investigators found tomato consumption had no significant effect on plasma fasting blood sugar levels [WMD = 0.59 mg/dL, 95% CI = -0.28 to 1.46, I2 = 95%, p = 0.001].

The investigators concluded that tomato consumption increases plasma HDL cholesterol (good cholesterol) levels and decreases plasma total cholesterol, LDL cholesterol (bad cholesterol) and triglyceride levels.

Original title:
Effect of Tomato Consumption on Fasting Blood Glucose and Lipid Profiles: A Systematic Review and Meta-Analysis of Randomized Controlled Trials by Li H, Chen, A, [...],Yin X.

Link:
https://pubmed.ncbi.nlm.nih.gov/32243013/

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Find more information/studies on tomato consumption and lowering of cholesterol levels right here.

Patients with heart disease often have high LDL cholesterol, low HDL cholesterol and high triglycerides levels.

Objectives:
Undernutrition is associated with an elevated risk of mortality among children in low- and middle-income countries. Small-quantity lipid-based nutrient supplements (LNS) have been evaluated as a method to prevent undernutrition and improve infant development, but the effects on mortality are unknown. Therefore, this review article has been conducted.

Do lipid-based nutrient supplements reduce risk of undernutrition among children 6-24 months old?

Study design:
This review article included 18 RCTs conducted in 11 countries that enrolled 41,280 children and reported 586 deaths.

Results and conclusions:
The investigators found in 13 RCTs that lipid-based nutrient supplements significantly reduced risk of all-cause mortality with 27% [RR = 0.73, 95% CI = 0.59 to 0.89, I2 = 23.2%] among children 6-24 months old.
Estimates were similar when trials with maternal lipid-based nutrient supplements intervention arms were added or when alternative formulations of lipid-based nutrient supplements were excluded.

The investigators found the results appeared stronger in trials in which lipid-based nutrient supplements were compared with passive control arms.

The investigators found excluding these contrasts and only comparing multicomponent arms with lipid-based nutrient supplements groups and comparison groups that contained all the same components without lipid-based nutrient supplements attenuated the effect estimate [RR = 0.82, 95% CI = 0.61 to 1.10].

The investigators concluded lipid-based nutrient supplements provided for the prevention of undernutrition may reduce risk of all-cause mortality among children 6-24 months old, but more trials with appropriate comparison groups allowing isolation of the effect of lipid-based nutrient supplements alone are needed.
 
Original title:
Lipid-based Nutrient Supplements and All-Cause Mortality in Children 6-24 Months of Age: A Meta-Analysis of Randomized Controlled Trials by Stewart CP, Wessells KR, […], Dewey KG.

Link:
https://academic.oup.com/ajcn/article/111/1/207/5613093

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Objectives:
Do dietary calcium intakes or calcium supplements increase risk of cardiovascular disease?
 
Study design:
This review article included 26 prospective cohort studies and 16 RCTs.

Results and conclusions:
The investigators found in cohort studies that dietary calcium intakes ranging from 200 to 1500 mg/d did not affect the risk of cardiovascular disease [relative risk = 0.96, 95% CI = 0.87 to 1.05].

The investigators found in cohort studies that dietary calcium intakes ranging from 200 to 1500 mg/d did not affect the risk of coronary heart disease [relative risk = 0.98, 95% CI = 0.88 to 1.08].

The investigators found in cohort studies that dietary calcium intakes ranging from 200 to 1500 mg/d did not affect the risk of stroke [relative risk = 0.94, 95% CI = 0.85 to 1.04].

The investigators found in RCTs that calcium supplements significantly increased risk of coronary heart disease with 20% [relative risk = 1.20, 95% CI = 1.08 to 1.33, I2 = 0.0%].

The investigators found in RCTs that calcium supplements significantly increased risk of myocardial infarction with 21% [relative risk = 1.21, 95% CI = 1.08 to 1.35, I2 = 0.0%].

The investigators concluded that 200-1500 mg/d calcium intake from dietary sources do not increase the risk of cardiovascular disease, including coronary heart disease and stroke, while calcium supplements increase coronary heart disease risk, especially myocardial infarction.

Original title:
The Evidence and Controversy Between Dietary Calcium Intake and Calcium Supplementation and the Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis of Cohort Studies and Randomized Controlled Trials by Yang C, Shi X, […], Sun G.

Link:
https://pubmed.ncbi.nlm.nih.gov/31625814/

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Find more information/studies on calcium and lowering of blood pressure right here.

Objectives:
Does rotavirus vaccination reduce risk of rotavirus associated diarrhea in sub-Saharan Africa?

Study design:
This review article included 17 studies with a total of 176,698 participants and all were children less than 5 years of age.

There was no evidence of publication bias.

Results and conclusions:
The investigators found the pooled proportion for pre-vaccination period was 42% [95% CI = 38% to 46%, I2 = 99.00%] and reduced to 21% [95% CI = 17% to 25%, I2 = 99.05%] during post-vaccination period.

The investigators found rotavirus diarrhea significantly reduced in children 12 months as compared to children 12-24 months old.

The investigators found seasonal peaks of rotavirus diarrhea were between June-September.

The investigators concluded the proportions of rotavirus-positive cases reduce from 42% during the pre-vaccination period to 21% post-vaccination period. Thus, there is evidence that the introduction of the rotavirus vaccine in sub-Saharan Africa, has significantly reduced the burden of rotavirus associated diarrhea by half. Therefore, there is a need to encourage the remaining countries to introduce the vaccine to their routine national immunization programs.

Original title:
Evidence of rotavirus vaccine impact in sub-Saharan Africa: Systematic review and meta-analysis by Godfrey O, Zhang W, […], Li D.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7185587/

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

Objectives:
Epidemiologic studies focusing on the association between 1-carbon metabolism-related vitamins (ie, folate, vitamin B6, vitamin B2, vitamin B12) and breast cancer risk have reported inconsistent findings. Therefore, this review article (meta-analysis) has been conducted.

Does higher dietary intake of folate (folic acid), vitamin B2, B6 or B12 reduce breast cancer risk?

Study design:
This review article included 27 studies (case-control and cohort studies) with a total of 49,707 cases (persons with breast cancer) among 1,274,060 individuals.

Results and conclusions:
The investigators found for the highest folate dietary intake compared with the lowest, a significantly reduced risk of 7% [pooled relative risk = 0.93, 95% CI = 0.88 to 0.99, p = 0.018] for breast cancer.

The investigators found for the highest vitamin B6 dietary intake compared with the lowest, a significantly reduced risk of 6% [pooled relative risk = 0.94, 95% CI = 0.89 to 1.00, p = 0.037] for breast cancer.

The investigators found for the highest vitamin B2 dietary intake compared with the lowest, a significantly reduced risk of 10% [pooled relative risk = 0.90, 95% CI = 0.82 to 0.99, p = 0.026] for breast cancer.

The investigators found no significant association between vitamin B12 and breast cancer risk [RR = 0.99, 95% CI = 0.94 to 1.04, p = 0.604].

The investigators found folate and vitamin B6 dietary intake significantly decreased the risk of estrogen receptor-negative (ER-)/progesterone receptor-negative (PR-) breast cancer but not ER+/PR+ breast cancer.

The investigators found an increment of 100 μg/d folate dietary intake corresponded to a 7% [RR = 0.93, 95% CI = 0.89 to 0.98, p = 9.007] deceased risk of ER-/PR- breast cancer.

The investigators concluded both higher folate, vitamin B2 and B6 dietary intake decreases risk of breast cancer, especially ER-/PR- breast cancer.

Original title:
Association Between One-carbon Metabolism-related Vitamins and Risk of Breast Cancer: A Systematic Review and Meta-analysis of Prospective Studies by Zeng J, Gu Y, […], Chang H.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32241696

Additional information of El Mondo:
Find more information/studies on folate, vitamin B2 and B6 intake and breast cancer right here.

If breast cancer cells have estrogen receptors, the cancer is called ER-positive breast cancer. If breast cancer cells have progesterone receptors, the cancer is called PR-positive breast cancer. If the cells do not have either of these 2 receptors, the cancer is called ER/PR-negative.

Objectives:
Older people (≥60 years old) are particularly vulnerable to influenza virus infection and vaccine is effective in reducing the disease burden in this population. However, it remains obscure whether their antibody response is lower than those of younger adults (18-60 years old). Therefore, this review article has been conducted.

Have older people (≥60 years old) a lower antibody response to influenza virus infection than younger adults (18-60 years old)?

Study design:
This review article included 6 RCTs with a  total of 7,976 participants.

Results and conclusions:
The investigators found for the seroprotection rate (SPR) the pooled risk ratio (RR) was 0.92 [95% CI = 0.90 to 0.94, I2 = 66%, p 0.0001] for A/H1N1 and 0.94 (95% CI = 0.90 to 0.98, I2 = 91%, P = .002) for B/Victoria and the antibody responses of A/H3N2 and B/Yamagata were similar in the two age groups.

The investigators found for the seroconversion rate (SCR), the pooled RR was 0.85 [95% CI = 0.76 to 0.94, I2 = 93%, p = 0.003], 0.77 [95% CI = 0.66 to 0.91, I2 = 94%, p = 0.002] and 0.83 (95% CI: 0.71-0.96, I2 = 94%, p = 0.02] for A/H1N1, B/Victoria and B/Yamagata, respectively and the antibody responses of A/H3N2 were similar in the two groups.

The investigators found some variations in the antibody responses across virus types and subtypes after influenza vaccination.

The investigators concluded the seroprotection rate (SPR) and the seroconversion rate (SCR) of older adults (≥60 years old) are lower than those in younger adults (18-60 years old) for A/H1N1 and B/Victoria, while the two age groups have similar antibody responses for A/H3N2. But, the antibody responses to vaccines are not associated with real-world vaccine effectiveness (VE), indicating that antibody response might not fully reflect the vaccine effectiveness of A/H3N2.

Original title:
Immunogenicity of influenza vaccine in elderly people: a systematic review and meta-analysis of randomized controlled trials, and its association with real-world effectiveness by Meng Z, Zhang J, [...], Yang X.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32347787

Additional information of El Mondo:
Find more information/studies on vaccination ight here.

Objectives:
Multiple sclerosis (MS) is a demyelinating and disabling inflammatory disease of the central nervous system. Multiple sclerosis is triggered by complex environmental factors which mostly affect genetically the susceptible young people. Emerging data has suggested that changes of homocysteine (Hcy), vitamin B12 and folate serum levels may be associated with multiple sclerosis. However, previous findings are not always consistent. Therefore, this review aricle has been conducted.

Does a low serum homocysteine, vitamin B12 or folate level increase risk of multiple sclerosis?

Study design:
This review article included 21 original studies with 1,738 multiple sclerosis patients and 1,424 controls (patients without multiple sclerosis). There were 17 studies for measuring homocysteine, 16 studies for measuring vitamin B12 and 13 studies for measuring folate in patients with multiple sclerosis, respectively.

Results and conclusions:
The investigators found patients with multiple sclerosis (MS) had higher serum levels of homocysteine [SMD = 0.64, 95% CI = 0.33 to 0.95, p 0.0001] compared with control groups.

The investigators found no significant differences of SMD for vitamin B12 [SMD = -0.08, 95% CI = -0.35 to 0.20, p = 0.58] or folate [SMD = 0.07, 95% CI = -0.14 to 0.28, p = 0.52] between MS and controls.

The investigators found subgroup analysis demonstrated that there was statistically significant difference for homocysteine between relapsing-remitting MS (RRMS) patients and controls with a SMD of 0.67 [95% CI = 0.21 to 1.13, p = 0.004].

However, no significant difference of homocysteine serum levels between secondary progressive MS patients or primary progressive MS patients and controls.

The investigators found no significant difference of homocysteine levels in females [SMD = 0.22, 95% CI = -0.16 to 0.60, p = 0.25] or males [SMD = 0.56, 95% CI = -0.13 to 1.26, p = 0.11] between MS patients and controls.

The investigators concluded higher serum levels of homocysteine increase risk of multiple sclerosis (MS), especially for relapsing-remitting MS (RRMS) patients. Functional studies are required to assess the effects of homocysteine on patients with MS at the molecular level.

Original title:
Serum levels of Homocysteine, Vitamin B12 and Folate in Patients with Multiple Sclerosis: an Updated Meta-Analysis by Li X, Yuan J, [...], Hu W.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7085269/

Additional information of El Mondo:
Find here more information/studies about lowering serum levels of homocysteine.

Objectives:
Is there a causal relationship between daily egg consumption and positive effects on blood pressure?
 
Study design:
This review article included 15 RCTs with a total of 748 participants and mean age range from 23.3 to 67.1 years old.

All included studies used whole egg as an intervention which varied from one egg/day to three eggs/day and duration of supplementation ranged from 3 to 12 weeks.

No evidence of publication bias was seen in the meta-analyse (review article) of systolic blood pressure [Begg’s p = 0.235, Eggers’s p = 0.433] and diastolic blood pressure [Begg’s p = 0.254, Eggers’s p = 0.267].

No heterogeneity was found among included studies.

Results and conclusions:
The investigators found, overall, egg consumption had no significant effect on systolic blood pressure [WMD = 0.046 mmHg, 95% CI = - 0.792 to 0.884, p = 0.914, I2 = 0.0%, p = 0.453] and diastolic blood pressure [WMD = -0.603 mmHg, 95% CI = -1.521 to 0.315, p = 0.198, I2 = 38.1%, p = 0.067].
Subgroup analyses had no effect on pooled results.
Sensitivity analysis indicated that excluding each trial did not significantly change the overall observed effects of egg consumption.

The investigators found nonlinear dose-response meta-analysis did not reveal a significant effect of egg consumption [p-nonlinearity = 0.76] and study duration on diastolic blood pressure [p-nonlinearity = 0.63].

The investigators found subgroup analyses based on study design, sex, population health status, obesity and hypertension status, diet adherence, study duration and amount of egg consumption did not affect the overall effects of egg consumption on systolic blood pressure and diastolic blood pressure values.

The investigators concluded that 1-3 eggs/day during 3 to 12 weeks have no effect on blood pressure. However, high-quality RCTs with longer durations are needed to further confirm the effects of egg consumption on blood pressure.

Original title:
Effect of Egg Consumption on Blood Pressure: a Systematic Review and Meta-analysis of Randomized Clinical Trials by Kolahdouz-Mohammadi R, Malekahmadi M, […], Soltani S.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7189334/

Additional information of El Mondo:
Find more information/studies on causal relationship/significantly, egg consumption and lowering of blood pressure right here.

Objectives:
Physical exercise may offer multiple benefits to patients with chronic kidney disease (CKD). However, it was not traditionally recommended because of the possibility of impairing renal function and increasing proteinuria. Therefore, this review aricle has been conducted.

Does low-intensity physical exercise offer benefits to patients with chronic kidney disease?

Study design:
This review article included 21 RCTs with a intervention of at least 12 weeks and 927 patients.

The frequency of low-intensity physical exercise in 14 studies was 3 times per week during 30 minutes.

Results and conclusions:
The investigators found no differences in glomerular filtration rate or proteinuria between the intervention group (group with low-intensity physical exercise) and the control group (group without low-intensity physical exercise) [SMD = -0.3, p = 0.81 and SMD = 26.6, p = 0.82].

The investigators found positive effects on peak oxygen consumption [SMD = 2.5, p 0.001], functional capacity [SMD = 56.6, p 0.001], upper limb strength [SMD = 6.8, p 0.001] and haemoglobin [SMD = 0.3, p = 0.003] for the intervention group.

The investigators found an improvement on the quality of life, using the KDQOL-36 survey [SMD = 3.56, p = 0.02] and the SF-36 survey [SMD = 6.66, p = 0.02] for the intervention group.

The investigators concluded low-intensity physical exercise routinely has no negative impact on renal function. On the contrary, it improves aerobic and functional capacity, impacting positively on the quality of life.

Original title:
Impact of physical exercise in patients with chronic kidney disease: Sistematic review and meta-analysis by Villanego F, Naranjo J, […], Mazuecos A.

Link:
https://reader.elsevier.com/reader/sd/pii/S0211699520300266?token=62CEB2BCF50CE23B396565B5DC989F795AEEB75C666C74AA410FD2172DB39F90DBBB5D72BF3B4347C0C8AD2FEF8B0110

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

Low-intensity physical exercises are a casual walk, a stretch session, a beginners' yoga class or tai chi.

Objectives:
Has probiotic supplementation positive effects on the outcomes of preterm infants in India?

Study design:
This review article included 9 RCTs (n = 1,514).

Results and conclusions:
The investigators found in 9 RCTs that probiotics supplementation significantly reduced risk of necrotizing enterocolitis (NEC) ≥ Stage II with 64% [risk ratio = 0.36, 95% CI = 0.20 to 0.66, p = 0.0009].  

The investigators found in 7 RCTs that probiotics supplementation significantly reduced risk of late onset sepsis with 44% [risk ratio = 0.56, 95% CI = 0.45 to 0.71, p  0.00001].

The investigators found in 8 RCTs that probiotics supplementation significantly reduced risk of mortality with 38% [risk ratio = 0.62, 95% CI = 0.41 to 0.95, p = 0.03].

The investigators found that probiotics supplementation significantly reduced the time to full feeds [mean difference = -4.09 d, 95% CI = -4.52 to -3.65, p  0.00001, 5 RCTs] and duration of hospital stay [MD = -2.00 d, 95% CI = -2.46 to -1.53, p  0.00001, 6 RCTs].  

The investigators concluded probiotic supplementation has positive effects on the outcomes of preterm infants in India.

Original title:
Probiotics for Preterm Infants in India - Systematic Review and Meta-Analysis of Randomized Controlled Trials by Balasubramanian H, Ananthan A, […], Patole S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32185693

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

Objectives:
Does high magnesium dietary intake reduce risk of type 2 diabetes and stroke?

Study design:
This review article included 53 prospective cohort studies with a total of 1,912,634 participants and 76,678 cases (persons with type 2 diabetes or stroke).

Participants were predominately middle aged at baseline (at the beginning of the studies), with a mean magnesium intake of 370 mg/day for the highest category and 232 mg/day for the lowest category.

The mean duration of all eligible studies was 10.7 years.

Results and conclusions:
The investigators found, when comparing the highest category of magnesium dietary intake (370 mg/day) to the lowest (232 mg/day), a significantly reduced risk of 22% [RR = 0.78, 95% CI = 0.75 to 0.81, p 0.001, I2 = 35.6%, p = 0.021] for type 2 diabetes.

The investigators found, when comparing the highest category of magnesium dietary intake (370 mg/day) to the lowest (232 mg/day), a significantly reduced risk of 11% [RR = 0.89, 95% CI = 0.83 to 0.94, p 0.001, I2 = 0%, p = 0.529] for total stroke.

The investigators found, when comparing the highest category of magnesium dietary intake (370 mg/day) to the lowest (232 mg/day), a significantly reduced risk of 12% [RR = 0.88, 95% CI = 0.81 to 0.95, p = 0.001, I2 = 16.9%, p = 0.265] for ischaemic stroke.

The investigators found in studies adjusted for cereal fiber dietary intake, a significantly reduced risk of 21% [RR = 0.79, 95% CI = 0.73 to 0.85, p 0.001] for type 2 diabetes.

The investigators found in studies adjusted for calcium dietary intake, a significantly reduced risk of 11% [RR = 0.89, 95% CI = 0.80 to 0.99, p = 0.040] for total stroke.

The investigators found in stratified analyses by characteristics of the population and study design, a significantly reduced risk of 9% [RR = 0.91, 95% CI = 0.83 to 0.99] for total stroke among female.

The investigators found in stratified analyses by characteristics of the population and study design, a significantly reduced risk of 11% [RR = 0.89, 95% CI = 0.79 to 1.00] for ischaemic stroke among female.

The investigators found in stratified analyses by characteristics of the population and study design, a significantly reduced risk of 11% [RR = 0.89, 95% CI = 0.82 to 0.96] for total stroke among individuals with BMI ≥25 kg/m².

The investigators found in stratified analyses by characteristics of the population and study design, a significantly reduced risk of 12% [RR = 0.88, 95% CI = 0.81 to 0.96] for ischaemic stroke among individuals with BMI ≥25 kg/m².

The investigators found in stratified analyses by characteristics of the population and study design, a significantly reduced risk of 11% [RR = 0.89, 95% CI = 0.83 to 0.95] for total stroke among studies wtith ≥12-year follow-up.

The investigators found in stratified analyses by characteristics of the population and study design, a significantly reduced risk of 12% [RR = 0.88, 95% CI = 0.81 to 0.95] for ischaemic stroke among studies wtith ≥12-year follow-up.

The investigators found for every 100 mg/day increment of magnesium dietary intake, a significantly reduced risk of 6% [RR = 0.94, 95% CI = 0.93 to 0.95] for type 2 diabetes.

The investigators found for every 100 mg/day increment of magnesium dietary intake, a significantly reduced risk of 2% [RR = 0.98, 95% CI = 0.97 to 0.99] for total stroke.

The investigators found for every 100 mg/day increment of magnesium dietary intake, a significantly reduced risk of 2% [RR = 0.98, 95% CI = 0.97 to 0.99] for ischaemic stroke.

The investigators concluded magnesium dietary intake has a substantial inverse association with type 2 diabetes and (total/ ischaemic) stroke. Furthermore, female, participants with obesity (BMI ≥ 25 kg/m²) and with a longer follow-up period (≥12 years) obtain greater benefit from magnesium intake with a lower risk of total and ischaemic stroke incidence. Overall, these findings support the guidelines to address the role of magnesium dietary intake in early prevention strategies to combat type 2 diabetes and stroke. However, additional RCTs are needed in the future to validate the causality.

Original title:
Association of magnesium intake with type 2 diabetes and total stroke: an updated systematic review and meta-analysis by Zhao B, Zeng L, [...], Zhang W.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7103847/

Additional information of El Mondo:
Find more information/studies magnesium consumption, stroke and diabetes right here.

Objectives:
Does Alzheimer disease increase risk of stroke?

Study design:
This review article included 8 studies, representing 121,719 individuals (Alzheimer disease = 73,044 and non-Alzheimer disease = 48,675).

Results and conclusions:
The investigators found patients with Alzheimer disease had a significantly increased risk of 42% [relative risk = 1.42, 95% CI = 1.23 to 1.64] for hemorrhagic stroke.

The investigators concluded Alzheimer disease increases risk of hemorrhagic stroke.

Original title:
Risk of hemorrhagic and ischemic stroke in patients with Alzheimer disease: A synthesis of the literature by Waziry R, Chibnik LB, […], Hofman A.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31949087

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