Nutrition and health

Objectives:
The associations between intake of anthocyanins and anthocyanin-rich berries and cardiovascular risks remained to be established. Therefore, this review article has been conducted.

Do purified anthocyanin supplements and dietary intakes of anthocyanin-rich berries reduce cardiovascular risk?

Study design:
This review article included 44 eligible RCTs consisting of 52 comparison groups and 2,353 subjects and 15 prospective cohort studies with 5,54,638 subjects (persons).

7 of the 44 RCTs were crossover trials with the rest parallel-designed.
15 of the included studies investigated the effects of purified anthocyanins, all of which were produced from berries. For the remaining anthocyanin-rich berry studies, interventions were blueberry in 13 studies, cranberry in 12 studies, bilberry in 3 studies and blackcurrant in 1 study.
The intervention durations ranged from 2 weeks to 24 months with a median of 8 weeks.
24 of the 44 RCTs were rated as high quality with the others as low to moderate quality.

The follow-up periods of 15 cohort studies ranged from 4.3 to 24 years with a median of 12 years. Most of the included cohort studies used FFQ to assess dietary anthocyanin intake and only 3 of them used dietary records.
12 of the 15 cohort studies were rated as high quality.

There was no publication bias, except for the effects of purified anthocyanins on HDL cholestrerol levels [Begg's p = 0.016].

Results and conclusions:
The investigators found pooled analysis of RCTs showed that purified anthocyanin supplements significantly reduced blood LDL cholesterol (bad cholesterol) concentrations [WMD = -5.43 mg/dL, 95% CI = -8.96 to -1.90 mg/dL, p = 0.003]. 

The investigators found pooled analysis of RCTs showed that purified anthocyanin supplements significantly reduced triglyceride concentrations [WMD = -6.18 mg/dL, 95% CI = -11.67 to -0.69 mg/dL, p = 0.027, I2 = 0%]. 

The investigators found pooled analysis of RCTs showed that purified anthocyanin supplements significantly increased HDL cholesterol (good cholesterol) concentrations [WMD = 2.76 mg/dL, 95% CI = 1.34 to 4.18 mg/dL, p 0.001, I2 = 43.5%].
Subgroup analysis showed that the effects on HDL cholesterol concentrations were not significantly influenced by study duration, health status of subjects, anthocyanin doses, study quality and funding source.

The investigators found pooled analysis of RCTs showed that purified anthocyanin supplements significantly reduced tumor necrosis factor alpha concentrations [WMD = -1.62 pg/mL, 95% CI = -2.76 to -0.48 pg/mL, p = 0.005, I2 = 0%].

The investigators found pooled analysis of RCTs showed that purified anthocyanin supplements significantly reduced C-reactive protein concentrations [WMD = -0.028 mg/dL, 95% CI = -0.050 to -0.005 mg/dL, p = 0.014, I2 = 26%].

The investigators found pooled analysis of RCTs showed administration of anthocyanin-rich berries (blueberry, cranberry, bilberry and blackcurrant) significantly reduced blood total cholesterol concentrations [WMD = -4.48 mg/dL, 95% CI = -8.94 to -0.02 mg/dL, p = 0.049]. 

The investigators found pooled analysis of RCTs showed administration of anthocyanin-rich berries (blueberry, cranberry, bilberry and blackcurrant) significantly reduced C-reactive protein concentrations [WMD = -0.046 mg/dL, 95% CI = -0.070 to -0.022 mg/dL, p 0.001, I2 = 0%].

The investigators found pooled analysis of cohort studies showed high dietary anthocyanins intakes significantly reduced risk of coronary heart disease (CHD) with 17% [relative risk = 0.83, 95% CI = 0.72 to 0.95, p = 0.009, I2 = 51.2%].

The investigators found pooled analysis of cohort studies showed high dietary anthocyanins intakes significantly reduced risk of total cardiovascular disease incidence with 27% [relative risk = 0.73, 95% CI = 0.55 to 0.97, p = 0.03, I2 = 76.7%].

The investigators found pooled analysis of cohort studies showed high dietary anthocyanins intakes significantly reduced risk of cardiovascular disease deaths with 9% [relative risk = 0.91, 95% CI = 0.87 to 0.96, p 0.001, I2 = 0%].

Subgroup analysis revealed that the protective roles of dietary anthocyanins against cardiovascular disease deaths was only found in women [RR = 0.89, 95% CI = 0.82 to 0.96, p = 0.003, I2 = 0.0%] and not in men [RR = 0.92, 95% CI = 0.79 tot 1.07, p = 0.263, I2 = 0.0%].

The investigators concluded current clinical and epidemiological evidence show the protective roles of purified anthocyanin supplements during 8 weeks and anthocyanin-rich berries (blueberry, cranberry, bilberry and blackcurrant) on cardiovascular health. These results suggest that regular consumption of either purified anthocyanins or anthocyanin-rich berries could prevent cardiovascular disease through their lipid-lowering and anti-inflammatory properties. Therefore, anthocyanins and anthocyanin-rich berries should be taken into consideration when formulating cardioprotective diets in the future.

Original title:
Anthocyanins, Anthocyanin-Rich Berries, and Cardiovascular Risks: Systematic Review and Meta-Analysis of 44 Randomized Controlled Trials and 15 Prospective Cohort Studies by Xu L, Tian Z, […], Yang Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8714924/

Additional information of El Mondo:
Find more information/studies on anthocyanins, lowering cholesterol levels and cardiovascular disease right here.

Objectives:
Previous studies have not fully described the relationship between high-density lipoprotein cholesterol (HDL-C) and death risks from all cause and cardiovascular disease (CVD). Therefore, this review article has been conducted.

Does a high HDL cholesterol level (good cholesterol) reduce all cause and cardiovascular disease mortality risk?

Study design:
This review article included 32 prospective cohort studies with a total of 369,904 participants and 33,473 total deaths (9,426 cardiovascular disease deaths or cardiovascular disease mortality).

Results and conclusions:
The investigators found compared to the lowest HDL cholesterol level, the highest HDL cholesterol level significantly reduced all cause mortality risk by 18% [RR = 0.82, 95% CI = 0.73 to 0.93].
The lowest all cause mortality risk was observed at approximately 1.34 mmol/L.

The investigators found compared to the lowest HDL cholesterol level, the highest HDL cholesterol level significantly reduced cardiovascular disease mortality risk by 36% [RR = 0.64, 95% CI = 0.46 to 0.89].
The lowest cardiovascular disease mortality risk was observed at approximately 1.55 mmol/L.

The investigators found every increment of HDL cholesterol level with 1 mmol/L significantly reduced all cause mortality risk by 15% [RR = 0.85, 95% CI = 0.79 to 0.92].
Significant means that there is an association with a 95% confidence.

The investigators found every increment of HDL cholesterol level with 1 mmol/L significantly reduced cardiovascular disease mortality risk by 23% [RR = 0.77, 95% CI = 0.69 to 0.87].

The investigators found evidence of nonlinear and negative dose-response associations of HDL cholesterol level with all cause and cardiovascular disease mortality risk [p nonlinearity 0.001].

The investigators concluded HDL cholesterol level (good cholesterol) reduces all cause and cardiovascular disease mortality risk under approximately 2.05 and 2.33 mmol/L, respectively. Optimal doses require investigation via clinical practice or high-quality research.

Original title:
A dose-response meta-analysis to evaluate the relationship between high-density lipoprotein cholesterol and all-cause and cardiovascular disease mortality by Liu L, Han M, […], Hong F.

Link:
https://pubmed.ncbi.nlm.nih.gov/34676492/

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

Objectives:
Chemotherapy-induced peripheral neuropathy (CIPN) is a common symptom, but prophylactic measures cannot still be carried out effectively. In addition, the efficacy of vitamin E in preventing peripheral neurotoxicity caused by chemotherapy is inconclusive. Therefore, this review article has been conducted.

Does vitamin E supplementation decrease risk of chemotherapy-induced peripheral neuropathy?

Study design:
This review article included 8 RCTs with a total of 488 patients.
The number of participants in each arm ranged from 13 to 96.
The experimental intervention was vitamin E supplementation as an adjuvant to cisplatin, paclitaxel and other chemotherapies.
There was no publication bias.

Results and conclusions:
The investigators found patients who received vitamin E supplementation of 600 mg/day had a significantly lower incidence of chemotherapy-induced peripheral neuropathy of 69% [risk ratio = 0.31, 95% CI = 0.14 to 0.65, p = 0.002, I2 = 0%] than the placebo group (group without vitamin E).

The investigators found patients in the cisplatin chemotherapy group who received vitamin E supplementation had a significantly lower incidence of chemotherapy-induced peripheral neuropathy of 72% [risk ratio = 0.28, 95% CI = 0.14 to 0.54, p = 0.0001, I2 = 0%]  than the placebo group.

The investigators found, moreover, vitamin E supplementation significantly decreased patients’ sural amplitude after 3 rounds of chemotherapy [MD = -2.66, 95% CI = -5.09 to -0.24, p = 0.03, I2 = 0%] in contrast with that of placebo supplementation, while no significant difference was observed when patients were treated with vitamin E after 6 rounds of chemotherapy [MD = -1.28, 95% CI = -3.11 to 0.54, p = 0.17, I2 = 40%].

The investigators found, in addition, the vitamin E-supplemented group had better improvement in the neurotoxicity score and lower incidence of reflexes and distal paraesthesias than the control group.

The investigators concluded that vitamin E supplementation of 600 mg/day decreases risk of chemotherapy-induced peripheral neuropathy, particularly in the cisplatin chemotherapy group. More high-quality trials with standardized reporting of clinical outcomes about peripheral neuropathy are needed to explore the exact role of vitamin E in the prevention of chemotherapy-induced peripheral neuropathy.

Original title:
Protective Effects of Vitamin E on Chemotherapy-Induced Peripheral Neuropathy: A Meta-Analysis of Randomized Controlled Trials by Miao H, Li R [...], Wen Z.

Link:
https://www.karger.com/Article/FullText/515620

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Objectives:
The efficacy of dendritic cell vaccine for newly diagnosed glioblastoma remains controversial. Therefore, this review article has been conducted.

Does dendritic cell vaccine provide benefits for the newly diagnosed glioblastoma?

Study design:
This review article included 3 randomized controlled trials (RCTs).

Results and conclusions:
The investigators found overall, compared with control group for newly diagnosed glioblastoma, dendritic cell vaccine showed no substantial effect on:
-median overall survival [SMD = 0.11, 95% CI = -0.18 to 0.41, p = 0.45];
-median progression-free survival [SMD = 0.12, 95% CI = -0.24 to 0.48, p = 0.50];
-progression-free survival rate [risk ratio = 1.29, 95% CI = 0.82 to 2.04, p = 0.27];
-overall survival rate [risk ratio = 1.29, 95% CI = 0.61 to 2.72, p = 0.50] or;
-nervous system disorders [risk ratio = 0.80, 95% CI= 0.59 to 1.08, p = 0.14].

The investigators concluded dendritic cell vaccine provides no obvious benefits for the newly diagnosed glioblastoma.

Original title:
The Efficacy of Dendritic Cell Vaccine for Newly Diagnosed Glioblastoma: A Meta-analysis of Randomized Controlled Studies by Tan L, Peng J, […], Wu Q.

Link:
https://pubmed.ncbi.nlm.nih.gov/34767325/

Additional information of El Mondo:
Find more information/studies on RCTs/cohort/significantly/review article and cancer right here.

Dendritic cells (DCs) are professional antigen-presenting cells that link innate and adaptive immunity and are critical for the induction of protective immune responses against pathogens.

Glioblastoma is an aggressive type of cancer that can occur in the brain or spinal cord.

Objectives:
The relation between sodium intake and cardiovascular disease remains controversial, owing in part to inaccurate assessment of sodium intake. Assessing 24-hour urinary excretion over a period of multiple days is considered to be an accurate method. Therefore, this review article has been conducted.

Do higher sodium and lower potassium dietary intakes, as measured in multiple 24-hour urine samples, reduce in a dose-response manner cardiovascular risk?

Study design:
This review article included 6 prospective cohort studies with a total of 10,709 healthy adults (54.2% women), of whom, 571 cardiovascular events were ascertained during a median study follow-up of 8.8 years (incidence rate: 5.9 per 1000 person-years).

The mean (±SD) age was 51.5±12.6 years.

Results and conclusions:
The investigators found that the median 24-hour urinary sodium excretion was 3,270 mg (10th to 90th percentile, 2099 to 4899).

The investigators found higher sodium excretion, lower potassium excretion and a higher sodium-to-potassium ratio were all significantly associated with a higher cardiovascular risk in analyses that were controlled for confounding factors [p ≤ 0.005 for all comparisons].

The investigators found in analyses that compared quartile 4 of the urinary biomarker (highest) with quartile 1 (lowest), the hazard ratios were 1.60 [95% CI = 1.19 to 2.14] for sodium excretion, 0.69 [95% CI = 0.51 to 0.91] for potassium excretion and 1.62 [95% CI = 1.25 to 2.10] for the sodium-to-potassium ratio.

The investigators found each daily increment of 1,000 mg in 24-hour urinary sodium excretion was significantly associated with an 18% increase in cardiovascular risk [hazard ratio = 1.18, 95% CI = 1.08 to 1.29].

The investigators found each daily increment of 1,000 mg in 24-hour urinary potassium excretion was significantly associated with an 18% decrease in cardiovascular risk [hazard ratio = 0.82, 95% CI = 0.72 to 0.94].

The investigators concluded higher sodium and lower potassium dietary intakes, as measured in multiple 24-hour urine samples, reduce in a dose-response manner cardiovascular risk. These findings may support reducing sodium intake and increasing potassium intake from current levels.

Original title:
24-Hour Urinary Sodium and Potassium Excretion and Cardiovascular Risk by Ma Y, He FJ, […], Hu FB.

Link:
https://pubmed.ncbi.nlm.nih.gov/34767706/

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

A 24-hour urine sample is simply a collection of all urine passed over a 24-hour period of time. The test is used to check kidney function.
The normal range for 24-hour urine volume is 800 to 2,000 milliliters per day (with a normal fluid intake of about 2 liters per day).

Objectives:
Potential effects of inositol supplementation on blood pressure (BP) have been examined in several interventional studies. Nevertheless, findings in this context are controversial. Therefore, this review article has been conducted.

Do inositol supplements reduce blood pressure in humans?

Study design:
This review article included 7 eligible RCTs.

Results and conclusions:
The investigators found significant decline in both systolic blood pressure (SBP) [WMD = -5.69 mmHg, 95% CI = -7.35 to -4.02, p 0.001] and diastolic blood pressure (DBP) [WMD = -7.12 mmHg, 95% CI = -10.18 to -4.05, p 0.001] following supplementation with inositol.

The investigators found subgroup analysis showed that studies performed in individuals with metabolic syndrome with a longer duration (>8 weeks) and a dose of 4000 mg inositol supplements resulted in a more effective reduction in systolic blood pressure and diastolic blood pressure with acceptable homogeneity.

The investigators concluded that 4000 mg inositol supplements during at least 8 weeks reduce blood pressure, particularly in individuals with metabolic syndrome. Further large-scale RCTs with better design are needed to confirm these findings.

Original title:
The effect of inositol supplementation on blood pressure: A systematic review and meta-analysis of randomized-controlled trials by Tari SH, Sohouli MH, […], Rahideh ST.

Link:
https://pubmed.ncbi.nlm.nih.gov/34330516/

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

Objectives:
Epidemiological studies have shown that higher intake of flavonoid is inversely associated with coronary heart disease (CHD) risk. However, which flavonoid subclass (including anthocyanins, flavonols) could reduce CHD risk has remained controversial. Therefore, this review article has been conducted.

Do dietary intakes of anthocyanins, proanthocyanidins, flavonols, flavones and isoflavones reduce coronary heart disease?

Study design:
This review article included 19 independent prospective cohort studies with 894,471 participants and 34,707 persons with coronary heart disease.
 
Results and conclusions:
The investigators found that dietary intakes of anthocyanins significantly reduced risk of coronary heart disease with 10% [RR = 0.90, 95% CI = 0.83 to 0.98].

The investigators found that dietary intakes of proanthocyanidins significantly reduced risk of coronary heart disease with 22% [RR = 0.78, 95% CI = 0.65 to 0.94].

The investigators found that dietary intakes of flavonols significantly reduced risk of coronary heart disease with 12% [RR = 0.88, 95% CI = 0.79 to 0.98].

The investigators found that dietary intakes of flavones significantly reduced risk of coronary heart disease with 6% [RR = 0.94, 95% CI = 0.89 to 0.99].

The investigators found that dietary intakes of isoflavones significantly reduced risk of coronary heart disease with 10% [RR = 0.90, 95% CI = 0.83 to 0.98].

The investigators found in dose-response analysis that increment of 50 mg/d dietary anthocyanins significantly reduced risk of coronary heart disease with 5%.

The investigators found in dose-response analysis that increment of 100 mg/d dietary proanthocyanidins significantly reduced risk of coronary heart disease with 5%.

The investigators found in dose-response analysis that increment of 25 mg/d dietary flavonols significantly reduced risk of coronary heart disease with 5%.

The investigators found in dose-response analysis that increment of 5 mg/d dietary flavones significantly reduced risk of coronary heart disease with 5%.

The investigators found in dose-response analysis that increment of 0.5 mg/d dietary isoflavones significantly reduced risk of coronary heart disease with 5%.

The investigators found sensitivity and subgroup analyses supported these associations.

The investigators concluded that daily dietary intakes of 50mg anthocyanins, 100 mg proanthocyanidins, 25mg flavonols, 5mg flavones or 0.5mg isoflavones reduce coronary heart disease.

Original title:
Flavonoid subclasses and coronary heart disease risk: a meta-analysis of prospective cohort studies by Fan ZK, Wang C, [...], Li D.

Link:
https://pubmed.ncbi.nlm.nih.gov/34470681/

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Find more information/studies on flavonoid and cardiovascular disease right here.

Objectives:
Does breastfeeding reduce risk of ovarian cancer in women with BRCA1 mutation or BRCA2 mutation?

Study design:
This review article included 1 cohort study and 4 case-control studies with a total of 14,601 women with a BRCA1 or BRCA2 mutation.

There was no publication bias.

Results and conclusions:
The investigators found ever having performed breastfeeding significantly reduced risk of ovarian cancer with 23.3% [pooled OR = 0.767, 95% CI = 0.688 to 0.856, I2 = 0%] in women with BRCA1 mutation.

The investigators found ever having performed breastfeeding non-significantly reduced risk of ovarian cancer with 18.3% [pooled OR = 0.817, 95% CI = 0.650 to1.028, I2 = 0%] in women with BRCA2 mutation.

The investigators found breastfeeding for >1 year significantly reduced risk of ovarian cancer with 21.3% [pooled OR = 0.787, 95% CI = 0.682 to 0.907, I2 = 0%] in women with BRCA1 mutation.

The investigators found breastfeeding for >1 year significantly reduced risk of ovarian cancer with 43.3% [pooled OR = 0.567, 95% CI = 0.400 to 0.802, I2 = 0%] in women with BRCA2 mutation.

The investigators concluded that ever having performed breastfeeding reduces risk of ovarian cancer in women with BRCA1 mutation and breastfeeding for >1 year reduces risk of ovarian cancer in women with BRCA2 mutation.

Original title:
The preventive effect of breastfeeding against ovarian cancer in BRCA1 and BRCA2 mutation carriers: A systematic review and meta-analysis by Eoh KJ, Park EY, […], Lim MC.

Link:
https://pubmed.ncbi.nlm.nih.gov/34304906/

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

Objectives:
LDL particle size and number (LDL-P) are emerging lipid risk factors. Nonsystematic reviews have suggested that diets lower in carbohydrates and higher in fats may result in increased LDL particle size when compared with higher-carbohydrate diets. Therefore, this review article has been conducted.

Do dietary interventions restricted in carbohydrates increase LDL peak particle size and decrease the numbers of total and small LDL particles?

Study design:
This review article included 38 randomized trials (of any length that reported on dietary carbohydrate restriction (intervention) compared with higher carbohydrate intake (control)) with a total of 1,785 participants.

Results and conclusions:
The investigators found dietary carbohydrate restriction were significantly associated with an increase in LDL peak particle size [SMD = 0.50, 95% CI = 0.15 to 0.86, p 0.01] and a reduction in LDL particle number [SMD = -0.24, 95% CI = -0.43 to -0.06, p = 0.02], when compared with higher carbohydrate intake.  

The investigators found the effect of carbohydrate-restricted dietary interventions on LDL peak particle size appeared to be partially explained by differences in weight loss between intervention groups and exploratory analysis revealed a shift from small dense to larger LDL subclasses.

The investigators found no statistically significant association between carbohydrate-restricted dietary interventions and mean LDL particle size [SMD = 0.20, 95% CI = -0.29 to 0.69, p = 0.37], when compared with higher carbohydrate intake.  

The investigators concluded that dietary interventions restricted in carbohydrates increase LDL peak particle size and decrease the numbers of total and small LDL particles.
 
Original title:
Effect of carbohydrate-restricted dietary interventions on LDL particle size and number in adults in the context of weight loss or weight maintenance: a systematic review and meta-analysis by Falkenhain K, Roach LA, […], Little JP.

Link:
https://pubmed.ncbi.nlm.nih.gov/34159352/

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

LDL particle number (LDL-P) is a much more accurate predictor of cardiovascular disease risk than either LDL or total cholesterol. Increased LDL-P could be one of the reasons that some people have heart attacks even though their total cholesterol and LDL cholesterol levels are not particularly high.

A low-carbohydrate diet is a diet with 20-40 En% carbohydrate. The easiest way to follow a diet with 20-40 En% carbohydrate is to choose only meals/products with 20-40 En% carbohydrate. Check here which products contain 20-40 En% carbohydrate.
However, the most practical way to follow a diet with 20-40 En% carbohydrate is, all meals/products that you eat on a daily basis should on average contain 20-40 En% carbohydrate.
20-40 En% carbohydrate means that the total amounts of carbohydrates make up for a 20-40% of the total kcal of the diet.

Use the 7-points nutritional profile app to see if your daily eaten products contain on average 20-40 En% carbohydrate.

Objectives:
Previous studies have provided limited evidence for the effect of carrot intake on bladder cancer incidence. Therefore, this review article has been conducted.

Is there a relationship between dietary carrot intake and bladder cancer incidence?

Study design:
This review article included 3 cohort studies.

Results and conclusions:
The investigators found in a meta-analyse of 3 cohort studies no significant association between dietary carrot intake and bladder cancer risk [summary HR = 1.02, 95% CI = 0.95 to 1.10, I2 = 0.0%, p = 0.859].

The investigators concluded that there is no association between dietary consumption of carrot and the risk of bladder cancer.

Original title:
Association of Dietary Carrot Intake With Bladder Cancer Risk in a Prospective Cohort of 99,650 Individuals With 12.5 Years of Follow-Up by Xu X, Zhu Y, […], Xia D.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8349976/

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Find more information/studies on carrot consumption and cancer right here.

Objectives:
Studies indicate that onion supplementation may be effective in the treatment of dyslipidemia; however, the results remain controversial. Therefore, this review article has been conducted.

Does supplementation of onion improve levels of cholesterol and triglycerides or in other words, does eating onions causally lower cholesterol and triglycerides levels?  

Study design:
This review article included 10 RCTs with 446 participants, that were randomly assigned to either the placebo group or the onion group.

The number of participants in each study ranged from 12 to 92.
The duration of intervention in the included studies ranged from 2 to 12 weeks.
There was no evidence of publication bias.

Results and conclusions:
The investigators found the pooled findings of 10 studies showed that onion supplementation significantly increased high-density lipoprotein cholesterol (good cholesterol or HDL cholesterol) levels [MD = 2.29 mg/dL, 95% CI = 0.87 to 3.72, I2 = 0%], when compared to the control group.

The investigators found the pooled findings of 10 studies showed that onion supplementation significantly decreased low-density lipoprotein cholesterol (bad cholesterol or LDL cholesterol) levels [MD = -6.64 mg/dL, 95% CI = -10.91 to -2.36, I2 = 32%], when compared to the control group.
The pooled effect size of LDL cholesterol was not affected by any of the studies in sensitivity analysis.

The investigators found the pooled findings of 10 studies showed no association between onion supplementation and lower triglycerides (TG) levels [MD = -6.55 mg/dL, 95% CI = -15.64 to 2.53, I2 = 45%], when compared to the control group.

The investigators found the pooled findings of 9 studies showed that onion supplementation significantly increased total cholesterol (TC) levels [MD = -5.39 mg/dL, 95% CI = -10.68 to -0.09, I2 = 49%], when compared to the control group.

The investigators found in subgroup analysis that onion supplementation showed a greater benefit in lowering total cholesterol [MD = -17.23 mg/dL, 95% CI = -27.99 to -6.47, I2 = 8%] and LDL cholesterol levels [MD = -12.70 mg/dL, 95% CI = -23.12 to -2.27, I2 = 0%] in subjects with dyslipidemia.

The investigators found in subgroup analysis that onion supplementation longer than 10 weeks showed more increases in HDL cholesterol concentrations [MD = 2.81 mg/dL, 95% CI = 1.08 to 5.54, I2 = 17%].

The investigators concluded supplementation of onion is beneficial to control dyslipidemia, including improving levels of HDL, LDL and total cholesterol, but could not reduce triglycerides levels. The therapeutic benefits of onion for dyslipidemia need to be treated with caution considering that some of the results are not robust.

Original title:
Effect of onion on blood lipid profile: A meta-analysis of randomized controlled trials by Huang W, Tang G, [...], Wei Z.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8269690

Additional information of El Mondo:
Find more information/studies on vegetable consumption, lowering cholesterol and cardiovascular disease right here.

Dyslipidemia is defined as having blood lipid levels that are too high or low. Blood lipids are fatty substances, such as triglycerides and cholesterol.

A causal relationship can be found in RCTs.

Objectives:
Omega-3 polyunsaturated fatty acid (PUFA) supplementation has been proposed as a potential therapy for cancer-related malnutrition, which affects up to 70% of patients with cancer. Therefore, this review article has been conducted.

Do patients with cancer benefit from oral omega-3 PUFA supplements?

Study design:
This review article included 31 RCTs.
Trials supplementing ≥600 mg/d omega-3 PUFA (oral capsules, pure fish oil or oral nutritional supplements) compared with a control intervention for ≥3 weeks.

The Cochrane risk of bias tool graded most trials as “unclear” or “high” risk of bias.

Results and conclusions:
The investigators found meta-analyses showed no significant difference between omega-3 PUFA supplements and control intervention on muscle mass, quality of life and body weight.

The investigators found oral omega-3 PUFA supplements significantly reduced the likelihood of developing chemotherapy-induced peripheral neuropathy with 80% [OR = 0.20, 95% CI = 0.10 to 0.40, p 0.001, I2 = 0%].  

The investigators concluded that oral omega-3 PUFA supplementation may reduce the incidence of chemotherapy-induced peripheral neuropathy in patients with cancer. May reduce because most trials were graded as “unclear” or “high” risk of bias.

Original title:
The effect of oral omega-3 polyunsaturated fatty acid supplementation on muscle maintenance and quality of life in patients with cancer: A systematic review and meta-analysis by Lam CN, Watt AE, [...], van der Meij BS.

Link:
https://pubmed.ncbi.nlm.nih.gov/34130028/

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

Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most frequent side effects caused by antineoplastic agents. Antineoplastic drugs are medications used to treat cancer. Antineoplastic drugs are also called anticancer, chemotherapy, chemo, cytotoxic or hazardous drugs.

Objectives:
Personalized nutrition and protective diets and lifestyles represent a key cancer research priority. The association between consumption of specific dietary components and colorectal cancer (CRC) incidence has been evaluated by a number of population-based studies, which have identified certain food items as having protective potential, though the findings have been inconsistent. Therefore, this review article has been conducted.

Which food groups reduce risk of colorectal cancer?

Study design:
This review article included 46 studies (case-control studies and cohort studies).

Results and conclusions:
The investigators found in pooled analyses that colorectal cancer risk was significantly reduced with 10% in patients with higher vs lower consumption of cruciferous vegetables [OR = 0.90, 95% CI = 0.85 to 0.95, p = 0.00, I2 = 31.02%].
This reduced risk was only significant in case-control studies, but not in cohort studies.

The investigators found in pooled analyses that colorectal cancer risk was significantly reduced with 10% in patients with higher vs lower consumption of citrus fruits [OR = 0.90, 95% CI = 0.84 to 0.96, p = 0.00, I2 = 21.65%].
This reduced risk was only significant in case-control studies, but not in cohort studies.

The investigators found in pooled analyses that colorectal cancer risk was significantly reduced with 17% in patients with higher vs lower consumption of garlic [OR = 0.83, 95% CI = 0.76 to 0.91, p = 0.00, I2 = 32.64%].
This reduced risk was only significant in case-control studies, but not in cohort studies.

The investigators found in pooled analyses that colorectal cancer risk was significantly reduced with 11% in patients with higher vs lower consumption of tomatoes [OR = 0.89, 95% CI = 0.84 to 0.95, p = 0.00, I2 = 0%].
This reduced risk was only significant in case-control studies, but not in cohort studies.

The investigators found in subgroup analysis of cohort studies that colorectal cancer risk was significantly reduced with 26% in patients with higher vs lower consumption of nut [OR = 0.74, 95% CI = 0.58 to 0.94, p = 0.01, I2 = 35.48%].

The investigators concluded that an increased consumption of cruciferous vegetables, citrus fruits, garlic and tomatoes may reduce colorectal cancer risk. May reduce because the reduced risk is only found in case-control studies and not in cohort studies.

Original title:
Phytochemically rich dietary components and the risk of colorectal cancer: A systematic review and meta-analysis of observational studies by Borgas P, Gonzalez G, […], Reza Mirnezami R.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8223713/

Additional information of El Mondo:
Find more information/studies on vegetables, fruit, garlic, nut and colorectal cancer right here.

Objectives:
There appears to be a sex-specific association between obesity and colorectal neoplasia in patients with Lynch Syndrome (LS). Therefore, this review article has been conducted.

Does obesity (BMI>30) increase colorectal cancer in patients with Lynch Syndrome?

Study design:
This review article included 3 prospective cohort studies with 2,463 subjects (persons), of which 735 subjects with colorectal cancer.

All studies with a prospective study design (cohort studies) expressed the association between obesity and colorectal cancer in terms of adjusted HR (95% CI).

There was no publication bias.

Results and conclusions:
The investigators found a twofold risk of colorectal cancer in obese men with Lynch Syndrome compared to nonobese men with Lynch Syndrome [SRR = 2.09, 95% CI = 1.23 to 3.55, I2 = 33%].  
No significantly increased risk due to obesity was found for women [SRR = 1.41, 95% CI = 0.46 to 4.27, I2 = 68%].  

The investigators found a significantly 49% increased colorectal cancer risk for obesity (BMI>30) for subjects with an MLH1 mutation [SRR = 1.49, 95% CI = 1.11 to 1.99, I2 = 0%].

The investigators concluded that obesity (BMI>30) increases colorectal cancer in men with Lynch Syndrome, particularly with an MLH1 mutation.

Original title:
A Meta-Analysis of Obesity and Risk of Colorectal Cancer in Patients with Lynch Syndrome: The Impact of Sex and Genetics by Lazzeroni M, Bellerba F, […], Gandini S.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8160758

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

Lynch syndrome, also known as hereditary non-polyposis colorectal cancer (HNPCC), is an autosomal dominantly inherited disease. People with Lynch syndrome have about a 40% to 80% chance of getting colorectal cancer by age 70. They’re also at risk for cancer of the uterus, ovaries or stomach. And they tend to get cancer at younger ages than other people, often in their 30s and 40s.

An error or mutation, in one copy of the MLH1 gene is one of the causes of Lynch syndrome. Men and women with a mutation in MLH1 have a 52-82% lifetime risk (up to age 70) to develop colon or rectal cancer.
 

Objectives:
Does calcium reduce the risk of incidence and recurrence of colorectal adenomas and advanced adenomas?

Study design:
This review article included 37 relevant clinical trials and observational studies involving over 10,964 cases.

Results and conclusions:
The investigators found that calcium consumption significantly reduced the risk of colorectal adenomas incidence by 8% [RR = 0.92, 95% CI = 0.89 to 0.96].

The investigators found that calcium intake as a food significantly reduced the risk of colorectal adenomas incidence by 21% [RR = 0.79, 95% CI = 0.72 to 0.86].

The investigators found that calcium intake as dairy product significantly reduced the risk of colorectal adenomas incidence by 12% [RR = 0.88, 95% CI = 0.78 to 0.98].

The investigators found, however, calcium supplements did not show a significant effect on colorectal adenomas incidence [RR = 0.97, 95% CI = 0.89 to 1.05].

The investigators found that total calcium intake significantly reduced the risk of advanced colorectal adenomas incidence by 21% [RR = 0.79, 95% CI = 0.73 to 0.85].

The investigators found that total calcium intake significantly reduced the risk of recurrence of adenomas by 12% [RR = 0.88, 95% CI = 0.84 to 0.93].

The investigators concluded that natural sources of calcium such as dairy products and foods have more effective role than supplementary calcium in terms of reducing the risk of incidence and recurrence of colorectal adenomas and advanced adenomas.

Original title:
Calcium and dairy products in the chemoprevention of colorectal adenomas: a systematic review and meta-analysis by Emami MH, Salehi M, […], Maghool F.

Link:
https://pubmed.ncbi.nlm.nih.gov/33951958/

Additional information of El Mondo:
Find more information/studies on calcium, dairy products and colorectal cancer right here.

The colorectal adenoma is a benign glandular tumor of the colon and the rectum. It is a precursor lesion of the colorectal adenocarcinoma (colon cancer).

Objectives:
Apart from ruminant fat, trans fatty acids are produced during the partial hydrogenation of vegetable oils, (eg, in the production of ultraprocessed foods). Harmful cardiovascular effects of trans fatty acids are already proven, but the link with cancer risk has not yet been summarized. Therefore, this review article has been conducted.

Does high consumption of dietary trans fat increase risk of cancer?

Study design:
This review article included 17 cohort and case-control studies on breast cancer, 11 cohort and case-control studies on prostate cancer and 9 cohort and case-control studies on colorectal cancer.

Results and conclusions:
The investigators found that high consumption of dietary total trans fat significantly increased prostate cancer with 49% [OR = 1.49, 95% CI = 1.13 to 1.95].
Significantly means that there is an association with a 95% confidence.

The investigators found that high consumption of dietary total trans fat significantly increased colorectal cancer with 26% [OR = 1.26, 95% CI = 1.08 to 1.46].
Significant because OR of 1 was not found in the 95% CI of 1.08 to 1.46. OR of 1 means no risk/association.

The investigators found no association between high consumption of dietary total trans fat and the risk of breast cancer [OR = 1.12, 95% CI = 0.99 to 1.26].
No association ant because OR of 1 was found in the 95% CI of 0.99 to 1.26. OR of 1 means no risk/association.

The investigators found results were dependent on the fatty acid subtype, with even cancer-protective associations for some partially hydrogenated vegetable oils.

The investigators found enhancing moderators in the positive transfat-cancer relation were gender (direction was cancer-site specific), European ancestry, menopause, older age and overweight.

The investigators concluded that high consumption of dietary total trans fat increases prostate cancer and colorectal cancer. Future studies need methodological improvements (eg, using long-term follow-up cancer data and intake biomarkers). Owing to the lack of studies testing trans-fatty acid subtypes in standardized ways, it is not clear which subtypes (eg, ruminant sources) are more carcinogenic.

Original title:
Dietary trans-fatty acid intake in relation to cancer risk: a systematic review and meta-analysis by Michels N, Specht IO and Huybrechts I.

Link:
https://pubmed.ncbi.nlm.nih.gov/34104953/

Additional information of El Mondo:
Find more information/studies on trans fat, breast cancer and colorectal cancer right here.

A diet high in trans fat is a diet with more than 1 En% trans fat.

Trans fat can be found in doughnuts, cakes, pie crusts, biscuits, frozen pizza, cookies, crackers and stick margarines and other spreads.

Objectives:
Is an increased homocysteine (Hcy) level an independent predictor of unfavorable outcomes in acute ischemic stroke (AIS)?

Study design:
This review article included 17 cohort studies (4 of them were retrospective studies and the remaining 13 were prospective studies) with 15,636 patients with acute ischemic stroke.

There was no publication bias.

Results and conclusions:
The investigators found the patients with acute ischemic stroke group had significantly higher levels of homocysteine than the control group [SMD = 5.11, 95% CI = 1.87 to 8.35, p = 0.002].
The results of subgroup analyses on ethnicity showed that the associations were statistically significant in both Caucasian and Asian patients [Caucasian: OR = 3.56, 95% CI = 2.54 to 4.98, p 0.00001, I2 = 20% and Asian: HR = 1.39, 95% CI = 1.19 to 1.63, p 0.00001, I2 = 86%], but not in African patients [OR = 1.04, 95% CI = 0.99 to 1.10, p = 0.11].

The investigators found, moreover, high homocysteine levels were closely associated with gender, B12 deficiency, smoking and patients who received tissue plasminogen activator treatment.
However, no significant difference was found between increased homocysteine levels and age, drinking, hypertension, diabetes mellitus and hyperlipidemia.

The investigators found, in addition, the cut-off value (20.0 μmol/L) might be an optimum cut-off index for acute ischemic stroke patients in clinical practice.

The investigators concluded that the homocysteine level may serve as an independent predictor for unfavorable survival outcomes in acute ischemic stroke patients, particularly in Caucasian and Asian acute ischemic stroke patients. Further studies can be conducted to clarify this relationship.

Original title:
The Prognostic Value of Homocysteine in Acute Ischemic Stroke Patients: A Systematic Review and Meta-Analysis by Huang S, Cai J and Tian Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7907516/

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

Objectives:
Low- and middle-income countries (LMICs) are currently experiencing increasing cardiovascular disease (CVD) rates. Green leafy vegetables (GLV), which are abundant in these countries, are known to be particularly rich in cardioprotective nutrients. Therefore, this review article has been conducted.

Does green leafy vegetables consumption reduce cardiovascular disease?

Study design:
This review article included 17 cohort studies.

Results and conclusions:
The investigators found green leafy vegetables consumption significantly reduced incident cardiovascular disease events with 7% [pooled RR = 0.93, 95% CI = 0.92 to 0.95].

The investigators found in subgroup analyses that green leafy vegetables consumption significantly reduced incident cerebral infarction with 8% [RR = 0.92, 95% CI = 0.88 to 0.96].

The investigators found in subgroup analyses that green leafy vegetables consumption significantly reduced heart disease with 7% [RR = 0.93, 95% CI = 0.87 to 0.99].

The investigators found in subgroup analyses that green leafy vegetables consumption significantly reduced other cardiovascular disease events with 5% [RR = 0.95, 95% CI = 0.93 to 0.98].

The investigators concluded that green leafy vegetables consumption reduces incident cardiovascular disease, particularly incident cerebral infarction and heart disease. These findings are especially important in low- and middle-income countries where the burden of cardiovascular disease remains high.

Original title:
Dietary intakes of green leafy vegetables and incidence of cardiovascular diseases by Ojagbemi A, Okekunle AP, […], Owolabi M.

Link:
https://pubmed.ncbi.nlm.nih.gov/34128951/

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

The green leafy vegetables are:

arugula
beet greens
bok choy
cabbage
collard greens
endive
kale
microgreens
romaine lettuce
spinach
swiss chard
turnip greens
watercress

Objectives:
Despite the widespread increase in the incidence of early-onset colorectal cancer (EoCRC), the reasons for this increase remain unclear. Therefore, this review article has been conducted.

What are the risk factors of early-onset colorectal cancer?

Study design:
This review article included 20 studies.

With the exception of alcohol consumption, there was considerable heterogeneity among studies [I2 > 60%].

Results and conclusions:
The investigators found colorectal cancer history in a first-degree relative was significantly associated with a 4.21-fold enhanced risk of early-onset colorectal cancer [RR = 4.21, 95% CI = 2.61 to 6.79].

The investigators found hyperlipidemia significantly increased risk of early-onset colorectal cancer with 62% [RR = 1.62, 95% CI = 1.22 to 2.13].

The investigators found obesity (BMI>30) significantly increased risk of of early-onset colorectal cancer with 54% [RR = 1.54, 95% CI = 1.01 to 2.35].

The investigators found compared to non-drinkers, high alcohol consumption significantly increased risk of of early-onset colorectal cancer with 71% [RR = 1.71, 95% CI = 1.62 to 1.80].

The investigators concluded that colorectal cancer history in a first-degree relative, hyperlipidemia (a high level of lipids (fats, cholesterol and triglycerides) circulating in the blood), obesity and high alcohol consumption are risk factors of early-onset colorectal cancer. High-quality studies conducted on generalizable populations and that comprehensively examine risk factors for early-onset colorectal cancer are required to inform primary and secondary prevention strategies.

Original title:
Risk Factors for Early-Onset Colorectal Cancer: A Systematic Review and Meta-analysis by O'Sullivan DE, Sutherland RL, […], Brenner DR.

Link:
https://pubmed.ncbi.nlm.nih.gov/33524598/

Additional information of El Mondo:
Find more information/studies on obesity, alcohol consumption and colorectal cancer right here.

Early-onset colorectal cancer is colorectal cancer diagnosed in a patient younger than age 50.

 

Objectives:
Does guarana supplementation reduce cancer-related fatigue?

Study design:
This review article included 7 RCTs with a total of 427 cancer patients.
Some studies presented a low risk of bias for all the categories.
Meta-analysis was conducted for 3 studies about breast cancer, which presented sufficient data.

The instruments used to analyze fatigue were the Brief Fatigue Inventory (BFI), the Chalder Fatigue Scale, the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-FATIGUE) and the Piper Scale.

Results and conclusions:
The investigators found guarana supplementation did not reduce cancer-related fatigue compared with placebo groups [mean = -0.02, 95% CI = -1.54 to 1.50, p = 0.98] and the quality of evidence according to GRADE was very low.

The investigators concluded that guarana supplementation did not reduce cancer-related fatigue. However, further studies with better methodological quality are needed.

Original title:
The use of guarana (Paullinia cupana) as a dietary supplement for fatigue in cancer patients: a systematic review with a meta-analysis by de Araujo DP, Pereira PTVM, […], Garcia JBS.

Link:
https://pubmed.ncbi.nlm.nih.gov/34146166/

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

 

Objectives:
Systemic inflammation and oxidative stress (OS) are associated with breast cancer. Coenzyme Q10 (CoQ10) as an adjuvant treatment with conventional anti-cancer chemotherapy has been demonstrated to help in the inflammatory process and oxidative stress. Therefore, this review article has been conducted.

Does coenzyme Q10 supplementation reduce levels of inflammatory markers, oxidative stress parameters and matrix metalloproteinases/tissue inhibitor of metalloproteinases (MMPs/TIMPs) in patients with breast cancer?

Study design:
This review article included 9 RCTs.

Results and conclusions:
The investigators found that coenzyme Q10 supplementation (100 mg/day for 45-90 days) significantly decreased the levels of
-vascular endothelial growth factor (VEGF) [SMD = -1.88, 95% CI = -2. 62 to -1.13, I2 = 93.1%, p 0.001];
-IL-8 [SMD = -2.24, 95% CI = -2.68 to -1.8, I2 = 79.6%, p = 0.001];
-matrix metalloproteinase-2 (MMP-2) [SMD = -1.49, 95% CI = -1.85 to -1.14, I2 = 76.3%, p = 0.005] and
-matrix metalloproteinase-9 (MMP-9) [SMD = -1.58, 95% CI = -1.97 to -1.19, I2 = 79.6%, p = 0.002].

The investigators concluded that 100 mg/day coenzyme Q10 supplementation for 45-90 days reduces some of the important markers of inflammation and matrix metalloproteinases in patients with breast cancer. However, further studies with controlled trials for other types of cancer are needed to better understand and confirm the effect of coenzyme Q10 on tumor therapy.

Original title:
Effects of coenzyme Q10 supplementation on inflammation, angiogenesis, and oxidative stress in breast cancer patients: a systematic review and meta-analysis of randomized controlled trials by Alimohammadi M, Rahimi A, […], Rafiei A.

Link:
https://pubmed.ncbi.nlm.nih.gov/34008150/

Additional information of El Mondo:
Find more information/studies on coenzyme Q10 and breast cancer right here.

Vascular endothelial growth factor (VEGF) plays a central role in promoting angiogenesis and is over-expressed in breast cancer.

IL-8 is a marker of ER-negative and/or HER2-positive breast cancer.

Matrix metalloproteinases (MMPs) are a group of zinc-containing, calcium dependent endopeptidases which play a substantial role in breast carcinogenesis through several mechanisms. These mechanisms include remodeling of extracellular matrix (ECM), cell proliferation and angiogenesis which promote metastasis and result in tumor progression.

Objectives:
Does a high BMI increase liver cancer mortality and occurrence of primary liver cancer?

Study design:
This review article included 28 prospective cohort studies with 8,135,906 subjects, of which 6,059,561 subjects (persons) with primary liver cancer occurrence and 2,077,425 subjects with liver cancer-related mortality.

Results and conclusions:
The investigators found in the meta-analysis, that an increase in BMI significantly increased the occurrence of primary liver cancer with 69% [HR = 1.69, 95% CI = 1.50 to 1.90, I2 = 56%].
Significant means that there is an association with a 95% confidence.

The investigators found that a BMI>25 (overweight) significantly increased the occurrence of primary liver cancer with 36% [HR = 1.36, 95% CI = 1.02 to 1.81].
Significant because HR of 1 was not found in the 95% CI of 1.02 to 1.81. HR of 1 means no risk/association.

The investigators found that a BMI>30 (obesity) significantly increased the occurrence of primary liver cancer with 77% [HR = 1.77, 95% CI = 1.56 to 2.01].
Significantly means it can be said with a 95% confidence that a BMI>30 really increased the occurrence of primary liver cancer with 77%.

The investigators found that a BMI>35 significantly increased the occurrence of primary liver cancer with 208% [HR = 3.08, 95% CI = 1.21 to 7.86].

The investigators found that an increase in BMI significantly increased liver cancer-related mortality with 61% [HR = 1.61, 95% CI = 1.14 to 2.27].

The investigators concluded that high BMI increases liver cancer mortality and occurrence of primary liver cancer. Obesity (BMI>30) is an independent risk factor for the occurrence of and mortality from primary liver cancer.

Original title:
Obesity and the risk of primary liver cancer: A systematic review and meta-analysis by Sohn W, Lee S, [...], Yoon SK.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7820201/

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

Am I overweight?

Which products are suitable for persons with overweight?

Use the 7-points nutritional profile app to see if your daily eaten products are suitable for you if you are overweight.

Objectives:
The association of meat consumption with mortality and morbidity for non-communicable diseases has been extensively studied. However, the relation of white meat consumption with health outcomes remains controversial. Therefore, this review article has been conducted.

Does consumption of white meat reduce mortality and morbidity rate?

Study design:
This review article included 22 prospective cohort studies with 3,132,149 subjects.
11 studies (14 data-sets) reported data on all-cause mortality, 10 studies (15 datasets) on cardiovascular mortality and 10 studies (11 datasets) on non-fatal cardiovascular events.
The evaluation of methodological quality of each study showed a median NOS score of 6.

Funnel plot examination suggested the absence of publication bias and of small-study effect, confirmed by the Egger’s test for all-cause mortality.

Results and conclusions:
The investigators found the analysis of the 11 studies (14 datasets) on all-cause mortality showed a statistically significant lower mortality rate of 6% for subjects in the highest vs. lowest unprocessed white meat consumption category [OR = 0.94, 95% CI = 0.90 to 0.97, p 0.001, I2 = 95.6%, p 0.001].

The investigators found an overall neutral association between high unprocessed white meat consumption and cardiovascular mortality and morbidity.

The investigators concluded that consumption of unprocessed white meat reduces all-cause mortality.

Original title:
White Meat Consumption, All-Cause Mortality, and Cardiovascular Events: A Meta-Analysis of Prospective Cohort Studies by Lupoli R, Vitale M, […], Vaccaro O.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7924043/

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

Objectives:
Branched-chain amino acids (BCAAs; leucine, isoleucine and valine) are essential amino acids involved in immune responses and may have roles in protein malnutrition and sarcopenia (a type of muscle loss (muscle atrophy) that occurs with aging and/​or immobility). Furthermore, certain liver diseases have been associated with a decreased Fischer's ratio (BCAAs to aromatic amino acids; phenylalanine, tyrosine and tryptophan). However, a comprehensive synthesis of the evidence from human controlled studies on the supplemental use of BCAAs during the oncology peri-operative period has not been published. Therefore, this review article (meta-analysis) has been conducted.

Does branched-chain amino acids (BCAAs) supplementation during the oncological surgical period reduce post-operative morbidity from infections and ascites?

Study design:
This review article included 13 RCTs and 6 cohort studies with 2,019 participants.
Mean (or median) ages of the RCTs populations were from 53 to 67 years old and all of the RCTs had a predominantly male population.
9 RCTs (69%) evaluated oral intake of BCAAs and 4 (31%) administered (parenteral) BCAAs intravenously in hospital.
Duration of treatment use in the RCTs ranged from intra-operatively (single intravenous administration) up to a maximum duration of 13 months (oral administration).

Among 13 RCTs, 77% involved liver cancer. Methodological study quality scored substantial risk-of-bias across most RCTs.

Overall, 6 cohort studies were of low methodological quality.

Results and conclusions:
The investigators found meta-analysis of RCTs showed a 38% significantly decreased risk of post-operative infections in BCAAs group compared to controls [RR = 0.62, 95% CI = 0.44 to 0.87, p= 0.006, I2 = 0%, number of RCTs, k = 6, total sample size, n = 389].

The investigators found BCAAs supplementation was also beneficial for ascites [RR = 0.55, 95% CI = 0.35 to 0.86, p = 0.008, I2 = 0%, k = 4, n = 296], body weight [MD = 3.24 kg, 95% CI = 0.44 to 6.04, p = 0.02, I2 = 24%, k = 3, n = 196] and hospitalization length [MD = -2.07 days, 95% CI = -3.97 to -0.17, p = 0.03, I2 = 59%, k = 5, n = 362].

The investigators found no differences between BCAAs and controls for mortality, recurrence, other post-operative complications (liver failure, edema, pleural effusion), blood loss, quality of life, ammonia level and prothrombin time.

The investigators found no serious adverse events were related to BCAAs; however, serious adverse events were reported due to intravenous catheters. No safety concerns from observational studies were identified.

The investigators concluded that branched-chain amino acids (BCAAs) supplementation during the oncological surgical period may reduce important post-operative morbidity from infections and ascites compared to controls. May reduce because the included studies were of low methodological quality. Therefore, blinded, placebo-controlled confirmatory trials of higher methodological quality are warranted, especially using oral, short-term BCAAs-enriched supplements within the context of recent ERAS programs.

Original title:
Are Supplemental Branched-Chain Amino Acids Beneficial During the Oncological Peri-Operative Period: A Systematic Review and Meta-Analysis by Cogo E, Elsayed  M, […], Papadogianis P.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7930658/

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

Ascites is the buildup of fluid in the space around the organs in the abdomen. When ascites is caused by cancer, it is called malignant ascites.
 

Objectives:
Due to the rapid increase of primary liver cancer incidence and the poor prognosis, it is imperative to identify new modifiable factors such as diet and nutrition for the prevention of liver cancer. Diet high in saturated fatty acids (SFA) has been hypothesized to be associated with increased risk of cancers. However, the associations between dietary fatty acids and liver cancer are not consistent. Therefore, this review article has been conducted.

Does a diet high in saturated fatty acids or cholesterol increase risk of liver cancer?

Study design:
This review article included 14 prospective cohort studies with 15,890 liver cancer cases.

Results and conclusions:
The investigators found for the highest dietary saturated fat versus lowest intake, a significantly increased risk of 34% [RR = 1.34, 95% CI = 1.06 to 1.69, I2 = 16.9%, n = 5] for liver cancer.

The investigators found for every increase with 1 En% saturated fat, a significantly increased risk of 4% [RR = 1.04, 95% CI = 1.01 to 1.07, I2 = 16.8%, n = 5] for liver cancer.

The investigators found per 0.1-unit increase in ratio of monounsaturated fatty acids (MUFA): saturated fat (SFA), a significantly decreased risk of 9% [RR = 0.91, 95% CI = 0.86 to 0.95] for liver cancer.

The investigators found per 0.1-unit increase in ratio of unsaturated fatty acids (UFA):saturated fat (SFA), a significantly decreased risk of 6% [RR = 0.94, 95% CI = 0.90 to 0.97] for liver cancer.

The investigators found for every increase with 100 mg dietary cholesterol intake per day, a significantly increased risk of 16% [RR = 1.16, 95% CI = 1.01 to 1.07, I2 = 0%, n = 2] for liver cancer.

The investigators found for the highest serum total cholesterol levels versus lowest levels, a significantly decreased risk of 58% [RR = 0.42, 95% CI = 0.33 to 0.54, I2 = 90.7%, n = 7] for liver cancer.

The investigators found for the highest serum total cholesterol levels versus lowest levels, a significantly decreased risk of 61% [RR = 0.39, 95% CI = 0.27 to 0.57] for liver cancer among men. 

The investigators found for the highest serum total cholesterol levels versus lowest levels, a significantly decreased risk of 69% [RR = 0.31, 95% CI = 0.26 to 0.38] for liver cancer among women. 

The investigators found for every increase with 1 mmol/L in serum cholesterol level, a significantly decreased risk of 28% [RR = 0.72, 95% CI = 0.69 to 0.75, I2 = 75.3%, n = 7] for liver cancer.

The investigators found for every increase with 1 mmol/L in serum HDL cholesterol level, a significantly decreased risk of 58% [RR = 0.42, 95% CI = 0.27 to 0.64, I2 = 0%, n = 2] for liver cancer.

The investigators found these findings were generally robust and stable in sensitivity analyses.

The investigators concluded there is an increased risk for dietary saturated fat with liver cancer using both category and dose-response analyses. Higher ratios of monounsaturated fatty acids (MUFA):saturated fat (SFA) and unsaturated fatty acids (UFA):saturated fat (SFA) are associated with a lower risk of developing liver cancer. Higher serum total and HDL cholesterol are associated with a lower risk of liver cancer with high between-studies variability.

Original title:
Dietary Fats, Serum Cholesterol and Liver Cancer Risk: A Systematic Review and Meta-Analysis of Prospective Studies by Zhao L, Deng C, [...], Zhang X.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8037522/

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

A diet high in saturated fat (unhealthy fat) is a diet with more than 10 En% saturated fat.

The easiest way to follow a diet with more than 10 En% saturated fat is to choose only products/meals that also contain more than 10 En% saturated fat. Check here which products contain more than 10 En% saturated fat.

More than 10% saturated fat means that the total amounts of saturated fat make up more than 10% of the total kcal of the diet. So a 2000 kcal diet with more than 10 En% saturated fat contains more than 22 grams of saturated fat. 22 grams of saturated fat provides 22x9 kcal = 198 kcal. 198 kcal is 10% of 2000 kcal.

However, products with more than 10 En% saturated fat are unhealthy products.