Nutrition and health

500 mg/d dietary flavonoid intake reduces cardiovascular disease, diabetes and hypertension

Afbeelding

Objectives:
Several epidemiological studies have suggested that flavonoid intake is associated with a decreased risk of cardiometabolic disease. However, the results remained inconsistent and there is no dose-response meta-analysis for specific outcomes. Therefore, this review article has been conducted.

Is there a dose-response relationship between dietary flavonoid intake and reduced risk of cardiometabolic disease?

Study design:
This review article included 47 prospective cohort studies with a total of 1,346,676 participants and 127,507 persons with cardiometabolic disease.

Results and conclusions:
The investigators found for every 500 mg/d increase in dietary flavonoid intake a reduced risk of 7% [summary RR = 0.93, 95% CI = 0.88 to 0.98] for cardiovascular disease.
Significant means that there is an association with a 95% confidence.

The investigators found for every 500 mg/d increase in dietary flavonoid intake a reduced risk of 11% [summary RR = 0.89, 95% CI = 0.84 to 0.94] for diabetes.
Significant because summary RR of 1 was not found in the 95% CI of 0.84 to 0.94. Summary RR of 1 means no risk/association.

The investigators found for every 500 mg/d increase in dietary flavonoid intake a reduced risk of 3% [summary RR = 0.97, 95% CI = 0.94 to 0.99] for hypertension.
Significantly means it can be said with a 95% confidence that every 500 mg/d increase in dietary flavonoid intake really reduced risk of hypertension with 3%.

The investigators found a linearity dose-response association between total dietary flavonoid intake and cardiovascular disease [p nonlinearity = 0.541] and diabetes [p nonlinearity = 0.077].

The investigators concluded that a higher level of dietary flavonoid intake, at least 500 mg/d  is beneficial for the prevention of cardiometabolic diseases, particularly cardiovascular disease, diabetes and hypertension.

Original title:
Total dietary flavonoid intake and risk of cardiometabolic diseases: A dose-response meta-analysis of prospective cohort studies by Li T, Zhao Y, […], Liu J.

Link:
https://pubmed.ncbi.nlm.nih.gov/36148848/

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Find more information/studies on flavonoid, diabetes, cardiovascular disease and lowering blood pressure right here.

Cardiometabolic diseases are a group of common but often preventable conditions including heart attack, stroke, diabetes, insulin resistance and non-alcoholic fatty liver disease.

Serum vitamin D concentrations between 40 and 75 nmol/L reduce hypertension in adult

Afbeelding

Objectives:
Findings of observational studies that evaluated the association of serum vitamin D status and high blood pressure were contradictory. Therefore, this review article has been conducted.

Does a high serum vitamin D concentration reduce risk of hypertension in the adult population?

Study design:
This review article included 10 prospective cohort, 1 nested case-control study and 59 cross-sectional studies.
Overall 66,757 and 260,944 participants were included in cohort and cross-sectional studies, respectively.
Among cohort studies, the NOS scores were between 6 and 9.
Among cross-sectional studies, the NOS scores ranged between 4 and 10.
There was no publication bias.

Results and conclusions:
The investigators found in the pooled analysis of cohort studies (66,757 participants) a 16% significant decrease in risk of hypertension in participants who had a high level of serum vitamin D compared with those with low level [pooled RR = 0.84, 95% CI = 0.73 to 0.96, I2 = 64%, p = 0.001].
Sensitivity analysis showed that excluding each stuy had no significant effect on pooled RR.

The investigators found combining effect sizes of 10 cohort studies involving a total of 63,602 individuals and 25,019 cases of hypertension showed that each 25 nmol/L increase in serum vitamin D level resulted in a 5% reduction in risk of hypertension [RR = 0.95, 95% CI = 0.90 to 1.00].
Also, a significant non-linear association between serum vitamin D levels and hypertension was observed [p non-inearity 0.001].
A reduction trend in risk of hypertension was observed for serum vitamin D levels between 45 and 70 nmol/L, although for higher vitamin D levels the risk did not decrease anymore and eventually started increasing.

The investigators found meta-analysis of cross-sectional studies showed that highest level of vitamin D in comparison to the lowest level was associated with a 16% significant decrease in risk of hypertension [OR overall = 0.86, 95% CI = 0.79 to 0.90, I2 = 67.5%, p 0.001].
Sensitivity analysis determined that the exclusion of each study did not significantly affect the overall estimate.

The investigators found combining effect sizes of 30 cross-sectional studies involving a total of 139,685 individuals and 40,178 cases of hypertension showed that each 25 nmol/L increase in serum vitamin D level resulted in a 6% reduction in risk of hypertension [OR = 0.94, 95% CI = 0.90 to 0.99].  

Also, a significant non-linear association between serum vitamin D levels and hypertension was seen [p non-linearity 0.001].
A reduction trend in risk of hypertension was observed for serum vitamin D levels between 40 and 75 nmol/L, although higher vitamin D levels did not reduce odds of hypertension.

The investigators concluded that serum vitamin D concentrations between 40 and 75 nmol/L reduce risk of hypertension in the adult population, in both prospective cohort and cross-sectional studies.

Original title:
Serum Vitamin D Levels in Relation to Hypertension and Pre-hypertension in Adults: A Systematic Review and Dose-Response Meta-Analysis of Epidemiologic Studies by Mokhtari E, Hajhashemy Z and Saneei P.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8961407/

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Unsaturated fatty acids improve absorption of carotenoids

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Objectives:
Dietary fats are one of the well-known stimulators of carotenoid absorption, but the effects of the quantity and the type of dietary fats on carotenoid absorption have not yet been studied systematically. Therefore, this review article has been conducted.

Do dietary fats improve the absorption of carotenoids?

Study design:
This review article included a total of 27 in vitro studies and 12 RCTs.

Results and conclusions:
The investigators found meta-regression of in vitro studies showed that the bioaccessibility of carotenoids, except for lycopene, was positively associated with the concentration of dietary fats.

The investigators found meta-analysis of RCTs showed that the bioavailability of carotenoids was enhanced when a higher quantity of dietary fats was co-consumed.

The investigators found, moreover, fats rich in unsaturated fatty acids resulted in greater improvement in carotenoid bioavailability [SMD = 0.90, 95% CI = 0.69 to 1.11] as compared with fats rich in saturated fatty acids [SMD = 0.27, 95% CI = 0.08 to 0.47].

The investigators concluded that co-consuming dietary fats, particularly those rich in unsaturated fatty acids, with carotenoid-rich foods can improve the absorption of carotenoids.

Original title:
Effects of dietary fats on the bioaccessibility and bioavailability of carotenoids: a systematic review and meta-analysis of in vitro studies and randomized controlled trials by Yao Y, Tan P and Kim JE.

Link:
https://pubmed.ncbi.nlm.nih.gov/34897461/

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High folate dietary intake reduces colon cancer in people with medium or high alcohol consumption

Objectives:
Colorectal cancer is one of the most commonly diagnosed and deadly cancers worldwide. Epidemiological studies on the relationship between folate intake and the risk of colorectal cancer have reported inconsistent findings since folate fortification in the USA. Therefore, this review article has been conducted.

Does a high folate (folic acid) ietary intake reduce risk of colorectal cancer (colon and rectal cancer)?

Study design:
This review article included 24 cohort studies involving 6,165,894 individuals, of which 37,280 persons with colorectal cancer.

Results and conclusions:
The investigators found compared with the lowest dietary intake, the highest folate dietary intake significantly reduced risk of colorectal cancer with 12% [combined relative risk (RR) = 0.88, 95% CI = 0.83 to 0.92, p = 0.0004].
Significantly means that there is an association with a 95% confidence.

The investigators found compared with the lowest dietary intake, the highest folate dietary intake significantly reduced risk of colorectal cancer with 3% among persons witih medium alcohol consumption [RR = 0.97, 95% CI = 0.96 to 0.99, p = 0.008].
Significantly because RR of 1 was not found in the 95% CI of 0.96 to 0.99. RR of 1 means no risk/association.

The investigators found compared with the lowest dietary intake, the highest folate dietary intake significantly reduced risk of colorectal cancer with 5% among persons witih high alcohol consumption [RR = 0.95, 95% CI = 0.92 to 0.97, p = 0.003].

The investigators found compared with the lowest dietary intake, the highest folate dietary intake did not reduce risk of colorectal cancer among non-drinkers [RR = 1.00, 95% CI = 0.98 to 1.02, p = 0.827].

The investigators found compared with the lowest dietary intake, the highest folate dietary intake significantly reduced risk of colon cancer with 14% [RR = 0.86, 95% CI = 0.81 to 0.92, p = 0.0004].
Significantly because the calculated p-value of 0.0004 was less than the p-value of 0.05.

The investigators found compared with the lowest dietary intake, the highest folate dietary intake did not reduce risk of rectal cancer [RR = 0.92, 95% CI = 0.84 to 1.02, p = 0.112].

The investigators found compared with the lowest dietary intake, the highest folate dietary intake significantly reduced risk of colorectal cancer in USA and Europe but not in other regions.

The investigators concluded that high folate dietary intake reduces risk of colon cancer, particularly in people with medium or high alcohol consumption, but it still needs to be further confirmed.

Original title:
Folate intake and risk of colorectal cancer: a systematic review and up-to-date meta-analysis of prospective studies by Fu H, He J, […], Chang H.

Link:
https://pubmed.ncbi.nlm.nih.gov/35579178/

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Colorectal cancer starts in the colon or the rectum. These cancers can also be called colon cancer or rectal cancer, depending on where they start.

Higher dietary intake of processed meat increases hepatocellular carcinoma

Afbeelding

Objectives:
The association between meat intake and hepatocellular carcinoma (HCC) risk is still unclear. Therefore, this review article has been conducted.

Does a higher dietary intake of meat increases the risk of hepatocellular carcinoma?

Study design:
This review article included 17 observational studies involving 2,915,680 participants, of which 4,953 cases of hepatocellular carcinoma.

10 studies reported red meat intake, 9 reported white meat intake, 9 reported fish intake, 7 reported processed meat intake and 5 reported total meat intake.

Results and conclusions:
The investigators found results showed that the consumption of red meat [relative risk = 1.04, 95% CI = 0.91 to 1.18, I2 = 50.50%, p = 0.033] and total meat intake [relative risk = 1.01, 95% CI =  0.90 to 1.13, I2 = 15.50%, p = 0.316] were not significantly associated with risk of hepatocellular carcinoma.

The investigators found, however, a higher dietary intake of processed meat significantly increased the risk of hepatocellular carcinoma with 20% [relative risk = 1.20, 95% CI = 1.02 to 1.41, I2 = 26.30%, p = 0.228].
Significant because relative risk of 1 was not found in the 95% CI of 1.02 to 1.41. Relative risk of 1 means no risk/association.

The investigators found, in contrast, a higher dietary intake of white meat significantly decreased the risk of hepatocellular carcinoma with 24% [relative risk = 0.76, 95% CI = 0.63 to 0.92, I2 = 68.30%, p = 0.001].

The investigators found, in contrast, a higher dietary intake of fish significantly decreased the risk of hepatocellular carcinoma with 9% [relative risk = 0.91, 95% CI = 0.86 to 0.96, I2 = 40.90%, p = 0.095].

The investigators concluded that a higher dietary intake of processed meat increases the risk of hepatocellular carcinoma, while a higher dietary intake of both white meat and fish decrease the risk of hepatocellular carcinoma. Therefore, these findings suggest that dietary intervention may be an effective approach to preventing hepatocellular carcinoma. These need to be verified with further well-designed observational studies and experimental clinical research.  

Original title:
Meat Intake and the Risk of Hepatocellular Carcinoma: A Meta-Analysis of Observational Studies by Yu J, Liu Z, […], Chen W.

Link:
https://pubmed.ncbi.nlm.nih.gov/35583453/

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Processed meats are meats that have been preserved by smoking or salting, curing or adding chemical preservatives. They include deli meats, bacon and hot dogs.

200 mg/day flavan-3-ols dietary intake reduce stroke

Afbeelding

Objectives:
Epidemiological studies indicate that higher intakes of flavonoids are associated with reduced stroke risk. However, which subtypes play significant roles to protect against stroke remain unclear. Therefore, this review article has been conducted.

Does dietary intake of different flavonoid subclasses (flavanones, flavan-3-ols) reduce risk of stroke?

Study design:
This review article included 10 independent prospective cohort studies with 387,076 participants and 9,564 events (persons with stroke).

Results and conclusions:
The investigators found higher intakes of flavanones significantly reduced risk of stroke with 15% [RR = 0.85, 95% CI = 0.78 to 0.93].

The investigators found dose-response analysis showed that 50 mg/day increment of flavanones dietary intake was significantly associated with 11% reduction in stroke risk [RR = 0.89, 95% CI = 0.84 to 0.94].

The investigators found dose-response analysis showed that 200 mg/day increment of flavan-3-ols dietary intake was significantly associated with 14% reduction in stroke risk [RR = 0.86, 95% CI = 0.75 to 0.98].

The investigators found no association with respect to other flavonoid subclasses.

The investigators concluded that both 50 mg/day flavanones and 200 mg/day flavan-3-ols dietary intake reduce stroke risk. The findings of these associations of the present study need to be confirmed in other regions and ethnic origins.

Original title:
A meta-analysis of prospective cohort studies of flavonoid subclasses and stroke risk by Li XQ, Wang C, […], Guo XF.

Link:
https://pubmed.ncbi.nlm.nih.gov/35023220/

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Dietary oat supplementation may improve BMI among obese participants with mild metabolic disturbances

Afbeelding

Objectives:
Oat supplementation interventions (OSIs) may have a beneficial effect on cardiovascular disease (CVD) risk. However, dietary background can modulate such effect. Therefore, this review article has been conducted.

Does dietary oat supplementation lower levels of blood lipids (cholesterol, triglycerides) and improve anthropometric parameters (glucose level, body mass index, weight, blood pressure, waist circumference) among participants with predominantly mild metabolic disturbances?

Study design:
This review article included 74 RCTs with a total of 4,937 predominantly hypercholesterolemic, obese subjects, with mild metabolic disturbances. Of these, 59 RCTs contributed to the meta-analyses.

The majority of included RCTs (81.1%) had some concerns for risk of bias.

Results and conclusions:
The investigators found oat supplementation (as oat, oat beta-glucan-rich extracts or avenanthramides), compared to control arms without oats, significantly improved levels of:
-total cholesterol (TC) [WMD = -0.42 mmol/L, 95% CI = -0.61 to -0.22];
-LDL cholesterol [WMD = -0.29 mmol/L, 95% CI = -0.37 to -0.20];
-glucose [WMD = -0.25 nmol/L, 95% CI = -0.36 to -0.14];
-body mass index [WMD = -0.13 kg/m2, 95% CI = -0.26 to -0.01];
-weight [WMD = -0.94 kg, 95% CI = -1.84 to -0.05] and;
-waist circumference [WMD = -1.06 cm, 95% CI = -1.85 to -0.27].

The investigators found RCTs on inflammation and/or oxidative stress markers were scarce and with inconsistent findings.

The investigators found RCTs comparing an oat supplementation intervention to heterogeneous interventions (e.g., wheat, eggs, rice, etc.), showed lowered levels of glycated haemoglobin, diastolic blood pressure, HDL cholesterol and apolipoprotein B.

The investigators concluded dietary oat supplementation (as oat, oat beta-glucan-rich extracts or avenanthramides) may lower levels of blood lipids and improve anthropometric parameters among obese participants with predominantly mild metabolic disturbances, regardless of dietary background or control. May lower because the majority of included RCTs had some concerns for risk of bias. Therefore, further high-quality trials are warranted to establish the role of oat supplementation intervention on blood pressure, glucose homeostasis and inflammation markers.

Original title:
Effect of oat supplementation interventions on cardiovascular disease risk markers: a systematic review and meta-analysis of randomized controlled trials by Llanaj E, Dejanovic GM, […], Muka T.

Link:
https://pubmed.ncbi.nlm.nih.gov/34977959/

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These products are suitable for persons with cardiovascular diseases.

 


 

Dietary intake of vegetables and vitamin C could reduce renal cell carcinoma

Afbeelding

Objectives:
Evidence associating diet with the incidence of renal cell carcinoma (RCC) is inconclusive. Therefore, this umbrella review article has been conducted.

What is the association between diet and renal cell carcinoma incidence?

Study design:
This umbrella review article included 22 meta-analyses with a total of 502 individual studies and 64 summary hazard ratios (HRs) for renal cell carcinoma incidence: dietary patterns or dietary quality indices (n = 6), foods (n = 13), beverages (n = 4), alcohol (n = 7), macronutrients (n =15) and micronutrients (n =19).

No meta-analyses had high methodological quality.

59% of these 502 individual studies were cohort studies (n = 298), 39% were case-control studies (n = 196) and 2% were pooled studies (n = 8).

Sixty (94%) exposures in the included meta-analyses had more than 1,000 cases or 20,000 participants.

Results and conclusions:
The investigators found no dietary factors showed convincing or highly suggestive evidence of association with renal cell carcinoma incidence in the overall analysis.

The investigators found in the overall analysis that dietary intake of vegetables significantly reduced risk of renal cell carcinoma with 26% [summary HR = 0.74, 95% = 0.63 to 0.86, suggestive evidence].

The investigators found in the overall analysis that dietary intake of vitamin C significantly reduced risk of renal cell carcinoma with 23% [summary HR = 0.77, 95% = 0.66 to 0.90, suggestive evidence].

The investigators found in the overall analysis that moderate drinking significantly reduced risk of renal cell carcinoma with 23% [summary HR = 0.77, 95% = 0.70 to 0.84, convincing evidence] in Europe and North America.

The investigators found in the overall analysis that dietary intake cruciferous vegetables significantly reduced risk of renal cell carcinoma with 22% [summary HR = 0.78, 95% = 0.70 to 0.86, highly suggestive evidence] in North America.

The investigators concluded dietary intake of vegetables and vitamin C could reduce renal cell carcinoma risk. Moderate drinking might be beneficial for Europeans and North Americans and cruciferous vegetables might be beneficial to North Americans, but the results should be interpreted with caution because no meta-analyses had high methodological quality. More researches are needed in the future.

Original title:
The role of diet in renal cell carcinoma incidence: an umbrella review of meta-analyses of observational studies by Liao Z, Fang Z, […], Luo Z.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8812002/

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An umbrella review article is a scientific article which only includes meta-analyses (also called review articles). The results found in an umbrella review article are more reliable than found in an individual review article.

One swallow does not make a summer. A famous Dutch saying that could not be any more obvious. Just because one single scientific study about a certain topic makes certain claims, it does not necessarily mean it is true. On the other hand, a review article (a collection of scientific studies on a certain topic) of randomized, placebo-controlled double blind clinical trials (RCTs) will answer the following question:
"Do taking dietary supplements make sense?" Yes for a positive conclusion and no for a negative conclusion.

One swallow does not make a summer. A famous Dutch saying that could not be any more obvious. Just because one single scientific study about a certain topic makes certain claims, it does not necessarily mean it is true. On the other hand, a review article (a collection of scientific studies on a certain topic) of (prospective) cohort studies or case-control studies will answer the following question:
"Should I change my diet?".

A high olive oil consumption reduces cancer risk

Afbeelding

Objectives:
Does a high olive oil consumption reduce cancer risk?

Study design:
This review article included 37 case-control studies with 17,369 cases (persons with cancer) and 28,294 controls (persons without cancer) and 8 cohort studies with 12,461 incident cases among 929,771 subjects (participants).

Significant publication bias was detected via Egger’s test in the analysis on overall cancer risk [p 0.001], breast cancer [p = 0.013] and gastrointestinal cancer risk [p = 0.048].

Results and conclusions:
The investigators found in pooled analysis of case-control and cohort studies that highest olive oil consumption was significantly associated with a 31% lower risk of any cancer [pooled RR = 0.69, 95% CI = 0.62 to 0.77].  
Significantly means that there is an association with a 95% confidence.

The investigators found subgroup analyses showed that the protective effect of high olive oil consumption in terms of cancer risk was also significant in case-control studies [37 study arms, RR = 0.65, 95% CI = 0.57 to 0.74] but not in cohort studies [8 study arms, RR = 0.90, 95% CI = 0.77 to 1.05].
Furthermore, the protective association was also found in a multivariate analysis [32 study arms, RR = 0.72, 95% CI = 0.65 to 0.81], a high study quality analysis [RR = 0.72, 95% CI = 0.64 to 0.81], Mediterranean participants [RR = 0.69, 95% CI = 0.60 to 0.79] and non-Mediterranean participants [RR = 0.49, 95% CI = 0.34 to 0.71].

The investigators found in pooled analysis of case-control and cohort studies that highest olive oil consumption was significantly associated with a 33% lower risk of breast cancer [pooled RR = 0.67, 95% CI = 0.52 to 0.86].  
Significantly because RR of 1 was not found in the 95% CI of 0.52 to 0.86. RR of 1 means no risk/association.

The investigators found subgroup analyses showed that the beneficial effect was reproducible in case-control studies [RR = 0.63, 95% CI = 0.45 to 0.87] but not in cohort studies.
Furthermore, high olive oil consumption was linked to a reduced breast cancer risk in Mediterranean [RR = 0.67, 95% CI = 0.49 to 0.92] and non-Mediterranean populations [RR = 0.25, 95% CI = 0.07 to 0.89].

The investigators found in pooled analysis of case-control and cohort studies that highest olive oil consumption was significantly associated with a 23% lower risk of gastrointestinal cancer [pooled RR = 0.77, 95% CI = 0.66 to 0.89].  
Subgroup analyses showed an inverse relationship between highest olive oil consumption and risk for esophageal cancer [RR = 0.47, 95%CI = 0.24 to 0.93] and pancreatic cancer [RR = 0.58, 95% CI = 0.35 to 0.97].
Furthermore, significant effects were also found in case-control studies [RR = 0.72, 95% CI = 0.61 to 0.85), studies within the Mediterranean area [RR = 0.77, 95% CI = 0.67 to 0.88], multivariate analyses [RR = 0.76, 95% CI = 0.63 to 0.90] and high quality studies [RR = 0.73, 95% CI = 0.62 to 0.86].

The investigators found in pooled analysis of case-control and cohort studies that highest olive oil consumption was significantly associated with a 26% lower risk of upper aerodigestive cancer [pooled RR = 0.74, 95% CI = 0.60 to 0.91].  
Subgroup analyses showed results remained significant for case-control studies [RR = 0.74, 95% CI = 0.60 to 0.91], multivariate analyses [RR = 0.75, 95% CI = 0.66 to 0.86] and studies of high quality [RR = 0.68, 95% CI = 0.52 to 0.89].

The investigators found in pooled analysis of case-control studies that highest olive oil consumption was significantly associated with a 54% lower risk of urinary tract cancer [pooled RR = 0.46, 95% CI = 0.29 to 0.72].  
Subgroup analyses showed results remained significant for studies of high quality [RR = 0.46, 95% CI = 0.32 to 0.66].

The investigators concluded highest versus lowest olive oil consumption is associated with 31% lower cancer risk, especially for breast, overall gastrointestinal, upper aerodigestive and urinary tract cancer. Additional prospective cohort studies on various cancer types, especially in non-Mediterranean regions, as well as large randomized trials, seem desirable in order to provide further insight into the role of olive oil in preventing cancer.

Original title:
Olive oil intake and cancer risk: A systematic review and meta-analysis by Markellos C, Ourailidou ME, […], Psaltopoulout T.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8751986/

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The conclusions in scientific studies are even more reliable when they are also found in cohort studies, multivariate analyzes (studies where adjustments were made for multiple confounding factors) and high-quality studies.
 

Postoperative coffee or caffeine consumption causally reduces postoperative ileus

Afbeelding

Objectives:
Does postoperative coffee or caffeine consumption causally reduce risk of postoperative ileus (POI) in patients undergoing elective colorectal surgery?

Study design:
This review article included 4 RCTs with 312 subjects.

Results and conclusions:
The investigators found postoperative coffee or caffeine consumption significantly decreased the time to first bowel movement [MD = -10.36 h, 95% CI = -14.61 to -6.11], shortened the length of hospital stay [MD = -0.95 days, 95% CI = -1.57 to -0.34] and was significantly  associated with a 36%-decreased risk of the use of any laxatives after the procedure [RR = 0.64, 95% CI = 0.44 to 0.92].

The investigators found the time to first flatus, time to tolerance of solid food, risk of any postoperative complication, postoperative reinsertion of a nasogastric (NG) tube and anastomotic leakage showed no statistical differences between groups.

The investigators concluded postoperative coffee or caffeine consumption causally improves bowel movement and decreases the duration of hospital stay in patients undergoing elective colorectal surgery. This method is safe and can prevent or treat postoperative ileus (POI).

Original title:
The effect of coffee/caffeine on postoperative ileus following elective colorectal surgery: a meta-analysis of randomized controlled trials by Yang TW, Wang CT, […], Tsai MC.

Link:
https://pubmed.ncbi.nlm.nih.gov/34993568/

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Postoperative ileus is a prolonged absence of bowel function after surgical procedures, usually abdominal surgery.

Purified anthocyanin supplements reduce cardiovascular risk

Afbeelding

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/

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HDL cholesterol level under 2.33 mmol/L reduces cardiovascular disease mortality

Afbeelding

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/

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600 mg/d vitamin E supplementation decreases chemotherapy-induced peripheral neuropathy

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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Dendritic cell vaccine provides no benefits for newly diagnosed glioblastoma

Afbeelding

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/

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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.

Higher sodium and lower potassium reduce in a dose-response manner cardiovascular risk

Afbeelding

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/

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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).

4000 mg inositol supplements reduce blood pressure

Afbeelding

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/

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25 mg/d dietary flavonols or 5 mg/d dietary flavones reduce coronary heart disease

Afbeelding

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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Breastfeeding reduces ovarian cancer in women with BRCA1 or BRCA2 mutation

Afbeelding

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/

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Low-carbohydrate diets decrease LDL particle number

Afbeelding

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/

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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.

No association between consumption of carrot and bladder cancer

Afbeelding

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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Onion causally increases good cholesterol

Afbeelding

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

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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.

Omega-3 PUFA supplementation may reduce chemotherapy-induced peripheral neuropathy

Afbeelding

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/

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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.

High consumption of cruciferous vegetables, citrus fruits, garlic and tomatoes may reduce colorectal cancer

Afbeelding

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/

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Obesity increases colorectal cancer in men with Lynch Syndrome

Afbeelding

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

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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.
 

Dietary calcium intake reduces colorectal adenomas

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/

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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).