Nutrition and health

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/

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

Objectives:
Although current guidelines recommend reduction of salt intake in patients with diabetes, the benefits of reducing salt intake in people with type 2 diabetes mellitus (T2DM) lack clear evidence. Therefore, this review articles has been conducted.

Does dietary sodium restriction causally reduce blood pressure in patients with type 2 diabetes mellitus (T2DM)?

Study design:
This review article included 8 RCTs with 10 trials (7 cross-over and 3 parallel designs).
No publication bias was found from Begg's and Egger's tests.

Results and conclusions:
The investigators found compared with ordinary sodium intake, dietary sodium restriction significantly decreased 24-hour urine sodium level [WMD = -38.430 mmol/24h, 95% CI = -41.665 mmol/24h to -35.194 mmol/24h].

The investigators found dietary sodium restriction significantly lowered systolic blood pressure [WMD = -5.574 mm Hg, 95% CI = -8.314 to -2.834 mm Hg, I2 = 0.0%] and diastolic blood pressure [WMD = -1.675 mm Hg, 95% CI = -3.199 to -0.150 mm Hg, I2 = 0.0%].

The investigators concluded that dietary sodium restriction causally reduces systolic blood pressure and diastolic blood pressure in patients with type 2 diabetes mellitus (T2DM).

Original title:
Effect of dietary sodium restriction on blood pressure in type 2 diabetes: A meta-analysis of randomized controlled trials by Ren Y, Liqiang Qin L, […], Ma Y.

Link:
https://pubmed.ncbi.nlm.nih.gov/33838996/

Additional information of El Mondo:
Find more information/studies on sodium and diabetes right here.

Salt consists of sodium and chloride. So a dietary sodium restriction means a reduction in dietary salt intake.

A diet with dietary salt restriction is a diet with maximum 0.2 grams of salt per 100 kcal.

The easiest way to follow this diet is to choose only products/meals with maximum 0.2 grams of salt per 100 kcal. These products from the supermarket contain maximum 0.2 grams of salt per 100 kcal.

However, the most practical way to follow this diet is, all your daily consumed products/meals should contain on average maximum 0.2 grams of salt per 100 kcal.
To do this, use the 7-points nutritional profile app to see if your daily diet contains maximum 0.2 grams of salt per 100 kcal.

Objectives:
Evidence regarding associations between potato consumption and type 2 diabetes (T2D) and gestational diabetes mellitus (GDM) risks is accumulating. Therefore, this review article has been conducted.

Does a high potato intake increase type 2 diabetes and gestational diabetes mellitus (diabetes mellitus during pregnancy) risk?

Study design:
This review article included 19 studies (13 for type 2 diabetes and 6 for gestational diabetes mellitus) with a total of 21,357 type 2 diabetes cases among 323,475 participants and 1,516 gestational diabetes mellitus cases among 29,288 pregnancies.

Results and conclusions:
The investigators found meta-analysis showed a significantly increased risk of 19% [RR = 1.19, 95% CI = 1.06 to 1.34] for type 2 diabetes for total potato intakes among Western populations.

The investigators found meta-analysis showed a significantly increased risk of 8% [RR = 1.08, 95% CI = 1.00 to 1.16] for type 2 diabetes for baked/boiled/mashed potato intakes among Western populations.

The investigators found meta-analysis showed a significantly increased risk of 33% [RR = 1.33, 95% CI = 1.03 to 1.70] for type 2 diabetes for French fries/fried potato intakes among Western populations.

The investigators found dose-response meta-analysis demonstrated a significantly increased type 2 diabetes risk by 10% [95% CI = 1.07 to 1.14, p for trend 0.001], 2% [95% CI = 1.00 to 1.04, p for trend = 0.02] and 34% [95% CI = 1.24 to 1.46, p for trend 0.001] among Western populations for each 80 g/day (serving) increment in total potato, unfried potato and fried potato intakes, respectively.

The investigators found dose-response meta-analysis demonstrated a significantly increased gestational diabetes mellitus risk by 22% [95% CI = 1.06 to 1.42, p for trend 0.007] among Western populations for each 80 g/day (serving) increment in total potato intakes.

The investigators found dose-response meta-analysis demonstrated a significantly increased gestational diabetes mellitus risk by 26% [95% CI = 1.07 to 1.48, p for trend = 0.006] among Western populations for each 80 g/day (serving) increment in unfried potato intakes.

The investigators concluded that higher potato intake (at least 80g per day) is associated with higher type 2 diabetes risk among Western populations. The positive relationship presents a significant dose-response manner. Wisely controlled potato consumption may confer potential glucometabolic benefits.

Original title:
Dietary potato intake and risks of type 2 diabetes and gestational diabetes mellitus by Guo F, Zhang Q, [...], Ma L.

Link:
https://pubmed.ncbi.nlm.nih.gov/34130021/

Additional information of El Mondo:
Find more information/studies on potato intakes and diabetes right here.

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:
Does vitamin C supplementation improve triglyceride and cholesterol levels in patients with type 2 diabetes mellitus?

Study design:
This review article included 15 studies with 872 participants.

Results and conclusions:
The investigators found, findings from 15 studies indicated that vitamin C supplementation significantly decreased triglyceride (TG) levels [WMD= -16.48 mg/dL, 95% CI = -31.89 to -1.08, p 0.001] and total cholesterol (TC) levels [WMD = -13.00 mg/dL, 95% CI = -23.10 to -2.91, p 0.001] in patients with type 2 diabetes mellitus.

The investigators found, however, vitamin C supplementation failed to improve LDL (bad cholesterol) and HDL cholesterol (good cholesterol) levels. 

The investigators found the meta-regression analysis suggested that lipid profile improvement was affected by duration of vitamin C treatment.

The investigators found dose-response analysis showed that vitamin C supplementation changed LDL cholesterol significantly based on vitamin C dose.

The investigators concluded that vitamin C supplementation improves lipid profile via decreases in triglyceride and total cholesterol levels in patients with type 2 diabetes mellitus. It appears that vitamin C supplementation is more beneficial to lipid profile in long-term vs. short term interventions.

Original title:
Does vitamin C supplementation exert profitable effects on serum lipid profile in patients with type 2 diabetes? A systematic review and dose-response meta-analysis by Namkhah Z, Ashtary-Larky D, […], Asbaghi O.

Link:
https://pubmed.ncbi.nlm.nih.gov/33984490/

Additional information of El Mondo:
Find more information/studies on vitamine C, cholesterol and diabetes 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:
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 spirulina supplementation improve glycemic related markers (like, fasting blood glucose, post prandial blood sugar and HbA1c levels) and lipid profile (like, triglyceride and cholesterol levels) among type 2 diabetes patients?

Study design:
This review article included 8 RCTs (9 arms).

Results and conclusions:
The investigators found, spirulina supplementation significantly reduced fasting blood glucose levels [-17.88 mg/dL, 95% CI = -26.99 to -8.78, I2 = 25%] among type 2 diabetes patients.

The investigators found, spirulina supplementation significantly reduced triglyceride levels [-30.99 mg/dL, 95% CI = -45.20 to -16.77, I2 = 50%] among type 2 diabetes patients.

The investigators found, spirulina supplementation significantly reduced total cholesterol levels [-18.47 mg/dL, 95% CI = -33.54 to -3.39, I2 = 73%] among type 2 diabetes patients.

The investigators found, spirulina supplementation significantly reduced LDL cholesterol (bad cholesterol) levels [-20.04 mg/dL, 95% CI = -34.06 to -6.02, I2 = 75%] among type 2 diabetes patients.

The investigators found, spirulina supplementation significantly reduced VLDL cholesterol levels [-6.96 mg/dL, 95% CI = -9.71 to -4.22, I2 = 33%] among type 2 diabetes patients.

The investigators found, spirulina supplementation significantly increased HDL cholesterol (good cholesterol) levels among type 2 diabetes patients.

The investigators found no significant effect on HbA1C or post prandial blood sugar among type 2 diabetes patients following spirulina supplementation.

The investigators concluded that spirulina supplementation has beneficial effects on fasting blood glucose and blood lipid profiles among type 2 diabetes patients.

Original title:
The effect of spirulina on type 2 diabetes: a systematic review and meta-analysis by Hatami E, Ghalishourani SS, […], Mansour-Ghanaei F.

Link:
https://pubmed.ncbi.nlm.nih.gov/34178867/

Additional information of El Mondo:
Find more information/studies on lowering cholesterol levels and diabetes right here.

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:
Even though many studies have examined the possible effect of low-fat diet on breast cancer survival, the relationship remains unclear. Therefore, this review article has been conducted.

Does low-fat diet reduce risk of recurrence of breast cancer?

Study design:
This review article included 2 randomized controlled trials (RCTs) and 1 large multi-center prospective cohort study with 9,966 breast cancer patients.

Results and conclusions:
The investigators found post-diagnostic low-fat diet significantly reduced risk of recurrence of breast cancer by 23% [HR = 0.77, 95% CI = 0.63 to 0.94, p = 0.009] and all cause mortality of breast cancer by 17% [HR = 0.83, 95% CI = 0.69 to 1.00, p = 0.05].

The investigators concluded post-diagnostic low-fat diet reduces risk of recurrence of breast cancer. However, more trials of the relationship between low-fat diet and all-cause mortality of breast cancer are still needed.

Original title:
Effect of low-fat diet on breast cancer survival: a meta-analysis by Xing MY, Xu SZ and Shen P.

Link:
https://pubmed.ncbi.nlm.nih.gov/24606431/

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

A low-fat diet is a diet with maximum 30 En% fat and maximum 7 En% saturated fat.  
30 En% fat means that the amounts of fat contribute 30% to the total calories (kcal) of the diet.
If the diet contains 2000 kcal, 66.7 grams of fat contribute 30% to this 2000 kcal.
1 gram of fat gives 9 kcal. Thus, 66.7 grams of fat provide 600 kcal and 600 kcal is 30% of 2000 kcal.

The most easy way to follow a diet a diet with maximum 30 En% fat and maximum 7 En% saturated fat is to choose only meals/products with maximum 30 En% fat and maximum 7 En% saturated fat. Check here which products contain maximum 30 En% fat and maximum 7 En% saturated fat.

However, the most practical way to follow a diet with maximum 30 En% fat and maximum 7 En% saturated fat is, all meals/products that you eat on a daily basis should contain on average maximum 30 En% fat and maximum 7 En% saturated fat.

To do this, use the 7-points nutritional profile app to see whether your daily diet contains maximum 30 En% fat and maximum 7 En% saturated fat.

Objectives:
The influence of dietary fat upon breast cancer mortality remains largely understudied despite extensive investigation into its influence upon breast cancer risk. Therefore, this review article has been conducted.

Does higher total fat or saturated fat dietary intake increase risk of breast-cancer-specific death (breast cancer mortality) among women?

Study design:
This review article included 15 prospective cohort studies investigating total fat and/or saturated fat intake (g/day) and breast cancer mortality.

Results and conclusions:
The investigators found there was no difference in risk of breast-cancer-specific death [HR = 1.14, 95% CI = 0.86 to 1.52, p = 0.34, n = 6] or all-cause death [HR = 1.73, 95% CI = 0.82 to 3.66, p = 0.15, n = 4] for women in the highest versus lowest category of total fat dietary intake.
No difference because HR of 1 was found in the 95% CI of 0.82 to 3.66. HR of 1 means no risk/association.

The investigators found for the highest versus lowest category of saturated fat dietary intake, a significantly increased risk of 51% for breast-cancer-specific death among women [HR = 1.51, 95% CI = 1.09 to 2.09, p 0.01 n = 4].
Significant because HR of 1 was not found in the 95% CI of 1.09 to 2.09. HR of 1 means no risk/association.

The investigators concluded that higher saturated fat dietary intake increases risk of breast-cancer-specific death among women.

Original title:
Dietary fat and breast cancer mortality: A systematic review and meta-analysis by Brennan SF, Woodside JV, […], Cantwell MM.

Link:
https://pubmed.ncbi.nlm.nih.gov/25692500/

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

A diet high in saturated fat is a diet with more than 10 En% saturated fat.
The most easy way to follow a diet with more than 10 En% saturated fat is to choose only meals/products with more than 10 En% saturated fat. Check here which products contain more than 10 En% saturated fat.

However, the most practical way to follow a diet with more than 10 En% saturated fat is, all meals/products that you eat on a daily basis should contain on average more than 10 En% saturated fat.

To do this, use the 7-points nutritional profile app to see whether your daily diet contains more than 10 En% saturated fat.

However, a diet with more than 10 En% saturated fat is an unhealthy diet.

A diet low in saturated fat is a diet with maximum 7 En% saturated fat.
 

Objectives:
Systematic reviews of case-control studies evaluating the relationship between dietary salt intake and gastric cancer showed a positive association, however a quantitative analysis of longitudinal cohort studies is lacking. Therefore, this review article has been conducted.

Does a high salt intake increase gastric cancer risk?

Study design:
This review article contained 10 cohort studies with 268,718 participants, of which 1,474 gastric cancer events and a follow-up of 6-15 years.

Meta-regression analyses did not detect specific sources of heterogeneity.

There was no evidence of publication bias.

Results and conclusions:
The investigators found for high vs low salt intake a significantly increased risk of 68% for gastric cancer [RR = 1.68, 95% CI = 1.17 to 2.41, p = 0.005].

The investigators found for moderate vs low salt intake a significant increased risk of 41% for gastric cancer [RR = 1.41, 95% CI = 1.03 to 1.93, p = 0.032].

The investigators found the association was stronger in the Japanese population and higher consumption of selected salt-rich foods was also associated with greater risk.

The investigators concluded high salt intake is directly associated with an increased risk of gastric cancer in prospective population studies, with progressively increasing risk across consumption levels.

Original title:
Habitual salt intake and risk of gastric cancer: A meta-analysis of prospective studies by D’Elia L, Rossi G, […], Strazzullo P.

Link:
http://www.clinicalnutritionjournal.com/article/S0261-5614%2812%2900005-2/abstract

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

According to WHO, a high salt intake is a salt intake of more than 5 grams salt per day.

A diet with more than 5 grams salt per day is a diet with mainly products/meals with more than 0.25 grams salt per 100 kcal. Check here which products contain maximum 5 grams salt per 100 kcal.
Use the 7-points nutritional profile app to see whether your daily diet contains maximum 5 grams salt per 100 kcal.
 

Objectives:
Does grapes/grape products supplementation improve glycemic indices (like HOMA-IR, Hb1Ac and fasting insulin level) in adults or in other words, does eating grapes or grape products causally improve glycemic indices in adults?

Study design:
This review article included 29 RCTs with a total of 1,297 participants.

Results and conclusions:
The investigators found, overall, the grapes/grape products supplementation significantly reduced homeostatic model assessment of insulin resistance (HOMA-IR) [WMD = -0.54, 95% CI = -0.91 to -0.17, p = 0.004] in adults.   
Significantly because the calculated p-value of = 0.004 was less than the p-value of 0.05.

The investigators found, however, the grapes/grape products supplementation did not affect fasting insulin levels [WMD = -0.90 μIU/mL, 95% CI = -1.04 to 2.84, p = 0.362] and hemoglobin A1c (Hb1Ac) percentage [WMD = 0.00%, 95% CI = -0.10 to 0.11, p = 0.916] in the main analyses.
Did not affect because the calculated p-value of 0.916 was larger than the p-value of 0.05.

The investigators concluded that the grapes/grape products supplementation reduces homeostatic model assessment of insulin resistance (HOMA-IR) in adults. Further, large-scale RCTs with longer duration are required to confirm these results.

Original title:
The effect of grapes/grape products on glycemic response: A systematic review and meta-analysis of randomized controlled trials by Moodi V, Abedi S, […], Miraghajani M.

Link:
https://pubmed.ncbi.nlm.nih.gov/33893683/

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

Homeostatic model assessment of insulin resistance (HOMA-IR) is a method for assessing β-cell function and insulin resistance (IR) from basal (fasting) glucose and insulin or C-peptide concentrations. HOMA-IR is an indicator of insulin resistance in diabetic patients. The higher the value, the more resistant you are to insulin. Diabetic patients often have a high HOMA-IR value.

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/

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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/

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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.

Objectives:
Does chromium supplementation improve lipid profile (serum levels of triglyceride and cholesterol) in patients with type 2 diabetes mellitus (T2DM)?

Study design:
This review article included  24 RCTs (with 28 effect sizes).

Results and conclusions:
The investigators found that chromium supplementation resulted in a significant decrease in serum levels of triglyceride (TG) in patients with type 2 diabetes mellitus [MD = -6.54 mg/dL, 95 % CI = -13.08 to -0.00, p = 0.050].
Significant means that there is an association with a 95% confidence.

The investigators found that chromium supplementation resulted in a significant decrease in serum levels of total cholesterol (TC) in patients with type 2 diabetes mellitus [WMD = -7.77 mg/dL, 95 % CI = -11.35 to -4.18, p 0.001].

The investigators found that chromium supplementation significantly increased high-density lipoprotein cholesterol (HDL cholesterol or good cholesterol) in patients with type 2 diabetes mellitus [WMD = 2.23 mg/dL, 95 % CI = 0.07 to 4.40, p = 0.043] level.

The investigators found, however, chromium supplementation did not have significant effects on low-density lipoprotein cholesterol (LDL cholesterol or bad cholesterol) in patients with type 2 diabetes mellitus [WMD = -8.54 mg/dL, 95 % CI = -19.58 to 2.49, p = 0.129] level.

The investigators concluded that chromium supplementation decreases serum levels of triglyceride (TG) and total cholesterol (TC) and increases HDL cholesterol (good cholesterol) levels in patients with type 2 diabetes mellitus. It should be noted that the lipid-lowering properties of chromium supplementation are small and may not reach clinical importance.

Original title:
Effects of chromium supplementation on lipid profile in patients with type 2 diabetes: A systematic review and dose-response meta-analysis of randomized controlled trials by Asbaghi O, Naeini F, […], Naeini AA.

Link:
https://pubmed.ncbi.nlm.nih.gov/33813266/

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Objectives:
Does mushroom dietary intake reduce risk of cancer at any site?

Study design:
This review article included 11 case-control studies and 6 cohort studies.

Results and conclusions:
The investigators found higher mushroom consumption significantly reduced total cancer with 34% [pooled RR for the highest compared with the lowest consumption groups = 0.66, 95% CI = 0.55 to 0.78, n = 17].

The investigators found higher mushroom consumption significantly reduced breast cancer with 35% [pooled RR for the highest compared with the lowest consumption groups = 0.65, 95% CI = 0.52 to 0.81, n = 10].

The investigators found higher mushroom consumption significantly reduced nonbreast cancer with 20% [pooled RR for the highest compared with the lowest consumption groups = 0.80, 95% CI = 0.66 to 0.97, n = 13].

The investigators found there was evidence of a significant nonlinear dose-response association between mushroom consumption and the risk of total cancer [p-nonlinearity = 0.001, n = 7].

The investigators concluded higher mushroom consumption reduces risk of cancer, particularly breast cancer.

Original title:
Higher Mushroom Consumption Is Associated with Lower Risk of Cancer: A Systematic Review and Meta-Analysis of Observational Studies by Ba DM, Ssentongo P, […], Richie JP.

Link:
https://pubmed.ncbi.nlm.nih.gov/33724299/

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Objectives:
Controversial results of the association between green tea consumption and risk for esophageal cancer (EC) were reported by previous meta-analysis. Therefore, this review article (meta-analysis) has been conducted.

Does green tea consumption reduce esophageal cancer risk?

Study design:
This review article included 14 studies with a total of 5,057 esophageal cancer cases among 493,332 participants.

Results and conclusions:
The investigators found in the dose-response analysis, no association for a 1 cup/d increase in green tea and esophageal cancer risk [the summary OR = 1.00, 95% CI = 0.95 to 1.04, I2 = 77%].

The investigators found no nonlinearity association was observed between tea consumption and risk for esophageal cancer [p = 0.71 for nonlinearity].

The investigators found in the subgroup analysis of sex, a significantly reduced risk of 21% for esophageal cancer among women for a 1 cup/d increase in green tea [summary OR = 0.79, 95% CI = 0.68 to 0.91, I2 = 0%].
However, this reduced risk was not found for men [summary OR for a 1 cup/d increase in green tea = 1.03, 95% CI = 0.95 to 1.11, I2 = 67%].
Significant because OR of 1 was not found in the 95% CI of 0.68 to 0.91. OR of 1 means no risk/association.

The investigators concluded that a 1 cup/d increase in green tea consumption reduces esophageal cancer among women. Notably, these findings might be influenced by limited studies and potential bias, such as dose of green tea assessment and select bias of case-control studies. Further larger number, prospective and well-designed larger-scale studies are needed to provide more precise evidence, especially in women and more regions (United States and Europe).

Original title:
Green tea consumption and risk for esophageal cancer: A systematic review and dose-response meta-analysis by Zhao H, Mei K, […], Lixia Xie L.

Link:
https://pubmed.ncbi.nlm.nih.gov/33744644/

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Objectives:
Does L-arginine supplementation improve biomarkers (fasting blood sugar, insulin, HbA1c and HOMA-IR values) of glycemic control in adults?

Study design:
This review article included 12 randomised clinical trials (RCTs).

Results and conclusions:
The investigators found L-arginine supplementation had no significant effect on serum fasting blood sugar (FBS) [weighted mean difference (WMD) = -3.38 mg/dL, 95% CI = -6.79 to 0.04, p = 0.53], serum insulin [WMD = -0.12 Hedges' g, 95% CI = -0.33 to 0.09, p = 0.27], glycated haemoglobin A1c (HbA1c) [WMD = -0.04%, 95% CI = -0.25 to 0.17, p = 0.71] and homeostasis model assessment for insulin resistance (HOMA-IR) [WMD = -0.48, 95% CI = -1.15 to 0.19, p = 0.15].
No significant because the calculated p-value of 0.15 was larger than the p-value of 0.05.

The investigators concluded although several animal studies have proposed that L-arginine supplementation might improve blood glucose control, the present review article could not confirm this benefit in humans.

Original title:
Effects of L-arginine supplementation on biomarkers of glycemic control: a systematic review and meta-analysis of randomised clinical trials by Karimi E, Hatami E, […], Askari G.

Link:
https://pubmed.ncbi.nlm.nih.gov/33426939/

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Find more information/studies on L-arginine and diabetes right here.

Arginine is classified as a semiessential or conditionally essential amino acid, depending on the developmental stage and health status of the individual, that helps the body build protein. L-arginine is also found in most protein-rich foods, including fish, red meat, poultry, soy, whole grains, beans and dairy products.
 

Objectives:
The etiology of cancer type may vary significantly due to anatomy, embryology and physiology of the cancer site. Although the association between potato consumption and colorectal cancer (CRC) was summarized in a 2018 meta-analysis of 5 cohort studies, however, no meta-analysis has evaluated potato consumption in relation to multiple cancer sites in adults. Therefore, this review article has been conducted.

Do potato intakes increase multiple cancer sites risk?

Study design:
This review article included 20 prospective cohort studies (with a total of 785,348 participants, of which 19,882 incident cases (persons with cancer)) and 36 case-control studies ( with a total of 21,822 cases (persons with cancer) and 66,502 controls (persons without cancer)).

Certainty of the evidence was low for total cancer, colorectal cancer, colon, rectal, renal, pancreatic, breast, prostate and lung cancer and very low for gastric and bladder cancer.

Results and conclusions:
The investigators found among cohort studies, no association between high versus low intake of total potato (white and yellow) consumption and overall cancers [RR = 1.04, 95% CI = 0.96 to 1.11, tau2 = 0.005, n = 18].

The investigators found no relation between total potato consumption (high compared with low intake) and risk of colorectal, pancreatic, colon, gastric, breast, prostate, kidney, lung or bladder cancer in cohort or case-control studies.

The investigators found no association between high versus low consumption of potato preparations (boiled/fried/mashed/roasted/baked) and risk of gastrointestinal-, sex-hormone-, or urinary-related cancers in cohort or case-control studies.

The investigators concluded that potato intakes or potato preparations are not associated with multiple cancer sites when comparing high and low intake categories. This finding is consistent with the findings from the 2018 meta-analysis regarding potato intake and risk of colorectal cancer.

Original title:
Potato Consumption and Risk of Site-Specific Cancers in Adults: A Systematic Review and Dose-Response Meta-Analysis of Observational Studies by Mofrad MD, Mozaffari H, […], Azadbakht L.

Link:
https://pubmed.ncbi.nlm.nih.gov/33861304/

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Objectives:
Does garlic supplementation reduce adiponectin and leptin serum levels?

Study design:
This review article included 5 RCTs.

Results and conclusions:
The investigators found that garlic supplementation did not significantly affect adiponectin [Hedges's = 0.20, 95% CI = -0.06 to 0.47, p = 0.12] and leptin [Hedges's = 0.08, 95% CI = -0.26 to 0.41, p = 0.65] concentrations in comparison with placebo.

The investigators found, however, in the subgroup analysis, significantly increased serum adiponectin level was seen following garlic supplementation in trials with a mean age of participants ˂30 years [Hedges's = 0.44, 95% CI = 0.01 to 0.87, p = 0.04], the doses ˂1.5 g/day [Hedges's = 0.38, 95% CI = 0.02 to 0.71, p = 0.04] and trials with duration ≥8 weeks [Hedges's = 0.48, 95% CI = 0.08 to 0.89, p = 0.02].

The investigators concluded that ˂1.5 g/day garlic supplementation during ≥8 weeks reduces adiponectin level among participants ˂30 years.

Original title:
Systematic review and meta-analysis of randomized, controlled trials on the effects of garlic supplementation on serum adiponectin and leptin levels by Shekarchizadeh-Esfahani P, Hassani B, […], Soraya N.

Link:
https://pubmed.ncbi.nlm.nih.gov/33792129/

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Find here more information/studies about review article/significant and garlic.

Adiponectin is a fat-derived hormone that appears to play a crucial role in protecting against insulin resistance/diabetes and atherosclerosis (atherosclerosis is the dominant cause of cardiovascular disease (CVD)). Decreased adiponectin levels are thought to play a central role in the development of obesity, cardiovascular disease and type 2 diabetes in humans.

Objectives:
Previous meta-analyses, with some methodological controversies, have assessed the relation between nut consumption and type 2 diabetes (T2D) risk and pointed to contradictory results. Therefore, this review article has been conducted.

Does nut consumption reduce risk of type 2 diabetes?

Study design:
This review article included 5 prospective cohort studies and 3 cross-sectional studies.
The certainty of the evidence using NutriGrade was very low for all the exposures.

Results and conclusions:
The investigators found meta-analyses of cross-sectional studies and prospective cohort studies, comparing the highest with the lowest categories, revealed a nonsignificant association between total nut consumption and type 2 diabetes.
Nonsignificant means that there is no association with a 95% confidence.

The investigators found meta-analyses of prospective cohort studies showed that peanut butter consumption significantly reduced type 2 diabetes incidence with 13% [RR = 0.87, 95% CI = 0.77 to 0.98, I2 = 50.6%, p = 0.16], whereas no association was observed between peanuts or tree nuts and type 2 diabetes.

The investigators found there was no evidence of a linear dose-response or nonlinear dose-response gradient for total nut and peanut consumption in prospective cohort studies.

The investigators concluded peanut butter consumption may reduce type 2 diabetes incidence. May reduce because the certainty of the evidence using NutriGrade was very low.

Original title:
Nut consumption and type 2 diabetes risk: a systematic review and meta-analysis of observational studies by Becerra-Tomás N, Paz-Graniel I, […], Salas-Salvadó J.

Link:
https://pubmed.ncbi.nlm.nih.gov/33471083/

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