Nutrition and health

Objectives:
Many studies have investigated the association between dietary iron intake and death due to cardiovascular disease (CVD), but the results were inconsistent. Therefore, this review article has been conducted.

Does dietary iron intake increase risk of death due to cardiovascular disease (cardiovascular disease mortality)?

Study design:
This review article included 19 prospective cohort studies including 720,427 participants (46,045 deaths due to cardiovascular disease).

Results and conclusions:
The investigators found when comparing the highest versus lowest level, the highest level of dietary heme iron intake significantly increased risk of death due to cardiovascular disease with 19% [pooled RR = 1.19, 95% CI = 1.01-1.39].

The investigators found every 1-mg/day increase in dietary heme iron intake significantly increased risk of death due to cardiovascular disease with 25% [pooled RR = 1.25, 95% CI = 1.17-1.33].

The investigators found every 1-mg/day increase in dietary heme iron intake significantly increased risk of death due to stroke with 17% [pooled RR = 1.17, 95% CI = 1.04-1.32].

The investigators found the association between dietary iron intake and cardiovascular disease mortality was linear [p nonlinearity > 0.05].

The investigators concluded higher dietary intake of heme iron (at least 1-mg/day) is associated with a greater risk of cardiovascular disease mortality. Therefore, reducing consumption of heme iron may help to prevent premature death due to cardiovascular disease.

Original title:
Dietary iron intake and risk of death due to cardiovascular diseases: A systematic review and dose-response meta-analysis of prospective cohort studies by Han M, Guan L, […], Lu J.

Link:
https://pubmed.ncbi.nlm.nih.gov/32674239/

Additional information of El Mondo:
Find more information/studies on significant/cohort studies, iron consumption and cardiovascular disease right here.

Food items of heme iron are:

• Beef or chicken liver
• Beef
• Canned light tuna
• Canned sardines
• Organ meats
• Oysters, clams, mussels
• Poultry

Objectives:
Previous studies lack consistent conclusions as to whether astaxanthin is actually linked to various health benefits as claimed. Therefore, this review article has been conducted.

Is there a causal relationship between astaxanthin consumption and improvements in risk factors for diabetes or cardiovascular disease?

Study design:
This review article included 14 RCTs.

Results and conclusions:
The investigators found that astaxanthin consumption was not associated with FBS, HbA1c, TC, LDL-C, TG, BMI, BW, DBP and SBP.

The investigators found that astaxanthin consumption was associated with an increase in HDL cholesterol levels [WMD = 1.473 mg/dL, 95% CI = 0.319 to 2.627, p = 0.012].

The investigators found that astaxanthin consumption during ≥12 weeks was associated with a decrease in CRP levels [WMD = -0.528 mg/L, 95% CI = -0.990 to -0.066].

The investigators found that >12 mg/day astaxanthin consumption was associated with a decrease in CRP levels [WMD = -0.389 mg/dL, 95% CI = -0.596 to -0.183].

The investigators concluded that astaxanthin consumption is causally associated with an increase in HDL cholesterol levels (good cholesterol) and a decrease in CRP levels for >12 mg/day astaxanthin consumption during ≥12 weeks. Significant associations are not observed for other outcomes.

Original title:
The effects of astaxanthin supplementation on obesity, blood pressure, CRP, glycemic biomarkers, and lipid profile: A meta-analysis of randomized controlled trials by Xia W, Tang N, [...], Zhu Y.

Link:
https://pubmed.ncbi.nlm.nih.gov/32755613/

Additional information of El Mondo:
Find here more information/studies about astaxanthin consumption and cholestrerol.

Objectives:
Type 1 diabetes mellitus (T1DM) causes the irreversible destruction of pancreatic beta cells. The Bacillus Calmette-Guerin (BCG) vaccine can modulate the immune response and decelerate disease progression. Therefore, this review article has been conducted.

Do patients with type 1 diabetes mellitus benefit from the Bacillus Calmette-Guerin (BCG) vaccine?

Study design:
This review article included 4 RCTs. The sample sizes ranged from 6 to 94, with a total of 198 subjects. The mean age of the examinees ranged from 10.1 to 36.0 years and the follow-up duration ranged from 1 to 8 years.

Results and conclusions:
The investigators found the pooled meta-analysis demonstrated no significant difference in HbA1c levels [MD = -0.12, 95% CI = -0.53 to 0.30, I2 = 56%] or fasting C-peptide levels [MD = -0.15, 95% CI = -0.35 to 0.06, I2 = 0%] in the BCG intervention group as compared with that in the placebo group.
The results remained unchanged after removing each study in the sensitivity analysis.

The investigators concluded there is no robust evidence to support the use of the Bacillus Calmette-Guerin (BCG) vaccine for the treatment of type 1 diabetes mellitus although the HbA1c levels tend to improve. Additional RCTs to assess the long-term effects of the Bacillus Calmette-Guerin (BCG) vaccine on glycemic control are warranted.

Original title:
Therapeutic Effects of BCG Vaccination on Type 1 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials by Chang YC, Lin CJ, […], Hsu HY.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7139880/

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

Objectives:
Dyslipidemia is a common metabolic disease worldwide and also an important predisposing factor for cardiovascular diseases (CVDs). Coffee is loved by people all over the world; however, the association between coffee consumption and blood lipids has yielded inconsistent results. Therefore, this review article has been conducted.

Is there a causal relationship between coffee consumption and dyslipidemia?

Study design:
This review article included 12 RCTs.

Results and conclusions:
The investigators found pooled results showed that coffee consumption significantly increased total cholesterol (TC) levels [WMD = 0.21 mmol/L, 95% CI = 0.04 to 0.39, p = 0.017].  
Significant means that there is an association with a 95% confidence.

The investigators found pooled results showed that coffee consumption significantly increased triglyceride (TG) levels [WMD = 0.12 mmol/L, 95% CI = 0.03 to 0.20, p = 0.006].  
Significant because the calculated p-value of 0.006 was less than the p-value of 0.05.

The investigators found pooled results showed that coffee consumption significantly increased LDL cholesterol (bad cholesterol) levels [WMD = 0.14 mmol/L, 95% CI = 0.05 to 0.24, p = 0.003].  

The investigators found pooled results showed that coffee consumption had no significant effect on HDL cholesterol (good cholesterol) levels [WMD = -0.01 mmol/L, 95% CI = -0.06 to 0.04, p = 0.707].
No significant means that there is no association with a 95% confidence.

The investigators found dose-response analysis results revealed significant positive nonlinear associations between coffee consumption and the increase in total cholesterol, LDL cholesterol and triglyceride levels.

The investigators concluded that coffee consumption is associated with an elevated risk for dyslipidemia and cardiovascular diseases. So a reasonable habit of coffee consumption (3 cups/d) is essential for the prevention of dyslipidemia.  

Original title:
Effect of coffee consumption on dyslipidemia: A meta-analysis of randomized controlled trials by Du Y, Lv Y, […], Luo Q.

Link:
https://pubmed.ncbi.nlm.nih.gov/33239163/

Additional information of El Mondo:
Find more information/studies on significant/RCTs/causal relationship, coffee consumption, lowering cholesterol levels and cardiovascular disease right here.

Dyslipidemia is elevation of plasma cholesterol, triglycerides (TGs), or both, or a low HDL cholesterol (good cholesterol) level that contributes to the development of atherosclerosis. Atherosclerosis is the main underlying cause of cardiovascular disease (CVD).

Objectives:
Does fish consumption reduce risk of coronary heart disease (CHD), stroke and all-cause mortality in patients with type 2 diabetes (T2D)?

Study design:
This review article included 9 prospective cohort studies with 57,394 diabetic patients.

Results and conclusions:
The investigators found for the highest compared with the lowest category of fish consumption, a significantly reduced risk of 14% [relative risk = 0.86, 95% CI = 0.76 to 0.96, I2 = 50%, n = 8] for all-cause mortality in patients with type 2 diabetes.

The investigators found for the highest compared with the lowest category of fish consumption, a significantly reduced risk of 39% [relative risk = 0.61, 95% CI = 0.29 to 0.93, I2 = 68%, n = 3] for coronary heart disease in patients with type 2 diabetes.

The investigators found there was a monotonic inverse association, with a nadir at fish consumption of approximately 2-3 servings/week, in both analyses.

The investigators concluded 2-3 servings/week of fish consumption reduce risk of all-cause mortality and coronary heart disease in patients with type 2 diabetes.

Original title:
Fish consumption and the risk of cardiovascular disease and mortality in patients with type 2 diabetes: a dose-response meta-analysis of prospective cohort studies by Jayedi A, Soltani S, […], Shab-Bidar S.

Link:
https://pubmed.ncbi.nlm.nih.gov/32410513/

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

Objectives:
Dietary sodium intake has received considerable attention as a potential risk factor of cardiovascular disease. However, evidence on the dose-response association between dietary sodium intake and cardiovascular disease risk is unclear. Therefore, this review article has been conducted.

Is there a dose-response association between dietary sodium intake and cardiovascular disease (CVD) risk?

Study design:
This review article included 36 cohort studies with a total of 616,905 participants.
The duration of follow-up ranged from 2.7 years to 29 years.

For dietary sodium intake assessment, 18 of the studies were based on twenty-four urinary excretion, 7 used food frequency questionnaires, 8 used 24 h dietary recall, 2 used dietary records; 1 used a self-administered questionnaire and 1 used single spot urine sodium excretion.
The daily dietary sodium intake ranged from 1.0 to 7.5 g.

The mean score (± standard deviation) for the quality of the included studies was 8.0 ± 1.0 according to the Newcastle-Ottawa Scale.

Results and conclusions:
The investigators found compared with individuals with low sodium intake, individuals with high sodium intake had an 19%-higher adjusted risk of cardiovascular disease [rate ratio = 1.19, 95% CI = 1.08 to 1.30].

The investigators found in dose-response meta-analysis that the risk of cardiovascular disease significantly increased by 6% when 1 g dose of sodium was ingested [rate ratio = 1.06, 95% CI = 1.01 to 1.11].

The investigators concluded that high sodium intake is an important risk factor of cardiovascular disease (CVD) and in dose-response meta-analysis, every 1 g of dietary sodium intake increases the risk of cardiovascular disease by 6%.

Original title:
Dietary Sodium Intake and Risk of Cardiovascular Disease: A Systematic Review and Dose-Response Meta-Analysis by Wang YJ, Yeh TL, [...], Chien KL.

Link:
https://www.mdpi.com/2072-6643/12/10/2934/htm

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

1 gram salt (sodium chloride) = 0.4 gram sodium.

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

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

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

No evidence of publication bias was found.

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

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

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

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

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

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

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

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

Additional information of El Mondo:
Find more information/studies/nutritional advices on fish consumption and coronary heart disease right here.

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

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

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

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

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

There was no significant publication bias.

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

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

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

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

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

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

Additional information of El Mondo:
Find more information/studies on cholesterol, vitamin B3 and diabetes right here.
 

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

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

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

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

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

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

There was no evidence of publication bias.

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

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

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

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

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

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

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

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

Additional information of El Mondo:
Find more information/studies on vitamin B6, folate and lowering of stroke right here.

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

Does a high serum vitamin C reduce blood pressure?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

None of the studies reported any side effects.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The investigators concluded barberry supplementation improves insulin levels.

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

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

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

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

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

Study design:
This review article included 8 clinical trials.

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

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

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

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

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

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

Additional information of El Mondo:
Find more information/studies on subgroup analysis/significant and soja consumption right here.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

No heterogeneity was found among included studies.

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

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

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

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

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

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

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

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

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

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

The mean duration of all eligible studies was 10.7 years.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Objectives:
Does Alzheimer disease increase risk of stroke?

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

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

The investigators concluded Alzheimer disease increases risk of hemorrhagic stroke.

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

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

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Find more information/studies on Alzheimer disease right here.

Objectives:
Is there a causal relationship between strawberry consumption and positive effects on cardiovascular risk factors?
 
Study design:
This review article included 11 RCTs (6 for blood pressure, 7 for lipid profile, 7 for fasting blood glucose and 6 for C-reactive protein).

There was little evidence of heterogeneity in the analysis and no evidence of publication bias.

Results and conclusions:
The investigators found overall, strawberry consumption significantly reduced C-reactive protein (CRP) levels by 0.63 mg/L [95% CI = -1.04 to -0.22] but did not affect blood pressure, lipid profile or fasting blood glucose in the main analyses.

The investigators found stratified by baseline endpoint levels, that strawberry consumption significantly reduced total cholesterol levels among people with baseline levels >5 mmol/L [-0.52 mmol/L, 95% CI = -088 to -0.15] and reduced LDL-cholesterol levels among people with baseline levels >3 mmol/L [-0.31 mmol/L, 95% CI = -0.60 to -0.02].

The investigators concluded strawberry consumption reduces C-reactive protein (CRP) levels and improves total cholesterol and LDL-cholesterol (bad cholesterol) in individuals with high baseline levels (level at the beginning of the study).

Original title:
Effects of strawberry intervention on cardiovascular risk factors: a meta-analysis of randomized controlled trials by Gao Q, Qin LQ, […], Dong JY.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32238201

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

Objectives:
Is there an association between total meat, red meat, processed meat, poultry and fish intake and risk of type 2 diabetes (T2D)?

Study design:
This review article included 28 prospective cohort studies.

Results and conclusions:
The investigators found when compared with the lowest category, the highest category of total meat intake, significantly increased risk of type 2 diabetes with 33% [summary relative risk = 1.33, 95% CI = 1.16 to 1.52].
Significantly means that there is an association with a 95% confidence.

The investigators found when compared with the lowest category, the highest category of red meat intake, significantly increased risk of type 2 diabetes with 22% [summary relative risk = 1.22, 95% CI = 1.16 to 1.28].
Significantly because summary relative risk of 1 was not found in the 95% CI of 1.16 to 1.28. Summary relative risk of 1 means no risk/association.

The investigators found when compared with the lowest category, the highest category of processed meat intake, significantly increased risk of type 2 diabetes with 25% [summary relative risk = 1.25, 95% CI = 1.13 to 1.37].
Significantly means it can be said with a 95% confidence that the highest category of processed meat intake really increased risk of type 2 diabetes with 25%.

The investigators found no association between highest category of poultry intake and risk of type 2 diabetes [summary relative risk = 1.00, 95% CI = 0.93 to 1.07].
No association because summary relative risk of 1 was found in the 95% CI of 0.93 to 1.07. Summary relative risk of 1 means no risk/association.

The investigators found no association between highest category of fish intake and risk of type 2 diabetes [summary relative risk = 1.01, 95% CI = 0.93 to 1.10].

The investigators found in the dose-response analysis, each additional 100g/day of total and red meat and 50g/day of processed meat, were found to be associated with a 36% [95% CI = 1.23 to 1.49], 31% [95% CI = 1.19 to 1.45] and 46% [95% CI = 1.26 to 1.69] increased risk of type 2 diabetes, respectively.

The investigators found, in addition, there was evidence of a non-linear dose-response association between processed meat and type 2 diabetes [p = 0.004], with the risk increasing by 30% with increasing intakes up to 30g/day.

The investigators concluded 100g/day of total meat, 100g/day red meat and 50g/day of processed meat, increase risk of type 2 diabetes.

Original title:
Meat and fish intake and type 2 diabetes: dose-response meta-analysis of prospective cohort studies by Yang X, Li Y, […], Li L.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32302686

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

Objectives:
Does fish consumption decrease risk of cardiovascular disease, depression, mortality and cancer?
 
Study design:
This review article included a total of 34 meta-analyses of prospective observational studies, reporting summary relative risks (SRR) for 40 different outcomes obtained from 298 primary prospective cohort studies.

The summary relative risk (SRR) for each meta-analysis was recalculated by using a random-effects model.

Results and conclusions:
The investigators found moderate-quality evidence showed that each 100-g/d increment in fish consumption was associated with a 8% lower risk of all-cause mortality [SRR = 0.92, 95% CI = 0.87 to 0.97].

The investigators found moderate-quality evidence showed that each 100-g/d increment in fish consumption was associated with a 25% lower risk of cardiovascular mortality [SRR = 0.75, 95% CI = 0.65 to 0.87].

The investigators found moderate-quality evidence showed that each 100-g/d increment in fish consumption was associated with a 12% lower risk of coronary heart disease [SRR = 0.88, 95% CI = 0.79 to 0.99].

The investigators found moderate-quality evidence showed that each 100-g/d increment in fish consumption was associated with a 25% lower risk of myocardial infarction [SRR = 0.75, 95% CI = 0.65 to 0.93].

The investigators found moderate-quality evidence showed that each 100-g/d increment in fish consumption was associated with a 14% lower risk of stroke [SRR = 0.86, 95% CI = 0.75 to 0.99].

The investigators found moderate-quality evidence showed that each 100-g/d increment in fish consumption was associated with a 20% lower risk of heart failure [SRR = 0.80, 95% CI = 0.67 to 0.95].

The investigators found moderate-quality evidence showed that each 100-g/d increment in fish consumption was associated with a 12% lower risk of depression [SRR = 0.88, 95% CI = 0.79 to 0.98].

The investigators found moderate-quality evidence showed that each 100-g/d increment in fish consumption was associated with a 35% lower risk of liver cancer [SRR = 0.65, 95% CI = 0.48 to 0.87].

The investigators concluded evidence of moderate quality shows that 100-g/d fish consumption is associated with a lower risk of cardiovascular disease, depression, mortality and liver cancer and therefore, can be considered as a healthy animal-based dietary source of protein. Further research is needed for outcomes for which the quality of the evidence was rated low and very low, considering types of fish consumed, different methods of cooking fish and all potential confounding variables.

Original title:
Fish Consumption and the Risk of Chronic Disease: An Umbrella Review of Meta-Analyses of Prospective Cohort Studies by Jayedi A and Shab-Bidar S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32207773

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Objectives:
Do fermented dairy foods and probiotics supplementation improve risk factors (such as metabolic syndrome, type 2 diabetes, cholesterol) of cardiovascular diseases?

Study design:
This review article included 20 prospective cohort studies and 52 RCTs.

Results and conclusions:
The investigators found in prospective cohort studies, that fermented milk was associated with a 4% reduction in risk of stroke, ischemic heart disease and cardiovascular mortality [RR = 0.96, 95% CI = 0.94 to 0.98].

The investigators found in prospective cohort studies, that yogurt intake was associated with a risk reduction of 27% [RR = 0.73, 95% CI = 0.70 to 0.76] for type 2 diabetes.

The investigators found in prospective cohort studies, that yogurt intake was associated with a risk reduction of 20% [RR = 0.80, 95% CI = 0.74 to 0.87] for metabolic syndrome development.

The investigators found in RCTs, that probiotic supplementation added into dairy matrices produced a greater reduction in lipid biomarkers than when added into capsules/powder in hypercholesterolemic subjects.

The investigators found in RCTs, that probiotic supplementation by capsules/powder produced a greater reduction in type 2 diabetes biomarkers than when added into dairy matrices in diabetic subjects.

The investigators found in RCTs, that probiotic supplementation by both treatments (dairy matrix and capsules/powder) resulted in a significant reduction in anthropometric parameters in obese subjects.

The investigators concluded fermented milk consumption is associated with reduced cardiovascular risk, while yogurt intake is associated with a reduced risk of type 2 diabetes and metabolic syndrome development in the general population. Furthermore, probiotic supplementation added into dairy matrices is beneficial for lowering lipid concentrations and reduce anthropometric parameters. Additionally, probiotic capsule/powder supplementation contributes to type 2 diabetes management and reduces anthropometric parameters. However, these results should be interpreted with caution due to the heterogeneity of the studies and the different probiotic strains used in the studies.

Original title:
Fermented Dairy Products, Probiotic Supplementation, and Cardiometabolic Diseases: A Systematic Review and Meta-analysis by Companys J, Pla-Pagà L, […], Valls RM.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32277831

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Find more information/studies on probiotic, diabetes, overweight and cardiovascular disease right here.