Nutrition and health

Objectives:
The association between dietary protein intake and type 2 diabetes risk has been inconsistent in the previous epidemiological studies. Therefore, this review article (meta-analysis) has been conducted.

Is there an association between dietary protein intake and type 2 diabetes risk?

Study design:
This review article included 10 prospective cohort studies with a total of 34,221 type 2 diabetes cases.
No publication bias was detected.

Results and conclusions:
The investigators found after adjustment of potential confounders, a 5% of energy (5 En%) increment from dietary total protein intake was related to a significantly 9% [95 CI = 1.04-1.13, I2 = 42.0%] higher risk of type 2 diabetes. The results were robust in sensitivity analysis.

The investigators found after adjustment of potential confounders, a 5% of energy (5 En%) increment from dietary animal protein intake was related to a significantly 12% [95 CI = 1.08-1.17, I2 = 14.0%] higher risk of type 2 diabetes. The results were robust in sensitivity analysis.

The investigators found after adjustment of potential confounders, a significant U-shaped curve was observed for plant protein intake with the most risk reduction at about 6% of energy from plant protein intake [p nonlinearity = 0.001]. The results were robust in sensitivity analysis.

The investigators concluded that the consumption of protein, particularly animal protein increases risk of type 2 diabetes.

Original title:
Dietary protein intake and risk of type 2 diabetes: a dose-response meta-analysis of prospective studies by Zhao LG, Zhang QL, [...], Xiang YB.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29858629

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

 

Objectives:
The association between coffee consumption and the level of C-reactive protein (CRP) has been evaluated in several epidemiological studies with conflicting results. Therefore, this meta-analysis (systematic review) has been conducted.

Does coffee consumption reduce level of C-reactive protein in humans?

Study design:
This review article included a total of 9 cross-sectional studies.

Results and conclusions:
The investigators found according to the combined standard mean difference (SMD) between the highest and the lowest coffee intake category, coffee consumption was associated with a significantly lower level of serum CRP level [SMD = -0.34, 95% CI = -0.62 to -0.06, p = 0.016].

The investigators found subgroup analysis for CRP marker showed that coffee consumption was associated with a significantly lower level of serum high-sensitivity CRP (hsCRP) [SMD = -0.51, 95% CI = -0.88 to -0.14, p = 0.007], but not standard CRP [SMD = 0.02, 95% CI = -0.28 to 0.32, p = 0.913].

The investigators concluded that coffee consumption is associated with a lower level of serum CRP, particularly serum high-sensitivity CRP. However, more well-designed prospective cohort studies are needed to elaborate the concerned issues further.

Original title:
Is coffee consumption associated with a lower level of serum C-reactive protein? A meta-analysis of observational studies by Zhang Y and Zhang DZ.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29405789

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

 

Objectives:
Epidemiological studies exploring the role of flavonoids intake in preventing type 2 diabetes mellitus (T2DM) showed inconsistent results. Therefore, this review article (meta-analysis) has been conducted.

Does flavonoids intake decrease risk of developing type 2 diabetes?

Study design:
This review article included 10 independent cohorts published between 2002 and 2017 with a total of 312,015 participants, of which 19,953 type 2 diabetes cases were identified during the follow-up periods from 4 to 28 years.
All participants were free of type 2 diabetes at baseline (at the beginning of the study), with age ranging from 28 to 75 years.
Dietary flavonoids intake was evaluated using food-frequency questionnaire and type 2 diabetes was frequently ascertained through medical records.
In the original studies, the median intake level of total flavonoids was 8.9 to 501.8 mg/day for the lowest categories and 33.2 to 1452.3 mg/day for the highest categories.
The most commonly adjusted variables included age, sex, total energy intake, body mass index, smoking, alcohol consumption and physical activity.
All included studies had a NOS score of ≥7, with an average score of 7.9, indicating the presence of high methodological quality.

There was no indication of publication bias from visual inspection of the funnel plot, which was further confirmed by Egger test [p = 0.253].

Results and conclusions:
The investigators found when compared with the lowest intake, the highest intake of total flavonoids was associated with a significantly 9% decreased risk of type 2 diabetes [RR = 0.91, 95% CI = 0.86-0.96, I2  =  21%, p =  0.257].
In stratified analyses, the pooled RR for total flavonoids intake was not modified by sample size, sex, follow-up duration and study location.
Leave-one-out sensitivity analysis showed that no individual study had a significant influence on the final result.

The investigators found in subgroup analyses when compared with the lowest intake, the highest intake of anthocyanidins significantly decreased risk of type 2 diabetes with 11% [RR = 0.89, 95% CI = 0.82-0.95].

The investigators found in subgroup analyses when compared with the lowest intake, the highest intake of flavan-3-ols significantly decreased risk of type 2 diabetes with 14% [RR = 0.86, 95% CI = 0.78-0.95].

The investigators found in subgroup analyses when compared with the lowest intake, the highest intake of flavonols significantly decreased risk of type 2 diabetes with 14% [RR = 0.86, 95% CI = 0.80-0.94].

The investigators found in subgroup analyses when compared with the lowest intake, the highest intake of isoflavones significantly decreased risk of type 2 diabetes with 9% [RR = 0.91, 95% CI = 0.84-0.98].

The investigators found in 9 cohort studies a curvilinear relationship between total flavonoids intake and type 2 diabetes risk [p for nonlinearity = 0.042] with a significant risk reduction at an intake of ≥550 mg/day.

The investigators found when assuming a linear association, the risk of type 2 diabetes was reduced by 5% [RR = 0.95, 95% CI = 0.93-0.97] for each 300-mg/day increment in total flavonoids intake.

The investigators concluded that intakes of total flavonoids, particularly ≥550 mg/day, anthocyanidins, flavan-3-ols, flavonols and isoflavones are associated with significantly decreased risks of type 2 diabetes in the highest versus lowest analyses. Additionally, the dose-response analysis suggest a curvilinear relationship of total flavonoids intake with type 2 diabetes risk; when assuming a linear manner, the risk of type 2 diabetes is reduced by 5% for an increment of 300 mg/day in total flavonoids intake.

Original title:
Flavonoids intake and risk of type 2 diabetes mellitus: A meta-analysis of prospective cohort studies by Xu H, Luo J, [...], Wen Q.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5959406/

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

Objectives:
N-3 polyunsaturated fatty acids (PUFA) have been postulated to have an anti-arrhythmic effect on postoperative atrial fibrillation (POAF), with conflicting results among studies. Therefore, this review article has been conducted.

Do n-3 polyunsaturated fatty acids reduce risk of postoperative atrial fibrillation among patients undergoing cardiac surgery?

Study design:
This review article included 4 studies with 3,570 patients.
The funnel plot and fail-safe number suggested insignificant publication bias.

Results and conclusions:
The investigators found n-3 polyunsaturated fatty acids significantly reduced risk of postoperative atrial fibrillation with 16% [RR = 0.84, 95% CI = 0.73-0.98, p = 0.03].
Significantly means it can be said with a 95% confidence that n-3 polyunsaturated fatty acids really reduced the risk of postoperative atrial fibrillation with 16%. 

The investigators found in subgroup analyses EPA:DHA 1 significantly reduced risk of postoperative atrial fibrillation with 49% [RR = 0.51, 95% CI = 0.36-0.73, p = 0.0003].

The investigators found in subgroup analyses, when placebo was usual care, n-3 polyunsaturated fatty acids significantly reduced risk of postoperative atrial fibrillation with 41% [RR = 0.59, 95% CI = 0.44-0.80, p = 0.0005].

The investigators found in subgroup analyses, n-3 polyunsaturated fatty acids significantly reduced risk of postoperative atrial fibrillation with 32% after coronary artery bypass grafting (CABG) [RR = 0.68, 95% CI = 0.47-0.97, p = 0.03].

The investigators concluded that n-3 polyunsaturated fatty acids (PUFA), particularly at EPA/DHA ratio of  1 reduce risk of postoperative atrial fibrillation after coronary artery bypass grafting (CABG). Further studies are needed to confirm the effect of PUFA on postoperative atrial fibrillation and to assess the proper use of PUFA against postoperative atrial fibrillation.

Original title:
N-3 polyunsaturated fatty acids for prevention of postoperative atrial fibrillation: updated meta-analysis and systematic review by Wang H, Chen J and Zhao L.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29380237

Additional information of El Mondo:
Find more information/studies on review article/significantly, EPA&DHA, PUFA and cardiovascular disease right here.

Objectives:
There is an increasing trend in the consumption of poor-quality diets worldwide, contributing to the increase of non-communicable diseases. Diet directly influences physiological composition and subsequently physical health. Studies have shown that dietary macronutrient and energy content can influence the proportion of intramuscular fat (IMF), which mediates various metabolic and endocrine dysfunction. Therefore, this review article has been conducted.

Do different types of dietary macronutrient intake increase the proportion of intramuscular fat?

Study design:
This review article included 13 trials (RCTs, quasi-RCTs, controlled trials, randomized controlled crossover trials or controlled crossover trials).

High-fat diets were diets with a proportion of fat between 38 and 85 En%. Participants in high-fat diets were all young to middle aged adults with ages varying between 18 and 50 years.

Participants in starvation diets (a decrease of 25% calorie from weight maintenance energy requirements) and hypocaloric diets (890 calories per day, until 15% weight reduction) followed the diet for 8 days with a 3-week washout period in between.

Cohen’s criteria were used to determine the effect size of SMDs, where a SMD between 0.2 and 0.5 is small, a SMD between 0.5 and 0.8 is moderate and a SMD above 0.8 is large. SMDs below 0.2 were considered unsubstantial.

Results and conclusions:
The investigators found in 6 studies with in a total of 134 participants receiving a high-fat intervention and 135 people receiving a control intervention, that high-fat diets (38 and 85 En% fat) significantly increased the proportion of intramuscular fat [SMD = 1.24, 95% CI = 0.43-2.05, p  = 0.003, I2 = 87%].  
Sensitivity analysis (excluding studies with a quality value 20, smallest sample size 8 and those that do not specify participant characteristics) showed a significantly SMD of 1.26 [95% CI = 0.23-2.28, p = 0.02]. 

The investigators found diets with an increased proportion of carbohydrates decreased the proportion of intramuscular fat.
However, increasing caloric intake with carbohydrates compared to a standardized diet (55 En% carbohydrates, 30 En% fat and 15 En% protein) increased the proportion of intramuscular fat.

The investigators found starvation diets (a decrease of 25% calorie from weight maintenance energy requirements) increased intramuscular fat stores and hypocaloric diets (890 calories per day, until 15% weight reduction) did not result in any intramuscular fat proportion changes.

The investigators concluded that high-fat diets (38 y 85 En%), excessive caloric intake in the form of carbohydrates and short-term starvation diets are associated with increases in the proportion of intramuscular fat. However, further studies are needed to assess the effects of macronutrient combinations on intramuscular fat and the influence of diet-induced intramuscular fat alterations on health outcomes. In addition, intramuscular fat poses a possibly effective clinical marker of health.

Original title:
The Effects of Diet on the Proportion of Intramuscular Fat in Human Muscle: A Systematic Review and Meta-analysis by Ahmed S, Singh D, [...], Kumbhare D.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5826234/

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

Higher intramuscular fat levels are positively associated with insulin resistance and an increased risk of developing type 2 diabetes.

Objectives:
Oxidative stress and inflammation are key parameters in developing metabolic disorders. Hence, antioxidant intake might be an appropriate approach. Several studies have evaluated the effect of coenzyme Q10 (CoQ10) supplementation on lipid profile among patients with metabolic diseases, though findings are controversial. Therefore, this review article has been conducted.

Does coenzyme Q10 supplementation improve lipid profile of patients with metabolic disorders?

Study design:
This review article included 21 RCTs with a total of 514 patients with metabolic disorders in the coenzyme Q10 supplementation group and 525 patients with metabolic disorders in the non-coenzyme Q10 supplementation group (control group).

Results and conclusions:
The investigators found coenzyme Q10 supplementation significantly reduced serum triglycerides levels of patients with metabolic disorders [SMD = -0.28, 95% CI = -0.56 to -0.005].

The investigators found coenzyme Q10 supplementation non-significantly reduced total-cholesterol levels of patients with metabolic disorders [SMD = -0.07, 95% CI = -0.45 to 0.31].

The investigators found coenzyme Q10 supplementation non-significantly increased LDL-cholesterol (bad cholesterol) levels of patients with metabolic disorders [SMD = 0.04, 95% CI = -0.27 to 0.36].

The investigators found coenzyme Q10 supplementation non-significantly increased HDL-cholesterol (good cholesterol) levels of patients with metabolic disorders [SMD = 0.10, 95% CI = -0.32 to 0.51].

The investigators concluded that coenzyme Q10 supplementation reduces serum triglycerides levels of patients with metabolic disorders. However, it has no effects on cholesterol levels.  

Original title:
The effects of coenzyme Q10 supplementation on lipid profiles among patients with metabolic diseases: a systematic review and meta-analysis of randomized controlled trials by Sharifi N, Tabrizi R, […], Asemi Z.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29623830

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

A metabolic disorder occurs when the metabolism process fails and causes the body to have either too much or too little of the essential substances, namely carbohydrates, aminoacids, fatty acids and organic acids needed to stay healthy.

Metabolic disorders can take many forms. This includes:

• a disease in the liver, pancreas, endocrine glands or other organs involved in metabolism
• nutritional deficiencies
• a missing enzyme or vitamin that’s necessary for an important chemical reaction
• abnormal chemical reactions that hinder metabolic processes

Objectives:
Observationally, homocysteine is associated with higher risk of diabetes. Folate, which reduces homocysteine, is promising for the prevention and treatment of diabetes. Previous meta-analysis (review) of 3 trials suggested folate might lower hemoglobin A1c (HbA1c). Therefore, this review article (meta-analysis) has been conducted.

Have folic acid supplementation positive effects on insulin resistance and glycemic control, like HbA1c level and fasting glucose level?

Study design:
This review article included 18 RCTs with in total of 21,081 people with/without diabetes.

Results and conclusions:
The investigators found that folic acid (folate) supplementation significantly reduced fasting glucose level with 0.15 mmol/L [95% CI = -0.29 to -0.01]. Significant means that there is an association with a 95% confidence.

The investigators found that folic acid (folate) supplementation significantly reduced homeostatic model assessment-insulin resistance (HOMA-IR) with 0.83 [95% CI = -1.31 to -0.34].

The investigators found that folic acid (folate) supplementation significantly reduced fasting insulin level with 1.94 μIU/mL [95% CI = -3.28 to -0.61].

The investigators found that folic acid (folate) supplementation had no clear effect on diabetes or HbA1c level.

The investigators concluded that folic acid (folate) supplementation reduces both fasting glucose level, fasting insulin level and homeostatic model assessment-insulin resistance (HOMA-IR) but it has no effect on diabetes or HbA1c level.

Original title:
The effects of folate supplementation on glucose metabolism and risk of type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials by Zhao JV, Schooling CM and Zhao JX.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29501221

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

Patients with diabetes often have both an increased fasting glucose level, HOMA-IR value and fasting insulin level.

Objectives:
The increasing prevalence of diabetes in the United Kingdom and worldwide calls for new approaches to its management and diets with low glycaemic index have been proposed as a useful means for managing glucose response. However, there are conflicting reports and differences in the results of studies in terms of their effectiveness. Furthermore, the impact of low-glycaemic index diets (low GI-diets) and their long-term use in patients with type 2 diabetes remains unclear. Therefore, this review article (meta-analysis) has been conducted.

Do patients with type 2 diabetes mellitus benefit from low-GI diets?

Study design:
This review article included 6 RCTs.

Results and conclusions:
The investigators found in 2 RCTs that low-glycaemic index (low-GI) diet resulted in a significant improvement in glycated haemoglobin (HbA1c) [0.05]:
low-GI diet Δ = -0.5% [95% CI = -0.61% to -0.39%] vs. high-cereal fibre diet Δ = -0.18% [95% CI = -0.29% to -0.07%] and;
low-GI legume diet Δ = -0.5% [95% = -0.6% to -0.4%] vs. high-wheat fibre diet Δ = -0.3% [95% Cl = -0.4 to -0.2%].

The investigators found in 4 RCTs significant improvements in fasting blood glucose in low-GI diets compared to higher-GI diets or control:
low-GI diet = [150.8 ± 8.7] vs. higher-GI diet = [157.8 ± 10.4 mg/dL, mean ± SD, p = 0.43];
low-GI diet = [127.7] vs. high-cereal fibre diet = [136.8 mg/dL, p = 0.02];
low-GI diet = [6.5 (5.6-8.4)] vs. standard diabetic diet = [6.7 (6.1-7.5 mmol/L), median and interquartile range p > 0.05] and;
low-GI diet = [7.3 ± 0.3] vs. conventional carbohydrate exchange diet = [7.7 ± 0.4 mmol/L, mean ± SEM (Standard Error of Mean), p 0.05].

The investigators concluded that the low-GI diet is more effective in controlling glycated haemoglobin (HbA1c) and fasting blood glucose compared with a higher-GI diet or control in patients with type 2 diabetes. It will useful to evaluate the long-term effectiveness of low-glycaemic index diet in patients with type 2 diabetes.

Original title:
The Effect of Dietary Glycaemic Index on Glycaemia in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials by Ojo O, Ojo OO, [...], Wang XH.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5872791/

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

A low-GI diet is a diet with a lot of products/meals with a low GI.
Products/meals with a low GI are products/meals with a GI-number of 55 or less.
In daily life, products/meals with a low GI contain at least 1.5 grams fiber per 100 kcal. These products and meals contain at least 1.5 grams fiber per 100 kcal.
 

Objectives:
Type 2 diabetes mellitus (T2DM) is one of the most important public health issues. Vitamin K supplementation might have favorable effect on risk factors of T2DM. Therefore, this review article (meta-analysis) has been conducted.

Have vitamin K supplementation favorable effects on risk factors of type 2 diabetes mellitus?

Study design:
This review article included 5 RCTs with in total of 533 participants.

There was no evidence of publication bias.

Results and conclusions:
The investigators found overall, meta-analysis did not show any beneficial effect of vitamin K supplementation on both:
-fasting blood sugar levels [-0.91 mg/dL, 95% CI = -2.57 to 0.76, p = 0.28];
-fasting insulin levels [-0.35 μIU/mL, 95% CI = -1.70 to 1.00, p = 0.61];
-HOMA-IR [-0.06, 95% CI = -0.32 to -0.19, p = 0.63] and
-2-h oral glucose tolerance test [-4.00 mg/dL, 95% CI = -20.00 to 11.99, p = 0.62].

The investigators found sensitivity analysis showed that overall estimates were not affected by elimination of any study.

The investigators concluded that vitamin K supplementation has no significant effect on glycemic control in healthy subjects. However, further studies should be performed on diabetic and pre-diabetic patients to determine the effect of vitamin K supplementation on impaired glycemic control.

Original title:
Effect of Vitamin K Supplementation on Glycemic Control: A Systematic Review and Meta-Analysis of Clinical Trials by Shahdadian F, Mohammadi H and Rouhani M.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29523009

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

Objectives:
The actual effects of L-carnitine administration on leptin serum level is inconsistent. Therefore, this review article (meta-analysis) has been conducted.

Does L-carnitine supplementation reduce leptin serum level?

Study design:
This review article included 7 RCTs with 325 cases (group with L-carnitine administration) and 330 controls (group without L-carnitine administration).

Subgroup analysis to find the sources of heterogeneity showed that L-carnitine dosage [ 2 g: I2 = 00.0%, p = 0.408] and study population [diabetes: I2 = 46.7%, p = 0.153 and non-diabetes: I2 = 15.1%, p = 0.317] were the potential sources of heterogeneity.

Results and conclusions:
The investigators found that L-carnitine supplementation had no significant effect on serum leptin concentrations [WMD = -0.565 ng/mL, 95% CI = -2.417 to 1.287, p = 0.550, I2 = 84.3%, p  0.0001].

The investigators found in subgroup analysis that  ≥ 2 mg L-carnitine supplementation significantly reduced serum leptin concentrations [WMD = -2.742 ng/mL, 95% CI = -3.039 to -2.444, p  0.001].

The investigators found in subgroup analysis that L-carnitine supplementation significantly reduced serum leptin concentrations in diabetic patients [WMD = -2.946 ng/mL, 95% CI = -3.254 to -2.638, p  0.001].

The investigators found in subgroup analysis that L-carnitine supplementation during 12 weeks significantly reduced serum leptin concentrations [WMD = -2.772 ng/mL, 95% CI = -3.073 to -2.471, p  0.001].

The investigators concluded that at least 3 mg L-carnitine per day in the course of 12 weeks reduce serum leptin concentrations, especially in diabetic patients.

Original title:
The effect of L-carnitine supplementation on serum leptin concentrations: a systematic review and meta-analysis of randomized controlled trials by Nazary-Vannani A, Ghaedi E, […], Varkaneh HK.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29453657

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

L-carnitine is a non-essential amino acid, which is also found in foods.

Objectives:
What are the effects of olive oil consumption compared with other plant oils on blood lipids?

Study design:
This review article included 27 RCTs, comprising 1,089 participantes.

Results and conclusions:
The investigators found compared to other plant oils, HDL cholesterol levels (good cholesterol) increased significantly more for olive oil consumption [WMD = 1.37 mg/dL, 95% CI = 0.4 to 2.36].

The investigators found, however, olive oil consumption reduced total cholesterol levels [WMD = 6.27 mg/dL, 95% CI = 2.8 to 10.6], LDL cholesterol levels (bad cholesterol) [WMD = 4.2 mg/dL, 95% CI = 1.4 to 7.01] and triglyceride levels [WMD = 4.31 mg/dL, 95% CI = 0.5 to 8.12] significantly less than other plant oils.

The investigators found that there were no significant effects on Apo lipoprotein A1 and Apo lipoprotein B.

The investigators concluded that olive oil consumption decreases serum total cholesterol, LDL cholesterol and triglyceride levels less but increases HDL cholesterol levels more than other plant oils.

Original title:
Comparison of blood lipid-lowering effects of olive oil and other plant oils: A systematic review and meta-analysis of 27 randomized placebo-controlled clinical trials by Ghobadi S, Hassanzadeh-Rostami Z, […], Faghih S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29420053

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

Objectives:
Does poultry intake reduce risk of stroke?

Study design:
This review article included 7 prospective cohort studies involving 354,718 participants.

Results and conclusions:
The investigators found for the highest versus lowest categories of poultry intake a non-significantly reduced risk of 8% for total stroke [pooled RR = 0.92, 95% CI = 0.82-1.03, I2 = 19.8%, p = 0.28].

The investigators found in subgroup analysis for the highest versus lowest categories of poultry intake, a significantly reduced risk of 14% for total stroke among US people [RR = 0.86, 95% CI = 0.77-0.95, I2 = 0.0%, p = 0.38].

The investigators found in subgroup analysis for the highest versus lowest categories of poultry intake, a significantly reduced risk of 17% for total stroke among women [RR = 0.83, 95% CI = 0.72-0.93, I2 = 0.0%, p = 0.63].

The investigators found in subgroup analysis no association between the highest poultry intake and ischemic stroke risk [RR = 0.91, 95% CI = 0.79-1.02, I2 = 0.0%, p = 0.93].

The investigators found in subgroup analysis no association between the highest poultry intake and hemorrhagic stroke risk [RR = 0.82, 95% CI = 0.59-1.04, I2 = 20.5%, p = 0.28].

The investigators found one serving per week increment in poultry intake was not associated with the risk of stroke [RR = 1.00, 95% CI = 0.96-1.03, I2 = 69.0%, p = 0.004].

The investigators found nonlinear dose-response meta-analysis showed a lower risk of stroke at consumption of 1 serving/week.  

The investigators concluded that 1 serving/week poultry intake reduces risk of stroke, particularly among US people and women.

Original title:
Dietary poultry intake and the risk of stroke: A dose-response meta-analysis of prospective cohort studies by Mohammadi H, Jayedi A, […], Shab-Bidar S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29460808

Additional information of El Mondo:
Find more information/studies on poultry intake and cardiovascular diseases right here.
1 serving poultry corresponds to 100 gram raw poultry.
This meal provides 75 grams of poultry.
Poultry are chickens, turkeys, geese and ducks.

Objectives:
New studies indicate that resveratrol can significantly reduce plasma lipids, but the result of randomized clinical trials (RCTs) on resveratrol effect and the serum lipid profile are contradictory. Therefore, this review article (meta-analysis) has been conducted.  

Do resveratrol supplements reduce plasma lipids, like cholesterol levels?

Study design:
This review article included 21 RCTs.

Results and conclusions:
The investigators found resveratrol supplements had no significant effects on both:
-total cholesterol (TC) [WMD = 0.08 mmol/L, 95% CI = -0.23 to 0.08, p = 0.349, I2 = 87.8%];
-low-density lipoprotein (LDL-C or bad cholesterol) [WMD = -0.04 mmol/L, 95% CI = -0.21 to 0.12, p  = 0.620, I2 = 93.4%] and;
-high density lipoprotein (HDL-C or good cholesterol) [WMD = -0.01 mmol/L, 95% CI = -0.04 to 0.02, p = 0.269, I2 = 88.6%].

The investigators found resveratrol supplements had significant effects on
triacylglycerol (TG) [WMD = 0.58 mmol/L, 95% CI = 0.34 to 0.82, p 0.0001, I2 = 99.8%]. But after removing 1 study the significance was eliminated.

The investigators also found that sex, age, BMI, resveratrol dosage and intervention duration could not change the results.

The investigators concluded that resveratrol supplements do not change lipid profile concentration, like cholesterol levels. Confirmation of this conclusion will require more studies exclusively on dyslipidemic patients in which the intake of lipid lowering agents is among the exclusion criteria.

Original title:
Effect of resveratrol on lipid profile: An updated systematic review and meta-analysis on randomized clinical trials by Haghighatdoost F and Hariri M.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29305228

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

Objectives:
What is the relationship between serum, dietary and urinary potassium and the risk of type 2 diabetes mellitus (T2DM)?  

Study design:
This review article included 8 prospective cohort studies involved 5,053 type 2 diabetes mellitus cases among 119,993 individuals.
The follow-up durations were from 5 to 18.1 years with a baseline age range from 18 to 95 years.
Serum potassium was measured using the ion-selective electrode method. Dietary potassium was estimated from food frequency questionnaire (FFQ). Urinary potassium samples were analyzed by potentiometric methods.
Most of the included studies provided risk estimates adjusted for age, sex, race, BMI and family history of diabetes.

Results and conclusions:
The investigators found in 5 studies involving 28,944 individuals and 3,849 type 2 diabetes mellitus cases, a non-significantly reduced risk of 21% [summary RR = 0.79, 95% CI = 0.60-1.04, I2 = 76.7%] for type 2 diabetes mellitus, when comparing the highest versus lowest serum potassium levels.
However, the sensitivity analysis did show a significant inverse association between serum potassium and type 2 diabetes mellitus risk [RR = 0.63, 95% CI = 0.52-0.73, I2 = 0%].

The investigators found in random dose-response meta-regression analysis a significantly reduced risk of 17% for type 2 diabetes mellitus [RR = 0.83, 95% CI = 0.73-0.95] per 1 mmol/L increase in serum potassium.

The investigators found in 6 studies involving 112,125 individuals and 4,573 type 2 diabetes mellitus cases, a non-significantly reduced risk of 7% [RR = 0.93, 95% CI = 0.81-1.06, I2 = 0.0%, p = 0.52] for type 2 diabetes mellitus, when comparing the highest versus lowest dietary potassium intake.
The sensitivity analysis did not significantly alter the association between dietary potassium and type 2 diabetes mellitus risk.

The investigators found there was no significant dose-response relationship between dietary potassium and type 2 diabetes mellitus risk [RR for every 1000mg increase dietary potassium per day = 1.00, 95% CI = 0.96-1.05].

The investigators found in 3 studies involving 4,376 individuals and 455 type 2 diabetes mellitus cases, a non-significantly reduced risk of 17% [RR = 0.83, 95% CI = 0.39-1.75, I2 = 73.9%, p = 0.02] for type 2 diabetes mellitus, when comparing the highest versus lowest urinary potassium levels.

The investigators found there was no significant dose-response relationship between urinary potassium levels and type 2 diabetes mellitus risk [RR for 10 mmol increase in urinary potassium per 24 hours = 1.00, 95% CI = 0.95-1.05].

The investigators concluded that serum potassium levels are linearly associated with the risk of type 2 diabetes mellitus, with each 1 mmol/L increase in serum potassium lowering the risk by 17%. However, neither dietary potassium nor urinary potassium shows any association with the risk of type 2 diabetes mellitus.

Original title:
Potassium measurements and risk of type 2 diabetes: a dose-response meta-analysis of prospective cohort studies by Peng Y, Zhong GC, […], Yang G.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5725047/

Additional information of El Mondo:
Find more information/studies on type 2 diabetes and potassium right here.
 

Objectives:
Fish oil supplementation has been shown to be associated with a lower risk of metabolic syndrome and benefit a wide range of chronic diseases, such as cardiovascular disease, type 2 diabetes and several types of cancers. However, the evidence of fish oil supplementation on glucose metabolism and insulin sensitivity is still controversial. Therefore, this review article (meta-analysis) has been conducted.

Does fish oil supplementation improve insulin sensitivity in humans?

Study design:
This review article included a total of 17 RCTs with 672 participants. One of the 17 studies was crossover design and others were parallel design.
The doses of active ingredients of fish oil (n-3 fatty acids) ranged from 1 g/d to 4 g/d. Duration of the interventions was ranged from 4 weeks to 24 weeks.
There was no suggestion of small study effect based on visual inspection of the funnel plot. Results of the Egger’s (p = 0.78) and Begg’s (p = 0.43) tests showed that there was no potential publication bias.

Results and conclusions:
The investigators found pooled analysis showed that fish oil supplementation had no effects on insulin sensitivity overall [SMD = 0.17, 95% CI = -0.15 to 0.48, p = 0.292, I2 = 58.1%, p = 0.001].

The investigators found subgroup analysis showed that fish oil supplementation significantly improved insulin sensitivity among people who were experiencing at least one symptom of metabolic disorders [SMD = 0.53, 95% CI = 0.17 to 0.88, p 0.001].

The investigators found subgroup analysis showed a positive effect of fish oil on insulin sensitivity among the short-term intervention group (12 weeks) rather than the long-term intervention group [SMD = 0.31, 95% CI = 0.01-0.61, p = 0.04].

The investigators found subgroup analysis showed that fish oil had no effects on insulin sensitivity among the healthy people or people with T2DM.

The investigators found there were no significant differences between subgroups of methods of insulin sensitivity and doses of omega-3 polyunsaturated fatty acids (n-3 PUFA) of fish oil supplementation.

The investigators found in sensitivity analysis that summary results did not differ significantly when omitting studies one at a time.

The investigators concluded that fish oil supplementation during 12 weeks improves insulin sensitivity among people who were experiencing at least one symptom of metabolic disorders.

Original title:
Fish oil supplementation and insulin sensitivity: a systematic review and meta-analysis by Gao H, Geng T, [...], Zhao Q.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5496233/

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

 

Objectives:
There are some indications of regional differences in the association between fish consumption and clinical outcomes. Therefore, this review article (meta-analysis) has been conducted.  

Are there regional differences in the association between fish consumption and risk of all-cause mortality and cardiovascular (CVD) mortality?

Study design:
This review article included 14 prospective cohort studies (10 publications) with 911,348 participants, of which 75,451 incident deaths.

Results and conclusions:
The investigators found dose-response meta-analysis showed a 20 g/d increment in fish consumption significantly reduced risk of cardiovascular mortality with 4% [relative risk = 0.96, 95% CI = 0.94-0.98, I2 = 0%, n = 8]. However, subgroup analysis resulted in a significant association only in Asian studies and not in Western studies.

The investigators found dose-response meta-analysis showed a 20 g/d increment in fish consumption significantly reduced risk of all-cause mortality with 2% [relative risk = 0.98, 95% CI = 0.97-1.00, I2 = 81.9%, n = 14]. However, subgroup analysis resulted in a significant association only in Asian studies and not in Western studies.

The investigators found analysis of Western studies suggested a nearly U-shaped association, with a nadir at fish consumption of 20 g/d in analysis of both outcomes. Meanwhile, the associations appeared to be linear in Asian studies.

The investigators concluded that fish consumption, particularly 20 g/d reduces boh risk of cardiovascular mortality and all-cause mortality. Furthermore, there is potential evidence of regional differences in the association between fish consumption and mortality. Therefore, it may be helpful to examine the associations by considering types of fish consumed and methods of fish preparation.

Original title:
Fish consumption and risk of all-cause and cardiovascular mortality: a dose-response meta-analysis of prospective observational studies by Jayedi A, Shab-Bidar S, […], Djafarian K.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29317009

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

Objectives:
Over the last 7 years there has been intense debate about the advice to reduce saturated fat and increase polyunsaturated fat to reduce cardiovascular (CVD) risk. Therefore, this review article (meta-analysis) has been conducted.

Does replacement of saturated fat with carbohydrate, polyunsaturated fatty acid (PUFA) or monounsaturated fatty acid (MUFA) reduce cardiovascular risk?

Study design:
This review article included cohort studies and intervention studies.

Results and conclusions:
The investigators found replacement of saturated fat with any carbohydrate, polyunsaturated fatty acid (PUFA) and monounsaturated fatty acid (MUFA) is associated with lower mortality with PUFA being more effective than MUFA [19% reduction versus 11%].

The investigators found per 5% of energy (5 En%) replacement of saturated fat with polyunsaturated fatty acid and fish oil significantly lowered risk of cardiovascular mortality with 28%.  

The investigators found replacing saturated fat with PUFA or MUFA was equally effective at reducing coronary heart disease (CHD) events

The investigators found replacement of saturated fat with whole grains significantly lowered coronary heart disease events while replacement with sugar and starch significantly increased coronary heart disease events.

The investigators found replacement of saturated fat with carbohydrate had no effect on coronary heart disease events or death.

The investigators found only PUFA replacement of saturated fat significantly lowered coronary heart disease events and cardiovascular and total mortality.

The investigators concluded reducing saturated fat and replacing it with carbohydrate will not lower coronary heart disease events or cardiovascular mortality although it will reduce total mortality. Replacing saturated fat with PUFA, MUFA or high-quality carbohydrate will lower coronary heart disease events.

Original title:
A systematic review of the effect of dietary saturated and polyunsaturated fat on heart disease by Clifton PM and Keogh JB.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29174025

Additional information of El Mondo:
Find more information/studies on fat, carbohydrates and cardiovascular diseases right here.

Objectives:
What are the cardiovascular benefits of indiscriminate supplementation of omega-3 supplementation?

Study design:
This review article included 8 RCTs.

Results and conclusions:
The investigators found omega-3 supplementation significantly resulted in a 8% decrease of the risk of cardiac death, unless the patients are treated by statins.

The investigators found omega-3 supplementation prolonged quality adjusted life years by about a month. Old people gained less, whereas diabetes mellitus type 2 patients and people with history of cardiovascular events gained more.

The investigators concluded omega-3 supplementation decreases risk of cardiac death, unless the patients are treated by statins.

Original title:
The cardiovascular benefits of indiscriminate supplementation of omega-3 fatty acids; meta-analysis and decision-making approach by Leshno M, Goldbourt U, [...], Lichtenberg D.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29171335

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

Objectives:
Beetroot is considered a complementary treatment for hypertension because of its high content of inorganic NO3.

The aim of this meta-analysis (review article) is to clarify several aspects of beetroot juice supplementation on systolic blood pressure (SBP) and diastolic blood pressure (DBP).

Study design:
This review article included 22 RCTs with a total of 47 intervention (n = 650) and 43 control (n = 598) groups.

Results and conclusions:
The investigators found overall, systolic blood pressure [-3.55 mmHg, 95% CI = -4.55 to -2.54 mmHg] and diastolic blood pressure [-1.32 mmHg, 95% CI = -1.97 to -0.68 mmHg] were significantly lower in the beetroot juice-supplemented groups than in the control groups.

The investigators found the mean difference of systolic blood pressure was larger between beetroot juice-supplemented and control groups in the longer than in the shorter (≥14 compared with 14 days) study durations [-5.11 compared with -2.67 mmHg].

The investigators found the mean difference of systolic blood pressure was larger between beetroot juice-supplemented and control groups in the highest compared with the lowest (500 compared with 70 and 140 mL/d] doses of beetroot juice [-4.78 compared with -2.37 mmHg].

The investigators found a positive correlation between beetroot juice doses and the mean differences of blood pressures.

The investigators found a smaller effect size of blood pressures after supplementation with higher NO3 (milligrams per 100 mL beetroot juice).

The investigators found a weak effect size in a meta-analysis of trials that used NO3-depleted beetroot juice as a placebo compared with other interventions [-3.09 compared with -4.51 mmHg for systolic blood pressure and -0.81 compared with -2.01 mmHg for diastolic blood pressure].

The investigators concluded beetroot juice supplementation, particularly 500 mL/d beetroot juice during at least 14 days, reduces blood pressure.

Original title:
The Nitrate-Independent Blood Pressure-Lowering Effect of Beetroot Juice: A Systematic Review and Meta-Analysis by Bahadoran Z, Mirmiran P, […], Ghasemi A.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29141968

Additional information of El Mondo:
Find more information/studies on fruit, hypertension prevention and cardiovascular diseases right here.

Objectives:
What is the relationship of the intake of whole grains, refined grains, vegetables, fruits, nuts, legumes, eggs, dairy, fish, red meat, processed meat and sugar-sweetened beverages (SSBs) and the risk of hypertension?

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

Results and conclusions:
The investigators found in dose-response meta-analysis of 4 studies with 28,069 incident hypertension cases, a significantly reduced risk of 8% [RR = 0.92, 95% CI = 0.87-0.98, I2 = 88%, p 0.0001] for hypertension for 30 g/day whole grains. Significant means that there is an association with a 95% confidence.
The reduced risk was highest (15%) at 90 g/day whole grains.

The investigators found in dose-response meta-analysis of 6 studies, a significantly reduced risk of 3% [RR = 0.97, 95% CI = 0.96-0.99, I2 = 64%, p = 0.02] for hypertension for 100 g/day fruits.
The strongest risk reduction was 7% at 300 g/day fruits.

The investigators found in dose-response meta-analysis of 9 studies with 31,509 incident hypertension cases, a significantly reduced risk of 5% [RR = 0.95, 95% CI = 0.94-0.97, I2 = 0%, p = 0.50] for hypertension for 200 g/day dairy products.
The strongest risk reduction was 15% at 800 g/day dairy products.

The investigators found in dose-response meta-analysis of 7 studies with 97,745 incident hypertension cases, a significantly increased risk of 14% [RR = 1.14, 95% CI = 1.02-1.28, I2 = 88%, p 0.001] for hypertension for 100 g/day red meat.
The increased risk was highest (40%) at 200 g/day red meat.

The investigators found in dose-response meta-analysis of 4 studies, a significantly increased risk of 12% [RR = 1.12, 95% CI = 1.00-1.26, I2 = 82%, p 0.001] for hypertension for 50 g/day processed meat.

The investigators found in dose-response meta-analysis of 4 studies, a significantly increased risk of 7% [RR = 1.07, 95% CI = 1.04-1.10, I2 = 64%, p = 0.04] for hypertension for 250 mL/day sugar-sweetened beverages.
The increased risk was highest (13%) at 450 mL/day sugar-sweetened beverages.

The investigators found compared with nonconsumption, an intake of 2 servings red meat/d [170g, RR = 1.35], 1 serving processed meat/d [35g, RR = 1.07], 1 serving fish/d [100g, RR = 1.08] and 2 servings sugar-sweetened beverages/d [500mL, RR = 1.14 was associated with a 78% increased risk of hypertension. On the other hand, a risk reduction by 44% would be achieved by not consuming these foods (red meat, processed meat, fish and sugar-sweetened beverages).

The investigators concluded a daily dietary intake of 30g whole grains, 100g fruits, 200g dairy products reduce risk of hypertension, whereas a daily dietary intake of 100g red meat, 50g processed meat, and 250mL sugar-sweetened beverages increase risk of hypertension. These findings need to be seen under the light of very-low to low credibility of meta-evidence. However, the findings support the current dietary recommendations in the primary prevention of hypertension.

Original title:
Food Groups and Risk of Hypertension: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies by Schwingshackl L, Schwedhelm C, […], Boeing H.

Link:
http://advances.nutrition.org/content/8/6/793.long

Additional information of El Mondo:
Find more information/studies on different food groups, hypertension prevention and cardiovascular diseases right here.

Objectives:
Previous meta‐analyses on meat intake and risk of stroke did not report the effect of white meat (poultry meat, excluding fish) and did not examine stroke incidence and mortality separately. Therefore, this review article (meta-analysis) has been conducted.

What is the relationship of total (red and processed meat), red (unprocessed or fresh red meat) and processed (processed red meat) meat consumption along with white meat on risk of stroke incidence and mortality disease risk?

Study design:
This review article included 15 prospective cohort studies (254,742 participants with 9,522 stroke incidents and 487,150 participants with 12,999 cases of stroke mortality). The follow-up duration varied from 5.5 to 26 years.

There was no significant publication bias based on the Egger test except that the evaluation of total meat with stroke incidence reached the significance threshold.

The average score for study quality assessed by the Newcastle‐Ottawa Scale was 7.29 (range 7-8) for studies on meat consumption and stroke incidence and 6.87 (range 6-8) for those on stroke mortality.

Results and conclusions:
The investigators found that a high total meat (red and processed meat) consumption resulted in a significantly higher risk of 18% [pooled relative risk = 1.18, 95% CI = 1.09-1.28, I2 = 0%] for total stroke incidence. Significantly means that there is an association with a 95% confidence.

The investigators found that a high red meat consumption resulted in a significantly higher risk of 11% [pooled relative risk = 1.11, 95% CI = 1.03-1.20, I2 = 0%] for total stroke incidence.

The investigators found that a high processed meat consumption resulted in a significantly higher risk of 17% [pooled relative risk = 1.17, 95% CI = 1.08-1.25, I2 = 0%] for total stroke incidence.

The investigators found that a high white meat consumption resulted in a significantly lower risk of 13% [pooled relative risk = 0.87, 95% CI = 0.78-0.97, I2 = 0%] for total stroke incidence.

The investigators found, however, no significant associations between consumption of total [RR = 0.97, 95% CI = 0.85-1.11, I2 = 0%] or red meat [RR = 0.87, 95% CI = 0.64-1.18, I2 = 70.9%] and stroke mortality. No significant associations because RR of 1 was found in the 95% CI of 0.64 to 1.18. RR of 1 means no risk/association.

The investigators found that a high total meat consumption was associated with an increased risk of 41% for hemorrhagic stroke [RR = 1.41, 95% CI = 1.08-1.84, I2 = 0%], but no significant association was found between a high total meat consumption and ischemic stroke [RR = 1.16, 95% CI = 0.94-1.43, I2 = 40.6%].

The investigators found a positive association between total meat consumption and stroke incidence, regardless of sex, number of cases and follow‐up duration.

The investigators found when stratified by adjustment variables, studies that adjusted for family history of myocardial infarction, fruit and vegetable intake and use of aspirin showed a statistically significant relationship between total meat intake and risk of stroke compared with other studies that did not include those as adjustment variables.

The investigators found that a high red meat consumption was associated with an increased risk of 24% for ischemic stroke [RR = 1.24, 95% CI = 1.05-1.46, I2 = 17.7%], but no significant association was found between a high red meat consumption and hemorrhagic stroke [RR = 1.11, 95% CI = 0.89-1.38, I2 = 0%].

The investigators found that a high processed meat consumption was linked to neither ischemic [RR = 1.10, 95% CI = 0.96-1.27, I2 = 11.4%] nor hemorrhagic stroke [RR = 1.19, 95% CI = 0.95-1.49, I2 = 8.10%].

The investigators concluded that higher consumption of red or processed meat is associated with an increase in the risk of stroke, while higher intake of white meat is related to a reduction in stroke incidence. Therefore, recommendations for replacing proportions of red and processed meat to white meat for the prevention of stroke may be considered in clinical practice.

Original title:
Role of Total, Red, Processed, and White Meat Consumption in Stroke Incidence and Mortality: A Systematic Review and Meta-Analysis of Prospective Cohort Studies by Kim K, Hyeon J, […], Park SM.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5634267/

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

Objectives:
Dietary fiber intake, especially viscous soluble fiber, has been established as a means to reduce cardiometabolic risk factors. Whether this is true for blood pressure remains controversial. Therefore, this review article (meta-analysis) has been conducted.

Does viscous soluble fiber supplementation reduce cardiovascular disease risk?

Study design:
This review article included 22 (n = 1430) and 21 RCTs (N = 1343) for systolic blood pressure (SBP) and diastolic blood pressure (DBP), respectively.

5 types of viscous fiber supplementation were β-glucan from oats and barley, guar gum, konjac, pectin and psyllium.

Results and conclusions:
The investigators found viscous soluble fiber supplementation significantly reduced systolic blood pressure [MD = -1.59 mmHg, 95% CI = -2.72 to -0.46, I2 = 72%, p 0.01] and diastolic blood pressure [MD = -0.39 mmHg, 95% CI = -0.76 to -0.01, I2 = 67%, p 0.01] at a median dose of 8.7 g/day (1.45-30 g/day) over a median follow-up of 7-weeks.

The investigators found within the five fiber types, systolic blood pressure reductions were observed only for supplementation using psyllium fiber [MD = -2.39 mmHg, 95% CI = -4.62 to -0.17].

The investigators concluded 8.7 g/day viscous soluble fiber supplementation, particularly psyllium fiber during 7 weeks reduces systolic blood pressure (SBP) and diastolic blood pressure (DBP). Therefore, inclusion of viscous fiber to habitual diets may have additional value in reducing cardiovascular risk via improvement in blood pressure.

Original title:
The effect of viscous soluble fiber on blood pressure: A systematic review and meta-analysis of randomized controlled trials by Khan K, Jovanovski E, […], Vuksan V.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29153856

Additional information of El Mondo:
Find more information/studies on fiber consumption, hypertension and cardiovascular diseases right here.

Objectives:
Elevated cholesterol has been linked to cardiovascular disease in adults and preclinical markers of atherosclerosis in children, thus reducing saturated (SFA) and trans-fatty acids (TFA) intake from an early age may help to reduce cholesterol and the risk of cardiovascular disease later in life. The World Health Organization (WHO) is currently updating its guidance on SFA and TFA intake in adults and children. Therefore, this review article (meta-analysis) has been conducted.

Does a diet with low saturated fatty acids reduce cholesterol and blood pressure in children and adolescents between 2 to 19 years of age?

Study design:
This review article included 8 RCTs (5 trials had a duration of 1 year and 3 had a duration of ≥ 1year with a total of 2,430 individual children and adolescents between 2 to 19 years of age) and 3 cohort studies.

Minimum duration was 13 days for RCTs and one year for cohort studies.

Saturated fatty acids intake was assessed using 24hr dietary recalls in 4 trials, 3-day diet records in 3 trials and food frequency questionnaires and/or checklists in 2 trials.

No trials were identified meeting the inclusion criteria for trans-fatty acids.

Publication bias was not assessed as the number of trials found was not sufficient to conduct funnel plot analyses for any outcome measure.

Results and conclusions:
The investigators found compared with control diets, there was a highly statistically significant effect of reduced saturated fatty acids intake on total cholesterol [MD = -0.16 mmol/L, 95% CI = -0.25 to -0.07, I2 = 64%], LDL cholesterol [MD = -0.13 mmol/L, 95% CI = -0.22 to -0.03, I2 = 77%] and diastolic blood pressure [MD = -1.45 mmol/L, 95% CI = -2.34 to -0.56].
The effects on cholesterol were greatest among those in which saturated fatty acids was replaced primarily with PUFA or MUFA and when the intervention group achieved a reduction in saturated fatty acids to below 10% of total energy intake.

The investigators found subgroup analysis of the effect of the initial lipid status of the participants showed a significantly different effect of saturated fatty acids reduction on total cholesterol [p = 0.05] between trials involving normolipidaemic/mixed status children [MD -0.21 mmol/L, 95% CI = -0.31 to -0.12] vs hyperlipidaemic children [MD = -0.08 mmol/L, 95% CI = -0.15 to -0.01].

The investigators found subgroup analysis of the effect of the initial lipid status of the participants showed the reduction in LDL cholesterol (bad cholesterol) was greater among the trials conducted in normolipidaemic/mixed status [MD -0.21 mmol/L, 95% CI = -0.30 to -0.13] vs hyperlipidaemic children [MD = -0.02 mmol/L, 95% CI = -0.14 to -0.11].

The investigators found there were no significant associations observed for HDL cholesterol (good cholesterol), triglycerides or apolipoproteins A1 or B.

The investigators found there were no significant associations observed between reduced saturated fatty acids intake and weight, height, body mass index (BMI) or waist circumference.

The investigators found there was no evidence of adverse effects of reducing saturated fatty acids intake in children on micronutrient intakes, cognitive development or sexual maturation in the small number of trials reporting these outcomes.  

The investigators concluded a diet with low saturated fatty acids reduces total cholesterol, LDL cholesterol and diastolic blood pressure in children and adolescents between 2 to 19 years of age without evidence of adverse effects on growth and development. The greatest effect on cholesterol occurred when saturated fatty acids was replaced with PUFA or a mixture of PUFA/MUFA and when saturated fatty acids intake was less than 10% of total energy intake. Therefore, dietary guidelines for children and adolescents should continue to recommend diets low in saturated fat.

Original title:
Health effects of saturated and trans-fatty acid intake in children and adolescents: Systematic review and meta-analysis by Morenga L and Montez JM.

Link:
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0186672

Additional information of El Mondo:
Find more information/studies on fat consumption, body mass index, hypertension, cholesterol and cardiovascular diseases right here.  

A diet with saturated fatty acids intake less than 10% of total energy intake is a diet with less than 10 En% saturated fat.
A diet with less than 10 En% saturated fat is a diet that is largely made up of meals/products with less than 10 En% saturated fat. Practically, this means that all meals/products that you eat on a daily basis should on average contain less than 10 En% saturated fat. Check here which products contain less than 10 En% saturated fat.

Objectives:
Despite growing evidence for food-based dietary patterns' potential to reduce cardiovascular disease risk, knowledge about the amounts of food associated with the greatest change in risk of specific cardiovascular outcomes and about the quality of meta-evidence is limited. Therefore, this review article (meta-analysis) has been conducted.

Which food-based dietary patterns reduce risk of cardiovascular diseases, such as coronary heart disease (CHD), stroke and heart failure (HF)?

Study design:
This review article included 123 prospective cohort studies.

Results and conclusions:
The investigators found whole grains significantly reduced risk of coronary heart disease with 5% [RR = 0.95, 95% CI = 0.92-0.98]. Significantly means that there is an association with a 95% confidence.

The investigators found whole grains significantly reduced risk of heart failure with 4% [RR = 0.96, 95% CI = 0.95-0.97]. Significantly because RR of 1 was not found in the 95% CI of 0.95 to 0.97. RR of 1 means no risk/association.

The investigators found vegetables significantly reduced risk of coronary heart disease with 3% [RR = 0.97, 95% CI = 0.96-0.99]. Significantly means it can be said with a 95% confidence that a intake of vegetables really decreased the risk of getting coronary heart disease with 3%.  

The investigators found fruits significantly reduced risk of coronary heart disease with 6% [RR = 0.94, 95% CI = 0.90-0.97].

The investigators found vegetables significantly reduced risk of stroke with 8% [RR = 0.92, 95% CI = 0.86-0.98].

The investigators found fruits significantly reduced risk of stroke with 10% [RR = 0.90, 95% CI = 0.84-0.97].

The investigators found nuts non-significantly reduced risk of coronary heart disease with 33% [RR = 0.67, 95% CI = 0.43-1.05]. Non-significantly means that there is no association with a 95% confidence.

The investigators found fish consumption significantly reduced risk of stroke with 14% [RR = 0.86, 95% CI = 0.75-0.99].

The investigators found fish consumption significantly reduced risk of heart failure with 20% [RR = 0.80, 95% CI = 0.67-0.95].

The investigators found egg significantly increased risk of heart failure with 16% [RR = 1.16, 95% CI = 1.03-1.31].

The investigators found red meat significantly increased risk of coronary heart disease with 15% [RR = 1.15, 95% CI = 1.08-1.23].

The investigators found red meat significantly increased risk of stroke with 12% [RR = 1.12, 95% CI = 1.06-1.17].

The investigators found red meat significantly increased risk of heart failure with 8% [RR = 1.08, 95% CI = 1.02-1.14].

The investigators found processed meat significantly increased risk of coronary heart disease with 27% [RR = 1.27, 95% CI = 1.09-1.49].

The investigators found processed meat significantly increased risk of stroke with 17% [RR = 1.17, 95% CI = 1.02-1.34].

The investigators found processed meat significantly increased risk of heart failure with 12% [RR = 1.12, 95% CI = 1.05-1.19].

The investigators found sugar-sweetened beverages significantly increased risk of coronary heart disease with 17% [RR = 1.17, 95% CI = 1.11-1.23].

The investigators found sugar-sweetened beverages significantly increased risk of heart failure with 7% [RR = 1.07, 95% CI = 1.02-1.12].

The investigators found sugar-sweetened beverages significantly increased risk of stroke with 8% [RR = 1.08, 95% CI = 1.05-1.12].

The investigators found there were clear indications for non-linear dose-response relationships between whole grains, fruit, nuts, dairy and red meat and coronary heart disease.

The investigators concluded there is a relationship between food-based dietary patterns and risk of cardiovascular diseases, with an increased risk for consumption of eggs, red meat, processed meat and sugar-sweetened beverages and a decreased risk for consumption of whole grains, vegetables, fruit and fish.

Original title:
Food groups and risk of coronary heart disease, stroke and heart failure: A systematic review and dose-response meta-analysis of prospective studies by Bechthold A, Boeing H, […], Schwingshackl L.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29039970

Additional information of El Mondo:
Find more information/studies on food groups and cardiovascular diseases right here. 

Objectives:
The therapeutic efficacy of coenzyme Q10 on patients with cardiac failure remains controversial. Therefore, this review article (meta-analysis) has been conducted.

Do patients with heart failure benefit from coenzyme Q10 supplements?

Study design:
This review article included a total of 14 RCTs with 1064 patients in coenzyme Q10 (treatment) group and 1085 patients in placebo (control) group.

Egger’s test results showed no significant evidence of publication bias in either endpoint.

Results and conclusions:
The investigators found compared with placebo, coenzyme Q10 supplementation significantly decreased mortality risk with 31% [RR = 0.69, 95% CI = 0.50 to 0.95, p = 0.02, I2 = 0%].

The investigators found a greater improvement in exercise capacity was established in patients who used coenzyme Q10 than in those who used placebo [SMD = 0.62, 95% CI = 0.02 to 0.30, p = 0.04, I2 = 54%].

The investigators found patients who used coenzyme Q10 and placebo associated with similar left heart ejection fraction [SMD = 0.14, 95% CI = -0.08 to 0.37, p = 0.22, I2 = 54%].

The investigators found no significant difference between coenzyme Q10 and placebo for NYHA classification [SMD = -0.70, 95% CI = -1.92 to 0.51, p = 0.26, I2 = 89%].

The investigators concluded in patients with heart failure, the administration of coenzyme Q10 results in lower mortality and improved exercise capacity compared with the effects of placebo treatment.

Original title:
Efficacy of coenzyme Q10 in patients with cardiac failure: a meta-analysis of clinical trials by Lei L and Liu Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5525208/

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