Nutritional advice

Objectives:
Polyunsaturated fats (PUFAs) have been shown to reduce type 2 diabetes (T2DM) risk and improve insulin responsiveness in T2DM subjects, but whether the plant sources of omega-3 PUFA (alpha-linolenic acid [ALA]) have an effect on glycemic control requires further investigation. Therefore, this review article (meta-analysis) has been conducted.

Does alpha-linolenic acid dietary intake reduce diabetes risk?

Study design:
This review article included a total of 8 RCTs involving 212 participants with type 2 diabetes.
5 trials (62.5%) were parallel designs and 3 (37.5%) were crossover designs.
Participants were generally middle-aged (median age  =  54 years, range  =  47-64 years) and overweight or obese (median BMI  =  30.7, range  =  28.0-33.2).
Overall, participants had controlled diabetes (median HbA1c = 6.8%, median FBG = 7.95 mmol/L) and the majority of studies indicated the use of hypoglycemic drugs or other medications, although all studies excluded the use of insulin therapy.
The dose of ALA ranged from 1.5 to 7.4 g/day with a median assigned dose of 4.4, 5.4 and 5.4 g/day of ALA for trials that reported HbA1c, FBG and FBI, respectively.
The median duration of the treatment was 3 months, ranging from 2 to 12 months.
7 studies (87.5%) were considered high quality (MQS ≥8).

Results and conclusions:
The investigators found compared to a control diet, a median dose of 4.4 g/day of alpha-linolenic acid intake for a median duration of 3 months did not affect HbA1c (%) of patients with type 2 diabetes [MD =  -0.01, 95% = -0.32 to 0.31, p  =  0.96].

The investigators found compared to a control diet, a median alpha-linolenic acid dose of 5.4 g/day did not lower fasting blood glucose (FBG) of patients with type 2 diabetes [MD  = 0 .07, 95% CI = -0.61 to 0.76, p  = 0 .84] or fasting blood insulin (FBI) of patients with type 2 diabetes [MD  =  7.03, 95% CI = -5.84 to 19.89, p  = 0 .28].

The investigators found summary effect estimates were generally compromised by considerable and unexplained heterogeneity [I2 ≥ 75%].

The investigators found in the subgroup analysis of continuous predictors, a reduction in HbA1c (%) and FBG (mmol/L) was significantly associated with an increased intake of ALA.

The investigators found further adjustment for publication bias using Duval and Tweedie's trim-and-fill analysis provided an adjusted, significant MD of 0.25 [95% CI = -0.38 to -0.12, 0.001) for HbA1c (%).

The investigators concluded alpha-linolenic acid-enriched diet with a median alpha-linolenic acid dose of 4.4 g/day during 3 months has no effects on HbA1c, FBG or FBI in patients with type 2 diabetes. The scarce number of existing RCTs and the presence of heterogeneity in the meta-analysis limit the ability to make firm conclusions about alpha-linolenic acid in type 2 diabetes management. The potential for alpha-linolenic acid to have dose-dependent effects warrants further research in this area.

Original title:
The effect of alpha-linolenic acid on glycemic control in individuals with type 2 diabetes: A systematic review and meta-analysis of randomized controlled clinical trials by Jovanovski E1, Li D, […], Vuksan V.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5457843/

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

4.4 g/day alpha-linolenic acid can be achieved by taking 1 to 2 tablespoons of flax or salba-chia seeds or about 12 whole walnuts per day.

 

Objectives:
Although epidemiological studies have examined the role of chocolate in preventing cardiometabolic disease, the results remain inconsistent. Therefore, this review article (meta-analysis) has been conducted.

Does chocolate consumption reduce risk of coronary heart disease (CHD), stroke and diabetes?

Study design:
This review article included 14 prospective cohort studies, with 508,705 participants from six countries and 7,267 coronary heart disease (CHD) cases, 8,197 stroke cases and 13,271 diabetes cases.
The follow-up duration of the studies ranged from 5 to 16 years.
One serving was defined as 30g of chocolate.
The majority of chocolate consumed in the included studies was milk or dark chocolate.

Results and conclusions:
The investigators found in 6 cohort studies for the highest versus lowest intake of chocolate a significant reduced risk of 10% for coronary heart disease [pooled RR = 0.90, 95% CI = 0.82-0.97, I2 = 24.3%, p = 0.25]. Leave-one-out sensitivity analysis had no significant influence on the pooled results.

The investigators found regarding CHD subtype, a significant reduced risk of 14% [RR = 0.86, 95% CI = 0.77-0.96] for myocardial infarction.

The investigators found for studies with follow-up duration of 10 years a significant reduced risk of 28% for coronary heart disease [RR = 0.72, 95% CI = 0.57-0.92].

The investigators found for studies with follow-up duration of ≥10 years a significant reduced risk of 8% for coronary heart disease [RR = 0.92, 95% CI = 0.86-0.99].

The investigators found in dose-response meta-analysis of 5 studies a curvilinear association between chocolate consumption and risk of coronary heart disease [p for nonlinearity = 0.006].

The investigators found in dose-response meta-analysis, compared with no intake, a significant reduced risk of 6% for coronary heart disease for 1 serving (30g) chocolate per week [RR = 0.94, 95 CI = 0.90-0.99].   

The investigators found in dose-response meta-analysis, compared with no intake, a significant reduced risk of 9% for coronary heart disease for 3 servings (90g) chocolate per week [RR = 0.91, 95 CI = 0.85-0.97].   

The investigators found in dose-response meta-analysis, compared with no intake, a significant reduced risk of 11% for coronary heart disease for 7 servings (210g) chocolate per week [RR = 0.89, 95 CI = 0.83-0.95].   

The investigators found in dose-response meta-analysis, compared with no intake, a significant reduced risk of 12% for coronary heart disease for 10 servings (300g) chocolate per week [RR = 0.88, 95 CI = 0.81-0.95].   

The investigators found in 8 reports from 7 studies for the highest versus lowest level of chocolate consumption a significant reduced risk of 16% for stroke [pooled RR = 0.84, 95% CI = 0.78-0.90, I2 = 0%, p = 0.49]. The pooled risk of total stroke was not obviously modified in the sensitivity analysis by excluding one study at a time
Egger’s test suggested the presence of publication bias [p = 0.008]. However, after introducing the “trim and fill” method to adjust this bias, the overall risk estimate remained significant in favor of chocolate intake [RR = 0.86, 95% CI = 0.79-0.92].

The investigators found with regard to stroke subtypes, a significant reduced risk of 13% [RR = 0.87, 95% CI = 0.78-0.96] for cerebral infarction and a significant reduced risk of 17% [RR = 0.83, 95% CI = 0.71-0.97] for hemorrhagic stroke.

The investigators found in the stratified analysis by gender, a significant reduced risk of 13% of total stroke for male [RR = 0.87, 95% CI = 0.79-0.97] and a significant reduced risk of 16% of total stroke for female [RR = 0.84, 95% CI = 0.74-0.94].

The investigators found a significant reduced risk of 44% for studies with follow-up durations of 10 years [RR = 0.56, 95% CI = 0.37-0.85].

The investigators found a significant reduced risk of 15% for studies with follow-up durations of ≥10 years [RR = 0.85, 95% CI = 0.79-0.91].

The investigators found in 7 reports from 6 studies a nonlinear correlation between chocolate intake and risk of stroke [p for nonlinearity = 0.001].

The investigators found in dose-response meta-analysis, compared with no intake, a significant reduced risk of 9% for stroke for 1 serving chocolate per week [RR = 0.91, 95% CI = 0.86-0.97].   

The investigators found in dose-response meta-analysis, compared with no intake, a significant reduced risk of 13% for stroke for 3 servings chocolate per week [RR = 0.87, 95% CI = 0.81-0.94].   

The investigators found in dose-response meta-analysis, compared with no intake, a significant reduced risk of 15% for stroke for 7 servings chocolate per week [RR = 0.85, 95% CI = 0.76-0.93].   

The investigators found in dose-response meta-analysis, compared with no intake, a significant reduced risk of 17% for stroke for 10 servings chocolate per week [RR = 0.83, 95% CI = 0.72-0.94].   

The investigators found in 4 studies using “trim and fill” method, for the highest versus lowest intake of chocolate, a non-significant reduced risk of 8% for diabetes [pooled RR = 0.92, 95% CI = 0.78-1.08].

The investigators found in stratified analysis by sex, a significant reduced risk of 21% [RR = 0.79, 95% CI = 0.65-0.96] for men and a non-significant reduced risk of 8% [RR = 0.92, 95% CI = 0.72-1.17] for women.
Similarly, the risks of diabetes were not different between subsets of studies with follow-up durations of below or over 10 years [p for interaction = 0.51].

The investigators found in dose-response meta-analysis of 6 reports, a curvilinear association between chocolate intake and risk of diabetes [p for nonlinearity 0.001].

The investigators found in dose-response meta-analysis, compared with no intake, a significant reduced risk of 20% for diabetes for 1 serving chocolate per week [RR = 0.80, 95% CI = 0.71-0.91]. Significant means that there is an association with a 95% confidence.

The investigators found in dose-response meta-analysis, compared with no intake, a significant reduced risk of 24% for diabetes for 3 servings chocolate per week [RR = 0.76, 95% CI = 0.63-0.91]. Significant because RR of 1 was not found in the 95% CI of 0.63 to 0.91. RR of 1 means no risk/association.

The investigators found in dose-response meta-analysis, compared with no intake, a non-significant reduced risk of 17% for diabetes for 7 servings chocolate per week [RR = 0.83, 95% CI = 0.67-1.03]. Non-significant means it cannot be said with a 95% confidence that 7 servings chocolate per week really decreased the risk of diabetes with 17%.

The investigators found in dose-response meta-analysis, compared with no intake, a non-significant reduced risk of 11% for diabetes for 10 servings chocolate per week [RR = 0.89, 95% CI = 0.69-1.16].   

The investigators found in general, the dose-response pattern was J-shaped and the peak reduction in diabetes risk occurred at an intake of 2 servings/week [RR = 0.75, 95% CI = 0.63-0.89], with no protective effects observed when consuming chocolate > 6 servings/week.

The investigators concluded that chocolate consumption confers reduced risks of coronary heart disease, stroke and diabetes. Consuming chocolate in moderation (1-6 servings/week or 30-180g) may be optimal for the prevention of these burdensome diseases. However, additional large prospective studies are required to confirm the observed benefits of chocolate in populations with different characteristics and to establish the optimum frequency of chocolate intake for preventing cardiometabolic disease.

Original title:
Chocolate Consumption and Risk of Coronary Heart Disease, Stroke, and Diabetes: A Meta-Analysis of Prospective Studies by Yuan S, Li X, […], Lu J.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5537803/

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

Objectives:
The clinical benefits of perioperative antioxidant vitamin therapy in cardiac patients remain controversial. Therefore, this review article (meta-analysis) has been conducted.

Do patients undergoing cardiac surgery benefit from perioperative antioxidant vitamin therapy?

Study design:
This review article included 12 RCTs with 1584 cardiac patients.

Results and conclusions:
The investigators found compared with placebo or no antioxidant vitamin therapy that administration of antioxidant vitamin therapy resulted in a significant reduction:
-in postoperative atrial fibrillation (POAF) [RR = 0.55, 95% CI = 0.42 to 0.73, p  0.0001];
-duration of hospital stay [MD = -0.68, 95% CI = -0.98 to -0.39, p  0.00001];
-intensive care unit length of stay [MD = -0.21, 95% CI = -0.30 to -0.12, p  0.00001] and;      
-intubation time [MD = -2.41, 95% CI = -3.83 to -0.98, p = 0.001].

The investigators also found a trend towards a decrease in postoperative complications [RR = 0.72, 95% CI = 0.48-1.08, p = 0.11] and duration of postoperative atrial fibrillation [MD = -1.950, 95% CI = -3.28 to 0.29, p = 0.10].

The investigators concluded that perioperative antioxidant vitamin therapy in patients undergoing cardiac surgery reduces the incidence of postoperative atrial fibrillation, duration of hospital stay, intensive care unit length of stay and intubation time.

Original title:
The clinical benefits of perioperative antioxidant vitamin therapy in patients undergoing cardiac surgery: a meta-analysis by Geng J, Qian J, […], Shen Z.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28645181

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

Objectives:
Studies implicate choline and betaine metabolite trimethylamine N-oxide (TMAO) in cardiovascular disease (CVD). Therefore, this review article (meta-analysis) has been conducted.

Is there an association between choline and betaine dietary intake and cardiovascular disease?

Study design:
This review article included a total of 6 prospective cohort studies comprising 18,076 incident cardiovascular disease events, 5,343 cardiovascular disease deaths among 184,010 participants.

There was no evidence for heterogeneity among studies.
Only 2 studies provided data on phosphatidylcholine and cardiovascular disease mortality.

Results and conclusions:
The investigators found in random effects meta-analysis, incident cardiovascular disease was not associated with choline [RR = 1.00, 95% CI = 0.98-1.02] or betaine [RR = 0.99, 95% CI = 0.98-1.01] dietary intake.
Results did not vary by study outcome (incident coronary heart disease, stroke, total cardiovascular disease).

The investigators found random effects meta-analysis did not support an association between choline and cardiovascular disease mortality [RR = 1.09, 95% CI = 0.89-1.35], but one study supported a positive association and there was significant heterogeneity [I2 = 84%, p 0.001].

The investigators concluded that there is no association between dietary choline/betaine intake with incident cardiovascular disease, but further research into choline and cardiovascular disease mortality are needed.

Original title:
Dietary Choline and Betaine and Risk of CVD: A Systematic Review and Meta-Analysis of Prospective Studies by Meyer KA and Shea JW.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28686188

Additional information of El Mondo:
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Objectives:
It has been unclear whether supplemental probiotics therapy improves clinical outcomes in type 2 diabetic patients. Therefore, this meta-analysis (systematic review) has been conducted.

Do probiotics supplements improve clinical outcomes in type 2 diabetic patients?

Study design:
This review article included 12 RCTs involving 684 type 2 diabetic patients.

Results and conclusions:
The investigators found a significant decreased glucose level in the probiotics group [pooled standardized mean difference = -0.18 mg/dL, 95% CI = -0.35 to -0.01, p = 0.04, I2 = 64%, p = 0.004] compared to the control group.

The investigators found a significant reduction in HbA1c in the probiotics group [pooled standardized mean difference = -0.38%, 95% CI = -0.62 to -0.14, p = 0.002, I2 = 0%, p = 0.72] compared to the control group.

The investigators found a significant reduction in fasting insulin level in the probiotics group [pooled standardized mean difference = -0.38, 95% CI = -0.59 to -0.18, p = 0.003, I2 = 0%, p = 0.81] compared to the control group.

The investigators found a significant reduced HOMA-IR level in the probiotics group [pooled standardized mean difference = -0.99, 95% CI = -1.52 to -0.4, p = 0.0002, I2 = 86%, p 0.00001] compared to the control group.

The investigators found a significant reduced CRP level in the probiotics group [pooled standardized mean difference = -1.34 mg/L, 95% CI = -1.76 to -0.92, p 0.00001, I2 = 90%, p 0.00001] compared to the control group.

The investigators found a non-significant reduction in both triglyceride levels [SMD = -0.23, 95% CI = -0.48 to 0.02, p = 0.07, I2 = 52%, p = 0.03] and cholesterol levels [total cholesterol: SMD = -0.18, 95% CI = -0.42 to 0.06, p = 0.14, I2 = 47%, p = 0.05 and LDL-cholesterol: SMD = -0.03, 95% CI = -0.20 to 0.14, p = 0.73, I2 = 3%, p = 0.41] in the probiotics group compared to the control group.

The investigators concluded that probiotics supplementation is associated with significant improvement in HbA1c and fasting insulin in type 2 diabetes patients. These results may provide evidence for encouraging use of probiotics in patients with type 2 diabetes mellitus. However, more randomized placebo-controlled trials with larger sample sizes are warranted to confirm these findings.

Original title:
Effect of Probiotics on Glucose and Lipid Metabolism in Type 2 Diabetes Mellitus: A Meta-Analysis of 12 Randomized Controlled Trials by Yao K, Zeng L, [...], Zou X.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5491138/

Additional information of El Mondo:
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Objectives:
Controversy exists on the association between alcohol consumption and risk of heart failure (HF). Therefore, this review article (meta-analysis) has been conducted.

Is there an association between alcohol consumption and risk of heart failure?

Study design:
This review article included a total of 13 prospective cohort studies, with 13,738 heart failure cases among 355,804 participants.

Results and conclusions:
The investigators found light alcohol drinking (0.1-7 drinks/week) significantly reduced risk of heart failure with 14% [RR = 0.86, 95% CI = 0.81-0.90]. However, there was no statistically significant association between moderate (7.1-14 drinks/week), high (14.1-28 drinks/week), or heavy (>28 drinks/week) alcohol consumption and heart failure risk.

The investigators found former drinking significantly increased risk of heart failure with 22% [RR = 1.22, 95% CI = 1.11-1.33] compared with never or occasional drinking.

The investigators concluded that light alcohol drinking (0.1-7 drinks/week) is associated with a lower risk of heart failure, while former drinking is associated with a higher risk of heart failure.

Original title:
Alcohol consumption and risk of heart failure: Meta-analysis of 13 prospective studies by Susanna C. Larsson, […], Alicja Wolk

Link:
http://www.sciencedirect.com/science/article/pii/S0261561417301681

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Objectives:
Low glycaemic index (GI) diets are beneficial in the management of hyperglycemia. Cardiovascular diseases are the major cause of mortality in diabetes therefore it is important to understand the effects of GI on blood lipids. Therefore, this review article has been conducted.

Does a low GI diet lower the cholesterol levels?

Study design:
This review article included 28 RCTs comparing low with high GI diets over at least 4 weeks. These 28 RCTs contained 1272 participants with studies ranged from 6 to 155 participants, one was powered on blood lipids and 3 had adequate allocation concealment.

Results and conclusions:
The investigators found that compared to high GI diet low GI diet significantly reduced total cholesterol by 0.13 mmol/L [95% CI = -0.22 to -0.04, p = 0.004, 27 trials, 1441 participants]. Significantly means, it can be said with 95% confidence that low GI diet really lowered the total cholesterol levels with 0.13 mmol/L.

The investigators found that compared to high GI diet low GI diet significantly reduced LDL-cholesterol by 0.16 mmol/L [95% CI = -0.24 to -0.08, p 0.0001, 23 studies, 1281 participants]. Significantly, because the p-value was less than 0.05.

The investigators found subgroup analyses suggested that reductions in LDL-cholesterol were greatest in studies of shortest duration and greatest magnitude of GI reduction. Furthermore, lipid improvements appeared greatest and most reliable when the low GI intervention was accompanied by an increase in dietary fiber.

The investigators found sensitivity analyses, removing studies without adequate allocation concealment, lost statistical significance but retained suggested mean falls of 0.10 mmol/L in both.

The investigators found no effects on HDL-cholesterol [MD = -0.03 mmol/L, 95% CI = -0.06 to 0.00, I2 = 0%], or triglycerides [MD was 0.01 mmol/L, 95% CI = -0.06 to 0.08, I2 = 0%].

The researchers concluded that low GI diets reduce total and LDL-cholesterol (bad cholesterol) but had no effect on HDL-cholesterol (good cholesterol) or triglycerides.

Original title:
Low glycemic index diets and blood lipids: A systematic review and meta-analysis of randomized controlled trials by Goff LM, Cowland DE, [...], Frost GS.

Link:
http://www.sciencedirect.com/science/article/pii/S0939475312001524

Additional information of El Mondo:
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High LDL-cholesterol levels and high triglyceride levels increase the risk of getting cardiovascular diseases whereas high HDL-cholesterol levels decrease the risk of getting cardiovascular diseases.

A low GI diet is a diet with a GI value of 55 or lower.

Objectives:
Recent evidence has suggested that flavonoid and lignan intake may be associated with decreased risk of chronic and degenerative diseases. Therefore, this review article (meta-analysis) has been conducted.

Does dietary flavonoid intake reduce risk of all-cause and cardiovascular disease mortality?

Study design:
This review article included 22 prospective cohort studies.

Results and conclusions:
The investigators found when compared with lower consumption, high consumption of total flavonoids was associated with a significant decreased risk of 26% for all-cause mortality [risk ratio = 0.74, 95% CI = 0.55-0.99].

The investigators found a 100-mg/day increment in dietary total flavonoids intake led to a (linear) decreased risk of 6% and 4% of all-cause and cardiovascular disease mortality, respectively.

The investigators found among flavonoid classes, significant results were obtained for intakes of flavonols, flavones, flavanones, anthocyanidins and proanthocyanidins.

The investigators found limited evidence was available on lignans intake and all-cause mortality.

The investigators concluded that higher dietary flavonoids intakes - at least 100-mg/day of flavonols, flavones, flavanones, anthocyanidins or proanthocyanidins - are associated with decreased risk of all-cause and cardiovascular disease mortality.

Original title:
Dietary Flavonoid and Lignan Intake and Mortality in Prospective Cohort Studies: Systematic Review and Dose-Response Meta-Analysis by Grosso G, Micek A, […], Giovannucci EL.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28472215

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Objectives:
Does diabetes increase risk of incident dementia and mild cognitive impairment?

Study design:
This review article included 19 prospective longitudinal studies including 6184 subjects with diabetes and 38530 subjects without diabetes. All subjects were without dementia or mild cognitive impairment at baseline (=at the beginning of the study).

There was no publication bias.

Results and conclusions:
The investigators found persons with diabetes had a significant increased risk of 46% for Alzheimer's disease [RR = 1.46, 95% CI = 1.20-1.77]. Significant means that there is an association with a 95% confidence.

The investigators found persons with diabetes had a significant increased risk of 148% for vascular dementia [RR = 2.48, 95% CI = 2.08-2.96].

The investigators found persons with diabetes had a significant increased risk of 51% for any dementia [RR = 1.51, 95% CI = 1.31-1.74]. Significant because RR of 1 was not found in the 95% CI of 1.31 to 1.74. RR of 1 means no risk/association.

The investigators found persons with diabetes had a significant increased risk of 21% for mild cognitive impairment [RR = 1.21, 95% CI = 1.02-1.45].

The investigators concluded diabetes is a risk factor for incident dementia (including Alzheimer's disease, vascular dementia and any dementia) and mild cognitive impairment.

Original title:
Diabetes as a risk factor for dementia and mild cognitive impairment: a meta-analysis of longitudinal studies by Cheng G, Huang G, [...], Wang H.

Link:
http://onlinelibrary.wiley.com/doi/10.1111/j.1445-5994.2012.02758.x/epdf

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Objectives:
The association between elevated serum phosphorus concentration and cardiovascular or all-cause mortality yielded conflicting results. Therefore, this review article (meta-analysis) has been conducted.

Does an elevated serum phosphorus concentration increase cardiovascular and all-cause mortality in the general population?

Study design:
This review article included 6 prospective cohort studies involving 120,269 subjects.

Results and conclusions:
The investigators found when compared the highest with the reference concentration of serum phosphorus, a significant increased risk of 36% for cardiovascular mortality [pooled RR = 1.36, 95% CI = 1.07-1.72]. Significant because RR of 1 was not found in the 95% CI of 1.07 to 1.72. RR of 1 means no risk/association.

The investigators found when compared the highest with the reference concentration of serum phosphorus, a significant increased risk of 33% for all-cause mortality [pooled RR = 1.33, 95% CI = 1.15-1.58]. Significant means that there is an association with a 95% confidence.

The investigators found stratified analyses revealed that elevated serum phosphorus significantly increased all-cause mortality risk with 33% among men [RR 1.33, 95% CI = 1.11-1.60], but not in women [RR = 1.09, 95% CI = 0.89-1.33].

The investigators concluded elevated serum phosphorus concentration is independently associated with excessive risk of cardiovascular and all-cause mortality in the general population without chronic kidney disease. Serum phosphorus on all-cause mortality risk appears to be pronounced in men but exhibits no clear effect on women. However, gender difference of elevated serum phosphorus on mortality risk should be verified by more prospective cohort studies.

Original title:
Serum phosphorus, cardiovascular and all-cause mortality in the general population: A meta-analysis by Bai W, Li J and Liu J.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/27475981

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Objectives:
Increased dietary potassium intake is thought to be associated with low blood pressure (BP). Whether potassium supplementation may be used as an antihypertensive agent is a question that should be answered. Therefore, this review article (meta-analysis) has been conducted.

Does potassium supplementation reduce blood pressure among patients with essential hypertension (SBP ≥140 mmHg and DBP ≥90 mmHg)?

Study design:
This review article included 23 trials (9 parallel and 14 crossover randomized placebo-controlled clinical trials with a minimum of 4 weeks of therapy to ensure that the intervention had sufficient time to produce an effect) involving 1,213 patients with essential hypertension (SBP ≥140 mmHg and DBP ≥90 mmHg).

The result of meta-regression revealed that the association between potassium dosage, follow-up period and mean age were not statistically significant; therefore they did not play an important role in the heterogeneity across studies.

There was no publication bias.

Results and conclusions:
The investigators found that potassium supplementation significantly reduced systolic blood pressure (SBP) of patients with essential hypertension with 4.25 mmHg [95% CI = -5.96 to -2.53, I2 = 41%].

The investigators found that potassium supplementation significantly reduced diastolic blood pressure (DBP) of patients with essential hypertension with 2.53 mmHg [95% CI = -4.05 to -1.02, I2 = 65%].

The investigators found in 8 RCTs when compared to baseline, the mean changes in systolic blood of patients with essential hypertension was -8.89 mmHg [95% CI = -13.67 to -4.11] significantly higher in the intervention group (group taking potassium supplements) than the control group. 

The investigators found in 8 RCTs when compared to baseline, the mean changes in diastolic blood pressure of patients with essential hypertension was -6.42 mmHg [95% CI = -10.99 to -1.84] significantly higher in the intervention group (group taking potassium supplements) than the control group. 

The investigators found in subgroup analysis that the mean difference in systolic blood of patients with essential hypertension was -2.64 mmHg [95% CI = -5.25 to -0.03] in America, -4.56 mmHg [95% CI = -6.51 to -2.62) in Europe and -5.21 mmHg [95% CI = -9.63 to -0.79] in Asia.

The investigators found a dose-response relationship between potassium intake and reduction in systolic and diastolic blood pressure (low-dose (50 mmol/day), moderate-dose (50-99 mmol/day) and high-dose (≥100 mmol/day)).

The investigators concluded that potassium supplementation for at least 4 weeks reduces blood pressure of patients with essential hypertension and therefore, can be recommended as an adjuvant antihypertensive agent for patients with essential hypertension (SBP ≥140 mmHg and DBP ≥90 mmHg).

Original title:
Oral potassium supplementation for management of essential hypertension: A meta-analysis of randomized controlled trials by Poorolajal J, Zeraati F, […], Maleki A.

Link:
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0174967

Additional information of El Mondo:
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Objectives:
Previous meta-analyses identified an inverse association of coffee consumption with the risk of type 2 diabetes. However, an updated meta-analysis is needed because new studies comparing the trends of association for caffeinated and decaffeinated coffee have since been published. Therefore, this review article has been conducted.

Does coffee intake reduce type 2 diabetes risk in a dose-response manner?

Study design:
This review article included 28 prospective cohort studies with 1109272 study participants and 45335 cases of type 2 diabetes. The follow-up duration ranged from 10 months to 20 years.

Results and conclusions:
The investigators found for compared with no or rare coffee consumption, a significant reduced risk of type 2 diabetes of:
8% [RR = 0.92, 95% CI = 0.90-0.94] for 1 cup/day;
15% [RR= 0.85, 95% CI = 0.82-0.88] for 2 cups/day;
21% [RR = 0.79, 95% CI = 0.75-0.83] for 3 cups/day;
25% [RR = 0.75, 95% CI = 0.71-0.80] for 4 cups/day;
29% [RR = 0.71, 95% CI = 0.65-0.76] for 5 cups/day and;
33% [RR = 0.67, 95% CI = 0.61-0.74] for 6 cups/day.

The investigators found a significant decreased risk of type 2 diabetes of 9% [RR = 0.91, 95% CI = 0.89-0.94] for an increasement of 1 cup/day caffeinated coffee and 6% [RR = 0.94, 95% CI = 0.91-0.98] for an increasement of 1 cup/day decaffeinated coffee [p for difference = 0.17].

The investigators concluded coffee consumption is inversely associated with the risk of type 2 diabetes in a dose-response manner. Both caffeinated and decaffeinated coffee is associated with reduced diabetes risk.

Original title:
Caffeinated and decaffeinated coffee consumption and risk of type 2 diabetes: a systematic review and a dose-response meta-analysis by Ding M, Bhupathiraju SN, […], Hu FB.

Link:
http://www.ncbi.nlm.nih.gov/pubmed/24459154

Additional information of El Mondo:
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Objectives:
The prevalence of obesity and diabetes is increasing among children, adolescents and adults. Although estimates of the efficacy of exercise training on fasting insulin and insulin resistance have been provided for adults, similar estimates have not been provided for youth. Therefore, this review article has been conducted.

Study design:
This review article included 24 trials.

Results and conclusions:
The investigators found a small to moderate effect for exercise training on fasting insulin and improving insulin resistance in youth [Hedges’ d effect size = 0.48, 95% CI = 0.22-0.74, p 0.001 and 0.31, 95% CI = 0.06-0.56, p 0.05, respectively].

The investigators concluded there is evidence to support the use of exercise training in the prevention and treatment of type 2 diabetes in youth.

Original title:
Exercise and Insulin Resistance in Youth: A Meta-Analysis by Fedewa MV, Gist NH, […], Dishman RK.

Link:
http://www.pediatricsdigest.mobi/content/133/1/e163.abstract

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Objectives:
Reported associations between protein intake from different sources and type 2 diabetes (T2D) have been inconsistent.Therefore, this review article has been conducted.

Study design:
This review article included 11 prospective cohort studies with 505,624 participants and 37,918 type 2 diabetes cases (follow-up range: 5-24 years).

Results and conclusions:
The investigators found for the comparison of the highest with lowest categories of total protein intakes a significant higher risk of 9% for type 2 diabetes [RR = 1.09, 95% CI = 1.06 to 1.13]. Significant means that there is an association with a 95% confidence.

The investigators found for the comparison of the highest with lowest categories of animal protein intakes a significant higher risk of 19% for type 2 diabetes [RR = 1.19, 95% CI = 1.11 to 1.28].

The investigators found for the comparison of the highest with lowest categories of plant protein intakes a non-significant reduced risk of 5% for type 2 diabetes [RR = 0.95, 95% CI = 0.89 to 1.02]. Non-significant means it cannot be said with a 95% confidence that a daily higher intake of plant protein really reduced risk of type 2 diabetes with 5%.

The investigators found for the comparison of the highest with lowest categories of plant protein intakes a significant reduced risk of 7% for type 2 diabetes among women [RR = 0.93, 95% CI = 0.85 to 1.00].

The investigators found for the comparison of the highest with lowest categories of plant protein intakes a significant reduced risk of 9% for type 2 diabetes among US populations [RR = 0.91, 95% CI = 0.84 to 0.97].

The investigators concluded that a higher intake of total and animal protein are both associated with an increased risk of of type 2 diabetes. However, a higher intake of plant protein decreases risk of type 2 diabetes among women and US populations.

Original title:
Dietary protein intake and risk of type 2 diabetes: results from the Melbourne Collaborative Cohort Study and a meta-analysis of prospective studies by Shang X, Scott D, […], Sanders KM.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/27629053

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Objectives:
Garlic is a common spicy flavouring agent also used for certain therapeutic purposes. Garlic's effects on blood glucose have been the subject of many clinical and animal studies. However, studies reporting hypoglycemic effects of garlic in humans are conflicting. Therefore, this review article (meta-analysis) has been conducted.

Has garlic supplementation lowering effects on glycemic control measurements such as fasting blood glucose (FBG), postprandial glucose (PPG) and glycated haemoglobin (HbA1c)?

Study design:
This review article included a total of 7 RCTs (parallel design) that involved 9 comparisons with 513 subjects. The trials varied in size from 33 to 180 subjects. The study duration varied from 4 to 24 week (median: 12 week). The trials enrolled male and female subjects, both healthy and with diabetes.

Doses of garlic in the treatment group ranged from 600 to 1500 mg/d.

Results and conclusions:
The investigators found pooled analyses showed that garlic supplementation resulted in a statistically significant lowering in fasting blood glucose [SMD = -1.67, 95% CI = -2.80 to -0.55, p = 0.004].

The investigators could not perform a pooled analyse for postprandial glucose (PPG) control and glycosylated haemoglobin (HbA1c) outcomes, because only 1 study included in the meta-analysis reported PPG variables and only 2 studies reported HbA1c variables.

The investigators concluded that garlic supplementation (600 to 1500 mg/d) during 12 weeks results in a lowering in fasting blood glucose. More trials are needed to investigate the effectiveness of garlic on HbA1c and PPG.

Original title:
Garlic intake lowers fasting blood glucose: meta-analysis of randomized controlled trials by Hou LQ, Liu YH and Zhang YY.

Link:
http://apjcn.nhri.org.tw/server/APJCN/24/4/575.pdf

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Objectives:
An increased intake of magnesium might lower blood pressure (BP), yet evidence from clinical trials is inconsistent, perhaps as a result of small sample size or heterogeneity in study design. Therefore, this review article (meta-analysis) has been conducted.

Are there dose-dependent effects of magnesium supplementation on blood pressure?

Study design:
This review article included 20 RCTs included 14 of hypertensive and 6 of normotensive persons totaling 1220 participants.
The doses of magnesium ranged from 10 to 40 mmol/day (median: 15.4 mmol/day or 370 mg per day).

Results and conclusions:
The investigators found magnesium supplementation resulted in only a small overall non-significant reduction in blood pressure. The pooled net estimates of blood pressure change were -0.6 mmHg [95% CI = -2.2 to 1.0] for systolic blood pressure and -0.8 mmHg [95% CI = -1.9 to 0.4] for diastolic blood pressure.

However, the investigators found an apparent dose-dependent effect of magnesium, with significant reductions of 4.3 mmHg systolic blood pressure [95% CI = 6.3 to 2.2, p 0.001) and non-significant reductions of 2.3 mmHg diastolic blood pressure [95% CI = 4.9 to 0.0, p = 0.09) for each 10 mmol/day (240 mg/day) increase in magnesium dose.

The investigators concluded there is a dose-dependent blood pressure reductions, especially systolic blood pressure from magnesium supplementation. However, adequately powered trials with sufficiently high doses of magnesium supplements need to be performed to confirm this relationship.

Original title:
The effect of magnesium supplementation on blood pressure: a meta-analysis of randomized clinical trials by Jeea SH, Miller ER, [...], Klagb MJ.

Link:
http://www.sciencedirect.com/science/article/pii/S0895706102029643

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Objectives:
The findings of prospective cohort studies are inconsistent regarding the association between dietary magnesium intake and serum magnesium concentration and the risk of hypertension. Therefore, this review article (meta-analysis) has been conducted.

Do dietary magnesium intake and serum magnesium concentrations reduce risk of hypertension?

Study design:
This review article included 10 cohort studies, including 20,119 cases of hypertension and 180,566 participants.

The range of dietary magnesium intake was 96-25 mg/day and serum magnesium levels were 0.66-0.95 mmol/L.

The funnel plot showed reasonable symmetry, with no evidence of publication bias (Egger’s test p = 0.95 and Begg’s test p = 0.71).

Results and conclusions:
The investigators found when comparing the highest to the lowest category of dietary magnesium consumption, a significant reduced risk of 8% for hypertension [pooled RR = 0.92, 95% CI = 0.86-0.98].

The investigators found for every 100 mg/day increment in dietary magnesium intake a significant reduced risk of 5% for hypertension [pooled RR = 0.95, 95% CI = 0.90-1.00, I2 = 39.3%, p = 0.13].
The reduced hypertension risk associated with 100 mg/day was tended to be observed when the duration of follow-up was more than 8 years and when the results were adjusted separately for calcium, sodium, fiber, cholesterol, saturated fat intake or smoking.

The investigators found the dose-response meta-analysis suggested a marginal linear relationship between dietary magnesium intake and hypertension risk [p for linearity = 0.057].

The investigators found no association between serum magnesium concentrations and reduced risk of hypertension [pooled RR = 0.91, 95% CI = 0.80-1.02, p = 0.10, I2 = 0%, p = 0.48].

The investigators concluded that increased dietary magnesium intake is associated with lower risk of hypertension in a linear dose-response pattern. However, there is no association between serum magnesium concentration and risk of hypertension.

Original title:
Dose-response relationship between dietary magnesium intake, serum magnesium concentration and risk of hypertension: a systematic review and meta-analysis of prospective cohort studies by Han H, Fang X, […], Cao Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5420140/

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Objectives:
What is the relationship between intake of 12 major food groups and risk of type 2 diabetes (T2D)?

Study design:
This review article included prospective cohort studies.
The 12 major food groups are whole grains, refined grains, vegetables, fruits, nuts, legumes, eggs, dairy, fish, red meat, processed meat and sugar-sweetened beverages (SSB).

The meta-evidence was graded "low" for legumes and nuts; "moderate" for refined grains, vegetables, fruit, eggs, dairy and fish; and "high" for processed meat, red meat, whole grains and sugar-sweetened beverages.

Results and conclusions:
The investigators found 6 out of the 12 food-groups showed a significant relation with risk of type 2 diabetes; 3 of them a decrease of risk with increasing consumption (whole grains, fruits and dairy) and 3 an increase of risk with increasing consumption (red meat, processed meat and sugar-sweetened beverages) in the linear dose-response meta-analysis.

The investigators found evidence of a non-linear relationship between fruits, vegetables, processed meat, whole grains and sugar-sweetened beverages and type 2 diabetes risk.

The investigators found optimal consumption of risk-decreasing foods resulted in a 42% reduction and consumption of risk-increasing foods was associated with a threefold type 2 diabetes risk, compared to non-consumption.

The meta-evidence was graded "low" for legumes and nuts; "moderate" for refined grains, vegetables, fruit, eggs, dairy and fish; and "high" for processed meat, red meat, whole grains, and sugar-sweetened beverages. Among the investigated food groups, selecting specific optimal intakes can lead to a considerable change in risk of type 2 diabetes.

The investigators concluded that a higher consumption of whole grains, fruits and dairy products reduces type 2 diabetes risk, while a higher consumption of red meat, processed meat and sugar-sweetened beverages increases type 2 diabetes risk.

Original title:
Food groups and risk of type 2 diabetes mellitus: a systematic review and meta-analysis of prospective studies by Schwingshackl L, Hoffmann G, […], Boeing H.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28397016

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Objectives:
Heart failure (HF) remains a major health problem affecting 5.7 million adults in USA. Data on the association of egg consumption with incident heart failure have been inconsistent. Therefore, this review article (meta-analysis) has been conducted.

Does egg consumption increase incident heart failure in the general population?

Study design:
This review article included 4 prospective cohort studies with a total of 105,999 subjects and 5,059 cases of new onset heart failure.

There was no evidence of publication bias on funnel plot analysis as supported by the Egger’s test (p = 0.68).

Results and conclusions:
The investigators found when comparing the highest (≥1/day) to the lowest category of egg consumption, a significant increased risk of 25% [pooled RR = 1.25, 95% CI = 1.12-1.39, p = 0.00, I2 = %] for heart failure.

The investigators found that sensitivity analysis (stratification by excluding studies with men/women, 20 years of follow-up duration, US/Non-US studies) did not alter the main conclusion.

The investigators concluded that at least 1 egg per day increases heart failure risk in the general population. Further studies are warranted to explore the underlying biological mechanisms.

Original title:
Egg Consumption and Incidence of Heart Failure: A Meta-Analysis of Prospective Cohort Studies by Khawaja O, Singh H, […], Djoussé L.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367008/

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Objectives:
Does a low salt intake reduce blood pressure?

Study design:
This review article included 34 randomized trials with 3230 participants (the median age was 50 (range 22-73)), of which 22 were in hypertensive individuals and 12 in normotensive individuals. Of the 34 trials, 23 used crossover design and 11 used paralleled comparisons. 22 of the 34 trials were double blind, in 11 the observer was blind to blood pressure and one did not report any blinding procedure.

The study duration varied from 4 weeks to 3 years (median 4 weeks). With the usual salt intake the median 24 hour urinary sodium was 160 mmol (range 125-200 mmol), equivalent to a salt intake of 9.4 g/day (range 7.3-11.7 g/day) and the median blood pressure was 141/86 mmHg.

Despite the fact that only 7 out of 34 trials performed intention to treat analysis, the percentage of participants lost to follow-up after randomization was small (6.7% on average).

Results and conclusions:
The investigators found meta-analysis showed that the mean change in urinary sodium (reduced salt v usual salt) was -75 mmol/24 h (equivalent to a reduction of 4.4 g/day salt), and with this reduction in salt intake, the mean change in blood pressure was -4.18 mmHg [95% CI = -5.18 to -3.18, I2 = 75%] for systolic blood pressure and -2.06 mmHg [95% CI = -2.67 to -1.45, I2 = 68%] for diastolic blood pressure.

The investigators found meta-regression showed that age, ethnic group, blood pressure status (hypertensive or normotensive) and the change in 24 hour urinary sodium were all significantly associated with the fall in systolic blood pressure, explaining 68% of the variance between studies.

The investigators found a 100 mmol reduction in 24 hour urinary sodium (equivalent to a reduction 6 g/day salt) was associated with a fall in systolic blood pressure of 5.8 mmHg [95% CI = -2.5 to -9.2,  p = 0.001] after adjustment for age, ethnic group and blood pressure status.
For diastolic blood pressure, age, ethnic group, blood pressure status and the change in 24 hour urinary sodium explained 41% of the variance between studies.

The investigators found meta-analysis by subgroup showed that in people with hypertension the mean effect was -5.39 mmHg [95% CI = -6.62 to -4.15, I2 = 61%] for systolic blood pressure and -2.82 mmHg [95% CI = -3.54 to -2.11, I2 = 52%] for diastolic blood pressure.
In normotensive people, the figures were -2.42 mmHg [95% CI = -3.56 to -1.29, I2 = 66%] and -1.00 mmHg [95% CI = -1.85 to -0.15, I2 = 66%], respectively.

The investigators found further subgroup analysis showed that the decrease in systolic blood pressure was significant in both white and black people and in men and women.

The investigators found meta-analysis of data on hormones and lipids showed that the mean change was:
0.26 ng/mL/h [95% CI = 0.17 to 0.36, I2 = 70%] for plasma renin activity;
73.20 pmol/L [95% CI = 44.92 to 101.48, I2 = 62%] for aldosterone;
187 pmol/L [95% CI = 39 to 336, I2 = 5%] for noradrenaline (norepinephrine);
37 pmol/L [95% CI = -1 to 74, I2 = 12%] for adrenaline (epinephrine);
0.05 mmol/L [95% CI = -0.02 to 0.11, I2 = 0%] for total cholesterol;
0.05 mmol/L [95% CI = -0.01 to 0.12, I2 = 0%] for low density lipoprotein cholesterol (LDL-cholesterol or bad cholesterol);
-0.02 mmol/L [95% CI = -0.06 to 0.01, I2 = 16%] high density lipoprotein cholesterol (HDL-cholesterol or good cholesterol) and:
0.04 mmol/L [95% CI = -0.02 to 0.09, I2 = 0%] for triglycerides.

The investigators concluded a modest reduction in salt intake of 4.4 g/day for 4 or more weeks causes, from a population viewpoint, important falls in blood pressure in people with both raised and normal blood pressure.
Salt reduction is associated with a small physiological increase in plasma renin activity, aldosterone and noradrenaline and no significant change in lipid concentrations.
The current recommendations to reduce salt intake from 9-12 to 5-6 g/day will have a major effect on blood pressure, but a further reduction to 3 g/day will have a greater effect and should become the long term target for population salt intake.

Original title:
Effect of longer term modest salt reduction on blood pressure: Cochrane systematic review and meta-analysis of randomised trials by He FJ, Li J and MacGregor GA.

Link:
http://www.bmj.com/content/346/bmj.f1325

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A daily diet with a maximum of 3 grams salt per day is a diet with a maximum of 0.15 gram salt per 100 kcal.
A daily diet with a maximum of 0.15 gram salt per 100 kcal is a diet with mainly products/meals with a maximum of 0.15 gram salt per 100 kcal.

Objectives:
Approximately 5.7 million Americans carry the diagnosis of systolic heart failure (HF), a major health care burden. Heart failure is a known manifestation of thiamine deficiency (TD). Therefore, this review article has been conducted.

Is thiamine deficiency (vitamin B1 deficiency) a risk factor of systolic heart failure?

Study design:
This review article included 9 studies (observational studies and RCTs).

Results and conclusions:
The investigators found systolic heart failure patients had a higher risk of 153% of getting a thiamine deficiency [odds ratio = 2.53, 95% CI = 1.65-3.87].

The investigators found diuretic use, changes in dietary habits and altered thiamine absorption and metabolism were identified as possible mechanisms of thiamine deficiency in heart failure patients.

The investigators found small observational studies and randomized control trials suggested that thiamine supplementation in heart failure population could improve ejection fraction and reduce symptoms.

The investigators concluded thiamine deficiency is more prevalent in heart failure population, and its supplementation may be beneficial. The therapeutic role of thiamine in heart failure warrants further study.

Original title:
Determining the Role of Thiamine Deficiency in Systolic Heart Failure: A Meta-Analysis and Systematic Review by Jain A, Mehta R, […], Winchester DE.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/26497757

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Objectives:
Previous systematic reviews and meta-analyses have evaluated the association of dairy consumption and the risk of cardiovascular disease (CVD). However, the findings were inconsistent. No quantitative analysis has specifically assessed the effect of yogurt intake on the incident risk of cardiovascular disease. Therefore, this review article (meta-analysis) has been conducted.

Is yogurt intake associated with a lower incident risk of cardiovascular disease?

Study design:
This review article included 9 prospective cohort studies involving a total of 291,236 participants. Follow-up durations ranged between 10.2 and 17.3 years. The baseline age of the participants ranged from ≥21 to ≥55 years. Yogurt intake was assessed by a food-frequency questionnaire (FFQ).

There was no publication bias.

Results and conclusions:
The investigators found when compared with the lowest category, highest category of yogurt consumption was not significantly related with the incident risk of cardiovascular disease [RR = 1.01, 95% = 0.95-1.08, I2 = 52%]. Not significantly because RR of 1 was found in the 95% CI of 0.95 to 1.08. RR of 1 means no risk/association.

The investigators found in the stratified analysis by type of outcome, the pooled RR of yogurt consumption was 1.04 [95% = 0.95 to 1.15] for CHD, RR = 1.02 [95% CI = 0.92 to 1.13] for stroke and RR = 0.87 [95% CI = 0.77 to 0.98] for the incident CVD events.

However, the investigators found intake of ≥200 g/day yogurt was significantly associated with a lower risk of 8% [RR = 0.92, 95% CI = 0.85 to 1.00] for cardiovascular disease in the subgroup analysis.

The investigators concluded that a daily dose of ≥200 g yogurt intake is associated with a lower incident risk of cardiovascular disease. Further cohort studies and randomized controlled trials are still demanded to establish and confirm the observed association in populations with different characteristics.

Original title:
Consumption of Yogurt and the Incident Risk of Cardiovascular Disease: A Meta-Analysis of Nine Cohort Studies by Wu L and Sun D.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5372978/

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Objectives:
Olive oil (OO) as food is composed mainly of fatty acids and bioactive compounds depending from the extraction method. Both had been discussed as health promoting with still open questions. Therefore, this meta-analysis (systematic review) has been conducted.

Does olive oil intake reduce risk of type 2 diabetes?

Study design:
This review article included 4 cohort studies including 15,784 type 2 diabetes cases and 29 intervention trials.

Results and conclusions:
The investigators found the highest olive oil intake category showed a 16% reduced risk of type 2 diabetes [RR = 0.84, 95% CI = 0.77, 0.92) compared with the lowest. The reduced risk was significant.

The investigators found evidence for a nonlinear relationship between olive oil intake and the reduced risk of type 2 diabetes.

The investigators found in patients with type 2 diabetes that olive oil supplementation resulted in a significantly more pronounced reduction in HbA1c [MD = -0.27%, 95% CI = -0.37 to -0.17] and fasting plasma glucose [MD = -0.44 mmol/L, 95% CI = -0.66 to -0.22] as compared with the control groups.

The investigators concluded that the intake of olive oil is beneficial for the prevention and management of type 2 diabetes. This conclusion regards olive oil as food and might not been valid for single components comprising this food.

Original title:
Olive oil in the prevention and management of type 2 diabetes mellitus: a systematic review and meta-analysis of cohort studies and intervention trials by Schwingshackl L, Lampousi AM, […], Boeing H1.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28394365

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Objectives:
Previous systematic reviews suggest beneficial effects of flavonoids on biomarkers of cardiovascular disease (CVD) risk, but have overlooked the impact of dose response or food complexity. Therefore, this review article has been conducted.

Do taking flavonoid supplements improve flow-mediated dilation (FMD) and blood pressure?

Study design:
This review article included 63 RCTs.

Results and conclusions:
The investigators found meta-analyses of combined flavonoid subclasses showed significant improvements in FMD [chronic: 0.73%, 95% CI = 0.17 to 1.30, 14 RCTs and acute: 2.33%, 95% CI = 1.58 to 3.08, 18 RCTs].

The investigators found meta-analyses of combined flavonoid subclasses showed significant improvements in blood pressures [systolic: -1.46 mmHg, 95% CI = -0.38 to -0.53, 63 RCTs and diastolic: -1.25 mmHg, 95% CI = -1.82 to -0.67, 63 RCTs].

The investigators found similar benefits were observed for the flavan-3-ol, catechol flavonoids (catechins, quercetin, cyanidin etc.), procyanidins, epicatechin and catechin subgroups.

The investigators found dose-response relationships were non-linear for FMD (R2 ≤ 0.30), with greater associations observed when applying polynomial regression analyses (R2 ≤ 0.72). However, there was no indication of a dose response for blood pressure.

The investigators concluded flavonoid subclasses supplements show significant improvements in FMD and blood pressure. However, the flavonoid bioactivity does not follow a classical linear dose-response association and this may have important biological implications.

Original title:
Relative impact of flavonoid composition, dose and structure on vascular function: A systematic review of randomised controlled trials of flavonoid-rich food products by Kay CD, Hooper L, […], Cassidy A.

Link:
http://onlinelibrary.wiley.com/doi/10.1002/mnfr.201200363/abstract;jsessionid=2CCB9E4E779A221E42AA38998C865DA6.d02t03?deniedAccessCustomisedMessage=&userIsAuthenticated=false

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The optimal blood pressure for a healthy adult is120 mmHg systolic pressure and 80 mmHg diastolic pressure.

When blood flow increases through a vessel, the vessel dilates. This phenomenon has been coined flow-mediated dilatation (FMD). Flow-mediated dilation is an accepted technique to quantify endothelial function and has shown to have prognostic value for future cardiovascular disease (CVD). 

Objectives:
Hypertension is a major risk factor for cardiovascular disease, myocardial infarction, stroke and renal failure. Sesame consumption may benefit blood pressure (BP) due to its high polyunsaturated fatty acids, fibre, phytosterol and lignans content. To clarify this association, this review article (meta-analysis) has been conducted.

Does sesame consumption reduce blood pressure?

Study design:
This review article included 8 controlled trials with a total of 843 participants.

Results and conclusions:
The investigators found that sesame consumption significantly reduced systolic blood pressure with 7.83 mmHg [95% CI = -14.12 to -1.54, p  0.05, I2 = 99%].

The investigators found that sesame consumption significantly reduced diastolic blood pressure with 5.83 mmHg [95% CI = -9.58 to -2.08, p  0.01, I2 = 98%].

However, to reduce the heterogeneity, the meta-analysis was limited to high methodology quality trials (n = 4), which resulted in a significant reduction of 3.23 mmHg in systolic blood pressure [95% CI = -5.67 to -0.79, I2 = 33%] and a non-significant reduction of 2.08 mmHg in diastolic blood pressure [95% CI = -4.85 to 0.69, I2 = 62%].

The investigators concluded that sesame consumption reduces the systolic blood pressure but not the diastolic blood pressure. However, further investigations with larger sample sizes and better methodology quality are required to confirm the blood pressure lowering effect of sesame consumption.

Original title:
Can sesame consumption improve blood pressure? A systematic review and meta-analysis of controlled trials by Khosravi-Boroujeni H, Nikbakht E, [...], Khalesi S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28387047

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