Nutritional Advice El Mondo

Nutritional advice

Elderly

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

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

2023:

  1. High selenium dietary intake reduces hip fracture
  2. Lower serum magnesium concentrations increase fractures
  3. Lower blood carotenoid level is a risk factor for dementia
  4. High antioxidant dietary intake reduces Alzheimer's disease
  5. Fish consumption reduces Alzheimer's disease

2022:

  1. High dietary intake of vitamin E reduces dementia
  2. Skim milk, poultry and non-meat animal products reduce age-related eye disease
  3. 800-1,000 IU/d vitamin D3 reduces fracture and fall risk among elderly
  4. 400 IU/day to 300,000 IU vitamin D supplementation improves handgrip strength in postmenopausal women
  5. Higher concentration of carotenoids and vitamin E in blood reduce age-related macular degeneration
  6. Protein supplementation + exercise increase lower-extremity strength in healthy older Asian adults with sarcopenia

2021:

  1. 100 µg/d vitamin K2 + 1000 mg/d calcium supplements increase lumbar spine bone mineral
  2. Mushroom consumption reduces all-cause mortality
  3. 200-700 g/d fruits and vegetables consumption decreases frailty
  4. Monounsaturated fatty acids dietary intake reduces all-cause mortality
  5. Chair-based exercise programmes improve upper extremity and lower extremity function in older adults
  6. Supplementation with 320-729 mg/d magnesium may improve sleep in older adults with insomnia
  7. <11 g/day alcohol and <2.8 cups/day coffee reduce cognitive deficits
  8. Higher plasma DHA and EPA levels reduce advanced age-related macular degeneration
  9. Alcohol consumption increases risk of any fractures
  10. 0.5-50 mg/d carotenoid supplementation improves cognitive performance among healthy adults
  11. Daily 700-1000 mg dietary calcium intake increases cardiovascular disease in healthy postmenopausal women
  12. Daily egg consumption have beneficial effects on macular pigment optical density
  13. A high dietary intake of β-cryptoxanthin reduce osteoporosis and hip fracture

2020:

  1. EPA + DHA supplements for at least 6 months increase walking speed among the elderly
  2. 54 mg/day genistein increase bone mineral density in postmenopausal women
  3. Vitamin K + D supplement increase bone mineral density
  4. Dairy products increase bone mineral density in postmenopausal women:
  5. LDL cholesterol levels >121 mg/dL increase Alzheimer's disease
  6. Dietary intake of vitamin C-rich foods reduces risk of osteoporosis
  7. Higher linoleic acid blood concentration reduces cancer mortality
  8. Statins improve activities of daily living ability in Alzheimer disease patients
  9. Carbohydrate intake does not increase risk of fracture
  10. Middle-aged people with diabetes are at higher risk of developing dementia

2019:

  1. miRNAs may be a promising biomarker for Alzheimer's disease
  2. 1 drink or more per day increases osteoporosis
  3. Low folate levels increase risk of depression among the aged people
  4. Lower vitamin E levels increase Alzheimer's disease
  5. High serum uric acid level decreases risk of fractures
  6. Soy/soy products consumption reduce risk of mortality from cardiovascular diseases
  7. High homocysteine level increases Alzheimer disease
  8. One serving of fruits and vegetables per day reduces fractures
  9. Saturated fat increases Alzheimer disease
  10. Vegetable-based diet reduces osteoporosis in postmenopausal women
  11. Diet with high total antioxidant capacity decreases cancer mortality
  12. Potato consumption does not increase risk of mortality in adults
  13. Dietary intake of 5 mg/d vitamin A reduces age-related cataract

2018:

  1. Alzheimer's disease patients have a low plasma vitamin E level
  2. A diet with high antioxidant properties reduces all-cause mortality risk
  3. All-cause mortality risk is lowest with a diet with 50-55 En% carbohydrates
  4. A low selenium level in the brain increases Alzheimer’s disease
  5. Monounsaturated fatty acids intake derived from animal sources increase risk of fracture
  6. High fish consumption decreases risk of age-related macular degeneration
  7. Coronary heart disease and heart failure increase risk of dementia
  8. Inflammatory markers are associated with an increased risk of all-cause dementia
  9. Insulin-degrading enzyme protein level is lower in Alzheimer's disease patients
  10. Vitamin D level of 25 to 35 ng/mL decreases risk of dementia and Alzheimer's disease
  11. Aerobic exercise benefits global cognition in mild cognitive impairment patients
  12. A high consumption of yogurt and cheese reduces hip fracture
  13. Regular aerobic exercise delays cognitive decline among individuals having Alzheimer's disease

2017:

  1. High tea consumption reduces hip fracture risk among women
  2. Dietary intake of n-3 PUFAs declines hip fracture risk
  3. Every 500 kcal increase per week reduce Alzheimer’s disease with 13%
  4. Higher dietary intake of vitamin A decreases total fracture risk
  5. A high vitamin D level increases walking speed among older adults
  6. Fruit and vegetables reduce risk of cognitive disorders
  7. Atrial fibrillation, previous stroke, myocardial infarction, hypertension, diabetes and previous TIA increase risk of post-stroke dementia
  8. At least 28 g/d whole grain intake reduce risk of total, cardiovascular and cancer mortality
  9. 50 mg/day dietary vitamin C intake decreases hip fracture risk
  10. At least 4 servings/week fish is associated with decreasing memory decline
  11. Low vitamin D status is related to poorer cognition in healthy adults
  12. Serum zinc/iron levels are decreased in Alzheimer's disease patients
  13. Circulatory selenium concentration is lower in Alzheimer's disease patients
  14. Higher protein intake may increase bone mineral density
  15. Tea consumption increases bone mineral density
  16. Daily 50μg vitamin K dietary intake decreases the risk of fractures
  17. Manganese deficiency may be a risk factor for Alzheimer’s disease
  18. Olive oil intake reduces risk of type 2 diabetes
  19. Weekly 100 grams fish reduces dementia of Alzheimer type
  20. Long-term cheese consumption does not increase risk of all-cause mortality
  21. Daily 100g fruit and vegetable reduces risk of cognitive impairment and dementia among elderly
  22. Decreased walking pace increases risk of dementia in elderly populations

2015:

  1. Serum non-ceruloplasmin copper is higher in Alzheimer's disease
  2. At least 580 mg/day DHA or 1 g/day DHA/EPA improves memory function in older adults with mild memory complaints

2013:

  1. 300 μg/d dietary lutein and zeaxanthin intake reduce nuclear cataract

2012:

  1. 75-87.5 nmol/L vitamin D decrease mortality in the general population
  2. Daily 54 mg soy isoflavone for 6 weeks to 12 months reduces the frequency and severity of hot flashes
  3. Diabetes increases risk of dementia and mild cognitive impairment
  4. Dietary intakes of vitamin C and E lower risk of Alzheimer's disease

2011:

  1. Alzheimer's disease patients have higher levels of copper

2009:

  1. Isoflavone-rich soy products decrease FSH and LH in premenopausal women

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Most developed world countries have accepted the chronological age of 65 years as a definition of elderly. The common problems in elderly are:

  • High blood pressure
  • Cardiovascular disease
  • Cancer
  • Mobility and falls
  • Dementia
  • Osteoporosis
  • Decreased vision
  • Pneumonia
  • Deterioration of hearing
  • Loss of appetite and thirst
  • Muscle loss
  • Malnutrition

Nutrition has a marked effect on the aging process. For example, a good nutritional status can retard the aging process while a daily energy intake below 1700 kcal can cause a deficiency of vitamins and minerals. A deficiency of vitamins and minerals can in turn accelerate the aging process.

The aging process does not begin at 65 of age, but already at 30 or even at younger age.

One consequence of elderly is the loss of muscle strength. Per year an elderly will lose around 0.25 kg muscle. Muscle loss can be counteracted by strength training (60-85% of 1RM and 3-4 times per week). Muscle loss will result in a lower resting metabolic rate.

Dietary guidelines for elderly:

  • To maintain strong bones in elderly, is advisable to choose products with 15-25 En% protein or your daily diet (=the average of all meals/products that you eat on a daily basis) should look like this:
    15-25 En% protein, 30-35 En% fat, of which 7-10 En% saturated fat, maximum 0.3 gram salt per 100 kcal and 1.3- 1.5 grams of fiber per 100 kcal. The easiest way to meet this diet is to choose for meals/products with also 15-25 En% protein, 30-35 En% fat, of which 7-10 En% saturated fat, maximum 0.3 gram salt per 100 kcal and 1.3- 1.5 grams of fiber per 100 kcal.
    However,  the most important factors for bone maintenance in elderly are 60-90 minutes of physical exercise (preferably strength training) per day in combination with 15-30 micrograms vitamin D and 1 gram calcium or more per day.
  • Stop smoking because smoking causes atherosclerosis. Atherosclerosis is a major risk factor for developing cardiovascular diseases.
  • Aim for a healthy weight. A healthy weight has a BMI of 18.5-25. BMI is weight divided by height squared (weight (kg)/height2 (m)).
  • Spend at least 60-90 minutes per day on physical exercises or at least 10000 steps per day.
  • Eat at least 2 times a week (100-150 g fish per time) oily fishes or take daily 250-500 mg EPA and DHA. EPA and DHA are found in fish oil supplements. However, fish oil supplements cannot match the positive effects of eating fish.
  • Oily fishes are sardines, herring, salmon, anchovies, eel and mackerel.
  • Eat 300 grams of vegetables and five servings of fruit per day or 30 grams of fiber per day. 10-30 grams of fiber a day decreases the LDL cholesterol levels.
  • 30 grams of fiber per dag corresponds to a daily diet of minimum 1.5 grams of fiber per 100 kcal.
  • Limit alcohol to 2-3 glasses for men and 1-2 glasses for women per day.
  • Eat no more than 6 grams of salt per day, corresponding to 2400 mg of sodium.
  • 6 grams of salt per day corresponds to a daily diet of <0.3 g salt per 100 kcal.
  • Eat no more than 200 grams of cholesterol per day at an elevated LDL cholesterol level.
  • Eat no more than 19 grams of saturated fat per day at 2500 kcal and 15 grams of saturated fat at 2000 kcal. The WHO advises 2000 kcal per day for women and 2500 kcal for men.
  • Eat with other people because group eating can increase the appetite. Elderly people often have a poor appetite.
  • Put every day 1 bottle of 2 liters of water on the table. This ensures that you’ll get enough fluid because the sensation of thirst in the elderly can be significantly reduced.
  • Take daily 15-30 micrograms (600-1200 IU) of vitamin D. Take dietary supplements always in consultation with a dietitian, nutritionist or your GP!
  • Take daily a multi-vitamin supplement.
  • Take 500 micrograms of folic acid per day at a high homocysteine ​​level.
  • Take daily 1000 mg calcium. It can be through diet or dietary supplements.
  • Do not take antioxidant supplements. They do more harm than good!
  • It is preferable to obtain antioxidants through diet (200-300 grams of vegetables and 2-5 servings of fruit per day).

Cardiovascular diseases

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

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

2023:

  1. 500 mL/d orange juice consumption causally reduce bad cholesterol
  2. 30g/d whole grains consumption reduce all-cause mortality
  3. Dietary intake of 200-700 mg/day calcium reduces stroke among Asians
  4. Green tea may causally improve risk factors of cardiovascular disease
  5. Green tea causally lowers blood pressure in healthy individuals

2022:

  1. 20 g/day olive oil reduce all-cause mortality
  2. 25-200 g/d peanuts may causally reduce total cholesterol levels
  3. Brassica vegetables causally reduce total cholesterol
  4. Higher dietary fiber intake improves causally cardiovascular risk factors
  5. 500 mg/d dietary flavonoid intake reduces cardiovascular disease, diabetes and hypertension
  6. Serum vitamin D concentrations between 40 and 75 nmol/L reduce hypertension in adult
  7. 200 mg/day flavan-3-ols dietary intake reduce stroke
  8. Dietary oat supplementation may improve BMI among obese participants with mild metabolic disturbances

2021:

  1. Purified anthocyanin supplements reduce cardiovascular risk
  2. HDL cholesterol level under 2.33 mmol/L reduces cardiovascular disease mortality
  3. Higher sodium and lower potassium reduce in a dose-response manner cardiovascular risk
  4. 4000 mg inositol supplements reduce blood pressure
  5. 25 mg/d dietary flavonols or 5 mg/d dietary flavones reduce coronary heart disease
  6. Low-carbohydrate diets decrease LDL particle number
  7. Onion causally increases good cholesterol
  8. Dyslipidemia increases severity and mortality of COVID-19
  9. Best cut-off point of homocysteine for predicting acute ischemic stroke is 20.0 μmol/L
  10. Green leafy vegetables reduce cardiovascular disease
  11. Clinical screening for blood pressure in cerebral palsy is needed
  12. White meat reduces all-cause mortality
  13. Obesity increases atrial fibrillation recurrence in patients undergoing catheter ablation
  14. Cardiovascular drugs may not be associated with poor COVID-19 outcomes
  15. Low to moderate alcohol intake decreases venous thromboembolism
  16. Rice bran oil causally decreases cholesterol and triglyceride levels in adults
  17. Most prevalent neurological comorbidity in COVID-19 is cerebrovascular disease
  18. Weekly 175-350 grams oily fish lower cardiovascular disease among patients with vascular disease
  19. Mortality is more frequently in COVID-19 patients with chronic kidney diseases and cardiovascular disease
  20. Soy consumption causally lowers blood pressure in adults
  21. Daily 700-1000 mg dietary calcium intake increases cardiovascular disease in healthy postmenopausal women
  22. High NT-pro BNP and CK-MB levels in COVID-19 patients correlate with worse outcomes
  23. Diet with <30 En% carbohydrates causally increases adiponectin concentration in adults
  24. Omega-3 fatty acids consumption reduce recurrent venous thromboembolism

2020:

  1. 1-mg/day dietary heme iron intake increase cardiovascular disease mortality
  2. <3 cups/d coffee is essential for the prevention of dyslipidemia 
  3. Higher intakes of total protein reduce all-cause mortality
  4. 2-3 servings/week fish reduce all-cause mortality in patients with type 2 diabetes
  5. Every 1 gram sodium increases cardiovascular disease risk by 6%
  6. Most prevalent comorbidities among COVID-19 are hypertension, diabetes, cardiovascular disease, liver disease, lung disease, malignancy, cerebrovascular disease, COPD and asthma
  7. A higher fish consumption reduces coronary heart disease
  8. Dietary intake of vitamin B6 and folate reduces stroke
  9. A high serum vitamin C reduces blood pressure
  10. Male, age, cardiovascular disease, hypertension and diabetes mellitus increase mortality in patients with COVID-19
  11. Green tea reduces blood pressure in subjects with hypertension
  12. Potassium intake from 3,128 mg per day increases blood pressure
  13. Tomato consumption reduces bad cholesterol levels
  14. 200-1500 mg/d dietary calcium intakes do not increase cardiovascular disease
  15. 1-3 eggs/day during 3 to 12 weeks have no effect on blood pressure
  16. 100 mg/day magnesium dietary intake reduce type 2 diabetes
  17. Alzheimer disease increases risk of hemorrhagic stroke
  18. Pneumococcal vaccination may decrease all-cause mortality in patients with cardiovascular disease
  19. 100-g/d fish consumption decreases liver cancer
  20. Yogurt intake is associated with a reduced risk of type 2 diabetes
  21. Daily 1 cup tea decreases all-cause mortality among elderly
  22. Hypertension, diabetes, COPD, cardiovascular disease and cerebrovascular disease are major risk factors for patients with COVID-19
  23. Hypertension, cardiovascular diseases, diabetes mellitus, smoking, COPD, malignancy and chronic kidney disease are risk factors for COVID-19 infection
  24. Flaxseed supplementation decreases plasma lipoprotein(a) levels
  25. Higher linoleic acid blood concentration reduces cancer mortality
  26. Cardiovascular metabolic diseases increase risk of corona virus infection
  27. Vitamin C supplements during ≥6 weeks reduce blood pressure
  28. Quercetin supplements decrease triglycerides levels
  29. Heart failure increases risk of all-cause dementia
  30. Low-carbohydrate diet reduces cardiovascular disease

2019:

  1. Grape products reduce bad cholesterol in adults
  2. <400 mg coffee bean extract supplementation reduces blood pressure in hypertensive patients
  3. Higher circulating concentration of vitamin C, vitamin E and β-carotene reduce cardiovascular mortality
  4. Saturated fat increases Alzheimer disease
  5. Dietary intakes of anthocyanins reduce hypertension
  6. Cashew consumption improves triglyceride levels
  7. Coenzyme Q10 supplements reduce inflammation in patients with coronary artery disease
  8. Kiwifruit does not improve cardiovascular risk factors
  9. Trans fatty acids intake increases cardiovascular disease
  10. Diet with high total antioxidant capacity decreases cancer mortality
  11. Peanut consumption more than 12 weeks increases good cholesterol

2018:

  1. High dietary vitamin E intake reduces risk of stroke
  2. Diet with medium-chain saturated fatty acids leads to higher HDL cholesterol
  3. 150 g/day French-fries consumption increases risk of hypertension
  4. 10,000 steps a day do not decrease blood pressure in healthy adults
  5. Walnut-enriched diet reduces cholesterol and triglyceride levels
  6. Higher sodium intake and higher dietary sodium-to-potassium ratio are associated with a higher risk of stroke
  7. EPA/DHA ratio of < 1 reduces risk of postoperative atrial fibrillation after coronary artery bypass grafting
  8. Coronary heart disease and heart failure increase risk of dementia
  9. Coenzyme Q10 supplementation reduces serum triglycerides levels of patients with metabolic disorders
  10. Olive oil consumption decreases LDL cholesterol and triglyceride less than other plant oils
  11. 1 serving/week poultry intake reduces risk of stroke among US people
  12. Resveratrol supplements do not reduce LDL-cholesterol levels
  13. 20g/d of fish consumption reduce risk of CVD mortality

2017:

  1. Replacing saturated fat with PUFA will lower coronary heart disease events
  2. Omega-3 supplementation decreases risk of cardiac death
  3. 500 mL/d beetroot juice reduces blood pressure
  4. Atrial fibrillation, previous stroke, myocardial infarction, hypertension, diabetes and previous TIA increase risk of post-stroke dementia
  5. Daily dietary intake of 30g whole grains, 100g fruits and 200g dairy products reduce risk of hypertension
  6. At least 28 g/d whole grain intake reduce risk of total, cardiovascular and cancer mortality
  7. Red and processed meat increase risk of stroke
  8. 8.7 g/day viscous soluble fiber during 7 weeks reduces blood pressure
  9. A diet with <10 En% saturated fat reduces cholesterol and blood pressure in children
  10. Consumption of whole grains, fish, vegetables and fruit decrease risk of cardiovascular diseases
  11. Coenzyme Q10 supplements result in lower mortality and improved exercise capacity of patients with heart failure
  12. EPA and DHA supplements reduce risk of cardiovascular diseases
  13. Up to 12g/day nut consumption is associated with reduced all-cause and coronary heart disease mortality
  14. 1-724 mg/day anthocyanin supplementation improve vascular health
  15. Weekly 30-180 gram chocolate consumption reduces risk of coronary heart disease, stroke and diabetes
  16. Resistance training reduces blood pressure in prehypertensive and hypertensive subjects
  17. Perioperative antioxidant vitamin therapy in patients undergoing cardiac surgery reduces the incidence of postoperative atrial fibrillation and duration of hospital stay
  18. No association between dietary choline/betaine with incident cardiovascular disease
  19. 0.1-7 drinks/week reduce risk of heart failure
  20. 100-mg/day flavonoids decrease risk of all-cause and cardiovascular disease mortality
  21. Potassium supplementation for at least 4 weeks reduces blood pressure of patients with essential hypertension
  22. 100 mg/day dietary magnesium intake is associated with lower risk of hypertension
  23. Daily 1 egg increases heart failure risk
  24. A daily dose of ≥200 g yogurt intake decreases cardiovascular disease risk
  25. Sesame consumption reduces systolic blood pressure
  26. Higher lycopene exposure reduces risk of cardiovascular diseases
  27. Abdominal adiposity and higher body fat mass increase risk of atrial fibrillation
  28. Tomatoes reduce cardiovascular risk among adults

2016:

  1. Elevated serum phosphorus concentration increases risk of all-cause mortality among men without chronic kidney disease
  2. Garlic supplementation reduces cardiovascular disease risk

2015:

  1. Vitamin B1 deficiency increases systolic heart failure risk
  2. A high GL diet is a risk factor of stroke events

2014:

  1. Olive oil consumption reduces stroke
  2. Perioperative antioxidant supplementations with NAC, PUFA and vitamin C prevent atrial fibrillation after cardiac surgery

2013:

  1. A reduction of 4.4 g/day salt causes important falls in blood pressure in people with both raised and normal blood pressure

2012:

  1. A low GI diet decreases LDL-cholesterol
  2. Flavonoid supplements show significant improvements in vascular function and blood pressure

2011:

  1. Daily dietary intake of 1.6g potassium decreases risk of stroke

2002:

  1. 240 mg magnesium per day decrease systolic blood pressure

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Cardiovascular disease is a class of diseases that involves the heart or blood vessels (arteries, capillaries and veins). Cardiovascular diseases are TIA, heart attack, stroke and vascular disease of the large vessels, such as claudication. Cardiovascular diseases are currently number 1 cause of death in the Western world.

The main causes of cardiovascular diseases are:

Rules of thumb:

  • % reduction of cholesterol = % risk reduction of cardiovascular disease.
  • Per kg weight loss = 1 mmHg blood pressure reduction. So from 130 to 120 mmHg would practically mean 10 kg weight loss.
  • Each gram of salt above 6 grams of salt per day will increase the blood pressure by 1 mmHg.

Daily intake of 3 grams of plant sterols or stanols during 2-3 weeks reduces the LDL cholesterol level by 11.3%. However, avoiding dietary cholesterol is not the solution to a high cholesterol level.  The solution is to choose products with maximum 30 En% fat, and maximum 7 En% saturated fat.

It is very difficult to decrease the cholesterol level by 15% by diet only.

A cholesterol lowering diet contains:

  • Products with maximum 30 En%
  • Products with maximum 7 En% saturated fat
  • Products with maximum 15 En% protein
  • Up to 200 grams of cholesterol per day
  • Products with at least 1.5 grams of fiber per 100 kcal

Heredity also plays a role in cardiovascular diseases. The inherited forms of cardiovascular disease are:

  • Hypertrophic cardiomyopathy (=a heart disease in which the heart muscle is thickened)
  • Dilated cardiomyopathy (=a heart disease in which the heart muscle is dilated)
  • Long-QT syndrome
  • Catecholaminergic polymorphic ventricular tachycardia (CPVT)
  • Brugada syndrome
  • Arrhythmogenic right ventricular dysplasia (ARVD)
  • Familial hypercholesterolemia (FH)

Symptoms of myocardial infarction in men and women are not the same.

Symptoms of myocardial infarction in men are chest pressure, sweating and pain radiating to the arms and jaw.

Symptoms that may indicate a heart attack in women are:

  • Palpitations (pounding heart)
  • Sudden dizziness, a feeling of weakness
  • Insomnia
  • An uncomfortable feeling in the stomach, possibly with nausea
  • A sudden onset of extreme fatigue
  • Shortness of breath
  • Burning sensation below the sternum
  • Unpleasant clamping or tightness in the chest
  • Unpleasant sensation or pain between the shoulder blades, pain in the neck

Dietary guidelines for cardiovascular disease prevention:

  • Choose products with maximum 30 En% fat, products with maximum 7 En% saturated fat, products with maximum 0.3 gram salt per 100 kcal, products with minimum 1.5 grams of fiber per 100 kcal and for fish which provides at least 1000 mg of EPA and DHA per day or in other words, your daily diet (=all meals/products that you eat on a daily basis on average) should contain maximum 30 En% fat, of which maximum 7 En% saturated fat, maximum 0.3 gram salt per 100 kcal and minimum 1.5 grams of fiber per 100 kcal.
  • Stop smoking because smoking causes atherosclerosis.
  • Aim for a healthy weight. A healthy weight has a BMI of 18.5-25. BMI is weight divided by height squared (weight (kg)/height2 (m)).
  • Spend at least 60-90 minutes of physical exercises per day or at least 10000 steps per day.
  • Eat at least 2 times (100-150 g fish per time) a week oily fish. Oily fishes are sardines, herring, salmon, anchovies, eel and mackerel.
  • Eat 250 mg omega-3 fatty acids per day. Omega-3 fatty acids are alpha-linolenic acid, EPA and DHA.
  • Eat 300 grams of vegetables and five servings of fruit per day or 30 grams of fiber per day.
    30 grams of fiber per dag corresponds to a daily diet of minimum 1.5 grams of fiber per 100 kcal.
    10 to 30 grams of fiber a day decreases the LDL cholesterol levels.
  • Eat plenty of whole grains (brown bread, brown rice and oats) and legumes.
  • Limit alcohol consumption to 2 glasses for men and 1 glass for women per day.
  • Eat no more than 6 grams of salt per day, corresponding to 2400 mg of sodium.
  • Eat no more than 200 grams of cholesterol per day at an elevated LDL-cholesterol level.
  • Eat no more than 19 grams of saturated fat per day at 2500 calories diet and 15 grams of saturated fat at 2000 kcal diet. The WHO advises 2000 kcal per day for women and 2500 kcal for men.
  • Take 500 micrograms of folic acid per day at a high homocysteine ​​level.
  • Do not take antioxidant supplements. They do more harm than good!
    Consult your doctor or a dietician when taking dietary supplements!
Target values ​​for a healthy heart:
MeasurementReference values
Total cholesterol level< 4.5 mmol/l
HDL cholesterol level for men> 0.9 mmol/l
HDL cholesterol level for women > 1.1 mmol/l
LDL cholesterol level< 2.5 mmol/l
Triglycerides (blood fats) level< 2.5 mmol/l
Fasting blood sugar level< 6 mmol/l
HbA1c< 7%
Homocysteine level< 12 micromol/l
Blood pressure120/80 mmHg.
120 is systolic blood pressure &
 80 is diastolic blood pressure
Blood pressure in people over 60 years140/90 mmHg

 

Lifestyle measures for the treatment and prevention of high blood pressure
Lifestyle changesRecommendationReduction of systolic blood pressure
Weight lossA healthy weight has a BMI of 18.5-25 kg/m25-20 mmHg
Salt reductionUp to 6 grams of salt a day or 2400 mg of sodium per day2-8 mmHg
Potassium intakePer every increment of 0.6 gram1 mmHg
Physical activities30-60 minutes of physical activity per day4-9 mmHg
Alcohol consumptionMaximum 2 glasses for  men & 1 glass for women2-4 mmHg
DASH dietNutritional pattern rich in fruits, vegetables and low-fat products8-14 mmHg
This table shows that the best way to prevent high blood pressure is to maintain a healthy weight

Cardiovascular diseases

Cardiovascular disease is a class of diseases that involves the heart or blood vessels (arteries, capillaries and veins). Cardiovascular diseases are TIA, heart attack, stroke and vascular disease of the large vessels, such as claudication. Cardiovascular diseases are currently number 1 cause of death in the Western world.

The main causes of cardiovascular diseases are:

  • Arteriosclerosis (a thickening and hardening of arteries)
  • Type 2 diabetes
  • High blood pressure
  • High cholesterol levels
  • High homocysteine ​​levels
  • Obesity

Rules of thumb:

  • % reduction of cholesterol = % risk reduction of cardiovascular disease.
  • Per kg weight loss = 1 mmHg blood pressure reduction. So from 130 to 120 mmHg would practically mean 10 kg weight loss.
  • Each gram of salt above 6 grams of salt per day will increase the blood pressure by 1 mmHg.

Daily intake of 3 grams of plant sterols or stanols during 2-3 weeks reduces the LDL cholesterol level by 11.3%. However, avoiding dietary cholesterol is not the solution to a high cholesterol level.  The solution is to choose products with maximum 30 En% fat, and maximum 7 En% saturated fat.

It is very difficult to decrease the cholesterol level by 15% by diet only.

A cholesterol lowering diet contains:

  • Products with maximum 30 En% fat
  • Products with maximum 7 En% saturated fat
  • Products with maximum 15 En% protein
  • Up to 200 grams of cholesterol per day
  • Products with at least 1.5 grams of fiber per 100 kcal
     

Heredity also plays a role in cardiovascular diseases. The inherited forms of cardiovascular disease are:

  • Hypertrophic cardiomyopathy (=a heart disease in which the heart muscle is thickened)
  • Dilated cardiomyopathy (=a heart disease in which the heart muscle is dilated)
  • Long-QT syndrome
  • Catecholaminergic polymorphic ventricular tachycardia (CPVT)
  • Brugada syndrome
  • Arrhythmogenic right ventricular dysplasia (ARVD)
  • Familial hypercholesterolemia (FH)

Symptoms of myocardial infarction in men and women are not the same.

Symptoms of myocardial infarction in men are chest pressure, sweating and pain radiating to the arms and jaw.

Symptoms that may indicate a heart attack in women are:

  • Palpitations (pounding heart)
  • Sudden dizziness, a feeling of weakness
  • Insomnia
  • An uncomfortable feeling in the stomach, possibly with nausea
  • A sudden onset of extreme fatigue
  • Shortness of breath
  • Burning sensation below the sternum
  • Unpleasant clamping or tightness in the chest
  • Unpleasant sensation or pain between the shoulder blades, pain in the neck

Dietary guidelines for cardiovascular disease prevention:

  • Choose products with maximum 30-35 En% fat, products with maximum 7-10 En% saturated fat, products with maximum 0.1 gram of sodium per 100 g (100 ml) product, products with minimum 1.5 grams of fiber per 100 kcal and for fish which provides at least 1000 mg of EPA and DHA per day.
  • Stop smoking because smoking causes atherosclerosis.
  • Aim for a healthy weight. A healthy weight has a BMI of 18.5-25. BMI is weight divided by height squared (weight (kg)/height2 (m)).
  • Spend at least 60-90 minutes of physical exercises per day or at least 10000 steps per day.
  • Eat at least 2 times (100-150 g fish per time) a week oily fish. Oily fishes are sardines, herring, salmon, anchovies, eel and mackerel.
  • Eat 250 mg omega-3 fatty acids per day. Omega-3 fatty acids are alpha-linolenic acid, EPA and DHA.
  • Eat 300 grams of vegetables and five servings of fruit per day or 30 grams of fiber per day.
    30 grams of fiber per dag corresponds to a daily diet of minimum 1.5 grams of fiber per 100 kcal.
    10 to 30 grams of fiber a day decreases the LDL cholesterol levels.
  • Eat plenty of whole grains (brown bread, brown rice and oats) and legumes.
  • Limit alcohol consumption to 2 glasses for men and 1 glass for women per day.
  • Eat no more than 6 grams of salt per day, corresponding to 2400 mg of sodium.
  • Eat no more than 200 grams of cholesterol per day at an elevated LDL-cholesterol level.
  • Eat no more than 19 grams of saturated fat per day at 2500 calories diet and 15 grams of saturated fat at 2000 kcal diet. The WHO advises 2000 kcal per day for women and 2500 kcal for men.
  • Take 500 micrograms of folic acid per day at a high homocysteine ​​level.
  • Do not take antioxidant supplements. They do more harm than good!
    Consult your doctor or a dietician when taking dietary supplements!

Target values ​​for a healthy heart:

MeasurementReference values
Total cholesterol level< 4.5 mmol/l
HDL cholesterol level for men> 0.9 mmol/l
HDL cholesterol level for women > 1.1 mmol/l
LDL cholesterol level< 2.5 mmol/l
Triglycerides (blood fats) level< 2.5 mmol/l
Fasting blood sugar level< 6 mmol/l
HbA1c< 7%
Homocysteine level< 12 micromol/l
Blood pressure120/80 mmHg.
120 is systolic blood pressure &
 80 is diastolic blood pressure
Blood pressure in people over 60 years140/90 mmHg

 

Lifestyle measures for the treatment and prevention of high blood pressure

Lifestyle changes

Recommendation

Reduction of systolic blood pressure

Weight lossA healthy weight has a BMI of 18.5-25 kg/m2

5-20 mmHg

Salt reductionUp to 6 grams of salt a day or 2400 mg of sodium per day

2-8 mmHg

Potassium intakePer every increment of 0.6 gram

1 mmHg

Physical activities30-60 minutes of physical activity per day

4-9 mmHg

Alcohol consumptionMaximum 2 glasses for  men & 1 glass for women

2-4 mmHg

DASH dietNutritional pattern rich in fruits, vegetables and low-fat products

8-14 mmHg

This table shows that the best way to prevent high blood pressure is to maintain a healthy weight


Scientific studies on the relationship between diet/nutrients and cardiovascular diseases.
Review articles of randomized, placebo-controlled double-blind clinical trials (RCTs) will answer the following question:
"Is taking dietary supplements make sense?". Yes at a positive conclusion and no at a negative conclusion.

Review articles of cohort studies or case-control studies will answer the following question:
"Should I change my diet?".

2017:

  1. Abdominal adiposity and higher body fat mass increase risk of atrial fibrillation
  2. Tomatoes reduce cardiovascular risk among adults

High selenium dietary intake reduces hip fracture

Objectives:
Previous studies have suggested that selenium as a trace element is involved in bone health, but findings related to the specific effect of selenium on bone health remain inconclusive. Therefore, this review article has been conducted.

Do both high dietary selenium intake and high serum selenium levels increase bone density?

Study design:
This review article included 8 cross-sectional studies, 7 case-control studies and 3 prospective cohort studies and 1 RCT with a total of 69,672 subjects.

The number of participants ranged from 60 to 21,939, while the mean age varied from 39.4 to 75.8 years, with mean selenium intake ranging from 41.2 to 154.4 μg/d or mean serum selenium level ranging from 66.7 to 131.1 μg/L.
All the observational studies had a NOS score ≥ 4, namely moderate- to high-quality scores.
There was no publication bias.

Results and conclusions:
The investigators found a significantly positive association between dietary selenium intake [β = 0.04, 95% CI = 0.00 to 0.07, p = 0.029, I2 = 95.91%] as well as serum selenium [β = 0.13, 95% CI = 0.00 to 0.26, p = 0.046, I2 = 86.60%] and bone mineral density.

The investigators found high dietary selenium intake significantly reduced risk of hip fracture with 56% [OR = 0.44, 95% CI = 0.37 to 0.52, p 0.001, I2 = 65.2%].

The investigators found osteoporosis patients had lower serum selenium level than healthy controls [WMD = -2.01, 95% CI = -3.91 to -0.12, p = 0.037, I2 = 0%].

The investigators concluded persons with higher dietary selenium intake and higher serum selenium have higher bone mineral density. Furthermore, high selenium dietary intake reduces hip fracture.

Original title:
The association between selenium and bone health: a meta-analysis by Xie H, Wang N, […], Wang Y.

Link:
https://boneandjoint.org.uk/article/10.1302/2046-3758.127.BJR-2022-0420.R1

Additional information of El Mondo:
Find more information/studies on selenium and preventing fractures right here.

Circulating concentration of selenium in blood (serum selenium level) can be increased by eating foods that are high in selenium and/or taking selenium supplements.

500 mL/d orange juice consumption causally reduce bad cholesterol

Objectives:
Does orange juice consumption causally improve lipid profile?

Study design:
This review article included 9 RCTs with a total of 386 participants.
The mean age of the participants ranged from 36 to 56 years.
All the RCTs used a parallel study design.
The dosage of orange juice ranged from 250 to 1000 mL/d.
The duration of interventions ranged from 3 to 12 weeks.

Results and conclusions:
The investigators found orange juice consumption significantly reduced LDL cholesterol (bad cholesterol) levels [WMD  = -8.35 mg/dL, 95% CI = -15.43 to 1.26, p = 0.021, I2 = 45.8%, p = 0.055].

The investigators found in subgroup analysis based on the administered dosage, LDL cholesterol levels significantly decreased following the consumption of >500 mL/d orange juice [WMD = -9.85 mg/dL, 95% CI = -18.18 to -1.52, p = 0.02].
Moreover, the subgroup analyses based on the duration of intervention revealed that the effect of orange juice supplementation on LDL cholesterol levels was significantly greater in trials lasting ≤8 weeks [WMD = -7.91 mg/dL, 95% CI = -15.91 to -36, p = 0·04].
Also, studies conducted on both genders were observed to be significantly more likely to reduce blood LDL-C levels [WMD = -12.61 mg/dL, 95% CI = -21.19 to -4.04, p = 0.004].

The investigators concluded that  at least 500 mL/d orange juice consumption causally reduce LDL cholesterol (bad cholesterol) levels.

Original title:
Orange juice intake and lipid profile: a systematic review and meta-analysis of randomised controlled trials by Amini MR, Sheikhhossein F, […], Askarpour M.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10052563/

Additional information of El Mondo:
Find more information/studies on orange juice consumption, cholesterol and cardiovasculair disease right here.
 

30g/d whole grains consumption reduce all-cause mortality

Objectives:
Although relationships between the intake of whole grains and refined grains and the incidence of cardiovascular disease (CVD) events and all-cause mortality have been investigated, the conclusions have been inconclusive. Therefore, this review article has been conducted.

Does consumption of whole grains reduce risk of stroke, coronary heart disease, heart  failure, cardiovascular disease and all-cause mortality?

Study design:
This review article included 68 prospective cohort studies (46 for whole grains and 22 for refined grains) with 1,624,407 participants.

The included studies had follow-up periods between 5.4 y and 26 y, with sample sizes varying from 535 to 461,047 participants.

Based on NOS, the mean score of the included studies was 7.74 for whole grains and 7.45 for refined grains.

Egger’s test and funnel plot did not indicate any publication bias for the relationships between 30g/d increases in whole grain consumption and the risk of stroke [p = 0.481], cardiovascular disease [p= 0.144] or all-cause mortality [p = 0.409].

The quality of meta-evidence for the association between whole grain consumption and risks of stroke, coronary heart disease, heart failure, cardiovascular disease and all-cause mortality was moderate, moderate, low, high and high, respectively.
The quality of evidence for refined grain was low.

Results and conclusions:
The investigators found a significantly reduced risk of 3% for stroke per 30-g increase in daily whole grain consumption [RR = 0.97, 95% CI = 0.96 to 0.99, I2 = 0%].

The investigators found a significantly reduced risk of 6% for coronary heart disease (CHD) per 30-g increase in daily whole grain consumption [RR = 0.94, 95% CI = 0.92 to 0.97, I2 = 54.4%].
Sensitivity analyses indicated that the result was stable.

The investigators found a significantly reduced risk of 8% for cardiovascular disease (CVD) per 30-g increase in daily whole grain consumption [RR = 0.92, 95% CI = 0.88 to 0.96, I2 = 82.9%].
Sensitivity analyses indicated that the result was stable.

The investigators found a significantly reduced risk of 6% for all-cause mortality per 30-g increase in daily whole grain consumption [RR = 0.94, 95% CI = 0.92 to 0.97, I2 = 89.8%].
Sensitivity analyses indicated that the result was stable.

The investigators found whole grain consumption was linearly associated with coronary heart disease [p nonlinearity = 0.231] and nonlinearly associated with cardiovascular disease [p nonlinearity = 0.002] and all-cause mortality [p nonlinearity = 0.001].

The investigators concluded that consumption of at least 30g/d whole grains reduce stroke, coronary heart disease, cardiovascular disease and all-cause mortality.

Original title:
Consumption of whole grains and refined grains and associated risk of cardiovascular disease events and all-cause mortality: a systematic review and dose-response meta-analysis of prospective cohort studies by Hu H, Zhao Y, […], Hu D.

Link:
https://www.sciencedirect.com/science/article/pii/S0002916522105186?via%3Dihub

Additional information of El Mondo:
Find more information/studies on whole grain consumption, cardiovasculair disease and stroke right here.

 

Dietary intake of 200-700 mg/day calcium reduces stroke among Asians

Objectives:
Prospective cohorts are inconsistent regarding the association between dietary calcium intake and the risk of stroke. Therefore, this review article has been conducted.

Does dietary intake of calcium reduce risk of stroke?

Study design:
This review article included 18 prospective cohort studies witth19,557 stroke cases (persons) among 882,181 participants.

Results and conclusions:
The investigators found a nonlinear association between calcium intake and risk of stroke [p nonlinearity 0.003].

The investigators found compared with the lowest value of zero assumed as the reference, dietary intake of 200 mg/day calcium significantly reduced stroke risk with 5% [95% CI = 0.92 to 0.98].
This protective effect was only found in Asian countries.

The investigators found compared with the lowest value of zero assumed as the reference, dietary intake of 300 mg/day calcium significantly reduced stroke risk with 6% [95% CI = 0.90 to 0.98].
This protective effect was only found in Asian countries.

The investigators found compared with the lowest value of zero assumed as the reference, dietary intake of 500 mg/day calcium significantly reduced stroke risk with 5% [95% CI = 0.90 to 0.99].
This protective effect was only found in Asian countries.

The investigators found no protective effect for stroke at dietary intake of 700 mg/day calcium or higher.

The investigators concluded dietary intake of 200-700 mg/day calcium reduces stroke risk among Asians.

Original title:
Dietary calcium intake and the risk of stroke: Meta-analysis of cohort studies by Wang ZM, Bu XX, […], Nie ZL.

Link:
https://pubmed.ncbi.nlm.nih.gov/36958976/

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

 

Lower serum magnesium concentrations increase fractures

Objectives:
Magnesium, an essential cation for numerous cellular processes, is a major component of bone. However, its relationship with the risk of fractures is still uncertain. Therefore, this review article has been conducted.

Do lower serum magnesium concentrations increase risk of incident fractures?

Study design:
This review article included 3 prospective cohort studies and 1 retrospective cohort study with a total of 119,755 participants and a mean follow-up duration of 79 months.
The mean age was 62 years, with a mean percentage of 33% women.
The analyses were adjusted for a mean of 15 potential confounders.
All 4 studies included in the meta-analysis were of high quality (Newcastle-Ottawa Scale of 9 for all).

Results and conclusions:
The investigators found lower serum magnesium concentrations were associated with a significantly higher risk of 58% for incident fractures [RR = 1.579, 95% CI = 1.216 to 2.051, p = 0.001, I2 = 46.9%].
The results were not affected by any heterogeneity [I2 = 31.2%, p = 0.201] nor publication bias [Egger’s test = 0.94 ± 0.43, p = 0.10]. After trimming, the recalculated effect size was only slightly reduced [RR = 1.25, 95% CI = 1.09 to 1.43].
Significant because RR of 1 was not found in the 95% CI of 1.09 to 1.43. RR of 1 means no risk/association.

The investigators concluded lower serum magnesium concentrations increase risk of incident fractures.

Original title:
Association between Serum Magnesium and Fractures: A Systematic Review and Meta-Analysis of Observational Studies by Dominguez LJ, Rodas-Regalado S, […], Barbagallo M.

Link:
https://www.mdpi.com/2072-6643/15/6/1304

Additional information of El Mondo:
Find more information/studies on magnesium and preventing fractures right here.

Circulating concentration of magnesium in blood can be increased by eating foods that are high in magnesium and/or taking magnesium supplements.

Lower blood carotenoid level is a risk factor for dementia

Objectives:
Given their potent antioxidation properties, carotenoids play a role in delaying and preventing dementia and mild cognitive impairment (MCI). However, observational studies have found inconsistent results regarding the associations between blood carotenoid levels and the risk of dementia and MCI. Therefore, this review article has been conducted.

Is a lower blood carotenoid level (like lycopene, zeaxanthin, lutein) a risk factor for dementia or mild cognitive impairment?

Study design:
This review article included 23 studies with 1,422 patients with dementia, 435 patients with mild cognitive impairment and 4,753 controls (persons without dementia or mild cognitive impairment).

Results and conclusions:
The investigators found meta-analysis showed that patients with dementia had lower blood lycopene [SMD = -0.521, 95% CI = -0.74 to -0.301], α-carotene [SMD = -0.489, 95% CI = -0.697 to -0.281] β-carotene [SMD = -0.476, 95% CI = -0.784 to -0.168], lutein [SMD = -0.516, 95% CI = -0.753 to -0.279], zeaxanthin [SMD = -0.571, 95% CI = -0.910 to -0.232] and β-cryptoxanthin [SMD = -0.617, 95% CI = -0.953 to -0.281] than the controls.

The investigators found owing to insufficient data, no similar and stable relationship between blood carotenoid levels and mild cognitive impairment was observed.

The investigators concluded lower blood carotenoid level is a risk factor for dementia.

Original title:
Low blood carotenoid status in dementia and mild cognitive impairment: A systematic review and meta-analysis by Wang L, Zhao T, […], Jiang Q.

Link:
https://pubmed.ncbi.nlm.nih.gov/36997905/

Additional information of El Mondo:
Find more information/studies on carotenoids and Alzheimer 's disease right here.

Circulating concentration of lycopene in blood can be increased by eating foods that are high in lycopene and/or taking lycopene supplements.

 

High antioxidant dietary intake reduces Alzheimer's disease

Objectives:
Does a high antioxidant dietary intake reduce risk of Alzheimer's disease and dementia?

Study design:
This review article included 17 cohort studies with 98,264 participants, of which 7,425 had dementia after 3-23 years of follow-up.

Results and conclusions:
The investigators found a high antioxidant dietary intake significantly reduced the incidence of Alzheimer's disease with 15% [RR = 0.85, 95% CI= 0.79 to 0.92, I2 = 45.5%].
However, this reduced risk was not significant for dementia [RR = 0.84, 95% CI = 0.77 to 1.19, I2 = 54.6%].
Significant because RR of 1 was not found in the 95% CI of 0.79 to 0.92. RR of 1 means no risk/association.

The investigators concluded that a high antioxidant dietary intake reduces Alzheimer's disease.

Original title:
Association of Dietary and Supplement Intake of Antioxidants with Risk of Dementia: A Meta-Analysis of Cohort Studies by Zhao R, Han X, […], You H.

Link:
https://pubmed.ncbi.nlm.nih.gov/36846999/

Additional information of El Mondo:
Find more information/studies on antioxidant and Alzheimer 's disease right here.

 

Green tea may causally improve risk factors of cardiovascular disease

Objectives:
Is there a causal relationship between drinking green tea and improving risk factors of cardiovascular disease, like cholesterol, fasting blood sugar, blood pressure, HbA1c, HOMA-IR?

Study design:
This review article included 55 RCTs with 63 effect sizes with 2,487 participants in the green tea group and 2,387 in the placebo group (group without green tea).

The participants’ mean age ranged between 18 and 68.7 years and the period of intervention ranged between 2 to 48 weeks.
Some of the studies enrolled only males or females and some of them included both genders.

TC, LDL, HDL, FBS, HbA1c and DBP-related evidence had moderate quality due to the serious inconsistency reasons. Additionally, it was shown that evidence regarding TG, fasting insulin, SBP and CRP had low quality due to serious imprecision and inconsistency reasons. The evidence relating to HOMA-IR was also downgraded to very low quality because of the serious inconsistency, imprecision and publication bias.

Results and conclusions:
The investigators found green tea supplementation significantly reduced total cholesterol levels (TC) [WMD = -7.62, 95% CI = -10.51 to -4.73, p ≤ 0.001, I2 = 90.9%].
This significantly reduced effect was also found if females or both males and females were included, the dosage of supplementation was less than 1,000 mg/d, the baseline BMI was between 25-29.9 kg/m2 and the baseline value of TC was more than 200 mg/dL.

The investigators found green tea supplementation significantly reduced LDL cholesterol levels (LDL-C) [WMD = -5.80, 95% CI = -8.30 to -3.30, p ≤ 0.001, I2 = 90.5%].
This significantly reduced effect was also found if males or both males and females were included, the baseline BMI was between 25-29.9 kg/m2 and participants were not affected by T2DM.

The investigators found green tea supplementation significantly reduced fasting blood sugar levels (FBS) [WMD = -1.67, 95% CI = -2.58 to -0.75, p ≤ 0.001, I2 = 72.2%].

This significantly reduced effect was also found when the baseline BMI of participants was between 25-29.9 kg/m2, female or both male and female were included, the duration of intervention was more than 12 weeks, the dosage of supplementation was less than 1,000 mg/d and baseline values of FBS were less than 100 mg/dL.

The investigators found green tea supplementation significantly reduced HbA1c levels [WMD = -0.15, 95% CI = -0.26 to -0.04, p = 0.008, I2 = 71.3%].
This significantly reduced effect was also found if the duration of intervention was ≤ 12 weeks, the dosage of supplementation was ≥ 1,000 mg/d, baseline values of HbA1c were less than 6.5%, male or both genders were involved and the baseline value of BMI was ≥ 30 kg/m2.

The investigators found green tea supplementation significantly reduced diastolic blood pressure (DBP) [WMD = -0.87, 95% CI = -1.45 to -0.29, p = 0.003, I2 = 92.4%].
This significantly reduced effect was also found if the duration of intervention was ≤ 12 weeks, the dosage of supplementation was less than 1,000 mg/d, baseline values of DBP were more than 80 mmHg and the baseline value of BMI was ≥ 30 kg/m2.

The investigators found green tea supplementation significantly increased HDL cholesterol levels (HDL-C) [WMD = 1.85, 95% CI = 0.87 to 2.84, p = 0.010, I2 = 94.4%].
This significantly increased effect was also found if females were included, the baseline BMI was lower more than 30 kg/m2, there was no past medical history of T2DM, the duration of intervention was more than 12 weeks, the dosage of supplementation was less than 1,000 mg/d and baseline values of HDL were more than 50 mg/dL.

The investigators found sensitivity analysis showed no significant difference in results with removing one single study for all considered cardiovascular risk factors including lipid profiles, glycemic indices, SBP and DBP and CRP.

The investigators concluded drinking ≤1,000 mg/d green tea may causally improve risk factors of cardiovascular disease. May improve because the RCTs are of low quality.

Original title:
The effects of green tea supplementation on cardiovascular risk factors: A systematic review and meta-analysis by Zamani M, Kelishadi MR, […], Asbaghi O.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9871939/

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

Green tea causally lowers blood pressure in healthy individuals

Objectives:
Is there a causal relationship between drinking green tea and lowering blood pressure in healthy individuals?

Study design:
This review article included 9 RCTs with 345 healty individuals in the intervention group (group with green tea) and 335 healthy individuals in the control group (group without green tea).

The mean age of the individuals in the intervention group was 35.89 ± 8.52, while the mean age of the control group was 36.48 ± 7.68.
All studies clearly described allocation randomization, none had incomplete outcome data, and all used appropriate statistical analysis.
The completion rate of the consumption of green tea ranged from 85-100%.
No publication bias was observed in the studies.

Results and conclusions:
The investigators found combined results of the studies showed that green tea was effective in lowering systolic blood pressure in healthy individuals [MD = -2.99, 95% CI = -3.77 to -2.22, p 0.00001, I2 = 0%].

The investigators found combined results of the studies showed that green tea was effective in lowering diastolic blood pressure in healthy individuals [MD= -0.95, 95% CI = -1.62 to -0.27, p = 0.006, I2 = 0%]. 

The investigators concluded in healthy individuals, green tea supplementation reduces systolic blood pressure by 2.99 mmHg and diastolic blood pressure by 0.95 mmHg.

Original title:
Effect of Green Tea on Blood Pressure in Healthy Individuals: A Meta-Analysis by Ayaz EY, Dincer B and Mesci B.

Link:
https://pubmed.ncbi.nlm.nih.gov/36689359/

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

 

20 g/day olive oil reduce all-cause mortality

Objectives:
Epidemiological studies have shown the preventive effects of olive oil consumption against cardiovascular events and all-cause deaths, but the results remain inconsistent. Therefore, this meta-analysis (review article) has been conducted.

Does higher olive oil consumption reduce the risk of cardiovascular disease and all-cause mortality?

Study design:
This review article included 13 prospective cohort studies.
These studies were published between 2003 and 2022, with follow-up intervals ranging from 4 to 28 years.
Most of studies collected the dietary data on olive oil intake based on food-frequency questionnaires and the outcome events were identified using International Classification of Diseases codes or other medical records.
All of the studies were assigned a NOS score of ≥7, indicating the evidence of high methodological quality.
There was no publication bias.

Results and conclusions:
The investigators found meta-analysis of 8 cohort studies (261,016 participants and 14,033 cardiovascular disease cases) showed versus lowest consumption of olive oil, high consumption of olive oil significantly reduced risk of cardiovascular disease with 15% [pooled RR = 0.85, 95% CI = 0.77 to 0.93, p 0.001, I2 = 41%, p = 0.107].
Subgroup analyses showed no significant differences between strata of study region, sample size, follow-up duration, sex and olive oil type.
The combined risk estimate of cardiovascular disease was not altered in the sensitivity analysis by omitting each study one at a time.

The investigators found meta-analysis of 11 cohort studies (713,000 participants and 173,817 deaths) showed versus lowest consumption of olive oil, high consumption of olive oil significantly reduced risk of all-cause mortality with 17% [pooled RR = 0.83, 95% CI = 0.77 to 0.90, p 0.001, I2 = 93%, p 0.001].
Excluding each report in sequence had no influence on the pooled result.
The combined RRs were similar between subsets stratified by the aforementioned features.

The investigators found in dose-response meta-analysis, a significantly reduced risk of 4% for cardiovascular disease per 5-g/day increase in olive oil intake [RR = 0.96, 95% CI = 0.93 to 0.99, p = 0.005].

The investigators found in dose-response meta-analysis, a significantly reduced risk of 4% for all-cause mortality per 5-g/day increase in olive oil intake [RR = 0.96, 95% CI = 0.95 to 0.96, p 0.001].

The investigators found non-linear associations of olive oil intake with cardiovascular disease and all-cause mortality [both p for non-linearity 0.001], with little additional or no risk reduction observed beyond the consumption of approximately 20 g/day.

The investigators concluded that olive oil consumption reduces the risk of cardiovascular disease and all-cause mortality. Such benefits seem to be obtained with an intake of olive oil up to 20 g/day. These results support the current dietary recommendations to increase the intake of olive oil instead of other fats for improving human health and longevity. Future prospective studies are required to further depict the dose-dependent cardiovascular and survival effects in relation to olive oil consumption.

Original title:
Olive oil consumption and risk of cardiovascular disease and all-cause mortality: A meta-analysis of prospective cohort studies by Xia M, Zhong Y, [...], Qian C.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9623257/

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

 

25-200 g/d peanuts may causally reduce total cholesterol levels

Objectives:
Although numerous studies have reported the protective effect of nut consumption on cardiovascular risk, evidence for the role of peanuts in maintaining cardiometabolic health is inconclusive. Therefore, this meta-analysis (review article) has been conducted.

Does a high consumption of peanuts improve causally cardiovascular risk factors, such as cholesterol levels and LDL/HDL ratio?

Study design:
This review article included 10 RCTs (8 parallel RCTs and 3 crossover RCTs) with a total of 643 participants (316 males and 327 females) aged between 18 and 84 years from Asia, North America, Europa, South America and Australia.

The administered doses of peanuts ranged between 25 and 200 g/d, with follow-up periods of 2-24 weeks.

The strength of evidence varied from very low to moderate, depending on the outcomes.

Results and conclusions:
The investigators found meta-analysis of clinical trials revealed that peanut consumption was significantly associated with a decrease in triglycerides levels compared to the control interventions [MD = -0.13, 95% CI = -0.20 to -0.07, p 0.0001].
This significant reduction was most acute in healthy subjects [MD = -0.13, 95% CI = -0.25 to -0.00, p = 0.04] and in those who consumed peanuts or peanut butter [MD = -0.14, 95% CI = -0.20 to -0.07, p 0.0001].

The investigators found meta-analysis of clinical trials revealed that peanut consumption signicantly lowered total cholesterol levels among healthy consumers [MD = -0.40, 95% CI = -0.71 to -0.09, p = 0.01].

The investigators found meta-analysis of clinical trials revealed that peanut consumption signicantly lowered total cholesterol levels among healthy consumers [MD = -0.40, 95% CI = -0.71 to -0.09, p = 0.01].

The investigators found meta-analysis of clinical trials revealed that peanut consumption resulted in a signicantly lower LDL-cholesterol/HDL-cholesterol ratio among healthy consumers [MD = -0.19, 95% CI = -0.36 to -0.01, p = 0.03].

The investigators found, however, individuals at high cardiometabolic risk experienced a significant increase in body weight after the peanut interventions [MD = 0.97, 95% CI = 0.54 to 1.41, p 0.0001], although not in body fat or body mass index.

The investigators found, according to the dose-response analyses, body weight increased slightly with higher doses of peanuts.

The investigators concluded that consumption of 25-200 g/d peanuts during 2-24 weeks may causally reduce triglycerides and total cholesterol levels. May reduce because the strength of evidence varied from very low to moderate. To gain more knowledge about the effects of peanut products on cardiometabolic risk factors, more carefully designed studies in larger populations are needed.

Original title:
Effect of Peanut Consumption on Cardiovascular Risk Factors: A Randomized Clinical Trial and Meta-Analysis by Parilli-Moser I, Hurtado-Barroso S, […], Lamuela-Raventós RM.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9011914/

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

Brassica vegetables causally reduce total cholesterol

Objectives:
Previous studies on the effect of Brassica vegetables on blood glucose and lipid profile have reported inconclusive findings. Therefore, this meta-analysis (review article) has been conducted.

Does higher Brassica vegetables consumption improve causally cardiovascular risk factors (levels of triglycerides, cholesterol, fasting blood sugar and glycated haemoglobin)?

Study design:
This review article included 9 RCTs with a total of 548 participants.

Results and conclusions:
The investigators found pooled analysis indicated a significant reduction in total cholesterol (TC) [SMD = -0.28, 95% CI = -0.48 to -0.08, p = 0.005] following Brassica vegetables consumption.

The investigators found, overall, Brassica vegetables had no significant impact on serum levels of triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, fasting blood sugar and glycated hemoglobin.

The investigators concluded that consumption of Brassica vegetables causally reduces total cholesterol concentration. However, further high-quality studies are needed to firmly establish the clinical efficacy of these plants.

Original title:
The effect of Brassica vegetables on blood glucose levels and lipid profiles in adults. A systematic review and meta-analysis by Darand M, Alizadeh S and Mansourian M.

Link:
https://pubmed.ncbi.nlm.nih.gov/35412701/

Additional information of El Mondo:
Find more information/studies on Brassica vegetables consumption, cholesterol and cardiovascular disease right here.

Brassica vegetables are broccoli, Brussels sprouts, cabbage, cauliflower, collard greens, kale and turnips.

High dietary intake of vitamin E reduces dementia

Objectives:
Dementia is a chronic progressive neurodegenerative disease that can lead to disability and death in humans, but there is still no effective prevention and treatment. Due to the neuroprotective effects of vitamin E, a large number of researchers have explored whether vitamin E can reduce the risk of dementia. Some researchers believe that vitamin E can reduce the risk of dementia, while others hold the opposite conclusion. Therefore, this review article has been conducted.

Do high intakes of diet or vitamin E supplements reduce the risk of dementia?

Study design:
This review article included 13 cohort studies (46,968 participants and 6,046 dementia patients after 4-23 years of follow-up) and 2 case-control studies with (3,157 controls and 3,459 patients).
The studies included in this meta-analysis (review article) were published between 1983 and 2022.
The literary NOS quality score ranged from 6 to 8.
There was no publication bias.

Results and conclusions:
The investigators found a high intake of diet or vitamin E supplements significantly decreased the risk of dementia by 21% [OR = 0.79, 95% CI = 0.70 to 0.88, I2 = 35.0%, p = 0.071].
This decreased risk was also significant in cohort studies [OR = 0.79, 95% CI = 0.69 to 0.89], dietary intake of vitamin E [OR = 0.78, 95% CI = 0.65 to 0.95], vitamin E supplement [OR = 0.83, 95% CI = 0.73 to 0.94] and studies with NOS scores >7 [OR = 0.85, 95% CI = 0.75 to 0.97].

The investigators found a high intake of diet or vitamin E supplements significantly decreased the risk of Alzheimer's disease by 22% [OR = 0.78, 95% CI = 0.64 to 0.94, I2 = 36.9%, p = 0.123].
This decreased risk was also significant in cohort studies [OR = 0.77, 95% CI = 0.63 to 0.94].

The investigators found in sensitivity analysis the pooled ORs fluctuated within a certain range after deleting each study, indicating that the results of this meta-analysis were stable.

The investigators concluded high intakes of diet or vitamin E supplements reduce the risk of dementia. Therefore, the elderly can reduce the risk of dementia by appropriately increasing foods rich in vitamin E, but also pay attention to the toxic side effects of vitamin E. Although the results are reliable, they should be further validated by large RCTs.

Original title:
Association of vitamin E intake in diet and supplements with risk of dementia: A meta-analysis by Zhao R, Han X, [...], You H.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9376618/

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

Skim milk, poultry and non-meat animal products reduce age-related eye disease

Objectives:
Do plant-based diets improve age-related ocular outcomes among adults?

Study design:
This review article included 15 studies (n = 51,695 participants) assessed the impact of fish consumption, 8 studies (n = 28,753 participants) analyzed the effect of red meat intake and 3 studies (n = 7,723 participants) assessed the impact of omission of skim milk, poultry and non-meat animal products and the presence of disease incidence as indicated by age-related macular degeneration or cataract development.

Results and conclusions:
The investigators found in 15 studies (n = 51,695 participants) that regular consumption of fish significantly reduced the risk of age-related eye disease development among adults with 30% [odds ratio = 0.70, 95% CI = 0.62 to 0.79].
Significant means that there is an association with a 95% confidence.

The investigators found in 3 studies (n = 7,723 participants) that regular consumption of skim milk, poultry and non-meat animal products significantly reduced the risk of age-related eye disease development among adults with 30% [odds ratio = 0.70, 95% CI = 0.61 to 0.79].
Significant because odds ratio of 1 was not found in the 95% CI of 1.07 to 1.72. Odds ratio of 1 means no risk/association.

The investigators found in 8 studies (n = 28,753 participants) that regular consumption of red meat significantly increased the risk of age-related eye disease development among adults with 41% [odds ratio = 1.41, 95% CI = 1.07 to 1.86].

The investigators concluded that regular consumption of both fish and skim milk, poultry and non-meat animal products reduce the risk of age-related eye disease development among adults, while regular consumption of red meat increases the risk of age-related eye disease development among adults. Results suggest a need for more initiatives promoting a healthy and balanced diet.

Original title:
Linkage between a plant-based diet and age-related eye diseases: a systematic review and meta-analysis by Cirone C, Cirone KD and Malvankar-Mehta MS.

Link:
https://pubmed.ncbi.nlm.nih.gov/36102832/

Additional information of El Mondo:
Find more information/studies on fish, milk, meat and elderly right here.

In practice, regular fish consumption corresponds to at least twice (100-150g per time) a week.
 

Higher dietary fiber intake improves causally cardiovascular risk factors

Objectives:
Although several meta-analyses have revealed the beneficial effects of dietary fiber intake on human health, some have reported inconsistent findings. Therefore, this umbrella meta-analysis (review article) has been conducted.

Does higher dietary fiber intake improve causally cardiovascular risk factors?

Study design:
This umbrella review article included 52 meta-analyses of RCTs with a total of 47,197 subjects.

Of the 52 meta-analyses, 35 used high-quality studies, 9 used studies with moderate quality, 7 did not report the quality of the included studies and 1 used low-quality studies.

The dosages and durations of dietary fiber intervention ranged from 3 g/day to 30 g/day (except for one study, which used guar gum at 15 mg/day and another study that used brown rice at 225 g/d) and 4 to 13 weeks, respectively.

Results and conclusions:
The investigators found, overall, higher dietary fiber intake significantly reduced:
-fasting plasma glucose [ES = -0.55, 95% CI = -0.73 to -0.38, p 0.001];
-fasting plasma insulin [ES = -1.22, 95% CI = -1.63 to -0.82, p 0.001];
-homeostasis model assessment of insulin resistance (HOMA-IR) [ES = -0.43, 95% CI = -0.60 to -0.27, p 0.001];

-glycosylated hemoglobin (HbA1c) [ES = -0.38, 95% CI = -0.50 to -0.26, p 0.001];
-serum level of total cholesterol [ES = -0.28, 95% CI = -0.39 to -0.16, p 0.001];
-low-density lipoprotein cholesterol (bad cholesterol) [ES = -0.25, 95% CI = -0.34 to -0.16, p 0.001];
-tumor necrosis factor-alpha serum levels [ES = -0.78, 95% CI = -1.39 to -0.16, p = 0.013];
-systolic blood pressure [ES = -1.72, 95% CI= -2.13 to -1.30, p 0.001];
-diastolic blood pressure [ES = -0.67, 95% CI = -0.96 to -0.37, p 0.001].
Significant means that there is an association with a 95% confidence.

The investigators found sensitivity analysis showed that the overall ESs did not change by excluding any individual meta-analysis.

The investigators found subgroup analysis revealed that the study population and type of dietary fiber could be partial sources of heterogeneity.

The investigators concluded that the present umbrella meta-analysis strongly support the beneficial effects of dietary fiber intake for the improvement cardiovascular risk factors, in particular cholesterol, fasting blood sugar, HbA1c, tumor necrosis factor-alpha and fasting insulin level, blood pressure and HOMA-IR value. However, it should be noted that the health-promoting effects of dietary fiber intake may differ between populations with different metabolic diseases.

Original title:
Associations between dietary fiber intake and cardiovascular risk factors: An umbrella review of meta-analyses of randomized controlled trials by Fu L, Zhang G, […], Tan M.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9511151/

Additional information of El Mondo:
Find more information/studies on dietary fiber consumption, diabetes, high blood pressure and cardiovascular disease right here.

A high dietary fiber intake corresponds to a diet with at least 1.5 grams fiber per 100 kcal. Use the 7-points nutrition profile app to see if your daily diet contains 1.5 grams fiber per 100 kcal.
These products in the supermarket contain 1.5 grams fiber per 100 kcal.

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

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

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

800-1,000 IU/d vitamin D3 reduces fracture and fall risk among elderly

Objectives:
Although recent studies comparing various dosages and intervals of vitamin D supplementation have been published, it is yet to be elucidated whether there is an appropriate dose or interval to provide benefit regarding fracture risk. Therefore, this review article has been conducted.

What are the putative beneficial effects of vitamin D supplements on fractures and falls according to various dosages and intervals?

Study design:
This review article included 32 RCTs with a total of 104,363 patients, with a median of 3,162 patients per study (range 46 to 36,282).
The median daily dose of cholecalciferol (D3) was 800 IU/day and 8 studies reported 800 IU/day, 15 studies reported 800 to 1,000 IU/day and 9 studies reported >1,000 IU/day.
The median follow-up duration was 24 months (range 9 to 120) and the median age was 72 years (range 53 to 85).

Results and conclusions:
The investigators found vitamin D3 supplementation with daily dose of 800 to 1,000 IU was significantly associated with a lower risk of 13% for osteoporotic fracture [pooled relative risk = 0.87, 95% CI = 0.78 to 0.97, I2 = 23.5%] while studies with 800 or >1,000 IU/day did not.

The investigators found vitamin D3 supplementation with daily dose of 800 to 1,000 IU was significantly associated with a lower risk of 9% for fall [pooled relative risk = 0.91, 95% CI = 0.85 to 0.98, I2 = 70.9%] while studies with 800 or >1,000 IU/day did not.

The investigators found daily administration of vitamin D3 was associated with the reduced risk of falls, while intermittent dose was not.
Also, patients with vitamin D deficiency showed a significant risk reduction of falls after vitamin D3 supplementation.

The investigators concluded that daily vitamin D3 dose of 800 to 1,000 IU (20-25 mcg) during 24 months is the most probable way to reduce the fracture and fall risk among elderly. Further studies designed with various regimens and targeted vitamin D levels are required to elucidate the benefits of vitamin D supplements.

Original title:
Effect of Vitamin D Supplementation on Risk of Fractures and Falls According to Dosage and Interval: A Meta-Analysis by Kong SH, Jang HN, […], Shin CS.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9081312/

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

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

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

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

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

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

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

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

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

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

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

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

Additional information of El Mondo:
Find more information/studies on flavonoid, diabetes, cardiovascular disease and lowering blood pressure right here.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Unsaturated fatty acids improve absorption of carotenoids

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

Do dietary fats improve the absorption of carotenoids?

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

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

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

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

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

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

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

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

400 IU/day to 300,000 IU vitamin D supplementation improves handgrip strength in postmenopausal women

Objectives:
In postmenopausal women, vitamin D deficiency (as defined by the circulating level of 25(OH)D being below 20 ng/mL (50 nmol/L)) is a regular occurrence. The effect of vitamin D supplementation on the muscle function of postmenopausal women has been controversial. Therefore, this review article has been conducted.

Does vitamin D supplementation enhance the muscular strength and mobility of postmenopausal women?

Study design:
This review article included 19 RCTs between 2003 and 2021, with 5,398 participants.
The sample size of the RCTs included in multiple countries ranges from 20 to 2,347. Furthermore, the duration of vitamin D supplementation ranged from 3 to 60 months.
Vitamin D3 was applied in 12 of the 19 retrieved trials, whose dosages ranged from 400 IU/day to 300,000 IU (10 tot 7500 mcg vitamin D3) in a single oral dose.
Visual inspection of the funnel plot and Egger’s linear regression test revealed no indication of publication bias in the meta-analysis of vitamin D supplementation on handgrip strength.

Results and conclusions:
The investigators found meta-analysis of 9 RCTs (1,997 participants supplemented with vitamin D and 2,232 participants as the control group (vitamin D in low dosage or placebo)), showed that vitamin D supplementation significantly improved handgrip strength in postmenopausal women [WMD = 0.876 kg, 95% CI = 0.180 to 1.571, p = 0.014, I2 = 68.5%, p = 0.001].
Moreover, according to subgroup analysis, vitamin D supplementation substantially raised handgrip strength when compared to baseline blood vitamin D levels >75 nmol/L (30 ng/ml) [WMD = 0.478 kg, 95% CI = 0.963 to 1.918, p = 0.003], without calcium [WMD = 1.931 kg, 95% CI = 0.166 to 3.697, p = 0.032] and subject to an age of more than 60 [WMD = 1.116 kg, 95% CI = 0.433 to 1.799, p = 0.001].

The investigators concluded that 400 IU/day to 300,000 IU vitamin D supplementation during 3 to 60 months improves handgrip strength in postmenopausal women over 60 years of age who are without calcium supplementation or whose baseline vitamin D is >75 nmol/L (30 ng/mL). These findings show that future trials should focus on determining the ideal dosage and duration and taking into account the several factors that may impair muscle performance, such as exercise, calcium consumption, frailty, a history of falls or fractures and baseline vitamin D status and the relationship between muscle function and/or strength with muscle composition.

Original title:
Vitamin D Supplementation Improves Handgrip Strength in Postmenopausal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials by Zhang JL, Poon CCW, […], Zhang Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9199366/

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

Higher concentration of carotenoids and vitamin E in blood reduce age-related macular degeneration

Objectives:
Data from studies support a beneficial effect of carotenoids and vitamins on an age-related macular degeneration (AMD) risk. However, studies on the relations between blood levels of these nutrients and AMD are limited and provided conflicting results. Therefore, this review article has been conducted.

Does a higher concentration of carotenoids (lutein/zeaxanthin, β-carotene, β-cryptoxanthin, lycopene) and vitamins in blood reduce age-related macular degeneration risk?

Study design:
This review article included 9 studies (1 cohort, 4 case-control and 4 cross-sectional studies) involving 15,674 participants and 2,077 AMD cases (persons with age-related macular degeneration).  
There was no evidence of publication bias.

Results and conclusions:
The investigators found in the meta-analysis that high blood lutein/zeaxanthin level significantly reduced risk of age-related macular degeneration with 47% [OR = 0.53, 95% CI = 0.40 to 0.72, p 0.001, I2 = 43.3%, p = 0.079], compared to those with low level.
Results stratified by factors yielded similar results to the main analysis.

The investigators found in the meta-analysis that high blood β-carotene level significantly reduced risk of age-related macular degeneration with 52% [OR = 0.48, 95% CI = 0.28 to 0.84, p = 0.01, I2 = 71.7%, p = 0.003], compared to those with low level.
A subgroup analysis by geographic region showed that the significant inverse association between blood β-carotene levels and risk of age-related macular degeneration was only found among the Asians.

The investigators found in the meta-analysis that high blood β-cryptoxanthin level significantly reduced risk of age-related macular degeneration with 52% [OR = 0.48, 95% CI = 0.23 to 1.00, p = 0.04, I2 = 83.5%, p 0.001], compared to those with low level.
In stratified analyses, no significant difference was observed for any subgroups.

The investigators found in the meta-analysis that high blood lycopene level significantly reduced risk of age-related macular degeneration with 30% [OR = 0.70, 95% CI = 0.54 to 0.90, p = 0.006, I2 = 0.0%, p = 0.67], compared to those with low level.

The investigators found in the meta-analysis that high blood α-tocopherol (vitamin E) level significantly reduced risk of age-related macular degeneration with 50% [OR = 0.50, 95% CI = 0.31 to 0.81, p = 0.005, I2 = 34.4%, p = 0.19], compared to those with low level.

The investigators found sensitivity analyses, that excluded one study at a time, did not change the statistical significance or the direction of the present findings, corroborating the robustness of the results.

The investigators concluded that there is a protective effect of higher concentration of carotenoids (lutein/zeaxanthin, β-carotene, β-cryptoxanthin, lycopene) and vitamin E in blood against age-related macular degeneration risk, which provides further evidence of the associations between carotenoid and vitamin status and the risk of age-related eye problems. Further randomized clinical trials are necessary for Asians to confirm such associations and to provide the most reliable direct information to base public health recommendations for age-related eye disease prevention by nutritional supplementation with carotenoids and vitamins.

Original title:
The Associations of Plasma Carotenoids and Vitamins With Risk of Age-Related Macular Degeneration: Results From a Matched Case-Control Study in China and Meta-Analysis by Jiang H, Fan  Y, […], Ma L.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8873933/

Additional information of El Mondo:
Find more information/studies on meta-analysis/cohort, carotenoids, vitamin E and elderly right here.

High blood levels of beta-carotene can be obtained by consuming beta-carotene-rich foods and/or taking beta-carotene supplements.
 

Protein supplementation + exercise increase lower-extremity strength in healthy older Asian adults with sarcopenia

Objectives:
While there is growing research interest in the effects of nutrition and exercise on delaying sarcopenia, the results are inconclusive and there is scarce information on regional patterns. Therefore, this review article has been conducted.

Do protein supplements combined with exercise improve extremity strength in healthy older adults with sarcopenia?

Study design:
This review article included 14 RCTs, involving a total of 888 healthy older adults (>60 years).

4 studies in Asian countries provided data on lower-extremity strength, involving 280 participants (138 in protein supplements + exercise group and 142 in exercise group).
Lower-extremity strength was assessed using knee extension (n = 3) or leg extension (n = 1).
The intervention period of all studies was 12 weeks.
The dosage of protein ranged from 3 g/d to 40 g/d.

Results and conclusions:
The investigators found in 4 studies in Asian countries a significant increase in the lower-extremity strength in the protein supplementation + exercise group compared to the exercise group, with a SMD of 0.24 [95% CI = 0.00 to 0.47, p = 0.048, I2 = 0.0%, p = 0.513].

The investigators concluded that protein supplements (3 g/d to 40 g/d during 12 weeks) combined with exercise (knee extension and leg extension) exerts superior benefit on lower-extremity strength in healthy older adults with sarcopenia in Asian countries, when compared to exercise alone or with a placebo. However, no additional benefits from protein supplementation are observed on upper-extremity strength, muscle mass and physical performance regardless of the regions. More well-designed RCTs with information on baseline and total protein intake for longer follow-up periods are warranted to evaluate the effectiveness of protein supplementation and exercise on the prevention and management of sarcopenia in healthy older adults.

Original title:
Effects of protein supplementation and exercise on delaying sarcopenia in healthy older individuals in Asian and non-Asian countries: A systematic review and meta-analysis by Li L, He Y, […], Liu X.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8808080/

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

Upper extremity is part of the body that includes the arm, wrist and hand.

Lower extremity refers to the part of the body from the hip to the toes.

Sarcopenia is a type of muscle loss (muscle atrophy) that occurs with aging and/or immobility. Sarcopenia can affect people in their 30s and beyond.