Nutrition and health

Objectives:
Do dietary choline and betaine increase mortality risk?

Study design:
This review article included 6 cohort studies comprising 482,778 total participants, 57,235 all-cause, 9,351 cardiovascular disease and 4,400 stroke deaths.

Results and conclusions:
The investigators found linear dose-response analysis showed that each 100 mg/day increase in dietary choline intake was significantly associated with 6% increases in risk of all-cause mortality [RR = 1.06, 95% CI = 1.03 to 1.10, I2 = 83.7%, p < 0.001].

The investigators found linear dose-response analysis showed that each 100 mg/day increase in dietary choline intake was significantly associated with 11% increases in risk of cardiovascular diseases mortality [RR = 1.11, 95% CI = 1.06 to 1.16, I2 = 54.3%, p = 0.02].

The investigators found the result of the nonlinear dose-response analysis showed a significant relationship between dietary betaine intake and stroke mortality at the dosages of 50 to 250 mg/day [p non-linearity= 0.0017]. 

The investigators concluded 100 mg/day of choline consumption is associated with a 6% and 11% higher risk of all-cause and cardiovascular disease mortality, respectively. In addition, a positive relationship between betaine dietary intake and stroke mortality at doses of 50 to 250 mg/day is observed. Due to the small number of the included studies and heterogeneity among them more well-designed prospective observational studies considering potential confounding variables are required. 

Original title: 
Higher dietary choline intake is associated with increased risk of all-cause and cause-specific mortality: A systematic review and dose-response meta-analysis of cohort studies by Sharifi-Zahabi E, Soltani S, […], Shidfar F. 
 

Link:
https://pubmed.ncbi.nlm.nih.gov/39341000/

Additional information of El Mondo:
Find here more information/studies about RCTs/significant, choline, and stroke. 

Betaine-rich foods are

• American Indian/Alaska native foods
• Baked products
• Beef products
• Cereal grains and pasta
• Restaurant foods
• Snacks
• Vegetables and vegetable products

Objectives:
The relationship between beverage consumption and risk of cardiovascular disease has been extensively examined in cross-sectional studies. However, limited studies have investigated beverage consumption as a longer-term habitual behavior, which is important owing to potential cumulative harmful or beneficial cardiovascular effects. Therefore, this review article has been conducted.

What is the relationship between sex-specific long-term consumption of beverages [sugar-sweetened beverages (SSBs) or artificial-sweetened beverages (ASBs), tea, coffee, fruit juices, energy drinks and alcohol] and cardiovascular disease-related mortality? 

Study design:
This review article included 20 prospective cohort studies. The length of follow-up ranged from 5.5 years to 40 years. 
There was no publication bias. 

Results and conclusions:
The investigators found long-term coffee consumption of 2-6 cups per day significantly reduced cardiovascular disease-related mortality with 37% in males [pooled HR = 0.63, 95% CI = 0.46 to 0.87, p = 0.005, I2 = 0%] but not in females [HR = 0.78, 95% CI = 0.60 to 1.02, p = 0.07]. 

The investigators found long-term higher intake of tea was significantly associated with a 19% lower risk of cardiovascular disease-related mortality in all adults [pooled HR = 0.81, 95% CI = 0.72 to 0.92, p ≤ 0.001]. 

The investigators found higher alcohol intake was significantly associated with a 44% higher stroke in males [pooled HR = 1.44, 95% CI = 1.06 to 1.94, p = 0.02] and a 126% higher stroke in females [pooled HR = 2.26, 95% CI = 1.34 to 3.81, p = 0.002]. 

The investigators found higher sugar-sweetened beverage was significantly associated with a 31% higher risk in cardiovascular disease-related mortality [pooled HR = 1.31, 95% CI = 1.16 to 1.46, p ≤ 0.0001]. 
However, no effect was found between artificial-sweetened beverages and cardiovascular disease-related mortality while comparing the highest intake with lowest intake [pooled HR = 1.05, 95% CI = 0.87 to 1.26, p = 0.61, I2 = 61%].
 
The investigators concluded long-term habitual coffee consumption (2-6 cups per day) is beneficial for males and tea consumption is beneficial for all adults. Long-term high alcohol and sugar-sweetened beverage consumption increased risk of cardiovascular disease-related mortality for both males and females. However, it is not possible to draw conclusions on the potential benefit or harm of the long-term consumption of fruit juice and energy drinks on cardiovascular disease-related mortality owing to the limited number of studies available.

Original title: 
Long-Term Consumption of 6 Different Beverages and Cardiovascular Disease-Related Mortality: A Systematic Review and Meta-Analysis of Prospective Cohort Studies by Bhandari B, Zeng L, […], Xu X. 

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10904171/

Additional information of El Mondo:
Find more information/studies on RCT’s/sensitivity analysis, coffee, alcohol and cardiovascular diseases right here. 

Objectives:
Hypertension (HTN) is regarded as a serious public health issue throughout the world. High blood pressure (BP) may be improved by carotenoid supplementation; however, randomized controlled trials (RCTs) provide conflicting evidence. Therefore, this review article has been conducted.

Do carotenoid supplements reduce blood pressure?

Study design:
This review article included 19 RCTs involving 1,151 participants.
Evidence for all systolic blood pressure, diastolic blood pressure and heart rate values was high quality.

Results and conclusions:
The investigators found carotenoid supplementation significantly reduced the systolic blood pressure (SBP) [WMD = -2.492 mmHg, 95% CI = -4.52 to -0.47, p = 0.016] and diastolic blood pressure (DBP) [MD = -1.60 mmHg, 95% CI = -2.73 to -0.47, p = 0.005]. 

The investigators found greater effects were observed in Asian participants, those aged >50 years, nonhealthy participants and participants with a baseline systolic blood pressure ≥130 mmHg and diastolic blood pressure ≥80 mmHg and at carotenoid dose >10 mg. 

The investigators found dose-response analysis showed that carotenoid supplementation decreased systolic blood pressure and diastolic blood pressure levels at doses of, respectively, 0-25 and 0-20 mg/d. 

The investigators concluded daily 10-25 mg carotenoid supplementation decrease blood pressure, especially in nonhealthy study participants with high blood presurre baseline levels.

Original title: 
Effect of carotenoid supplementation on blood pressure in adults: a GRADE-assessed systematic review and dose-response meta-analysis of randomized controlled trials by Behzadi M, Akbarzadeh M, […], Bideshki MV. 

Link:
https://pubmed.ncbi.nlm.nih.gov/38219250/

Additional information of El Mondo:
Find more information/studies on RCT’s/sensitivity analysis, carotenoids and cardiovascular diseases right here.

Heart patients are advised to choose low fat, low salt and fiber rich products. These products can be found here. 

Patients with a high blood pressure are advised to choose low salt products. These products can be found here. 

Objectives:
The aim of this review article was to assess the relation between the level of habitual potassium intake and the incidence of cardiovascular disease (CVD).

Study design:
This review article included 15 cohort studies involving a total of 247510 male and female participants, 7,066 strokes, 3,058 coronary heart disease (CHD) events and 2,497 total CVD events.
The weighted average follow-up time was 12.2 years (range 5 to 19 years).
There was significant heterogeneity among studies in terms of sample size, duration of observation, number of events and difference in dietary potassium intake between the groups being compared. This heterogeneity led to a reduced statistical power in detecting a possible association between dietary potassium and coronary heart disease and cardiovascular disease.

There was no evidence of publication bias by the Egger test.

Potassium intake was assessed by 24-h dietary recall (n = 2), food frequency questionnaire (n = 6) or 24-h urinary excretion (n = 3).

Results and conclusions:
The investigators found in a pooled analysis, a dietary intake of 1.64g (42 mmol) potassium per day was significantly associated with a 21% lower risk of stroke [RR = 0.79, 95% CI = 0.68 to 0.90, p = 0.0007]. Significant means it can be said with a 95% confidence that a daily intake of 1.64g potassium really decreased the risk of having a stroke.

The investigators found a trend toward an inverse association between higher potassium intake (average weighted difference = 1.38g or 35.3 mmol/day) and risk of coronary heart disease [RR = 0.92, 95% CI = 0.81 to 1.04], which was not statistically significant [p = 0.18].
Not significant means it cannot be said with a 95% confidence that a daily intake of 1.38g potassium really decreased the risk of coronary heart disease with 8%. 

The investigators found a trend toward an inverse relationship between higher potassium intake (average weighted difference = 1.30g or 33.4 mmol/day) and cardiovascular disease risk [RR = 0.85, 95% CI = 0.62 to 1.16], which was not statistically significant [p = 0.31].

The investigators found a trend toward lower risk of CHD [RR = 0.93, 95% CI = 0.87 to 0.99, p = 0.03] and total CVD [RR = 0.74, 95% CI = 0.60 to 0.91, p = 0.0037] that attained statistical significance after the exclusion of a single cohort, based on sensitivity analysis.

The results of meta-regression analyses indicated that potassium intake difference, length of follow-up, quality score, recruitment year and population potassium intake at baseline were not significant sources of heterogeneity in the relationship of the potassium intake effect on the risk of CHD.

The results of meta-regression analyses indicated that the length of follow-up (coefficient: -0.064, 95% CI = -0.112 to -0.015, p = 0.01) and quality score (coefficient: -0.165, 95% CI = -0.287 to -0.043, p = 0.01) were significant sources of heterogeneity.

The investigators concluded that 1.64g dietary potassium per day decreases the risk of having a stroke and might also reduce the risk of coronary heart disease and total cardiovascular disease. This result applies to the general population, not only to specific subgroups at higher risk.
The favorable effects of dietary potassium were documented at least to some extent independently of other factors.
The results of this meta-analysis support recommendations for higher consumption of potassium-rich foods to prevent vascular diseases.

Original title:
Potassium Intake, Stroke, and Cardiovascular Disease : A Meta-Analysis of Prospective Studies by D'Elia L, Barba G, [...], Strazzullo P.

Link:
http://www.sciencedirect.com/science/article/pii/S0735109710049764

Additional information of El Mondo:
Find more information/studies on potassium right here.
The protective effect of potassium against the risk of stroke may conceivably relate to its blood pressure lowering effect.