Nutrition and health

Objectives:
Findings from observational studies on the associations between vitamin E intake and stroke risk remain controversial and the dose-response relationship between vitamin E intake and risk of stroke remains to be determined. Therefore, this review article has been conducted.

Does dietary vitamin E intake reduce risk of stroke?

Study design:
This review article included 9 prospective cohort studies involving 3,284 cases of stroke among 220,371 participants.

Results and conclusions:
The investigators found high dietary vitamin E intake significantly reduced risk of overall stroke with 17% [RR = 0.83, 95% CI = 0.73 to 0.94].
Omission of any single study (=sensitivity analysis) did not alter the summary result.

The investigators found high dietary vitamin E intake significantly reduced risk of overall stroke with 16% [RR = 0.84, 95% CI = 0.72 to 0.91] among individuals who were followed-up for 10 years.

The investigators found a non-linear association between dietary vitamin E intake and stroke risk [p = 0.0249].

The investigators concluded that a higher dietary vitamin E intake is associated with a lower stroke risk.

Original title:
Vitamin E intake and risk of stroke: a meta-analysis by Cheng P, Wang L, [...], Zhu J.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30401005

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

Objectives:
Medium-chain saturated fatty acids (MCFAs) may affect circulating lipids and lipoproteins differently than long-chain saturated fatty acids (LCSFAs), but the results from human intervention trials have been equivocal. Therefore, this review article has been conducted.

Have medium-chain saturated fatty acids (MCFAs) and long-chain saturated fatty acids (LCSFAs) differential impacts on blood lipids and lipoproteins in humans?

Study design:
This review article included 11 crossover and 1 parallel trial with a total of 299 participants [weighted mean ± SD age: 38 ± 3 y; weighted mean ± SD body mass index (kg/m²): 24 ± 2]

There was no evidence of statistical heterogeneity for HDL cholesterol, apoA-I and triglyceride concentrations. However, significant heterogeneity was observed for the total cholesterol [I2 = 49%] and LDL cholesterol analysis [I2 = 58%].

Results and conclusions:
The investigators found diets enriched with medium-chain saturated fatty acids led to significantly higher HDL cholesterol (good cholesterol) concentrations than diets enriched with long-chain saturated fatty acids [MD = 0.11 mmol/L, 95% CI = 0.07 to 0.15 mmol/L] with no effect on triglyceride, LDL cholesterol (bad cholesterol) and total cholesterol concentrations.

The investigators found consumption of diets rich in medium-chain saturated fatty acids significantly increased apolipoprotein A-I (apoA-I) concentrations compared with diets rich in long-chain saturated fatty acids [MD = 0.08 g/L, 95% CI = 0.02 to 0.14 g/L].  

The investigators concluded diets enriched with medium-chain saturated fatty acids lead to higher HDL cholesterol concentrations and apolipoprotein A-I (apoA-I) concentrations than diets enriched with long-chain saturated fatty acids. However, further investigations are warranted to elucidate the mechanism by which the lipid profile is altered.

Original title:
Differential effects of medium- and long-chain saturated fatty acids on blood lipid profile: a systematic review and meta-analysis by Panth N, Abbott KA, […], Garg ML.

Link:
https://academic.oup.com/ajcn/article-abstract/108/4/675/5100313?redirectedFrom=fulltext

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

Medium-chain saturated fatty acids (MCFAs) have approximately 6 to 12 carbon atoms in the chain. Coconut oil, palm kernel oil and coconut milk are by far the foods with the highest amounts of medium-chain saturated fatty acids.

Apolipoprotein AI (apo AI) is the major apoprotein of HDL and its serum concentration also correlates inversely with the risk for coronary heart disease (CHD).

 

Objectives:
Is there a relationship between different types of potato consumption and risk of all-cause mortality, coronary heart disease (CHD), stroke, type 2 diabetes (T2D), colorectal cancer (CRC) and hypertension?

Study design:
This review article included 28 reports.

The quality of evidence was rated mostly low (moderate quality of evidence for the risk-associations of French-fries).

Results and conclusions:
The investigators found per one daily/serving (150 g/day) increase of total potato consumption did not associate with:
-all-cause mortality [RR = 0.88, 95% CI = 0.69-1.12];
-coronary heart disease [RR = 1.03, 95% CI = 0.96-1.09];
-stroke [RR = 0.98, 95% CI = 0.93-1.03] and;
-colorectal cancer [RR = 1.05, 95% CI = 0.92-1.20].

The investigators found consumption of one daily/serving (150 g/day) of boiled/baked/mashed-potatoes was also not associated with risk of hypertension [RR = 1.08, 95% CI = 0.96-1.21].
No association because RR of 1 was found in the 95% CI of 0.96 to 1.21. RR of 1 means no risk/association.

The investigators found consumption of one daily/serving (150 g/day) of boiled/baked/mashed-potatoes significantly increased risk of type 2 diabetes with 8% [RR = 1.08, 95% CI = 1.01-1.18].
Significantly because RR of 1 was not found in the 95% CI of 1.01 to 1.18. RR of 1 means no risk/association.

The investigators found for each 150 g/day increase in French-fries consumption a significantly increased risk of type 2 diabetes with 66% [RR =1.66, 95% CI = 1.43-1.94].

The investigators found for each 150 g/day increase in French-fries consumption a significantly increased risk of hypertension with 37% [RR =1.37, 95% CI = 1.15-1.63].
Significantly means that there is an association with a 95% confidence.

The investigators concluded that 150 g/day increase in French-fries consumption is associated with an increased risk of type 2 diabetes and an increased risk of hypertension.

Original title:
Potatoes and risk of chronic disease: a systematic review and dose-response meta-analysis by Schwingshackl L, Schwedhelm C, […], Boeing H.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29987352

Additional information of El Mondo:
Find more information/studies on coronary heart disease, stroke, type 2 diabetes, colorectal cancer and hypertension right here.
 

Objectives:
Is there a relationship between step count and changes in blood pressure (BP) in healthy adults?

Study design:
This review article included 14 trials involving healthy adults and an intervention in the form of brisk walking with a pedometer.

Net changes in blood pressure and step count in each trial were calculated and pooled. In addition, the pooled net changes of two categories (trials that achieved walking 10,000 steps a day and those that did not) were compared.

Results and conclusions:
The investigators found that pooled net changes in blood pressure improved significantly [systolic blood pressure = -3.1 mmHg and diastolic blood pressure = -1.6 mmHg].

The investigators found, however, when the trials were categorized depending on whether they achieved walking 10,000 steps a day, the pooled net change in systolic blood pressure and diastolic blood pressure did not differ significantly between both groups of subjects.

The investigators found the meta-regression analyses indicated that net change in systolic blood pressure was significantly associated with an increased step count (e.g., systolic blood pressure is expected to decrease approximately 4 mmHg if increased step count by 2000 steps a day).
However, net change in systolic blood pressure was not associated with the step count in an intervention group following the intervention.

The investigators concluded that there is no evidence that walking 10,000 steps a day lowers the blood pressure to any marked degree in healthy adults. In order to reduce systolic blood pressure by walking with a pedometer, one should be mindful of increasing one's step count to 20,000 steps per day.

Original title:
The required step count for a reduction in blood pressure: a systematic review and meta-analysis by Igarashi Y, Akazawa N and Maeda S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30127487

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Find more information/studies on review article/RCTs, lowering blood pressure, sport nutrition right here.

Objectives:
Intervention studies suggest that incorporating walnuts into the diet may improve blood lipids without promoting weight gain. Therefore, this review article has been conducted.

Does a diet with walnuts improve blood lipids profile (such as cholesterol and triglycerides) without promoting weight gain?

Study design:
This review article included 26 clinical trials with a total of 1,059 participants.
Weighted mean differences (WMDs) were used.

Results and conclusions:
The investigators found compared with control group, a walnut-enriched diet significantly reduced total blood cholestrerol level with 6.99 mg/dL [95% CI = -9.39 to -4.58 mg/dL, p 0.001; 3.25% greater reduction].

The investigators found compared with control group, a walnut-enriched diet significantly reduced low-density lipoprotein (LDL) cholesterol level with 5.51 mg/dL [95% CI = -7.72 to -3.29 mg/dL, p 0.001; 3.73% greater reduction].

The investigators found compared with control group, a walnut-enriched diet significantly reduced triglyceride concentrations with 4.69 mg/dL [WMD = -4.69 mg/dL, 95% CI = -8.93 to -0.45 mg/dL, p = 0.03; 5.52% greater reduction].  

The investigators found more pronounced reductions in blood lipids were observed when walnut interventions were compared with American and Western diets [WMD for total blood cholestrerol level = -12.30, 95% CI = -23.17 to -1.43] and for LDL blood cholestrerol level = -8.28, 95% CI = -13.04 to -3.51, p 0.001].

The investigators found apolipoprotein B was also reduced significantly more on walnut-enriched diet compared with control group [WMD = -3.74 mg/dL, 95% CI = -6.51 to -0.97 mg/dL, p = 0.008].

The investigators found a trend towards a reduction was observed for apolipoprotein A [WMD = -2.91, 95% CI = -5.98 to 0.08, p = 0.057].

The investigators found, however, walnut-enriched diet did not lead to significant differences in weight change compared with control diet [WMD = -0.12 kg, 95% CI = -2.12 to 1.88, p = 0.90], systolic blood pressure [WMD = -0.72 mmHg, 95% CI = -2.75 to 1.30, p = 0.48] or diastolic blood pressure [WMD = -0.10 mmHg, 95% CI = -1.49 to 1.30, p = 0.88].

The investigators concluded that walnut-enriched diet improves total and LDL cholesterol levels (bad cholesterol), apolipoprotein B levels and triglyceride levels without adversely affecting body weight or blood pressure.

Original title:
Effects of walnut consumption on blood lipids and other cardiovascular risk factors: an updated meta-analysis and systematic review of controlled trials by Guasch-Ferré M, Li J, […], Tobias DK.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29931130

Additional information of El Mondo:
Find more information/studies on review article/significantly, nut consumption and cholesterol right here.

Persons with atherosclerosis often have an elevated total cholesterol level, an elevated LDL cholesterol level, an elevated triglyceride level and an elevated apolipoprotein B level.

Persons with atherosclerosis are advised to choose products/meals with maximum 30 En% fat, maximum 7 En% saturated fat, maximum 0.2 gram salt per 100 kcal and minimum 1.5 grams fiber per 100 kcal. Check here which products/meals are suitable for persons with atherosclerosis.
 

Objectives:
The association of high sodium intake with risk of stroke has been accepted. But considering the proposed J/U-shaped association between sodium intake and risk of all-cause mortality, the shape of the dose-response relationship has not been determined yet. Therefore, this review article has been conducted.

Is there a dose-response association of dietary sodium and sodium-to-potassium ratio with risk of stroke in adults aged 18 years or older?

Study design:
This review article included 14 prospective cohort studies, 1 case-cohort study and 1 case-control study with a total of 261,732 participants, of which 10,150 cases of stroke.

Results and conclusions:
The investigators found a significantly increased risk of 6% [pooled RR = 1.06, 95% CI = 1.02 to 1.10, I2 = 60%, n = 14 studies] for stroke for a 1 gr/d increment in dietary sodium intake.

The investigators found a significantly increased risk of 22% [pooled RR = 1.22, 95% CI = 1.04 to 1.41, I2 = 60%, n = 5 studies] for stroke for a one-unit increment in dietary sodium-to-potassium ratio (mmol/mmol).

The investigators found the risk of stroke increased linearly with increasing dietary sodium intake and also along with the increase in dietary sodium-to-potassium ratio.

The investigators found no evidence of a J/U-shaped association in the analyses of total stroke, stroke incidence and stroke mortality.

The investigators found high sodium intake was associated with a somewhat worse prognosis among Asian countries as compared to westerns.

The investigators concluded that higher dietary sodium intake and higher dietary sodium-to-potassium ratio are associated with a higher risk of stroke in adults aged 18 years or older. Reducing dietary sodium-to-potassium ratio can be considered as a supplementary approach in parallel with the decrease in sodium intake in order to decrease stroke risk.

Original title:
Dietary sodium, sodium-to-potassium ratio, and risk of stroke: A systematic review and nonlinear dose-response meta-analysis by Jayedi A, Ghomashi F, […], Shab-Bidar S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29907351

Additional information of El Mondo:
Find more information/studies on review article/significantly, sodium, potassium and cardiovascular diseases prevention right here.

Sodium is a component of salt. Thus, a high sodium intake means a high salt intake.
A high salt diet means, practically, a diet with a lot of products with minimum 0.3 gram salt per 100 kcal.

A low salt diet means, practically, a diet with a lot of products with maximum 0.2 gram salt per 100 kcal. These products meet a low salt diet.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Metabolic disorders can take many forms. This includes:

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

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

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

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

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

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

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

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

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

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Objectives:
Does poultry intake reduce risk of stroke?

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

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

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

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

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

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

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

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

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

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

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

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1 serving poultry corresponds to 100 gram raw poultry.
This meal provides 75 grams of poultry.
Poultry are chickens, turkeys, geese and ducks.

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

Do resveratrol supplements reduce plasma lipids, like cholesterol levels?

Study design:
This review article included 21 RCTs.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Does a low GI diet lower the cholesterol levels?

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

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

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

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

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

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

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

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

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

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High LDL-cholesterol levels and high triglyceride levels increase the risk of getting cardiovascular diseases whereas high HDL-cholesterol levels decrease the risk of getting cardiovascular diseases.

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

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

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

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

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

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

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

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

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

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

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

Study design:
This review article included 63 RCTs.

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

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

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

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

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

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

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

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

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

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