Nutrition and health

Objectives:
Can the biomarker miRNAs predict Alzheimer's disease?

Study design:
This review article included 10 studies containing 770 Alzheimer's disease and 664 normal controls (persons without Alzheimer's disease).

Results and conclusions:
The investigators found miRNAs presented excellent diagnostic performance and the overall sensitivity was 0.80 [95% CI = 0.75-0.83], specificity was 0.83 [95% CI = 0.78-0.87] and diagnostic odds ratio was 14 [95% CI = 11-19].

The investigators found subgroup analysis suggested that the Caucasian group and blood group showed a better performance in Alzheimer's disease diagnosis and the diagnostic odds ratio was 42 and 34, respectively.

The investigators concluded that miRNAs may be a promising biomarker for Alzheimer's disease.

Original title:
Blood circulating miRNAs as biomarkers of Alzheimer's disease: a systematic review and meta-analysis by Zhang YH, Bai SF and Yan JQ.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31385521

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Objectives:
The morbidity of eczema has increased in the recent years and the methods to prevent or ameliorate its effects are becoming more important. Therefore, this review article has been conducted.

Do vitamin supplements reduce risk of eczema?

Study design:
This review article included 10 RCTs with a total of 456 patients.
The sample sizes ranged from 5 to 57. The studies were published from 2008 to 2018.
5 studies were conducted on atopic dermatitis, 3 studies were conducted on pediatric atopic dermatitis and 2 studies were conducted on winter-related atopic dermatitis.

Results and conclusions:
The investigators found that the SCORAD index or EASI scores significantly decreased in patients given vitamin D3 (cholecalciferol) supplements [mean difference = -5.96, 95% CI = -7.69 to -4.23, I2 = 33%].

The investigators found that the SCORAD index significantly decreased after the topical application of vitamin B12-containing cream [mean difference = -3.19, 95% CI = -4.27 to -2.10, I2 = 0%]. 

The investigators found that the SCORAD index significantly improved after vitamin E supplementation [mean difference = -5.72, 95% CI = -11.41 to -0.03, I2 = 0%]. 

The investigators concluded vitamin D3, B12 and E supplements could be important therapeutics to help manage eczema patients.

Original title:
Assessment of the Effectiveness of Vitamin Supplement in Treating Eczema: A Systematic Review and Meta-Analysis by Zhu Z, Yang Z, [...], Liu H.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6875217/

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Objectives:
Does alcohol consumption increase of risk of osteoporosis?

Study design:
This review article included  3 case control studies, 2 cohort studies and 1 cross-sectional study.

Results and conclusions:
The investigators found no association between consuming 0.5-1 drinks per day and the risk of developing osteoporosis [adjusted RR = 1.38, 95% CI = 0.90-2.12].
No association because RR of 1 was found in the 95% CI of 0.90 to 2.12. RR of 1 means no risk/association.

The investigators found compared with abstainers of alcohol, persons consuming 1-2 drinks per day had 1.34 times the risk of developing osteoporosis [adjusted RR = 1.34, 95% CI = 1.11-1.62].

The investigators found compared with abstainers of alcohol, persons consuming 2 drinks or more per day had 1.63 times the risk of developing osteoporosis [adjusted RR = 1.63, 95% CI = 1.01-2.65].

The investigators found a positive association between alcohol consumption and osteoporosis in the case-control studies [adjusted OR = 2.95, 95% CI = 1.78-4.90].

The investigators concluded there is a positive relationship between alcohol consumption, particularly 1 drink or more per day and osteoporosis.

Original title:
The effect of alcohol on osteoporosis: A systematic review and meta-analysis by Cheraghi Z, Doosti-Irani A, Almasi-Hashiani A, […], Mansournia MA.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30844616

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Objectives:
Do older adults benefit from high protein intake (>0.8 g/kg body weight/day)?

Study design:
This review article included 12 cohort studies and 1 RCT.
Studies had an intervention duration of at least 6 months.

Results and conclusions:
The investigators found meta-analysis of the cohort studies showed that high vs low protein intake resulted in a statistically significant decrease of 11% for hip fractures [pooled HR = 0.89, 95% CI = 0.84 to 0.94, p 0.001, I2 = 0.0%, p = 0.614].
Sensitivity analyses showed that there was no single study affecting the overall estimate considerably.

The investigators concluded there is an association between a dietary protein intake above the current RDA of 0.8 g/kg body weight/day and a reduced hip fracture risk in older adults. In comparison with younger adults, the body of evidence from the included studies is not strong enough to increase the protein recommendation for older adults with respect to bone health.

Original title:
High Versus low Dietary Protein Intake and Bone Health in Older Adults: a Systematic Review and Meta-Analysis by Groenendijk I, den Boeft L , [...], de Groot LCPGM.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6704341/

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A protein intake higher than 0.8 g/kg body weight/day corresponds to a diet with a minimum of 11 En% protein. The easiest way to follow a diet with at least 11 En% protein is to choose only products that contain at least 11 En% protein. These products from the supermarket contain at least 11% En% protein.
 

Objectives:
Do low folate levels and vitamin B12 levels increase risk of depression among the aged people?

Study design:
This review article included both gender data of 11 folate-related (7,949 individuals) and 9 B12-related studies (6,308 individuals) and gender-specific data of 4 folate-related (3,409 individuals) and 3 B12-related studies (1,934 individuals).

Results and conclusions:
The investigators found low folate levels significantly increased risk of depression among the aged people with 23% [OR =1.23, 95% CI =1.07-1.43]. 

The investigators found low vitamin B12 levels significantly increased risk of depression among the aged people with 20% [OR =1.20, 95% CI =1.02-1.42]. 

The investigators found in subgroup analysis low vitamin B12 levels significantly increased risk of depression among the aged women with 33% [OR =1.33, 95% CI =1.02-1.74]. 

The investigators concluded both low folate levels and low vitamin B12 levels increase risk of depression among the aged people.

Original title:
Folate and B12 serum levels in association with depression in the aged: a systematic review and meta-analysis by Petridou ET, Kousoulis AA, [...], Stefanadis C.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/26055921

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Objectives:
Low-potassium diets are recommended to reduce serum potassium (Sk) and prevent complications of chronic kidney disease (CKD), but evidence underpinning this recommendation has not been systematically reviewed and synthesized. Therefore, this review article has been conducted.

Do patients with chronic kidney disease benefit from low-potassium diets?

Study design:
This review article included 7 studies  with 3,489 participants.

Results and conclusions:
The investigators found in very-low-quality studies that restricted (1,295 mg/d) versus unrestricted (1,570 mg/d) dietary potassium lowered serum potassium by 0.22 mEq/L [95% CI = -0.33 to -0.10, I2 = 0%].

The investigators found in very-low-quality studies that lower (1,725 mg/d) versus higher (4,558 mg/d) dietary potassium was not significantly associated with disease progression [HR = 1.14, 95% CI = 0.77 to 1.70, I2 = 57%].

The investigators found in very-low-quality studies that lower (1,670 mg/d), compared with higher (4,414 mg/d) dietary potassium intake was associated with a 40% reduction in mortality hazard [HR = 0.60, 95% CI = 0.40 to 0.89, I2 = 56%].

The investigators concluded very-low-quality evidence supports consensus that dietary potassium restriction reduces serum potassium in normokalemia and is associated with a reduced risk of death in those with chronic kidney disease. However, high-quality randomized controlled trials are needed to confirm these findings.

Original title:
Effect of Dietary Potassium Restriction on Serum Potassium, Disease Progression, and Mortality in Chronic Kidney Disease: A Systematic Review and Meta-Analysis by Morris A, Krishnan N, […], Lycett D.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31734057

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Objectives:
Parkinson's disease (PD) is the most common neurodegenerative disease after Alzheimer's dementia. Whereas the exact etiology of Parkinson's disease remains unknown, risk of developing Parkinson's disease seems to be related to a combination of genetic and environmental factors. This also includes abnormal exposure to trace elements of nutritional and toxicological interest. Therefore, this review article has been conducted.

Is there a relationship between exposure to trace elements and Parkinson’s disease risk?

Study design:
This review article included 56 case-control studies reporting data for selenium (cases/controls: 588/721), copper (2,190/2,522), iron (2,956/3,469) and zinc (1,798/1,913) contents in cerebrospinal fluid (CSF) and blood.

Results and conclusions:
The investigators found patients with Parkinson's disease had significantly higher levels of selenium in cerebrospinal fluid compared with controls [+51.6%, WMD = 5.49, 95% CI = 2.82 to 8.15], while levels in serum were similar [-0.2%, WMD = -0.22, 95% CI = -8.05 to 7.62].

The investigators found patients with Parkinson's disease had non-significantly higher levels of copper in cerebrospinal fluid compared with controls [+4.5%, WMD = 1.87, 95% CI = -3.59 to 7.33] and non-significantly lower levels of copper in serum [WMD = -42.79, 95% CI = -134.35 to 48.76].

The investigators found patients with Parkinson's disease had significantly higher levels of iron in cerebrospinal fluid compared with controls [+9.5%, WMD = 9.92, 1.23 to 18.61] and significantly lower levels of iron both in serum/plasma [-5.7%, WMD = -58.19, 95% CI = -106.49 to -9.89] and whole blood [-10.8%, WMD = -95.69, 95% CI = -157.73 to -33.65].

The investigators found patients with Parkinson's disease had significantly lower levels of zinc in cerebrospinal fluid compared with controls [-10.8%, WMD = -7.34, 95% CI = -14.82 to -0.14] and significantly lower levels of zinc in serum/plasma [-7.5%, WMD = -79.93, 95% CI = -143.80 to -16.06].

The investigators found a longer duration of the disease tends to be associated with overall lower trace element levels in either cerebrospinal fluid or blood.

The investigators concluded higher levels of both selenium and iron in cerebrospinal fluid increase Parkinson's disease, while higher levels of zinc in cerebrospinal fluid decrease Parkinson's disease.

Original title:
Selenium and Other Trace Elements in the Etiology of Parkinson's Disease: A Systematic Review and Meta-Analysis of Case-Control Studies by Adani G, Filippini T, […], Vinceti M.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31454800

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Find here more information/studies about iron, zinc, selenium and chronic disease
 

Objectives:
Does omega-3 fatty acids supplementation improve serum levels of inflammatory biomarkers (C-reactive protein [CRP], high-sensitivity CRP [hs-CRP], tumor necrosis factor-alpha, interleukin-6) and albumin in patients on hemodialysis?

Study design:
This review article included 8 RCTs comprising 371 patients on hemodialysis.

Results and conclusions:
The investigators found omega-3 supplementation significantly decreased serum levels of CRP in patients on hemodialysis [SMD = -1.95 mg/dL, 95% CI = -3.09 to -0.80] and hs-CRP [SMD = -2.09, 95% CI = -3.62 to -0.56].

The investigators found, however, omega-3 supplementation did not significantly improved albumin [SMD = 0.91, 95% CI = -0.78 to 2.59], tumor necrosis factor-alpha [SMD = -1.51, 95% CI = -3.24 to 0.22] and interleukin-6 levels [SMD = 0.72, 95% CI = -0.56 to 1.99] in patients on hemodialysis.

The investigators concluded omega-3 supplementation leads to a significant decrease in serum levels of CRP and hs-CRP in patients on hemodialysis.

Original title:
The Effect of Omega-3 Supplementation on Serum Levels of Inflammatory Biomarkers and Albumin in Hemodialysis Patients: A Systematic Review and Meta-analysis by Dezfouli M, Moeinzadeh F, [...], Feizi A.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31420233

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Objectives:
Findings from observational studies and clinical trials on the associations between vitamin E and dementia remain controversial. Therefore, this review article has been conducted.

Do low vitamin E levels increase risk of Alzheimer's disease (AD) or age-related cognitive deficits and mild cognitive impairment (MCI)?

Study design:
This review article included 31 studies.

Results and conclusions:
The investigators found individuals with Alzheimer's disease had lower circulatory concentrations of α-tocopherol (vitamin E) compared with healthy controls [SMD = -0.97, 95% CI = -1.27 to -0.68, p  0.00001].

The investigators found individuals with age-related cognitive deficits had lower circulatory concentrations of α-tocopherol (vitamin E) compared with healthy controls [SMD = -0.72, 95% CI = -1.12 to -0.32, p  0.0005].

The investigators found individuals with mild cognitive impairment had lower circulatory concentrations of α-tocopherol (vitamin E) compared with healthy controls [SMD = -0.72, 95% CI = -1.12 to -0.32, p  0.0005].

The investigators found levels of β-, γ- and δ-tocopherols did not significantly differ between groups of Alzheimer's disease and age-related cognitive deficits compared to controls.

The investigators concluded that lower α-tocopherol (vitamin E) levels have a strong association with Alzheimer's disease and mild cognitive impairment supporting evidence for the role of diet and vitamin E in Alzheimer's disease risk and age-related cognitive decline.

Original title:
A meta-analysis of peripheral tocopherol levels in age-related cognitive decline and Alzheimer's disease by Ashley S, Bradburn S and Murgatroyd C.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31661399

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Find more information/studies on vitamin E and elderly.
 

Objectives:
Serum uric acid (SUA) accounts for about 50% of extracellular antioxidant activity, suggesting that hyperuricemia (an abnormally high level of uric acid in the blood) may have a protective role in diseases characterized by high levels of oxidative stress, such as osteoporosis. Therefore, this review article has been conducted.

Does a high serum uric acid level (also called hyperuricemia) increase bone mineral density (BMD)?

Study design:
This review article included 19 cross-sectional studies with a total of 55,859 participants.

Results and conclusions:
The investigators found in 6 studies that subjects with higher serum uric acid levels had significantly higher bone mineral density values for the spine [SMD = 0.29, 95% CI = 0.22-0.35, I2 = 47%].
Simple correlation analyses substantially confirmed this finding.

The investigators found in 7 studies that subjects with higher serum uric acid levels had significantly higher bone mineral density values for total hip [SMD = 0.29, 95% CI = 0.24-0.34, I2 = 33%].
Simple correlation analyses substantially confirmed this finding.

The investigators found in 6 studies that subjects with higher serum uric acid levels had significantly higher bone mineral density values for femoral neck [SMD = 0.25, 95% CI = 0.16-0.34, I2 = 71%].
Simple correlation analyses substantially confirmed this finding.

The investigators found in 3 studies that an increase of one standard deviation in serum uric acid levels significantly reduced risk of new fractures with 17% [HR = 0.83, 95% CI = 0.74-0.92, I2 = 0%].

The investigators found no significant differences between men and women, although data about women were limited.

The investigators concluded a high serum uric acid level is independently associated with higher bone mineral density values and a lower risk of fractures, supporting a protective role for uric acid in bone metabolism disorders.

Original title:
Hyperuricemia protects against low bone mineral density, osteoporosis and fractures: a systematic review and meta-analysis by Veronese N, Carraro S, […], Cereda E.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/27636234

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Objectives:
Environmental risk factors regrading rheumatoid arthritis (RA) have not been explored extensively. Selenium (Se), zinc (Zn) and copper (Cu) nutrients were reported to associate with rheumatoid arthritis, but the results were inconsistent. Therefore, this review article has been conducted.

Is there a relationship between serum selenium, zinc and copper levels and rheumatoid arthritis risk?

Study design:
This review article included 41 studies.

Results and conclusions:
The investigators found meta-analysis of 16 studies involving 806 rheumatoid arthritis patients and 959 health controls showed that serum selenium levels [SMD = -1.04, 95% CI = -1.58 to -0.50] were significantly decreased in rheumatoid arthritis patients.

The investigators found meta-analysis of 23 studies involving 1,398 rheumatoid arthritis patients and 1,299 health controls showed that serum zinc levels [SMD = -1.20, 95% CI = -1.74 to -0.67] were significantly decreased in rheumatoid arthritis patients.

The investigators found meta-analysis of 26 studies involving 1,723 rheumatoid arthritis patients and 1,451 health controls showed that serum copper levels [SMD = 1.26, 95% CI = 0.63 to 1.89] were significantly increased in rheumatoid arthritis patients.

The investigators found meta-regression reported that steroid use was positively related to serum level of selenium in rheumatoid arthritis [β = 0.041, 95% CI = 0.002 to 0.079].

The investigators found differences in serum selenium, zinc and copper between rheumatoid arthritis patients and controls were all related with the geographical distribution.

The investigators concluded patients with rheumatoid arthritis have significant decreased serum selenium and zinc levels and increased serum copper levels than health controls, suggesting potential roles of selenium, zinc and copper in the pathogenesis of rheumatoid arthritis. Patients and rheumatologist should give enough attention to the monitor of these elements during follow up.

Original title:
Common trace metals in rheumatoid arthritis: A systematic review and meta-analysis by Ma Y, Zhang X, […], Pan F.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31442958

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Find here more information/studies about selenium, zinc and copper and chronic disease.


 

Objectives:
Systematic inflammation plays a major role in all stages of chronic diseases. Recent evidence suggests that coenzyme Q10 (CoQ10), as an anti-inflammatory agent, has shown beneficial effects on the inflammatory process of various human diseases. However, several trials have examined the effects of coenzyme Q10 on pro-inflammatory cytokines with contrasting results. Therefore, this review article has been conducted.

Does coenzyme Q10 supplementation reduce inflammation in humans?

Study design:
This review article included 9 RCTs with a total of 509 patients (269 in the coenzyme Q10 arm and 240 in the control arm).

Results and conclusions:
The investigators found that oral coenzyme Q10 supplementation (60-500 mg/day for 8-12 weeks) resulted in significant reduction of TNF-α [SMD = -0.44, 95% CI = -0.81 to -0.07 mg/dL, I2 = 66.1%, p  = 0.00] and IL-6 levels [SMD = -0.37, 95% CI = -0.65 to -0.09, I2 = 57.2%, p  = 0.01], respectively.

The investigators found subgroup analyses represented a significant reduction of TNF-α and IL-6 levels in patients with BMI  26.
Due to the small number of studies and patients included in each subgroup, these subgroup analyses need to be interpreted cautiously.

The investigators concluded there is a significant effect of 60-500 mg/day coenzyme Q10 supplements for 8-12 weeks on some of the inflammatory markers among patients with chronic diseases which could attenuate the inflammatory state. However, well-designed studies with a larger sample size are required. Note that the results should be interpreted with caution because of the evidence of heterogeneity and limited number of studies.

Original title:
Can coenzyme Q10 supplementation effectively reduce human tumor necrosis factor-α and interleukin-6 levels in chronic inflammatory diseases? A systematic review and meta-analysis of randomized controlled trials by Vafa M.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31185284

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Objectives:
Do dietary intakes of soy, soy isoflavones and soy protein reduce risk of mortality from all causes, cancers and cardiovascular diseases?

Study design:
This review article included 23 prospective cohort studies with an overall sample size of 330,826 participants.

Results and conclusions:
The investigators found soy/soy products consumption significantly reduced risk of mortality from cancers with 12% [pooled relative risk = 0.88, 95% CI = 0.79 to 0.99, p = 0.03, I2 = 47.1%].

The investigators found soy/soy products consumption significantly reduced risk of mortality from cardiovascular diseases with 15% [pooled effect size = 0.85, 95% CI = 0.72 to 0.99, p = 0.04, I2 = 50.0%].

The investigators found such significant associations were also observed for all-cause mortality in some subgroups of the included studies, particularly those with higher quality.

The investigators found in addition, higher dietary intake of soy was associated with decreased risk of mortality from gastric, colorectal and lung cancers as well as ischemic cardiovascular diseases.

The investigators found participants in the highest category of dietary soy isoflavones intake had a 10% lower risk of all-cause mortality compared with those in the lowest category.

The investigators found that a 10-mg/day increase in dietary intake of soy isoflavones was associated with 7% and 9% decreased risk of mortality from all cancers and breast cancer, respectively.

The investigators found for each 5-g/day increase in consumption of soy protein a 12% reduction in breast cancer death.

The investigators found, however, dietary intake of soy protein was not significantly associated with all-cause and cardiovascular diseases mortality.

The investigators concluded that soy and its isoflavones consumption favorably influence risk of mortality. In addition, soy protein dietary intake is associated with a decreased risk in the mortality of breast cancer. These findings support the current recommendations to increase intake of soy for greater longevity.

Original title:
Soy, Soy Isoflavones, and Protein Intake in Relation to Mortality from All Causes, Cancers, and Cardiovascular Diseases: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies by Nachvak SM, Moradi S, […], Sadeghi O.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31278047

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Objectives:
There is little evidence whether eggs affect inflammation. Therefore, this review article has been conducted.

Does egg consumption increase risk of inflammation?

Study design:
This review article included 8 RCTs assessed high sensitivity c-reactive protein (hs-CRP), 4 RCTs assessed interleukin-6 (IL-6) and 5 RCTs assessed tumor necrosis factor alpha (TNF-α).

Results and conclusions:
The investigators found egg consumption did not affect hs-CRP [WMD = 0.24 mg/L, 95% CI = -0.43 to 0.90, I2 = 53.8%, p = 0.48], IL-6 [WMD = 0.20 pg/mL, 95% CI =  -0.71 to 1.11, I2 = 69.3%, p = 0.50] and TNF-α [WMD = -0.38 pg/mL, 95% CI = -0.87 to 0.10, I2 = 0.00%, p = 0.12] relative to controls.

The investigators concluded that egg consumption has no effect on serum biomarkers of inflammation in adults.

Original title:
Effect of Egg Consumption on Inflammatory Markers: A Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials by Sajadi Hezaveh Z, Khalighi Sikaroudi M, […], Soltani S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31259415

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Inflammation in human body can be measured by means of biomarkers. These biomarkers are hs-CRP, IL-6 and TNF-α.
 

Objectives:
Does a high blood homocysteine level increase risk of cognitive impairment, like Alzheimer's disease and vascular dementia?

Study design:
This review article included 28 prospective cohort studies with 2,557 cases (1,035 all-cause dementia, 530 Alzheimer's disease, 92 vascular dementia and >900 cognitive impairment without dementia (CIND)) among 28,257 participants.
 
The average follow-up period ranged from 2.7 to 35 years.

There was no clear evidence of publication bias with Begg's and Egger's tests for Alzheimer dementia [p = 0.806, 0.084, respectively].

Results and conclusions:
The investigators found there was a clear linear dose-response relationship between blood homocysteine concentration and risk of Alzheimer-type dementia [p > 0.05 for non-linearity].

The investigators found for every 5 μmol/L increase in blood homocysteine a significantly increased risk of 15% [pooled RR = 1.15, 95% CI = 1.04 to 1.26, I2 = 56.6%, n = 5] for Alzheimer-type dementia.
Sensitivity analysis showed similar results.

The investigators found due to the presence of publication bias and low statistical power, elevated levels of blood homocysteine were not appreciably associated with risk of all-cause, vascular dementia and cognitive impairment without dementia.

The investigators concluded every 5 μmol/L increase in blood homocysteine is linearly associated with a 15% increase in relative risk of Alzheimer-type dementia.

Original title:
Hyperhomocysteinemia and risk of incident cognitive outcomes: An updated dose-response meta-analysis of prospective cohort studies by Zhou F and Chen S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30826501

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Objectives:
The prevalence of overweight/obesity in adults is raised to 39%, which is nearly tripled more than 1975. The alteration of the gut microbiome has been widely accepted as one of the main causal factors. Therefore, this review article has been conducted.

Does probiotics supplementation prevent overweight/obesity in adults?

Study design:
This review article included 12 RCTs (11 randomized, double-blinded, controlled trials and 1 randomized, single-blinded, controlled trial) with a total of 821 participants (416 participants were given placebo and 405 participants were given probiotics).

7 RCTs included participants who consumed two or multiple strains of probiotics and 5 RCTs included participants who consumed a single strain of probiotics.
7 RCTs investigated a high dosage of probiotics (>1010 CFU) and 5 RCTs investigated lower dosage of probiotics (1010 CFU).
Probiotics were administered in different forms, including sachet, capsule, powder, kefir, yogurt and fermented milk.
Duration of the probiotics supplementation ranged from 8 to 24 weeks.

There was no significant publication bias.

Results and conclusions:
The investigators found compared with control groups, probiotics supplementation resulted in a significantly reduction in body weight [WMD = -0.55, 95% CI = -0.91 to -0.19 kg, I2 = 64%, p = 0.003].
Subgroup analyses stratified by probiotics dosage, the number of probiotics strains or forms of probiotics showed the effects of probiotics supplementation on body weight were significantly reduced in trials with high dose of probiotics [WMD = -0.58, 95% CI = -0.92 to 0.23 kg], a single strain of probiotics [WMD = -0.49, 95% CI = -0.92 to -0.07 kg] and the capsule or powder of probiotics [WMD = -0.55, 95% CI = -0.84 to -0.26 kg].
Sensitivity analyses revealed that no particular studies significantly affected the summary effects of body weight.

The investigators found compared with control groups, probiotics supplementation resulted in a significantly reduction in BMI [WMD = -0.30, 95% CI = -0.43 to -0.18 kg/m², I2 = 59%, p = 0.006].
Subgroup analyses stratified by probiotics dosage, the number of probiotics strains or forms of probiotics showed the effects of probiotics supplementation on BMI were significantly reduced with the high dose [WMD = -0.29, 95% CI = -0.46 to -0.12 kg/m²] and single strain of probiotics [WMD = -0.36, 95% CI = -0.52 to -0.20 kg/m²].
Sensitivity analyses revealed that no particular studies significantly affected the summary effects of BMI.

The investigators found compared with control groups, probiotics supplementation resulted in a significantly reduction in waist circumference [WMD = -1.20, 95% CI = -2.21 to -0.19 cm, p = 0.02, I2 = 90%, p 0.00001].
Subgroup analyses stratified by probiotics dosage, the number of probiotics strains or forms of probiotics indicated the effects of probiotics supplementation on waist circumference were significantly reduced in trials with high dose of probiotics [WMD = -1.53, 95% CI = -2.64 to -0.41 cm], a single strain of probiotics [WMD = -1.69, 95% CI = -3.04 to -0.33 cm] and the food form of probiotics [WMD = -1.11, 95% CI = -1.64 to -0.59 cm].
Sensitivity analyses revealed that no particular studies significantly affected the summary effects of waist circumference.

The investigators found compared with control groups, probiotics supplementation resulted in a significantly reduction in fat mass [WMD = -0.91, 95% CI = -1.19 to -0.63 kg, p 0.00001, I2 = 43%, p = 0.08] and fat percentage [WMD = -0.92, 95% CI = -1.27 to -0.56%, p 0.00001, I2 = 57%, p = 0.04].
Subgroup analyses stratified by probiotics dosage, the number of probiotics strains and forms of probiotics indicated that the effect of probiotics supplementation on fat mass was significantly reduced, showing a greater decrease in fat mass with high dosage probiotics WMD -1.08, 95% CI = -1.21 to -0.95 kg] compared to low dosage probiotics [WMD = -1.00, 95% CI = -1.59 to -0.42 kg], a greater decrease with single strain probiotics [WMD = -1.15, 95% CI = -1.28 to -1.02 kg] compared to multiple strain probiotics [WMD = -0.60, 95% CI = -0.94 to -0.26] kg] and a greater decrease with administration probiotics in the form of food [WMD = -1.13, 95% CI = -1.58 to -0.67 kg] compared to in the forms of capsule or powder [WMD = -1.07, 95% CI = -1.20 to -0.94 kg].
No particular study significantly affected the pooled effect of probiotics on fat mass and fat percentage by sensitivity analyses.

The investigators found compared with control groups, probiotics supplementation significantly improved total cholesterol levels [SMD = -0.43, 95% CI = -0.80 to -0.07, p = 0.02, I2 = 73%, p = 0.001].
Subgroup analyses only stratified by probiotics dosage and the number of probiotics strains indicated the effects of probiotics supplementation on total cholesterol were significantly reduced in trials with single strain probiotics [WMD = -0.61, 95% CI = -1.54 to -0.32], compared to multiple strain probiotics [WMD = -0.39, 95% CI = -0.66 to -0.13].
Sensitivity analyses revealed that no particular studies significantly affected the summary effects of total cholesterol.

The investigators found compared with control groups, probiotics supplementation significantly improved LDL-cholesterol levels [SMD = -0.41, 95% CI = -0.77 to -0.04, p = 0.03, I2 = 73%, p = 0.001].
Subgroup analyses stratified by probiotics dosage and the number of probiotics strains indicated the effects of probiotics supplementation on LDL-cholesterol were significantly reduced in trials with multiple strain probiotics [WMD = -0.33, 95% CI = -0.57 to -0.09]. Sensitivity analyses revealed that no particular studies significantly affected the summary effects of LDL-cholesterol.

The investigators found compared with control groups, probiotics supplementation significantly improved fasting plasma glucose (FPG) [SMD = -0.35, 95% CI = -0.67 to -0.02, p = 0.04, I2 = 64%, p = 0.02].

The investigators found compared with control groups, probiotics supplementation significantly improved insulin [SMD = -0.44, 95% CI = -0.84 to -0.03, p = 0.03, I2 = 76%, p = 0.0008].

The investigators found compared with control groups, probiotics supplementation significantly improved HOMA-IR [SMD = -0.51, 95% CI = -0.96 to -0.05, p = 0.03, I2 = 76%, p = 0.003].

The investigators concluded probiotics supplementation during 8 to 24 weeks reduces the body weight and fat mass and improves some of the lipid and glucose metabolism parameters, although some of the effects were small. Probiotics may become a new potential strategy for the prevention and treatment of overweight/obesity in adult individuals.

Original title:
The Potential Role of Probiotics in Controlling Overweight/Obesity and Associated Metabolic Parameters in Adults: A Systematic Review and Meta-Analysis by Wang ZB, Xin SS, [...], Zhang XD.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6500612/

Additional information of El Mondo:
Find more information/studies on probiotics, cholesterol, diabetes and obesity/overweight right here.

Objectives:
Previous studies reported that magnesium deficiency was associated with vascular calcifications, atherosclerosis and cardiovascular disease, which might play an independent pathogenic role in chronic kidney disease (CKD) and end-stage renal disease (ESRD) patients. However, the results of these studies were somewhat underpowered and inconclusive. Therefore, this review article has been conducted.

Does hypomagnesemia (a low blood magnesium concentration) increase risk of mortality in patients with chronic kidney disease and end-stage renal disease?

Study design:
This review article included 20 studies involving 200,934 participants.

Results and conclusions:
The investigators found hypomagnesemia significantly increased risk of all-cause mortality in patients with chronic kidney disease and end-stage renal disease with 32% [multivariable adjusted HR = 1.32, 95% CI = 1.19-1.47, p 0.00001]. 

The investigators found, on the contrary, hypermagnesemia (a high blood magnesium concentration) significantly decreased risk of all-cause mortality in patients with chronic kidney disease and end-stage renal disease with 14% [HR = 0.86, 95% CI = 0.79-0.94, p = 0.001] (per unit increase).

The investigators found, moreover, hypermagnesemia significantly decreased risk of cardiovascular mortality in patients with chronic kidney disease and end-stage renal disease with 29% [adjusted HR = 0.71, 95% CI = 0.53-0.97, p = 0.03]. 

The investigators found subgroup analysis showed that hypomagnesemia significantly increased all-cause mortality in hemodialysis patients with 29% [HR = 1.29, 95% CI = 1.12-1.50, p = 0.0005].

The investigators concluded hypomagnesemia (a low blood magnesium concentration) increases cardiovascular and all-cause mortality in patients with chronic kidney disease and end-stage renal disease. Further studies evaluating benefits of magnesium correction in chronic kidney disease and dialysis patients with hypomagnesemia should be performed.

Original title:
Serum magnesium, mortality, and cardiovascular disease in chronic kidney disease and end-stage renal disease patients: a systematic review and meta-analysis by Xiong J, He T, […], Zhao J.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30888644

Additional information of El Mondo:
Find here more information/studies about chronic disease, magnesium and kidney diseases.

Normal values of serum magnesium are considered those between 0.7 and 1.0 mmol/L.
Hypomagnesemia has a serum magnesium concentration of 0.7 mmol/L.
Blood magnesium concentration can be increased by eating magnesium-rich foods and/or taking magnesium supplements.

Objectives:
Although intake of fruits and vegetables seemed to have a protective effect on bone metabolism, its effect on fractures remains uncertain. Therefore, this review article has been conducted.

Does intake of fruits and vegetables reduce risk of fractures?

Study design:
This review article included 6 cohort studies and 4 RCTs.
6 cohort studies included 225,062 participants (134,365 women and 90,697 men) aged 50 years or older. The participants’ follow-up time ranged from 2.8 years to 20 years.

Validated food frequency questionnaires (FFQs), 24-hour food recall (24h-R) and 7-day food record were used to evaluate fruit and vegetable intake.

Results and conclusions:
The investigators found in 5 cohort studies that intake of at least one serving of fruits and vegetables per day significantly reduced risk of hip fractures with 8% [pooled HR = 0.92, 95% CI = 0.87 to 0.98, I2 = 55.7%, p = 0.060] among participants aged 50 years or older.

The investigators found in 2 cohort studies that intake of at least one serving of fruits and vegetables per day significantly reduced risk of any fractures with 10% [pooled HR = 0.90, 95% CI = 0.86 to 0.96, I2 = 24.9%, p = 0.249] among participants aged 50 years or older.

The investigators found no association between the bone resorption marker CTx and 3 months of fruit and vegetable intake evaluated by 4 RCTs.

The investigators concluded that at least one serving of fruits and vegetables per day is associated with a lower risk of fractures among participants aged 50 years or older.

Original title:
Fruit and vegetable intake and bones: A systematic review and meta-analysis by Brondani JE, Comim FV, […], Premaor MO.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6544223/

Additional information of El Mondo:
Find more information/studies on fruits and vegetables consumption and elderly.
 

Objectives:
Insulin resistance, dyslipidemia and increased systemic inflammation are important risk factors for chronic kidney disease (CKD). Hence, vitamin D administration might be an appropriate approach to decrease the complications of chronic kidney disease. Therefore, this review article has been conducted.

Have vitamin D supplements beneficial effects on people with chronic kidney disease?

Study design:
This review article included 17 RCTs.

Results and conclusions:
The investigators found pooling findings from 5 RCTs revealed a significant reduction in fasting glucose among people with chronic kidney disease [WMD = -18.87, 95% CI = -23.16 to -14.58] following the administration of vitamin D.

The investigators found pooling findings from 3 RCTs revealed a significant reduction in homeostatic model assessment of insulin resistance (HOMA-IR) among people with chronic kidney disease [WMD = -2.30, 95% CI = -2.88 to -1.72] following the administration of vitamin D.

The investigators found pooling findings from 6 RCTs revealed a significant reduction in triglycerides among people with chronic kidney disease [WMD = -32.52, 95% CI = -57.57 to -7.47] following the administration of vitamin D or treatment.

The investigators found pooling findings from 5 RCTs revealed a significant reduction in total cholesterol concentrations among people with chronic kidney disease [WMD = -7.93, 95% CI = -13.03 to -2.83] following the administration of vitamin D or treatment.

The investigators found there was no effect on insulin, HbA1c, LDL and HDL cholesterol and CRP levels among people with chronic kidney disease following the administration of vitamin D or treatment.

The investigators concluded there are beneficial effects of vitamin D supplementation or treatment on improving fasting glucose, HOMA-IR, triglycerides and total cholesterol levels among patients with chronic kidney disease.

Original title:
The effects of vitamin D treatment on glycemic control, serum lipid profiles, and C-reactive protein in patients with chronic kidney disease: a systematic review and meta-analysis of randomized controlled trials by Milajerdi A, Ostadmohammadi V, […], Asemi Z.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31338797

Additional information of El Mondo:
Find here more information/studies about chronic disease, cholesterol, vitamin D and kidney diseases.

Objectives:
Does a dietary low-ratio n-6/n-3 PUFA supplementation improve risk factors (such as fasting blood glucose, HbA1c) of diabetes?

Study design:
This review article included 11 RCTs.

No significant publication bias was observed for all blood glucose and other related indicators as suggested by Begg's test and Egger's test.

Results and conclusions:
The investigators found no significant effect of dietary low-ratio n-6/n-3 PUFA supplementation on:
-fasting blood glucose [WMD = 0.057 mmol/L, 95% CI = -0.090 to 0.204 mmol/L];
-insulin [WMD = -0.757 mIU/L, 95% CI = -2.419 to 0.904 mIU/L];
-insulin resistance index [WMD = -0.201, 95% CI = -0.566 to 0.165] and;
-glycosylated hemoglobin [WMD = -0.063%, 95% CI = -0.061 to 0.186%].

The investigators found subgroup analysis showed that the effect of dietary low-ratio n-6/n-3 PUFA on the reduction of the plasma insulin level in North America [WMD = -3.473 mIU/L, 95% CI = -5.760 to -1.185 mIU/L] was more obvious than that in Asian countries [WMD = -0.797 mIU/L, 95% CI = -2.497 to 0.902 mIU/L] and European countries [WMD = -0.063 mIU/L, 95% CI = -0.061 to 0.186 mIU/L].

The investigators found in the subgroup of diabetic subjects, dietary low-ratio n-6/n-3 PUFA supplementation significantly decreased plasma insulin level [WMD = -3.010 mIU/L, 95% CI = -5.371 to -0.648 mIU/L] and insulin resistance index [WMD = -0.460, 95% CI = -0.908 to -0.012].

The investigators found when the intervention period was longer than 8 weeks, dietary low-ratio n-6/n-3 PUFA supplementation significantly decreased the plasma insulin level [WMD = -2.782 mIU/L, 95% CI = -4.946 to -0.618 mIU/L].

The investigators concluded dietary low-ratio n-6/n-3 PUFA supplementation improves the glucose metabolism by reducing the insulin and insulin resistance in the diabetic patients. Dietary low-ratio n-6/n-3 PUFA supplementation also reduces the plasma insulin level when the supplementation duration is longer than 8 weeks.

Original title:
Effect of low-ratio n-6/n-3 PUFA on blood glucose: a meta-analysis by Li N, Yue H, […], Xu T.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31292599

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

Objectives:
The associations between dietary fat intake and cognitive function are inconsistent and inconclusive. Therefore, this review article has been conducted.

Is there a relationship between different types of fat intake and cognitive impairment?

Study design:
This review article included 9 prospective cohort studies covering a total of 23,402 participants.

Results and conclusions:
The investigators found compared with the lowest category of consumption, the highest category of saturated fat consumption significantly increased risk of cognitive impairment with 40% [RR = 1.40, 95% CI = 1.02-1.91].

The investigators found compared with the lowest category of consumption, the highest category of saturated fat consumption significantly increased risk of Alzheimer disease with 87% [RR = 1.87, 95% CI = 1.09-3.20].

The investigators found total and unsaturated fat dietary intakes were not statistically associated with cognitive outcomes with significant between-study heterogeneity.

The investigators concluded there is an increased risk between saturated fat consumption and both cognitive impairment and Alzheimer disease. Given the substantial heterogeneity in the sample size and methodology used across studies, the evidence presented here should be interpreted with caution.

Original title:
Dietary Fat Intake and Cognitive Function among Older Populations: A Systematic Review and Meta-Analysis by Cao GY, Li M, […], Xu B.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31062836

Additional information of El Mondo:
Find more information/studies on saturated fat intake, dementia and elderly right here.

A diet with a high saturated fat intake is a diet with >10 En% saturated fat.
>10 En% saturated fat means that the total amounts of saturated fat make up for >10% of the total kcal of the diet.
The easiest way to follow this diet is to choose only meals/products that also contain 10 En% saturated fat.
Check here which products contain >10 En% saturated fat.

A diet with a low saturated fat intake is a diet with 7 En% saturated fat.

Objectives:
Does dietary intake of n-3 PUFAs (such as DHA, EPA, DPA and ALA) or fish consumption improve lung function?

Study design:
This review article included 9 cohort studies from the Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium (n = 37,077 black and white participants).

In each cohort and each ancestry, separately, associations of dietary n-3 PUFA/fish intake with lung function were estimated in linear regression models.
Fixed-effects meta-analysis was used to generate summarized effect estimates across the cohorts and ancestries.

The lung function was measured by the forced expiratory volume in 1 second (FEV1) and the forced vital capacity (FVC).

Results and conclusions:
The investigators found dietary DPA, DHA, EPA and fish intake significantly improved forced expiratory volume in one second (FEV1) and forced vital capacity (FVC).
However, dietary α-linolenic acid (ALA) had little to no association with these lung function parameters.

The investigators found associations were similar for black and white participants and consistent in direction and magnitude across most cohort studies.

The investigators found for all participants, 1 standard deviation (SD) higher dietary intake of DPA (∼30 mg/d), DHA (∼200 mg/d) and EPA (∼150 mg/d) were associated with 12-16 mL higher FEV1 and 10-15 mL higher FVC.
The effect estimates for fish consumption were in the same direction but smaller in magnitude.

The investigators found ∼200 mg/d DHA and ∼150 mg/d EPA were associated with 28-32 mL higher FEV1 and 24-25 mL higher FVC in current smokers.

The investigators found ∼200 mg/d DHA and ∼150 mg/d EPA were associated with 17-21 mL higher FEV1 and 7-12 mL higher FVC in former smokers.

The investigators found ∼200 mg/d DHA and ∼150 mg/d EPA had little to no association with FEV1 and FVC in never smokers.

The investigators concluded that dietary ∼200 mg/d DHA, ∼30 mg/d DPA and ∼150 mg/d EPA and fish intake are associated with higher lung function, especially among current and former smokers.

Original title:
Positive Associations of Dietary Marine Omega-3 Polyunsaturated Fatty Acids with Lung Function: A Meta-analysis (P18-087-19) by Patchen B, Xu J, […], Cassano P.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6579416/  

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

DHA, DPA and EPA are found in fish.

 

Objectives:
Whether exercise can improve cardiovascular health in kidney transplant recipients (KTRs) is unclear. Therefore, this review article (meta-analysis) has been conducted.

Does exercise improve cardiovascular health in kidney transplant recipients?

Study design:
This review article included 12 RCTs (trials) in the review and 11 RCTs for further qualitative analysis.
Most trials provided a 30-60 minutes exercise session for 2-4 times per week.
In terms of the total intervention period, most trials ranged from 10 weeks to 6 months.

Results and conclusions:
The investigators found in 5 trials with a total of 199 participants that exercise had no effects on either systolic [MD = 1.67, 95% CI = -2.17 to 5.51, p = 0.39] or diastolic blood pressure [MD = 0.65, 95% CI = -4.02 to 5.32, p = 0.78].

The investigators found in 3 trials with a total of 261 participants that exercise had no significant benefits in overall lipid profile [MD = 0.03, 95% CI = -0.09 to 0.15, p = 0.62].
In subgroup analysis, total cholesterol [p = 0.15], LDL cholesterol [p = 0.83] and triglyceride [p = 0.82] were not ameliorated by exercise.

The investigators found in 2 trials with 22 subjects in the exercise group and 28 controls that a 12 months of resistance training or regimens of aerobic or resistance training for 12 weeks was not associated with an improvement in kidney function [MD = 2.60, 95% CI = -12.88 to 13.09, p = 0.74].

The investigators found that aerobic training, resistance training or the combination during 12 weeks to 12 months was not associated with an improvement on body weight [MD = -2.02, 95% CI = -8.24 to 4.20, p = 0.52, n = 3] or BMI [MD = 0.12, 95% CI = -1.52 to 1.77, p = 0.88, n = 4].

The investigators found in 2 trials with a total of 64 participants that a 12-week exercise showed a consistent improvement in small arterial stiffness [MD = -1.14, 95% CI = -2.19 to -0.08, p = 0.03].

The investigators found in 5 trials with a total of 202 participants that aerobic training, resistance training or combined method over the course of 12 weeks to 12 months had a significant improvement in exercise capacity (VO₂ peak) [MD = 2.25, 95% CI = 0.54 to 3.69, p = 0.01]. 

The investigators found exercise improved quality of life in different aspects, with significant enhancement in social functioning [MD = 16.76, 95% CI = 2.16 to 31.37, p = 0.02] and overall QOL scores [MD = 12.87, 95% CI = 6.80 to 18.94, p 0.01].

The investigators concluded exercise intervention in kidney transplant recipients improves arterial stiffness and it also improves exercise tolerance and quality of life. Additional long-term RCTs examining a greater number of patients are needed to understand the effects of exercise on cardiovascular health in kidney transplant recipients.

Original title:
Effects of exercise training on cardiovascular risk factors in kidney transplant recipients: a systematic review and meta-analysis by Chen G, Liu Gao L and Li X.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6534232/

Additional information of El Mondo:
Find here more information/studies about chronic disease and kidney disease and sport nutrition.

Objectives:
The role of fruit and vegetables (FVs) consumption in decreasing gallstone disease risk remains contradictory.Therefore, this review article has been conducted.

Does fruit or vegetables consumption reduce risk of gallstone disease?

Study design:
This review article included 1 cross-sectional study, 1 case-control studie and 9 cohort studies, covering approximately 33,983 patients with gallstone disease and 1,53,3752 participants.

Results and conclusions:
The investigators found in a pooled analysis, vegetables consumption was significantly related to a decreased gallstone disease risk of 17% [RR  =  0.83, 95% CI = 0.74-0.94, I2  =  91.1%]. This reduced gallstone disease risk was solid in most subgroup analysis.

The investigators found in a pooled analysis, fruits consumption was significantly related to a decreased gallstone disease risk of 12% [RR  =  0.88, 95% CI = 0.83-0.92, I2  =  0.01%].  
This reduced gallstone disease risk was solid in most subgroup analysis.

The investigators found nonlinear dose-response analysis indicated that gallstone risk was reduced by 4% [RR  =  0.96, 95% CI = 0.93-0.98, p =0.001] for every 200 g per day increment in vegetables consumption.

The investigators found nonlinear dose-response analysis indicated that gallstone risk was reduced by 3% [RR  =  0.97, 95% CI = 0.96-0.98, p =0.001] for every 200 g per day increment in fruits consumption.

The investigators concluded that vegetables and fruits consumption, particularly 200g fruits or 200g vegetables per day is correlated with a reduced risk of gallstone disease.

Original title:
Fruits and vegetables consumption and the risk of gallstone diasease: A systematic review and meta-analysis by Zhang JW, Xiong JP, [...], Zhao HT.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31305451

Additional information of El Mondo:
Find here more information/studies about chronic disease and vegetables and fruits consumption.

Objectives:
Has L-carnitine supplementation positive effects on inflammatory mediators including C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6)?

Study design:
This review article included 13 RCTs.

Results and conclusions:
The investigators found L-carnitine supplementation was significantly associated with lower levels of CRP in comparison to controls [WMD = -1.23 mg/L, 95% CI = -1.73 to -0.72 mg/dL, p  0.0001].
This reduced effect was greatest during an intervention of more than 12 weeks.

The investigators found L-carnitine supplementation was also significantly associated with lower levels of IL-6 in comparison to controls [WMD = -0.85 pg/dL, 95% CI = -1.38 to -0.32 pg/dL, p = 0.002].
This reduced effect was greatest during an intervention of more than 12 weeks.

The investigators found L-carnitine supplementation was also significantly associated with lower levels of TNF-α in comparison to controls [WMD = -0.37 pg/dL, 95% CI = -0.68 to -0.06 pg/dL, p = 0.018].
This reduced effect was greatest during an intervention of more than 12 weeks.

The investigators concluded that L-carnitine supplementation reduces levels of inflammatory mediators, especially in studies with a duration of more than 12 weeks. Further studies with different doses and intervention durations and separately in men and women are necessary.

Original title:
The effect of L-carnitine on inflammatory mediators: a systematic review and meta-analysis of randomized clinical trials by Haghighatdoost F, Jabbari M and Hariri M.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30915521 

Additional information of El Mondo:
Find here more information/studies about chronic disease and L-carnitine.