Nutrition and health

Objectives:
Women have a 50% risk of urinary tract infection (UTI) over their lifetime and 20-30% experience a subsequent urinary tract infection recurrence. Cranberry (Vaccinium spp.) has been advocated for treatment of urinary tract infection; however, its efficacy is controversial. Therefore, this review article (meta-analysis) has been conducted.

Does cranberry reduce the risk of urinary tract infection recurrence in healthy women?

Study design:
This review article included 7 RCTs conducted in healthy nonpregnant women aged ≥18 years with a history of urinary tract infection (n = 1498 participants).
Risk of bias indicated that 2 studies had high loss to follow-up or selective outcome reporting. Overall, the studies were relatively small, with only 2 having >300 participants.

Results and conclusions:
The investigators found that cranberry significantly reduced the risk of urinary tract infection by 26% [pooled risk ratio = 0.74, 95% CI = 0.55-0.98, I2 = 54%].

The investigators concluded that cranberry may be effective in preventing urinary tract infection recurrence in generally healthy women. May be effective because the studies were relatively small, with only 2 having >300 participants. Therefore, larger high-quality studies are needed to confirm these findings.

Original title:
Cranberry Reduces the Risk of Urinary Tract Infection Recurrence in Otherwise Healthy Women: A Systematic Review and Meta-Analysis by Zhuxuan Fu, DeAnn Liska, […], Mei Chung.

Link:
http://jn.nutrition.org/content/147/12/2282.abstract

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Objectives:
Epidemiological studies have provided controversial evidence between beverage consumption and the risk of ulcerative colitis (UC). Therefore, this review article (meta-analysis) has been conducted.

Is there a relationship between beverage consumption and risk of ulcerative colitis?

Study design:
This review article included 13 case-control studies and 3 prospective cohort studies, with a total of 3,689 cases (subjects with ulcerative colitis) and 335,339 controls (subjects without ulcerative colitis).

Egger test detected no significant publication bias.

Results and conclusions:
The investigators found high intake of soft drinks versus low intake, significantly increased risk of ulcerative colitis with 69% [pooled RR = 1.69, 95% CI = 1.24-2.30, I2  =  12.9%, p  = 0 .332].
In subgroup analysis, no substantial changes of the primary result were found between subgroups.

The investigators found high tea consumption versus low consumption, significantly decreased risk of ulcerative colitis with 31% [pooled RR = 0.69, 95% CI = 0.58-0.83, I2  =  0.0%, p  = 0 .697].
In subgroup analysis, no substantial changes of the primary result were found between subgroups.

The investigators found no significant association between alcohol [pooled RR = 1.08, 95% CI = 0.66-1.51] or coffee consumption [pooled RR = 0.58, 95% CI = 0.33-1.05, I2  =  87.5%, p    0.001] and risk of ulcerative colitis. No significant association because RR of 1 was found in the 95% CI of 0.66 to 1.51. RR of 1 means no risk/association.

The investigators concluded high consumption of soft drinks increases the risk of ulcerative colitis, while high tea consumption decreases the risk.

Original title:
Beverage consumption and risk of ulcerative colitis. Systematic review and meta-analysis of epidemiological studies by Nie JY and Zhao Q.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5728934/

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Objectives:
The role of omega-3 polyunsaturated fatty acids (omega-3 or n-3 PUFAs) in the pathogenesis and treatment of children and adolescents with attention deficit hyperactivity disorder (ADHD) is unclear. Therefore, this review article (meta-analysis) has been conducted.

Do children and adolescents with attention deficit hyperactivity disorder (ADHD) benefit from n-3 PUFA supplementation?

Study design:
This review article included 7 RCTs and 7 case-control studies.

Results and conclusions:
The investigators found in 7 RCTs (n = 534 randomised youth with ADHD) n-3 PUFAs supplementation significantly improved ADHD clinical symptom scores [g = 0.38, p 0.0001].

The investigators found in 3 RCTs (n = 214 randomised youth with ADHD) n-3 PUFAs supplementation significantly improved cognitive measures associated with attention [g = 1.09, p = 0.001].

The investigators found children and adolescents with ADHD had lower levels of DHA [7 case-control studies, n = 412, g = -0.76, p = 0.0002], EPA (7 case-control studies, n = 468, g = -0.38, p = 0.0008] and total n-3 PUFAs [6 case-control studies, n = 396, g = -0.58, p = 0.0001].

The investigators concluded there is evidence that n-3 PUFAs supplementation monotherapy improves clinical symptoms and cognitive performances in children and adolescents with ADHD and that these youth have a deficiency in n-3 PUFAs levels. These findings provide further support to the rationale for using n-3 PUFAs as a treatment option for ADHD.

Original title:
Omega-3 Polyunsaturated Fatty Acids in Youths with Attention Deficit Hyperactivity Disorder (ADHD): A Systematic Review and Meta-Analysis of Clinical Trials and Biological Studies by Chang JC, Su KP, [...], Pariante CM.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28741625

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EPA and DHA are n-3 PUFA.

Objectives:
Recent data pose the question whether conservative management of chronic kidney disease (CKD) by means of a low-protein diet can be a safe and effective means to avoid or defer transition to dialysis therapy without causing protein-energy wasting or cachexia. Therefore, this review article (meta-analysis) has been conducted.

Do subjects with chronic kidney disease benefit from a low-protein diet?

Study design:
This review article included 16 controlled trials of low-protein diet in chronic kidney disease that met the stringent qualification criteria including having 30 or more participants.

Results and conclusions:
The investigators found compared with diets with protein intake of >0.8 g/kg/day, diets with restricted protein intake (0.8 g/kg/day) were associated with higher serum bicarbonate levels, lower phosphorus levels, lower azotemia, lower rates of progression to end-stage renal disease and a trend towards lower rates of all-cause death.

The investigators found compared with diets with protein intake of >0.8 g/kg/day, very-low-protein diets (protein intake 0.4 g/kg/day) were associated with greater preservation of kidney function and reduction in the rate of progression to end-stage renal disease.

The investigators found safety and adherence to a low-protein diet was not inferior to a normal protein diet and there was no difference in the rate of malnutrition or protein-energy wasting.

The investigators concluded a low-protein diet, particularly protein intake 0.4 g/kg/day, appears to enhance the conservative management of non-dialysis-dependent chronic kidney disease and may be considered as a potential option for chronic kidney disease patients who wish to avoid or defer dialysis initiation and to slow down the progression of chronic kidney disease, while the risk of protein-energy wasting and cachexia remains minimal.
 
Original title:
Low-protein diet for conservative management of chronic kidney disease: a systematic review and meta-analysis of controlled trials by Rhee CM, Ahmadi SF, [...], Kalantar-Zadeh K.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29094800

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A protein intake of 0.8 g/kg/day usually corresponds to a diet with 11 En% protein.
A protein intake of 0.4 g/kg/day usually corresponds to a diet with 5.5 En% protein.
A diet with 5.5 En% protein is a diet with a lot of products with 5.5 En% protein. Check here which products contain 5.5 En% protein.
 

Objectives:
Does breastfeeding reduce risk of endometrial cancer?

Study design:
This review article included individual-level data from 3 cohort and 14 case-control studies, with a total of  8,981 women with endometrial cancer and 17,241 women in a control group.

Results and conclusions:
The investigators found ever breastfeeding was associated with an 11% reduction in risk of endometrial cancer [pooled OR = 0.89, 95% CI = 0.81-0.98].
The association with ever breastfeeding was not explained by greater parity and did not vary notably by body mass index or histologic subtype (grouped as endometrioid and mucinous compared with serous and clear cell).

The investigators found longer average duration of breastfeeding per child was associated with lower risk of endometrial cancer, although there appeared to be some leveling of this effect beyond 6-9 months.

The investigators concluded that reducing endometrial cancer risk can be added to the list of maternal benefits associated with breastfeeding. Ongoing promotion, support and facilitation of this safe and beneficial behavior might therefore contribute to the prevention of this increasingly common cancer.

Original title:
Breastfeeding and Endometrial Cancer Risk: An Analysis From the Epidemiology of Endometrial Cancer Consortium by Jordan SJ, Na R, […], Webb PM.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28486362

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Objectives:
Over 200 clinical trials have examined the effect of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) supplements on risk factors associated with cardiovascular disease. However, an updated analysis of the evidence is lacking. Therefore, this review article (meta-analysis) has been conducted.

Do EPA and DHA supplements reduce risk of cardiovascular diseases?

Study design:
This review article included 171 RCTs with acceptable quality (Jadad score ≥3).

Results and conclusions:
The investigators found compared to placebo-control, EPA and DHA supplements produced significant reductions of triglycerides of 0.368 mmol/L [95% CI = -0.427 to -0.309].
The triglyceride-lowering effect was dose-dependent.

The investigators found compared to placebo-control, EPA and DHA supplements produced significant reductions of systolic blood pressure of 2.195 mmHg [95% CI = -3.172 to -1.217].

The investigators found compared to placebo-control, EPA and DHA supplements produced significant reductions of diastolic blood pressure of 1.08 mmHg [95% CI = -1.716 to -0.444].

The investigators found compared to placebo-control, EPA and DHA supplements produced significant reductions of heart rate of 1.37 bpm [95% CI = -2.41 to -0.325].

The investigators found compared to placebo-control, EPA and DHA supplements produced significant reductions of C-reactive protein of 0.343 mg/L [95% CI = -0.454 to -0.232].

The investigators found compared to placebo-control, EPA and DHA supplements produced a significant increase of LDL cholesterol (bad cholesterol) [mean difference = 0.150 mmol/L, 95% CI = 0.058 to 0.243].

The investigators found compared to placebo-control, EPA and DHA supplements produced a significant increase of HDL cholesterol (good cholesterol) [mean difference = 0.039 mmol/L, 95% CI = 0.024-0.054].

The investigators concluded EPA and DHA supplements have lipid-lowering, hypotensive, anti-arrhythmic and anti-inflammatory effects.

Original title:
Eicosapentaenoic acid and docosahexaenoic acid containing supplements modulate risk factors for cardiovascular disease: a meta-analysis of randomised placebo-control human clinical trials by AbuMweis S, Jew S, […], Agraib L.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28675488

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Objectives:
The results of randomized controlled trials (RCTs) investigating resveratrol supplementation on risk factors of non-communicable diseases (NCDs) have been inconsistent. Therefore, this review article (meta-analysis) has been conducted.

Does resveratrol supplementation reduce risk of non-communicable diseases?

Study design:
This review article included 29 RCTs (30 treatment arms) with 1069 participants.

Results and conclusions:
The investigators found that resveratrol supplementation significantly reduced the concentrations of:
-fasting glucose [-4.77 mg/dL, 95% CI = -9.33 to -0.21 mg/dL, p = 0.040];
-total cholesterol (TC) [-9.75 mg/dL, 95% CI = -17.04 to -2.46 mg/dL, p = 0.009] and;
-C-reactive protein (CRP) [-0.81 mg/L, 95% CI = -1.42 to -0.21 mg/L, p = 0.009].

The investigators found that resveratrol intervention exerted significant reductions in systolic blood pressure (SBP) and diastolic blood pressure (DBP) in subjects with type 2 diabetes mellitus (T2DM).

The investigators found subgroup analysis also showed that the trials with resveratrol intervention ≥3 months significantly reduced the low-density lipoprotein (LDL) cholesterol (bad cholesterol), diastolic blood pressure and glycated hemoglobin (HbA1c) values.

The investigators found that resveratrol intervention had no favourable effects in altering high-density lipoprotein (HDL) cholesterol (good cholesterol), triglyceride (TAG) and homeostasis model assessment of insulin resistance (HOMA-IR).

The investigators concluded resveratrol supplementation ≥3 months has favourable effects on several risk factors of non-communicable diseases.

Original title:
Effects of resveratrol supplementation on risk factors of non-communicable diseases: A meta-analysis of randomized controlled trials by Guo XF, Li JM, [...], Li D.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28933578

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Non-communicable or chronic diseases are diseases of long duration and generally slow progression. The four main types of non-communicable diseases are cardiovascular diseases (like heart attacks and stroke), cancer, chronic respiratory diseases (such as chronic obstructed pulmonary disease and asthma) and diabetes.

Non-communicable diseases are by far the leading cause of death in the world.
 

Objectives:
Whether iron is associated with the development of gestational diabetes mellitus (GDM) is not clear. Therefore, this review article (meta-analysis) has been conducted.

Do increased dietary intake of iron and body iron status increase risk of gestational diabetes mellitus in pregnant women? 

Study design:
This review article included 12 case-control  studies, 9 cohort studies and  2  randomized  controlled  studies (RCT) with in total, 3,034 gestational diabetes mellitus pregnant women and 26,344 non-gestational diabetes mellitus pregnant women.

Results and conclusions:
The investigators found high dietary intake of heme iron was significantly associated with a 65% gestational diabetes mellitus risk [RR = 1.65, 95% CI = 1.28 to 2.12, I2 = 0%].

The investigators found for each 1 mg/day increment of dietary heme iron intake a significantly 38% gestational diabetes mellitus risk [RR = 1.38, 95% CI = 1.19 to 1.61, I2 = 0%].

The investigators found higher body iron stores, as represented by serum ferritin level, were correlated with a significantly increased gestational diabetes mellitus risk of 64% [RR = 1.64, 95% CI = 1.27 to 2.11, I2% = 7%].

The investigators found no association between gestational diabetes mellitus and the intakes of nonheme iron, total iron or supplemental iron.

The investigators concluded increased dietary intake of heme iron (at least 1 mg/day) and body iron status are positively associated with the risk of gestational diabetes mellitus development in pregnant women. Future studies are warranted to better understand the role of iron in gestational diabetes mellitus development.

Original title:
Dietary intake of heme iron and body iron status are associated with the risk of gestational diabetes mellitus: a systematic review and meta-analysis by Zhao L, Lian J, [...], Wang F.

Link:
http://apjcn.nhri.org.tw/server/APJCN/26/6/1092.pdf

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Gestational diabetes mellitus is a condition in which a woman without diabetes develops high blood sugar levels during pregnancy. Gestational diabetes mellitus affects between 2% and 5% of pregnant women.

Objectives:
The association between vitamin D deficiency and early spontaneous pregnancy loss (SPL) is unclear. Therefore, this review article (meta-analysis) has been conducted.

Does a vitamin D deficiency increase risk of early spontaneous pregnancy loss?

Study design:
This review article included 5 studies (case-control and cohort studies), including 10,630 pregnant women.

Results and conclusions:
The investigators found no significant association between a low 25(OH)D level (vitamin D level in blood) and an increased risk of early spontaneous pregnancy loss.

However, the investigators found in subgroup analysis, an extremely low 25(OH)D level (20 ng/mL) was significantly associated with an 124% increased risk of early spontaneous pregnancy loss in the first trimester [relative risk = 2.24, 95% CI = 1.15-4.37, I2 = 0.0%, p = 0.355].

The investigators concluded that severe vitamin D deficiency (20 ng/mL) could be detrimental to early embryonic development and increases risk of early spontaneous pregnancy loss.

Original title:
Meta-analysis of the effect of the maternal vitamin D level on the risk of spontaneous pregnancy loss by Zhang H, Huang Z, [...], Wei Y.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28500757

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Objectives:
Are there differences in serum ceruloplasmin levels between patients with preeclampsia and healthy controls?

Study design:
This review article included 15 studies, with a total number of 1927 women.

Results and conclusions:
The investigators found that maternal serum ceruloplasmin concentration was significantly higher in preeclamptic than in the healthy pregnant women [MD = 12.57 mg/dL, 95% CI = 8.81 to 16.33].

The investigators found that ceruloplasmin levels were significantly higher both in mild [MD = 13.8 mg/dL, 95% CI = 2.64 to 23.53] and severe [MD = 21.84 mg/dL, 95% CI = 0.97 to 42.71] preeclampsia, when compared to the control group.

The investigators found that the severity of the disease did not significantly affect the levels of protein [MD = -9.34 mg/dL, 95% CI = -20.93 to 2.26].

The investigators concluded that serum ceruloplasmin may be a useful screening and follow-up tool for the evaluation of pregnant women with an indicative history of developing preeclampsia. Future studies are needed to evaluate the levels of this specific protein throughout the pregnancy course and provide data on its sensitivity and specificity by introducing cut-off values.

Original title:
Serum ceruloplasmin levels in preeclampsia: a meta-analysis by Bellos I, Papantoniou N and Pergialiotis V.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28605950

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Ceruloplasmin carries 65% to 90% of the copper found in blood.

Objectives:
Promising experimental studies suggest that quercetin has potential anti-inflammatory effects. However, the results of current clinical trials on quercetin's effects on the C-reactive protein (CRP), a sensitive inflammatory biomarker, are ambiguous. Therefore, this review article (meta-analysis) has been conducted.

Does quercetin supplementation reduce CRP levels?

Study design:
This review article included 7 RCTs with 10 treatment arms.

Results and conclusions:
The investigators found a significant reduction of circulating CRP levels [WMD = -0.33 mg/L, 95% CI = -0.50 to -0.15, p 0.001] following quercetin supplementation.

The investigators found in subgroup analysis, a significant reducing effect in trials with ≥500 mg/day dosage [WMD = -0.34 mg/L, 95% CI = -0.52 to -0.16, p ≤ 0.001] and in those with CRP 3 mg/L [WMD = -0.34 mg/L, 95% CI = -0.51 to -0.18, p ≤ 0.001].

The investigators found in meta-regression, no association between changes in CRP concentrations, dose of supplementation and CRP baseline values.

The investigators concluded quercetin supplementation reduces circulating C-reactive protein levels; especially at doses above 500 mg/day and in patients with CRP 3 mg/L.
 
Original title:
Effects of supplementation with quercetin on plasma C-reactive protein concentrations: a systematic review and meta-analysis of randomized controlled trials by Mohammadi-Sartang M, Mazloom Z, […], Firoozi D.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28537580

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Objectives:
Previous studies have demonstrated that asthma might be associated with an increase in cardiovascular disease (CVD) and death. However, this relationship differs by gender. Therefore, this review article (meta-analysis) has been conducted.

Is asthma associate with an increase risk in cardiovascular disease and death among men and women?

Study design:
This review article included 4 retrospective cohort studies and 6 prospective cohort studies. The length of follow-up ranged from 4.5 to 27 years. The sample sizes of the cohorts ranged from 1,233 to 151,620 (a total of 406,426).

There was no evidence of publication bias [Begg’s, p = 1.000 and Egger’s linear regression, p = 0.150].

Results and conclusions:
The investigators found overall, subjects with asthma experienced a significant increased risk of 33% for cardiovascular disease events [RR = 1.33, 95% CI = 1.15-1.53, p 0.0001, I2 = 88%, p 0.00001]. These findings remained consistent after sensitivity analysis by omitting one study each time.

The investigators found in subgroup analyses that women with asthma had a significantly higher risk of cardiovascular disease as compared to the reference group [RR = 1.55, 95% CI = 1.20-2.00, p = 0.0007, I2 = 84%], whereas no significant association was found in men [RR = 1.20, I2 = 83%, 95% CI = 0.92-1.56, p = 0.17]. However, the combined RR value was 1.36, 95% CI = 1.15-1.62, p = 0.0003]. These findings remained consistent after sensitivity analysis by omitting one study each time.
To further explore the interaction between gender and asthma on cardiovascular disease risk, the “test for subgroup differences” were examined and gave a p = 0.17, which suggested that the influence of gender on the association between asthma and cardiovascular disease risk was not statistically significant. Therefore, it cannot confirm or refute a significant difference in the incidence of cardiovascular disease between male and female asthmatic patients.

The investigators found asthma was associated with an increased risk of 36% of all-cause mortality in a random effects model as compared to reference subjects without asthma [RR = 1.36, 95% CI = 1.01-1.83, p = 0.05, I2 = 62%, p = 0.05]. These findings remained consistent after sensitivity analysis by omitting one study each time.

The investigators concluded there is an association between asthma and an increased risk of cardiovascular disease and all-cause mortality and women with asthma have a higher risk of cardiovascular disease than men with asthma. These findings indicate a need for early detection and intervention during general outpatient visits in asthmatics who may have potential cardiovascular disease complications or mortality.

Original title:
Asthma and risk of cardiovascular disease or all-cause mortality: a meta-analysis by Xu M, Xu J and Yang X.

Link:
http://www.annsaudimed.net/index.php/vol37/vol37iss2/1109.html

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Objectives:
Iron deficiency is a prevalent nutritional disease and fatigue is a common complaint in the general and patient population, however, the association between iron deficiency without anaemia (IDNA) and fatigue is unclear. Therefore, this review article (meta-analysis) has been conducted.

Does improving iron status decrease fatigue in patients with iron deficiency without anaemia?

Study design:
This review article included a total of 6 RCTs and 6 cross-sectional studies.

Results and conclusions:
The investigators found in the meta-analysis of 6 RCTs, a significant therapeutic effect of iron supplements in fatigue patients with iron deficiency without anaemia [pooled effect size = 0.33, 95% CI = 0.17 to 0.48, I2 = 0.0%, p 0.0001]. A sensitivity analysis found that the overall results (i.e. significant association) were robust.

The investigators found in the meta-analysis of 6 cross-sectional studies, a non-significant therapeutic effect of iron supplements in fatigue patients with iron deficiency without anaemia [pooled effect size = 0.10, 95% CI = -0.11 to 0.31, I2 = 57.4%, p = 0.362]. A sensitivity analysis found that the overall results (i.e. no significant association) were not robust, however, removal of one study made the outcomes significant.

The investigators concluded improving iron status decreases fatigue in patients with iron deficiency without anaemia. However, further research is necessary to identify diagnostic criteria for selecting fatigue patients who might benefit from iron therapy and to assess the prevalence of patients with iron deficiency without anaemia in the general population.

Original title:
Iron deficiency without anaemia is a potential cause of fatigue: meta-analyses of randomised controlled trials and cross-sectional studies by Yokoi K and Konomi A.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28625177

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Objectives:
Dietary intake is potentially associated with the onset of Crohn’s disease (CD), but evidence from epidemiological studies has remained unclear. Therefore, this review article (meta-analysis) has been conducted.

Is there a positive association between fat, carbohydrate or protein intake and the risk of Crohn’s disease?

Study design:
This review article included 4 case-control studies with a total of 311 Crohn’s disease cases and 660 controls and 5 prospective cohort studies with a total of 238,887 participants and 482 Crohn’s disease cases.

The Egger’s test detected no obvious publication bias in fiber (p = 0.708), while there were not enough studies to conduct the analyses for carbohydrate, fat and protein.

Results and conclusions:
The investigators found no evidence of a non-linear relationship between total carbohydrate intake and Crohn’s disease risk [p for non-linearity = 0.376].

The investigators found no association between 10 g increment/day of total carbohydrate intake and Crohn’s disease risk [RR = 0.991, 95% CI = 0.978-1.004, I2 = 0.0%, p = 0.439]. No association because RR of 1 was found in the 95% CI of 0.978 to 1.004. RR of 1 means no risk/association.

The investigators found no evidence of a non-linear relationship between total fat intake and Crohn’s disease risk [p for non-linearity = 0.281].

The investigators found no association between 10 g increment/day of total fat intake and Crohn’s disease risk [RR = 1.018, 95% CI = 0.969-1.069, I2 = 44.6%, p = 0.125].

The investigators found no evidence of a non-linear relationship between total protein intake and Crohn’s disease risk [p for non-linearity = 0.163].

The investigators found no association between 10 g increment/day of total protein intake and Crohn’s disease risk [RR = 1.029, 95% CI = 0.955-1.109, I2 = 54.7%, p = 0.085].

The investigators found a non-linear relationship between fiber dietary intake and Crohn’s disease risk [p for non-linearity = 0.019].

The investigators found a significant reduced risk of 14.7% for Crohn’s disease for per 10 g increment/day of fiber [RR = 0.853, 95% CI = 0.762-0.955]. However, the protective role of fiber dietary intake in the development of Crohn’s disease was gone after adjustment for the risk factor smoking [RR for per 10 g increment/day = 0.890, 95% CI = 0.776-1.020].

The investigators found a non-linear relationship between sucrose intake and Crohn’s disease risk [p for non-linearity = 0.023].

The investigators found a significant increased risk of 8.8% for Crohn’s disease for per 10 g increment/day of sucrose [RR = 1.088, 95% CI = 1.020-1.160, I2 = 0.0%, p = 0.39]. Significant means it can be said with a 95% confidence that each 10 g increment/day of sucrose really increased the risk of Crohn’s disease. 

The investigators concluded there is a lack of association between total carbohydrate, fat or protein intake and the risk of Crohn’s disease, while high fiber dietary intake might decrease the risk but the association was influenced by study design and smoking adjustment. High sucrose intake might increase the risk of Crohn’s disease. However, large-scale prospective designed studies are needed to confirm these findings.

Original title:
Macronutrient Intake and Risk of Crohn’s Disease: Systematic Review and Dose–Response Meta-Analysis of Epidemiological Studies by Zeng L, Hu S, [...], Tan Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5452230/

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Objectives:
Epidemiological studies evaluating the associations between serum copper and ratios of copper/zinc (Cu/Zn) and the preeclampsia (PE) risk in Asian population have produced inconsistent results. Therefore, this review article (meta-analysis) has been conducted.

Do a higher serum copper and ratios of Cu/Zn increase the preeclampsia risk in Asian population?

Study design:
This review article included relevant studies up to November 2016.
Pooled standardized mean difference (SMD) was calculated with random effects model.

Results and conclusions:
The investigators found that preeclampsia patients significantly had a higher serum copper level [SMD = 1.05, 95% CI = 0.34 to 1.77, I2 = 96.9%, p 0.0001] compared with healthy pregnancy controls.

The investigators found in subgroup analyses, a higher serum copper level in preeclampsia patients was observed in case-control studies [SMD = 1.39, 95% CI = 0.44 to 2.34]. However, no significant difference was found between preeclampsia patients and healthy pregnancy controls for ratios of Cu/Zn [SMD = 0.26, 95% CI = -0.77 to 1.29, I2 = 95.8%, p 0.0001].

The investigators concluded that a higher serum copper level is associated with an increased risk of preeclampsia in Asian population. However, further studies are needed to confirm these results.

Original title:
High serum copper level is associated with an increased risk of preeclampsia in Asians: A meta-analysis by Song X, Li B, [...], Zhang D.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28385285

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Objectives:
Zinc sulfate may be a promising approach to treat neonatal jaundice. However, the results remain controversial. Therefore, this review article (meta-analysis) has been conducted.

Does zinc sulfate supplementation reduce neonatal jaundice?

Study design:
This review article included 5 RCTs involving 645 patients.

Results and conclusions:
The investigators found overall, compared with placebo, zinc sulfate supplementation failed to significantly reduce total serum bilirubin on 3 days [mean difference = 0.09 mg/dL, 95% CI = -0.49 to 0.67, p = 0.77]. Non-significant because p-value of 0.77 was greater than p-value of 0.05.

The investigators found overall, compared with placebo, zinc sulfate supplementation failed to significantly reduce total serum bilirubin on 7 days [mean difference= -0.37 mg/dL, 95% CI= -98 to 0.25, p  = 0.25].

The investigators found overall, compared with placebo, zinc sulfate supplementation failed to significantly reduce the incidence of hyperbilirubinemia [OR = 1.14, 95% CI = 0.74 to 1.76, p = 0.56].

The investigators found overall, compared with placebo, zinc sulfate supplementation showed no influence on phototherapy requirement [OR = 0.90, 95% CI = 0.41 to 1.98, p = 0.79]. Non-significant because OR of 1 was found in the OR of 0.41 to 1.98. OR of 1 means no risk/association.

The investigators found overall, compared with placebo, zinc sulfate supplementation significantly decreased duration of phototherapy [mean difference = -16.69 h, 95% CI = -25.09 to -8.3 h, p 0.000].

The investigators concluded zinc sulphate supplementation does not reduce the total serum bilirubin on 3 days and 7 days, the incidence of hyperbilirubinemia and phototherapy requirement, but significantly decreases duration of phototherapy.

Original title:
The influence of zinc sulfate on neonatal jaundice: a systematic review and meta-analysis by Yang L, Wu, [...], Tang J.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28372469

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Neonatal jaundice occurs when a baby has a high level of bilirubin in the blood. Bilirubin is a yellow substance that the body creates when it replaces old red blood cells. The liver helps break down the substance so it can be removed from the body in the stool.

A high level of bilirubin makes a baby's skin and whites of the eyes look yellow. This is called neonatal jaundice.

Jaundice is a common and usually harmless condition in newborn babies.
The symptoms of neonatal jaundice usually develop 2 to 3 days after the birth and tend to get better without treatment by the time the baby is about 2 weeks old.

Objectives:
C-reactive protein (CRP) has been proposed as a risk marker and risk factor of cardiovascular disease. There have been a number of clinical reports suggesting that supplementation with L-carnitine can modulate systemic inflammation and lower circulating CRP concentrations, but the results have not been consistent. Therefore, this review article (meta-analysis) has been conducted.

Does supplementation with L-carnitine reduce circulating CRP concentrations?

Study design:
This review article included 6 RCTs comprising 541 cases and 546 controls.
3 studies were conducted in diabetic or prediabetic patients, 2 studies in hemodialysis patients and 1 study in patients with non-alcoholic steatohepatitis.
Duration of L-carnitine supplementation ranged between 8 to 48 weeks.
Dosage of L-carnitine ranged between 1-2 g/day in all the included trials.

Results and conclusions:
The investigators found in random effect analysis a statistically significant pooled effect size [net change = -0.39 mg/L, 95% CI = -0.62 to -0.16, p = 0.001, I2 = 44%, p = 0.11] for the impact of L-carnitine supplementation among 541 cases and 546 controls. This effect size estimate was found to be robust and remained unaffected by the removal of each single study.

The investigators concluded the present meta-analysis support the clinically relevant benefit of L-carnitine supplementation (1-2 g/day) in lowering the circulating levels of CRP. Conducting future, large-scale, randomized clinical trials is warranted in homogenous populations to verify the findings of this meta-analysis.

Original title:
Effect of L-carnitine Supplementation on Circulating C-reactive Protein Levels: A Systematic Review and Meta-Analysis by Sahebkar A.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4922328/

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Higher circulating levels of CRP increase inflammation.
 

Objectives:
Is there a causal association between low serum vitamin D concentrations, increased body mass index (BMI) and pediatric-onset multiple sclerosis (MS) using genetic risk scores (GRS)?

Study design:
This review article included participants of non-Hispanic white individuals recruited from over 15 sites across the United States (n = 394 cases, 10,875 controls) and Sweden (n = 175 cases, 5,376 controls; total n = 16,820).

Results and conclusions:
The investigators found meta-analysis findings demonstrated that a vitamin D GRS associated with increasing levels of 25(OH)D in serum significantly decreased risk of pediatric-onset MS with 28% [OR =  0.72, 95% CI = 0.55-0.94, p = 0.02] after controlling for sex, genetic ancestry, HLA-DRB1*15:01 and over 100 non-human leukocyte antigen MS risk variants.

The investigators also found that a higher BMI GRS significant increased risk of pediatric-onset MS with 17% [OR = 1.17, 95% CI = 1.05-1.30, p = 0.01] after adjusting for covariates.

The investigators found estimates for each GRS were unchanged when considered together in a multivariable model.

The investigators concluded evidence supporting independent and causal effects of decreased vitamin D levels and increased BMI on susceptibility to pediatric-onset MS.

Original title:
Evidence for a causal relationship between low vitamin D, high BMI, and pediatric-onset MS by Gianfrancesco MA, Stridh P, […], Waubant E.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28356466

Additional information of El Mondo:
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Objectives:
Recent studies have found that the serum zinc levels were associated with the risk of Parkinson's disease (PD), but the results were inconsistent. Therefore, this meta-analysis (review article) has been conducted.

Is there an association between serum zinc levels and Parkinson's disease risk?

Study design:
This review article included 11 articles involving 822 Parkinson's disease patients and 777 healthy controls (subjects without Parkinson's disease).

No publication bias was found.

Results and conclusions:
The investigators found that the serum zinc levels in Parkinson's disease patients were significantly lower than those in health controls [SMD = -0.779, 95% CI = -1.323 to -0.234, p 0.001].

This association was also significant in oriental studies [SMD = -1.601, 95% CI = -2.398 to -0.805, p 0.001].

The investigators concluded that serum zinc levels in Parkinson's disease patients are significantly lower than those in healthy controls.

Original title:
Association Between Serum Zinc Levels and the Risk of Parkinson's Disease: a Meta-Analysis by Sun H, Liu X, […], Li W.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28160244

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

Objectives:
Is supplementation of formula milk with LCPUFA (long-chain polyunsaturated fatty acids) both safe and beneficial for full-term infants, while focusing on effects on visual function, neurodevelopment and physical growth?

Study design:
This review article included 15 RCTs (n = 1889).
9 studies assessed visual acuity, 6 of which used visual evoked potentials (VEP), 2 Teller cards and 1 both. 4 studies reported beneficial effects and the remaining 5 did not.
GRADE analysis of the outcomes indicated that the overall quality of evidence was low.

Results and conclusions:
The investigators found a meta-analysis of 3 RCTs (n = 244) showed significant benefit for sweep VEP acuity at 12 months (log of the minimum angle of resolution) [MD = -0.15, 95% CI = -0.17 to -0.13, I2 = 0%, low-quality of evidence].
However, the meta-analysis of 3 other RCTs (n = 256) showed no benefit for visual acuity measured with Teller cards at 12 months (cycles/degree) [MD = -0.01, 95% CI = -0.12 to 0.11, I2 = 0%, low-quality of evidence].

The investigators found meta-analysis of 4 RCTs (n = 661) revealed no significant differences between LCPUFA and placebo groups in BSID Mental Developmental Index scores at 18 months [MD = 0.06, 95% CI = -2.01 to 2.14, I2 = 75%, low-quality of evidence] and no significant differences in BSID Psychomotor Development Index scores at 18 months [MD = 0.69, 95% CI = -0.78 to 2.16, I2 = 61%, low-quality of evidence].

There were also no significant differences between the two groups in BSID-II scores at one year and two years of age.

The investigators found meta-analysis of 5 RCTs (n = 521) showed that the supplemented group had lower weight (z scores) at one year of age [MD = -0.23, 95% CI = -0.40 to -0.06, I2 = 83%, low-quality of evidence] and that the two groups showed no significant differences with respect to length and head circumference (z scores).

The investigators found meta-analysis at 18 months and at two years revealed no significant differences between the two groups with respect to weight (kg), length (cm) and head circumference (cm).

The investigators concluded there are no beneficial effects or harms of LCPUFA supplementation on neurodevelopmental outcomes of formula-fed full-term infants and no consistent beneficial effects on visual acuity. Therefore, routine supplementation of full-term infant milk formula with LCPUFA cannot be recommended at this time.

Original title:
Long chain polyunsaturated fatty acid supplementation in infants born at term by Jasani B, Simmer K, […], Rao SC.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28281303

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Objectives:
Is a low maternal circulating 25 hydroxyvitamin D (25-OHD) associated with an increased risk of preterm birth or spontaneous preterm birth and can vitamin D supplementation alone during pregnancy reduce risk of preterm birth?

Study design:
This review article included 6 RCTs and 18 observational studies.

Results and conclusions:
The investigators found maternal circulating 25-OHD deficiency significantly increased risk of preterm birth with 25% [pooled OR = 1.25, 95% CI = 1.13-1.38]. However, maternal circulating 25-OHD insufficiency was not associated with an increased risk of preterm birth [pooled OR = 1.09, 95% CI = 0.89-1.35]. Not associated because OR of 1 was found in 95% CI of 0.89 to 1.35. OR of 1 means no risk/association.

The investigators found vitamin D supplementation alone during pregnancy significantly reduced risk of preterm birth with 43% [pooled RR = 0.57, 95% CI = 0.36-0.91]. Significantly because RR of 1 was not found in 95% CI of 0.36 to 0.91. RR of 1 means no risk/association.

The investigators found maternal circulating 25-OHD 50 nmol/L significantly increased risk of spontaneous preterm birth with 45% [pooled OR = 1.45, 95% CI = 1.20-1.75]. 

The investigators concluded a maternal circulating 25-OHD 50 nmol/L increases risk of spontaneous preterm birth and vitamin D supplementation alone during pregnancy reduces risk of preterm birth. However, extrapolation of the results must be done with caution and there is urgent need for larger, better-designed RCT to confirm this effect.

Original title:
Vitamin D and risk of preterm birth: Up-to-date meta-analysis of randomized controlled trials and observational studies by Zhou SS, Tao YH, […], Tao FB.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28150405

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Find more information/studies about vitamin D, pregnancy, review article, significant and 95% CI right here.

Objectives:
Is there an association between folate level and the risk of schizophrenia?

Study design:
This review article included 16 high quality studies with a total of 1,183 (52.1%) cases and 1,089 (47.9%) controls.

There was no publication bias based on Egger’s and Begg’s tests [p = 0.48 and 0.30, respectively].

Results and conclusions:
The investigators found folate level in schizophrenia patients was significantly lower than that in healthy controls [SMD = -0.65, 95% CI = -0.86 to -0.45, p 0.00001].

The investigators found in subgroup analysis a decreased folate level in both Asian and European patients (SMD = -0.86, p 0.00001 and SMD = -0.44, p 0.00001, respectively], while there were no significant differences in patients from other areas [p > 0.05].

The investigators found sensitivity analysis confirmed that these results were stable and reliable.

The investigators concluded decreased folate level is a risk factor for schizophrenia, especially in Asian and European patients. More epidemiological and biochemistry studies are required to describe how folate or folate supplementation play roles in the progress of schizophrenia.

Original title:
Folate Deficiency Increased the Risk of Schizophrenia: a Meta-Analysis by Ding Y, Ju M, […], He L.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28124599

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The folate level of the human body can be increased by dietary folate intake and/or taking folate supplements.

Objectives:
Has coenzyme Q10 supplementation lowering effects on inflammatory mediator C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α)?

Study design:
This review article included 17 RCTs.

Results and conclusions:
The investigators found coenzyme Q10 supplementation significantly reduced the levels of circulating CRP with 0.35 mg/L [95% CI = -0.64 to -0.05, p = 0.022].
The results of meta-regression showed that the changes of CRP were independent of baseline CRP, treatment duration, dosage and patients characteristics.

The investigators found coenzyme Q10 supplementation significantly reduced the levels of circulating IL-6 with 1.61 pg/mL [95% CI = -2.64 to -0.58, p = 0.002].
In the meta-regression analyses, a higher baseline IL-6 level was significantly associated with greater effects of coenzyme Q10 on IL-6 levels [p for interaction = 0.006].

The investigators found coenzyme Q10 supplementation significantly reduced the levels of circulating TNF-α with 0.49 pg/mL [95% CI = -0.93 to -0.06, p = 0.027].

The investigators concluded coenzyme Q10 supplementation has lowering effects on CRP, IL-6 and TNF-α. However, these results should be interpreted with caution because of evidence of heterogeneity between studies and limited number of studies.

Original title:
Effects of coenzyme Q10 supplementation on inflammatory markers: A systematic review and meta-analysis of randomized controlled trials by Fan L, Feng Y, […], Chen LH.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28179205

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Objectives:
The associations between dietary zinc and iron intake and risk of depression remain controversial. Therefore, this meta-analysis (systematic review) has been conducted.

Do dietary zink and iron intake decrease risk of depression?

Study design:
This review article included a total of 9 studies for dietary zinc intake and 3 studies for dietary iron intake. 

Results and conclusions:
The investigators found for the highest versus lowest dietary zinc a significant reduced risk of 33% [pooled RR = 0.67, 95% CI = 0.58-0.76] for depression.

The investigators found for the highest versus lowest dietary iron a significant reduced risk of 43% [pooled RR = 0.57, 95% CI = 0.34-0.95] for depression.

The investigators found in subgroup analysis by study design, the inverse association between dietary zinc intake and risk of depression remained significant in cohort studies and cross-sectional studies.

The investigators found the pooled RRs (95% CIs) for depression did not substantially change in the influence analysis and subgroup analysis by adjustment for body mass index (BMI).

The investigators concluded dietary zinc intake reduces risk of depression.

Original title:
Dietary zinc and iron intake and risk of depression: A meta-analysis by Li Z, Li B, [...], Zhang D.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28189077

Additional information of El Mondo:
Find here more information/studies about zinc and review article/95% CI.

Objectives:
Arthritis patients often take fish oil supplements to alleviate symptoms, but limited evidence exists regarding their efficacy. Therefore, this meta-analysis (systematic review) has been conducted.

Do taking marine oil supplements alleviate pain in arthritis patients?

Study design:
This review article included 42 randomized trials; 30 trials reported complete data on pain.

The trials used treatment durations from 2 weeks to 18 months, with doses of EPA from 0.013 to 4.050 g/day and doses of DHA from 0.010 to 2.700 g/day.
Most trials used marine oil from whole fish, but some used cod liver oil, mussel extracts, seal oil and krill oil.

The trials included 2751 patients with a mean age of 53.8 years (range of mean age of 10-68 years) and the mean disease duration was 9.7 years (range 2.3-19.0 years).

Results and conclusions:
The investigators found a favorable effect [SMD = -0.24, 95% CI = -0.42 to -0.07, I2 = 63%] for using marine oil supplements.

The investigators found in 22 trials a significant effect in patients with rheumatoid arthritis [SMD = -0.21, 95% CI = -0.42 to -0.004] for using marine oil supplements.

The investigators also found in 3 trials a significant effect for other or mixed diagnoses [SMD = -0.63, 95% CI = -1.20 to -0.06] for using marine oil supplements, but no significant effect was found in osteoarthritis patients [5 trials: SMD = -0.17, 95% CI = -0.57 to 0.24].

The investigators found a significant, beneficial effect on pain for marine oil with an EPA/DHA ratio >1.5.

The investigators found a significant positive association between SMD and total dose of EPA and DHA [slope β, 0.13 (g/day), 95% CI = 0.04 to 0.22, p = 0.006], indicating less effect at higher dose, but there was no duration-response relationship [p = 0.568].

The investigators concluded using marine oil supplements (with an EPA/DHA ratio >1.5) alleviates pain in rheumatoid arthritis patients.

Original title:
Marine Oil Supplements for Arthritis Pain: A Systematic Review and Meta-Analysis of Randomized Trials by Senftleber NK, Nielsen SM, […], Christensen R.

Link:
http://www.mdpi.com/2072-6643/9/1/42/htm

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