Nutrition and health

<100 mg/day isoflavones reduce IL-6 and TNF-α levels

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Objectives:
Soy products contain several compounds with anti-inflammatory properties like genistein and daidzein which reported to act through different pathways. However, there are inconsistent results and lack of any comprehensive review regarding randomized controlled trials which assess the effect of soy products on inflammatory markers. Therefore, this review article has been conducted.

Does soy product supplementation reduce levels of inflammatory markers, like CRP, IL-6?

Study design:
This review article included 51 RCTs.

Results and conclusions:
The investigators found soy product supplementation significantly reduced CRP levels [MD = -0.27 mg/L, 95% CI = -0.51 to -0.02, p = 0.028] but it did not affect IL-6 [MD = 0.0 pg/mL, 95% CI = -0.06 to 0.06, p = 0.970] and TNF-α [MD = -0.04 pg/mL, 95% CI = -0.11 to 0.03, p = 0.252].

The investigators found subgroup analysis showed that soy supplementation had a significant impact on decreasing IL-6 and TNF-α levels when studies had a long-term intervention (≥12 weeks) and used low dose isoflavone (100 mg/day).

The investigators concluded there is a significant reduction in CRP levels after soy product supplementation.

Original title:
The effects of soy supplementation on inflammatory biomarkers: A systematic review and meta-analysis of randomized controlled trials by Asbaghi O, Yaghubi E, […], Ghaedi E.

Link:
https://pubmed.ncbi.nlm.nih.gov/32979840/

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0.5 servings of fish per week reduce multiple sclerosis

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Objectives:
There is some inconclusive evidence for the role of fish consumption in susceptibility to multiple sclerosis (MS). Therefore, this review article has been conducted.

Does fish consumption reduce multiple sclerosis (MS)?

Study design:
This review article included 6 observational studies.

Results and conclusions:
The investigators found that the consumption of fish (at least 0.5 servings of fish per week) significantly decreased the risk of multiple sclerosis with 23% [OR = 0.77, 95% CI = 0.64 to 0.92, p-value = 0.004, I2 = 54.7%] compared with controls.

The investigators concluded that dietary intake of at least 0.5 servings of fish per week during adolescence and after reduce the risk of multiple sclerosis; however, further studies are required to prove this preventive effect.

Original title:
Dietary fish intake and the risk of multiple sclerosis: a systematic review and meta-analysis of observational studies by Rezaeizadeh H, Mohammadpour Z, […], Homayon IA.

Link:
https://pubmed.ncbi.nlm.nih.gov/32787642/

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A higher dietary intake of fruit, dietary fiber, fish and vitamine C reduce COPD in adults

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Objectives:
The relationship between dietary pattern and the risk of chronic obstructive pulmonary disease (COPD) has been described; however, the exclusive role of dietary factors remains controversial. Therefore, this review article has been conducted.

Does a dietary intake of fruits and vegetables, dietary fiber, fish, n-3 or n-6 fatty acids and antioxidant vitamins reduce risk of COPD in adults?

Study design:
This review article included 10 cohort, 6 case-control and 20 cross-sectional studies.

To assess usual dietary intake, 28 studies had used food frequency questionnaires (FFQ), of which 2 studies had used FFQ and a 24-hour recall, 3 studies had used the crosscheck dietary method, 1 study had assessed with only 24-hour recall and 1 study had used weighted household food records.

Results and conclusions:
The investigators found a significantly reduced risk of 26% [relative risk = 0.74, 95% CI = 0.65 to 0.85] for COPD for the highest fruit intake group compared with the lowest intake group.
This significantly reduced risk was 29% in cohort studies [RR = 0.71, 95% CI = 0.63 to 0.79, I2 = 0.0%].

The investigators found a significantly reduced risk of 47% [relative risk = 0.53, 95% CI = 0.39 to 0.74, I2 = 0.0%, p = 0.65] for COPD mortality for the highest fruit intake group compared with the lowest intake group.

The investigators found a significantly reduced risk of 35% [relative risk = 0.65, 95% CI = 0.55 to 0.78] for COPD for the highest dietary fiber intake group compared with the lowest intake group.
This significantly reduced risk was 39% in cohort studies [RR = 0.61, 95% CI = 0.54 to 0.68, I2 = 0.0%, p = 0.9].

The investigators found a significantly reduced risk of 29% [relative risk = 0.71, 95% CI = 0.58 to 0.85] for COPD for the highest fish intake group compared with the lowest intake group.

The investigators found a significantly reduced risk of 11% [relative risk = 0.89, 95% CI = 0.76 to 0.99] for COPD for the highest vitamin C dietary intake group compared with the lowest intake group.

The investigators found no association between the risk of COPD and the intake of vegetables, n-3 fatty acids, vitamin E and β-carotene.

The investigators concluded that a higher dietary intake of fruit, dietary fiber, fish and vitamine C reduce the risk of COPD in adults.

Original title:
Dietary Factors and Risk of Chronic Obstructive Pulmonary Disease: A Systemic Review and Meta-Analysis by Seyedrezazadeh E, Moghaddam MP, […], Kolahdooz F.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7309892/

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Severe vitamin D deficiency (< 10 ng/mL) increases mortality in patients with sepsis

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Objectives:
Vitamin D deficiency has been related to the risk of sepsis. However, previous studies showed inconsistent results regarding the association between serum 25-hydroxyvitamin D (25 (OH)D) and mortality risk in septic patients. Therefore, this review article has been conducted.

Does a low serum 25-hydroxyvitamin D (vitamin D level in blood) increase mortality risk in septic patients?

Study design:
This review article included 8 follow-up studies (4 were prospective and the other 4 were retrospective) with 1,736 septic patients.

The sample sizes of the included studies varied from 57 to 610.
The mean ages of the patients included in each study ranged from 57 to 75 years and the proportions of male patients varied from 43% to 71%.

Optimal vitamin D level, vitamin D insufficiency, vitamin D deficiency and severe vitamin D deficiency are defined as serum 25 (OH)D > 30 ng/mL, 21-29 ng/mL and  20 ng/mL, 10 ng/mL, respectively.

There was no publication bias.

Results and conclusions:
The investigators found meta-analysis with a random-effect model showed that septic patients with lower serum 25 (OH)D ( 30 ng/ml) at admission was associated with a significantly increased mortality risk of 93% [adjusted RR = 1.93, 95% CI = 1.41 to 2.63, p  0.001, I2 = 63%, p = 0.003].
Sensitivity analysis by excluding one study at a time did not significantly change the results.

The investigators found subgroup analyses according to the severity of vitamin D deficiency showed that patients with severe vitamin D deficiency ( 10 ng/mL) was significantly associated with a 92% higher mortality risk [adjusted RR = 1.92, 95% CI = 1.09 to 2.55, p  0.001].
But the associations were not significant for vitamin D insufficiency (25 (OH)D = 20-30 ng/mL) or deficiency (25 (OH)D = 10-20 ng/mL).

The investigators found further analyses showed that the association between lower serum 25(OH) D and higher mortality risk were consistent in studies applied different diagnostic criteria for sepsis (SIRS, Sepsis-2.0 or Sepsis-3.0), short-term (within 1 month) and long-term studies (3-12 months) and in prospective and retrospective studies.

The investigators concluded that severe vitamin D deficiency ( 10 ng/mL) is independently associated with increased mortality in patients with sepsis. Large-scale prospective studies are needed to validate these findings.

Original title:
Serum 25-Hydroxyvitamin D and the risk of mortality in adult patients with Sepsis: a meta-analysis by Li Y and Ding S.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7057612/

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10-12 g/d arginine during 8 weeks improve sport performance

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Objectives:
Nitric oxide related ergogenic aids such as arginine (Arg) have shown to impact positively on sport performance through several physiological and metabolic mechanisms. However, research results have shown to be controversial. Therefore, this review article has been conducted.

Do both acute and chronic arginine supplementation increase aerobic (≤VO2max) and anaerobic (>VO2max) performance?

Study design:
This review article included 15 RCTs with 386 males and 8 females.

Arginine supplementation was ingested by participants in both acute and chronic protocols.
Acute arginine protocol was 0.15 g/kg (≈10-11 g) ingested between 60-90 minutes before physical exercises.

Chronic arginine protocol was 1.5-2 g/day during 4-7 weeks or 10-12 g/day during 8 weeks.

Random effects model and pooled standardized mean differences (SMD) were used according to Hedges’ g.

Egger’s analyses did not find publication bias in anaerobic performance [z = 0.786, p = 0.432]. However, funnel plot showed publication bias in aerobic performance data [z = 2.873, p 0.05].

Results and conclusions:
The investigators found both acute and chronic arginine supplementation significantly improved anaerobic performance [SMD = 0.24, 95% CI = 0.05 to 0.43, p = 0.01, I2 = 0%, p = 0.85].

The investigators found both acute and chronic arginine supplementation significantly improved aerobic performance [SMD = 0.84, 95% CI = 0.12 to 1.56, p = 0.02, I2 = 89%, p 0.001].

The investigators concluded both acute and chronic arginine supplementation improve (anaerobic/aerobic) performance.

Original title:
Effects of Arginine Supplementation on Athletic Performance Based on Energy Metabolism: A Systematic Review and Meta-Analysis by Viribay A, Burgos J, […], Mielgo-Ayuso J.

Link:
https://www.mdpi.com/2072-6643/12/5/1300/htm

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Higher serum levels of homocysteine increase multiple sclerosis

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Objectives:
Multiple sclerosis (MS) is a demyelinating and disabling inflammatory disease of the central nervous system. Multiple sclerosis is triggered by complex environmental factors which mostly affect genetically the susceptible young people. Emerging data has suggested that changes of homocysteine (Hcy), vitamin B12 and folate serum levels may be associated with multiple sclerosis. However, previous findings are not always consistent. Therefore, this review aricle has been conducted.

Does a low serum homocysteine, vitamin B12 or folate level increase risk of multiple sclerosis?

Study design:
This review article included 21 original studies with 1,738 multiple sclerosis patients and 1,424 controls (patients without multiple sclerosis). There were 17 studies for measuring homocysteine, 16 studies for measuring vitamin B12 and 13 studies for measuring folate in patients with multiple sclerosis, respectively.

Results and conclusions:
The investigators found patients with multiple sclerosis (MS) had higher serum levels of homocysteine [SMD = 0.64, 95% CI = 0.33 to 0.95, p 0.0001] compared with control groups.

The investigators found no significant differences of SMD for vitamin B12 [SMD = -0.08, 95% CI = -0.35 to 0.20, p = 0.58] or folate [SMD = 0.07, 95% CI = -0.14 to 0.28, p = 0.52] between MS and controls.

The investigators found subgroup analysis demonstrated that there was statistically significant difference for homocysteine between relapsing-remitting MS (RRMS) patients and controls with a SMD of 0.67 [95% CI = 0.21 to 1.13, p = 0.004].

However, no significant difference of homocysteine serum levels between secondary progressive MS patients or primary progressive MS patients and controls.

The investigators found no significant difference of homocysteine levels in females [SMD = 0.22, 95% CI = -0.16 to 0.60, p = 0.25] or males [SMD = 0.56, 95% CI = -0.13 to 1.26, p = 0.11] between MS patients and controls.

The investigators concluded higher serum levels of homocysteine increase risk of multiple sclerosis (MS), especially for relapsing-remitting MS (RRMS) patients. Functional studies are required to assess the effects of homocysteine on patients with MS at the molecular level.

Original title:
Serum levels of Homocysteine, Vitamin B12 and Folate in Patients with Multiple Sclerosis: an Updated Meta-Analysis by Li X, Yuan J, [...], Hu W.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7085269/

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Physical exercise offers benefits to patients with chronic kidney disease

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Objectives:
Physical exercise may offer multiple benefits to patients with chronic kidney disease (CKD). However, it was not traditionally recommended because of the possibility of impairing renal function and increasing proteinuria. Therefore, this review aricle has been conducted.

Does low-intensity physical exercise offer benefits to patients with chronic kidney disease?

Study design:
This review article included 21 RCTs with a intervention of at least 12 weeks and 927 patients.

The frequency of low-intensity physical exercise in 14 studies was 3 times per week during 30 minutes.

Results and conclusions:
The investigators found no differences in glomerular filtration rate or proteinuria between the intervention group (group with low-intensity physical exercise) and the control group (group without low-intensity physical exercise) [SMD = -0.3, p = 0.81 and SMD = 26.6, p = 0.82].

The investigators found positive effects on peak oxygen consumption [SMD = 2.5, p 0.001], functional capacity [SMD = 56.6, p 0.001], upper limb strength [SMD = 6.8, p 0.001] and haemoglobin [SMD = 0.3, p = 0.003] for the intervention group.

The investigators found an improvement on the quality of life, using the KDQOL-36 survey [SMD = 3.56, p = 0.02] and the SF-36 survey [SMD = 6.66, p = 0.02] for the intervention group.

The investigators concluded low-intensity physical exercise routinely has no negative impact on renal function. On the contrary, it improves aerobic and functional capacity, impacting positively on the quality of life.

Original title:
Impact of physical exercise in patients with chronic kidney disease: Sistematic review and meta-analysis by Villanego F, Naranjo J, […], Mazuecos A.

Link:
https://reader.elsevier.com/reader/sd/pii/S0211699520300266?token=62CEB2BCF50CE23B396565B5DC989F795AEEB75C666C74AA410FD2172DB39F90DBBB5D72BF3B4347C0C8AD2FEF8B0110

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Low-intensity physical exercises are a casual walk, a stretch session, a beginners' yoga class or tai chi.

 

Protein supplementation increases lean body mass in adults

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Objectives:
Does protein supplementation yield beneficial effects on body composition and muscle function (strength and synthesis) in healthy adults, with an emphasis on the timing of protein intake?

Study design:
This review article included 65 RCTs with 2,907 participants (1,514 men and 1,380 women, 13 unknown sex). 26, 8 and 24 studies were used for meta-analysis on lean body mass, handgrip strength and leg press strength, respectively.

Results and conclusions:
The investigators found protein supplementation was effective in improving lean body mass (LBM) in adults [MD = 0.62 kg, 95% CI = 0.36 to 0.88] and older adults [MD = 0.46 kg, 95% CI = 0.23 to 0.70].
Sensitivity analyses removing studies without exercise training had no impact on the outcome.

The investigators found no association between protein supplementation and handgrip strength [older adults: MD = 0.26 kg, 95% CI = -0.51 to 1.04] and leg press strength [adults: MD = 5.80 kg, 95% CI = -0.33 to 11.93 and older adults: MD = 1.97 kg, 95% CI = -2.78 to 6.72].
Sensitivity analyses removing studies without exercise training had no impact on the outcome.

The investigators found data regarding muscle synthesis were scarce and inconclusive.

The investigators found subgroup analyses showed no beneficial effect of a specific timing of protein intake on lean body mass, handgrip strength and leg press strength.

The investigators concluded there is a positive impact of protein supplementation on lean body mass of healthy adults and older adults, independently of intake timing.

Original title:
The Role of Protein Intake and its Timing on Body Composition and Muscle Function in Healthy Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials by Wirth J, Hillesheim E and Brennan L.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32232404

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The more lean body mass a person has, the higher their resting metabolic rate. Resting metabolic rate is the total number of calories burned when your body is completely at rest. Resting metabolic rate supports breathing, circulating blood, organ functions and basic neurological functions.

300 mg/day dietary anthocyanins reduce inflammation

Objectives:
Is there a causal relationship between dietary anthocyanins and reduced levels of systemic and vascular inflammation?

Study design:
This review article included 32 RCTs.

Results and conclusions:
The investigators found that dietary anthocyanins significantly decreased levels of C-reactive protein (CRP) [-0.33 mg/L, 95% CI = -0.55 to -0.11, p = 0.00], interleukin-6 (IL-6) [-0.41 ρg/mL, 95% CI = -0.70 to -0.13, p = 0.004], tumor necrosis factor-alpha (TNF-α) [-0.64 ρg/mL, 95% CI = -1.18 to -0.09, p = 0.023], intercellular adhesion molecule-1 [-52.4 ng/mL, 95% CI = -85.7 to -19.1, p = 0.002] and vascular adhesion molecule-1 (VCAM-1)  [-49.6 ng/mL, 95% CI = -72.7 to -26.5, p  0.001]. 

The investigators found that dietary anthocyanins significantly increased adiponectin level [0.75 μg/mL, 95% CI = 0.23 to 1.26, p = 0.004].

The investigators found subgroup analyses showed that administration of higher doses of anthocyanins (>300 mg/day) significantly decreased levels of CRP, IL-6, TNF-α and VCAM-1.

The investigators concluded that >300 mg/day dietary anthocyanins reduce the levels of systemic and vascular inflammation in the subjects.

Original title:
Impact of dietary anthocyanins on systemic and vascular inflammation: Systematic review and meta-analysis on randomised clinical trials by Fallah AA, Sarmast E, […], Jafari T.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31669599

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Inflammation in the body can be measured by the following biomarker; the pro-inflammatory cytokines. The pro-inflammatory cytokines are the C-reactive protein (CRP), IL-1, interleukin-6 (IL-6), IL-8, MCP-1, the vascular adhesion molecule-1 (VCAM-1) and tumor necrosis factor alpha (TNF-α).

 

Whole-body vibration improves bone mineral density in postmenopausal women

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Objectives:
Which types of exercise training (whole body vibration training, aerobic training, strength training and combined training) increase lumbar spine and femoral neck bone mineral density (BMD) in older postmenopausal women (PMW)?

Study design:
This review article included 16 RCTs with 1,624 subjects.

Results and conclusions:
The investigators found no significant change in lumbar spine bone mineral density following exercise training [MD = 0.01 g/cm2, 95% CI = -0.01 to 0.02].

The investigators found no significant change in femoral neck bone mineral density following exercise training [MD = 0.00 g/cm2, 95% CI = -0.01 to 0.01].

The investigators found, however, subgroup analysis by type of exercise training revealed that lumbar spine bone mineral density [MD = 0.01, 95% CI = 0.00 to 0.02] raised significantly when whole-body vibration (WBV) was employed as intervention compared with RCTs that utilized aerobic [MD = -0.01, 95% CI = -0.02 to -0.01], resistance [MD = 0.01, 95% CI = -0.04 to 0.06] or combined training [MD = 0.03, 95% CI = -0.01 to 0.08].

The investigators found, on the other hand, lumbar spine bone mineral density [MD = - 0.01, 95% CI = -0.02 to -0.01] reduced significantly when aerobic exercise training was used as intervention compared with RCTs that utilized resistance training, combined training or whole-body vibration. 

The investigators concluded whole-body vibration is an effective method to improve lumbar spine bone mineral density in older postmenopausal women.

Original title:
The Impact of Different Modes of Exercise Training on Bone Mineral Density in Older Postmenopausal Women: A Systematic Review and Meta-analysis Research by Mohammad Rahimi GR, Smart NA, […], Mohammad Rahimi N.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32055889

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Pomegranate decreases inflammation in adults

Objectives:
Is there a causal relationship between intake of pomegranate and decreased risk of getting inflammation in adults?

Study design:
This review article included 16 randomized controlled trials (RCTs) involving 572 subjects.

Results and conclusions:
The investigators found when compared to placebo, that pomegranate supplementation significantly reduced hs-CRP levels [WMD = -6.57 mg/L, 95% CI = -10.04 to -3.10, p = 0.000].

The investigators found when compared to placebo, that pomegranate supplementation significantly reduced IL-6 levels [WMD = -1.68 pg/mL, 95% CI = -3.52 to -0.157, p = 0.000].

The investigators found when compared to placebo, that pomegranate supplementation significantly reduced TNF-α levels [WMD = -2.37 pg/mL, 95% CI = -3.67 to -1.07, p = 0.00].

The investigators found no association between pomegranate supplementation and CRP levels [WMD = 2.19 mg/dL, 95% CI = -3.28 to 7.67, p = 0.61], E-selectin levels [WMD = 8.42 ng/mL, 95% CI = -22.9 to 39.8, p = 0.599], ICAM levels [WMD = -17.38 ng/mL, 95% CI = -53.43 to 18.66, p = 0.107], VCAM levels [WMD = -69.32 ng/mL, 95% CI = -229.26 to 90.61, p = 0.396] or MDA levels [WMD = 0.031 μmol/L, 95% CI = -1.56 to 0.218, p = 0.746].

The investigators concluded pomegranate supplementation reduces hs-CRP levels, IL-6 levels and TNF-α levels in adults.

Original title:
The effects of pomegranate supplementation on biomarkers of inflammation and endothelial dysfunction: A meta-analysis and systematic review by Wang P, Zhang Q, [...], Yao G.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32147056

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Inflammation in humans can be measured by biomarkers, such as highly sensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6) and the tumor necrosis factor alpha (TNF-α).

Inflammation in humans can lower the resistance. A low resistance makes the body susceptible to diseases.
 

Hepatitis B virus infection increases chronic kidney disease

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Objectives:
The activity of hepatitis B virus (HBV) as a risk factor for the incidence and progression of chronic kidney disease (CKD) has not been clarified. Therefore, this review article has been conducted.

Does hepatitis B virus infection increase risk of chronic kidney disease?

Study design:
This review article included 33 studies with a total of 7,849,849 patients.

Results and conclusions:
The investigators found in 11 cohort studies with 1,056,645 patients, that a positive HBV serologic status (hepatitis B virus infection) significantly increased risk of incidence of chronic kidney disease with 40% [adjusted HR = 1.40, 95% CI = 1.16 to 1.69, p 0.001, I2 = 49.5%, p 0.0001].

The investigators found in 10 cross-sectional studies with 3,222,545 patients, no relationship between hepatitis B virus infection and prevalence of chronic kidney disease [adjusted OR = 1.04, 95% CI = 0.90 to 1.218, p = 0.5].

The investigators found meta-regression analysis reported a relationship between positive HBsAg status and incidence of chronic kidney disease in the general population [p 0.015].

The investigators concluded hepatitis B virus infection increases risk of developing of chronic kidney disease in the adult general population. Studies aimed to understand the mechanisms responsible of such association are underway.

Original title:
HBV infection is a risk factor for chronic kidney disease: Systematic review and meta-analysis by Fabrizi F, Cerutti R, […], Messa P.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32037008

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Lead increases ALS

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Objectives:
Lead is a known risk factor for amyotrophic lateral sclerosis (ALS). However, the results of studies exploring the relationship between lead exposure and the occurrence of ALS are inconsistent. Therefore, this review article has been conducted.

Does a high lead exposure increase risk of ALS?

Study design:
This review article included 11 case-control studies.

Results and conclusions:
The investigators found a high lead exposure significantly increased risk of ALS with 28% [OR = 1.28, 95% CI = 1.02 to 1.63].
Subgroup and sensitivity analyses showed stable results.

The investigators concluded a high lead exposure increases risk of ALS.

Original title:
Population-based study of environmental/occupational lead exposure and amyotrophic lateral sclerosis: a systematic review and meta-analysis by Meng E, Mao Y, […], Jin W.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31578652

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Meat is not a risk factor for asthma in children

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Objectives:
Many studies have been reported that dietary meat intake may be associated with the risk of asthma in children, but the results are inconsistent. Therefore, this review article has been conducted.

Does dietary meat intake increase asthma in children?

Study design:
This review article included a total of 9 articles.

No publication bias was detected.

Results and conclusions:
The investigators found dietary meat intake 3 or more times per week compared with never/occasionally intake had no significant association with asthma risk among children [OR = 1.27, 95% CI  =  0.80-2.01, p =  0.308].
Not significant because OR of 1 was found in the 95% CI of 0.80 to 2.01. OR of 1 means no risk/association.

The investigators found, similarly, daily dietary intake of meat did not affect the risk of asthma in children when compared with never/occasionally intake [OR  =  1.13, 95% CI  =  0.93-1.37, p  =  0.234].

The investigators concluded dietary meat intake is not a risk factor for asthma in children. Due to some limitations that exist in this review article, more studies are needed to further assess the association between dietary meat intake and asthma risk in children.

Original title:
Dietary meat intake and risk of asthma in children: evidence from a meta-analysis by Zhang D, Cao L, [...], Wang Z.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31895767

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Vitamin B12, D and E reduce eczema

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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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Strength training decreases inflammation in adults

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Objectives:
Does strength training improve total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), C-reactive protein (CRP) and adiponectin levels of adults?

Study design:
This review article included clinical trials up to May 2017.

Results and conclusions:
The investigators found strength training significantly reduced total cholesterol levels [ES = -0.399, p  0.001]. 

The investigators found strength training significantly reduced triglycerides levels [ES = -0.204, p = 0.002]. 

The investigators found strength training significantly reduced LDL cholesterol levels [ES = -0.451, p  0.001]. 

The investigators found strength training significantly reduced CRP levels [ES = -0.542, p = 0.01]. 

The investigators found strength training significantly increased HDL cholesterol levels [ES = 0.363, p  0.001]. 

The investigators found strength training significantly increased adiponectin levels [ES = 1.105, p = 0.01]. 

The investigators concluded strength training promotes decreases in total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL) (also called bad cholesterol), C-reactive protein (CRP) levels and increases high-density lipoprotein (HDL) (also called good cholesterol) and adiponectin levels of adults. Thus, progressive strength training could be a potential therapeutic option for improving abnormalities in lipid and inflammatory outcomes in adults.

Original title:
Effect of Strength Training on Lipid and Inflammatory Outcomes: Systematic Review With Meta-Analysis and Meta-Regression by Costa RR, Buttelli ACK, […], Kruel LFM.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31023184

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1,670 mg/d dietary potassium may reduce mortality among patients with chronic kidney disease

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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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Higher levels of selenium in cerebrospinal fluid increase Parkinson's disease

Afbeelding

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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Omega-3 supplementation decreases CRP levels in patients on hemodialysis

Afbeelding

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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Creatine supplementation does not induce renal damage

Afbeelding

Objectives:
Creatine supplements are intended to improve performance, but there are indications that it can overwhelm liver and kidney functions, reduce the quality of life and increase mortality. Therefore, this review article has been conducted.

Does creatine supplementation increase risk of renal damage?

Study design:
This review article included 15 studies in the qualitative analysis and 6 studies in the quantitative analysis.

Results and conclusions:
The investigators found creatine supplementation did not significantly increase serum creatinine levels [standardized mean difference = 0.48, 95% CI = 0.24-0.73, p = 0.001, I2 = 22%].

The investigators found creatine supplementation did not significantly increase plasma urea values [standardized mean difference = 1.10, 95% CI = 0.34-1.85, p = 0.004, I2 = 28%].
The investigators concluded that creatine supplementation does not induce renal damage in the studied amounts and durations.

Original title:
Effects of Creatine Supplementation on Renal Function: A Systematic Review and Meta-Analysis by de Souza ESA, Pertille A, […], de Oliveira JJ.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31375416

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Low selenium and zinc levels increase rheumatoid arthritis

Afbeelding

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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60-500 mg/day coenzyme Q10 supplements reduce inflammation

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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Egg consumption does not increase inflammation

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.
 

Adults with overweight/obesity benefit from probiotics

Afbeelding

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/

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Hypomagnesemia increases all-cause mortality in end-stage renal disease patients

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

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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.