Nutritional Advice El Mondo

Nutrition and health

Elderly

Scientific studies (review articles) on the relationship between diet/nutrients and elderly prevention:
One swallow does not make a summer. A famous Dutch saying that could not be any more obvious. Just because one single scientific study about a certain topic makes certain claims, it does not necessarily mean it is true. On the other hand, a review article (a collection of scientific studies on a certain topic) of randomized, placebo-controlled double blind clinical trials (RCTs) will answer the following question:
"Do taking dietary supplements make sense?" Yes for a positive conclusion and no for a negative conclusion.

One swallow does not make a summer. A famous Dutch saying that could not be any more obvious. Just because one single scientific study about a certain topic makes certain claims, it does not necessarily mean it is true. On the other hand, a review article (a collection of scientific studies on a certain topic) of cohort studies or case-control studies will answer the following question:
"Should I change my diet?".

2024:

  1. Daily 500mg n-3 PUFA during 12 months improve cognitive functions 
  2. 15 g/day fish protein dietary intake may reduce fractures
     

2023:

  1. High selenium dietary intake reduces hip fracture
  2. Lower serum magnesium concentrations increase fractures
  3. Lower blood carotenoid level is a risk factor for dementia
  4. High antioxidant dietary intake reduces Alzheimer's disease
  5. Fish consumption reduces Alzheimer's disease

2022:

  1. High dietary intake of vitamin E reduces dementia
  2. Skim milk, poultry and non-meat animal products reduce age-related eye disease
  3. 800-1,000 IU/d vitamin D3 reduces fracture and fall risk among elderly
  4. 400 IU/day to 300,000 IU vitamin D supplementation improves handgrip strength in postmenopausal women
  5. Higher concentration of carotenoids and vitamin E in blood reduce age-related macular degeneration
  6. Protein supplementation + exercise increase lower-extremity strength in healthy older Asian adults with sarcopenia

2021:

  1. 100 µg/d vitamin K2 + 1000 mg/d calcium supplements increase lumbar spine bone mineral
  2. Mushroom consumption reduces all-cause mortality
  3. 200-700 g/d fruits and vegetables consumption decreases frailty
  4. Monounsaturated fatty acids dietary intake reduces all-cause mortality
  5. Chair-based exercise programmes improve upper extremity and lower extremity function in older adults
  6. Supplementation with 320-729 mg/d magnesium may improve sleep in older adults with insomnia
  7. <11 g/day alcohol and <2.8 cups/day coffee reduce cognitive deficits
  8. Higher plasma DHA and EPA levels reduce advanced age-related macular degeneration
  9. Alcohol consumption increases risk of any fractures
  10. 0.5-50 mg/d carotenoid supplementation improves cognitive performance among healthy adults
  11. Daily 700-1000 mg dietary calcium intake increases cardiovascular disease in healthy postmenopausal women
  12. Daily egg consumption have beneficial effects on macular pigment optical density
  13. A high dietary intake of β-cryptoxanthin reduce osteoporosis and hip fracture

2020:

  1. EPA + DHA supplements for at least 6 months increase walking speed among the elderly
  2. 54 mg/day genistein increase bone mineral density in postmenopausal women
  3. Vitamin K + D supplement increase bone mineral density
  4. Dairy products increase bone mineral density in postmenopausal women:
  5. LDL cholesterol levels >121 mg/dL increase Alzheimer's disease
  6. Dietary intake of vitamin C-rich foods reduces risk of osteoporosis
  7. Higher linoleic acid blood concentration reduces cancer mortality
  8. Statins improve activities of daily living ability in Alzheimer disease patients
  9. Carbohydrate intake does not increase risk of fracture
  10. Middle-aged people with diabetes are at higher risk of developing dementia

2019:

  1. miRNAs may be a promising biomarker for Alzheimer's disease
  2. 1 drink or more per day increases osteoporosis
  3. Low folate levels increase risk of depression among the aged people
  4. Lower vitamin E levels increase Alzheimer's disease
  5. High serum uric acid level decreases risk of fractures
  6. Soy/soy products consumption reduce risk of mortality from cardiovascular diseases
  7. High homocysteine level increases Alzheimer disease
  8. One serving of fruits and vegetables per day reduces fractures
  9. Saturated fat increases Alzheimer disease
  10. Vegetable-based diet reduces osteoporosis in postmenopausal women
  11. Diet with high total antioxidant capacity decreases cancer mortality
  12. Potato consumption does not increase risk of mortality in adults
  13. Dietary intake of 5 mg/d vitamin A reduces age-related cataract

2018:

  1. Alzheimer's disease patients have a low plasma vitamin E level
  2. A diet with high antioxidant properties reduces all-cause mortality risk
  3. All-cause mortality risk is lowest with a diet with 50-55 En% carbohydrates
  4. A low selenium level in the brain increases Alzheimer’s disease
  5. Monounsaturated fatty acids intake derived from animal sources increase risk of fracture
  6. High fish consumption decreases risk of age-related macular degeneration
  7. Coronary heart disease and heart failure increase risk of dementia
  8. Inflammatory markers are associated with an increased risk of all-cause dementia
  9. Insulin-degrading enzyme protein level is lower in Alzheimer's disease patients
  10. Vitamin D level of 25 to 35 ng/mL decreases risk of dementia and Alzheimer's disease
  11. Aerobic exercise benefits global cognition in mild cognitive impairment patients
  12. A high consumption of yogurt and cheese reduces hip fracture
  13. Regular aerobic exercise delays cognitive decline among individuals having Alzheimer's disease

2017:

  1. High tea consumption reduces hip fracture risk among women
  2. Dietary intake of n-3 PUFAs declines hip fracture risk
  3. Every 500 kcal increase per week reduce Alzheimer’s disease with 13%
  4. Higher dietary intake of vitamin A decreases total fracture risk
  5. A high vitamin D level increases walking speed among older adults
  6. Fruit and vegetables reduce risk of cognitive disorders
  7. Atrial fibrillation, previous stroke, myocardial infarction, hypertension, diabetes and previous TIA increase risk of post-stroke dementia
  8. At least 28 g/d whole grain intake reduce risk of total, cardiovascular and cancer mortality
  9. 50 mg/day dietary vitamin C intake decreases hip fracture risk
  10. At least 4 servings/week fish is associated with decreasing memory decline
  11. Low vitamin D status is related to poorer cognition in healthy adults
  12. Serum zinc/iron levels are decreased in Alzheimer's disease patients
  13. Circulatory selenium concentration is lower in Alzheimer's disease patients
  14. Higher protein intake may increase bone mineral density
  15. Tea consumption increases bone mineral density
  16. Daily 50μg vitamin K dietary intake decreases the risk of fractures
  17. Manganese deficiency may be a risk factor for Alzheimer’s disease
  18. Olive oil intake reduces risk of type 2 diabetes
  19. Weekly 100 grams fish reduces dementia of Alzheimer type
  20. Long-term cheese consumption does not increase risk of all-cause mortality
  21. Daily 100g fruit and vegetable reduces risk of cognitive impairment and dementia among elderly
  22. Decreased walking pace increases risk of dementia in elderly populations

2015:

  1. Serum non-ceruloplasmin copper is higher in Alzheimer's disease
  2. At least 580 mg/day DHA or 1 g/day DHA/EPA improves memory function in older adults with mild memory complaints

2013:

  1. 300 μg/d dietary lutein and zeaxanthin intake reduce nuclear cataract

2012:

  1. 75-87.5 nmol/L vitamin D decrease mortality in the general population
  2. Daily 54 mg soy isoflavone for 6 weeks to 12 months reduces the frequency and severity of hot flashes
  3. Diabetes increases risk of dementia and mild cognitive impairment
  4. Dietary intakes of vitamin C and E lower risk of Alzheimer's disease

2011:

  1. Alzheimer's disease patients have higher levels of copper

2009:

  1. Isoflavone-rich soy products decrease FSH and LH in premenopausal women

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Most developed world countries have accepted the chronological age of 65 years as a definition of elderly. The common problems in elderly are:

https://elmondo.org/en/dementia

  • Decreased vision
  • Pneumonia
  • Deterioration of hearing
  • Loss of appetite and thirst
  • Muscle loss
  • Malnutrition

Nutrition has a marked effect on the aging process. For example, a good nutritional status can retard the aging process while a daily energy intake below 1700 kcal can cause a deficiency of vitamins and minerals. A deficiency of vitamins and minerals can in turn accelerate the aging process.

The aging process does not begin at 65 of age, but already at 30 or even at younger age.

One consequence of elderly is the loss of muscle strength. Per year an elderly will lose around 0.25 kg muscle. Muscle loss can be counteracted by strength training (60-85% of 1RM and 3-4 times per week). Muscle loss will result in a lower resting metabolic rate.

Dietary guidelines for elderly:

  • To maintain strong bones in elderly, is advisable to choose products with 15-25 En% protein or your daily diet (=the average of all meals/products that you eat on a daily basis) should look like this:
    15-25 En% protein, 30-35 En% fat, of which 7-10 En% saturated fat, maximum 0.3 gram salt per 100 kcal and 1.3- 1.5 grams of fiber per 100 kcal. The easiest way to meet this diet is to choose for meals/products with also 15-25 En% protein, 30-35 En% fat, of which 7-10 En% saturated fat, maximum 0.3 gram salt per 100 kcal and 1.3- 1.5 grams of fiber per 100 kcal.
    However,  the most important factors for bone maintenance in elderly are 60-90 minutes of physical exercise (preferably strength training) per day in combination with 15-30 micrograms vitamin D and 1 gram calcium or more per day.
  • Stop smoking because smoking causes atherosclerosis. Atherosclerosis is a major risk factor for developing cardiovascular diseases.
  • Aim for a healthy weight. A healthy weight has a BMI of 18.5-25. BMI is weight divided by height squared (weight (kg)/height2 (m)).
  • Spend at least 60-90 minutes per day on physical exercises or at least 10000 steps per day.
  • Eat at least 2 times a week (100-150 g fish per time) oily fishes or take daily 250-500 mg EPA and DHA. EPA and DHA are found in fish oil supplements. However, fish oil supplements cannot match the positive effects of eating fish.
  • Oily fishes are sardines, herring, salmon, anchovies, eel and mackerel.
  • Eat 300 grams of vegetables and five servings of fruit per day or 30 grams of fiber per day. 10-30 grams of fiber a day decreases the LDL cholesterol levels.
  • 30 grams of fiber per dag corresponds to a daily diet of minimum 1.5 grams of fiber per 100 kcal.
  • Limit alcohol to 2-3 glasses for men and 1-2 glasses for women per day.
  • Eat no more than 6 grams of salt per day, corresponding to 2400 mg of sodium.
  • 6 grams of salt per day corresponds to a daily diet of <0.3 g salt per 100 kcal.
  • Eat no more than 200 grams of cholesterol per day at an elevated LDL cholesterol level.
  • Eat no more than 19 grams of saturated fat per day at 2500 kcal and 15 grams of saturated fat at 2000 kcal. The WHO advises 2000 kcal per day for women and 2500 kcal for men.
  • Eat with other people because group eating can increase the appetite. Elderly people often have a poor appetite.
  • Put every day 1 bottle of 2 liters of water on the table. This ensures that you’ll get enough fluid because the sensation of thirst in the elderly can be significantly reduced.
  • Take daily 15-30 micrograms (600-1200 IU) of vitamin D. Take dietary supplements always in consultation with a dietitian, nutritionist or your GP!
  • Take daily a multi-vitamin supplement.
  • Take 500 micrograms of folic acid per day at a high homocysteine ​​level.
  • Take daily 1000 mg calcium. It can be through diet or dietary supplements.
  • Do not take antioxidant supplements. They do more harm than good!
  • It is preferable to obtain antioxidants through diet (200-300 grams of vegetables and 2-5 servings of fruit per day).

Overweight

Scientific studies (review articles) on the relationship between diet/nutrients and overweight prevention:
One swallow does not make a summer. A famous Dutch saying that could not be any more obvious. Just because one single scientific study about a certain topic makes certain claims, it does not necessarily mean it is true. On the other hand, a review article (a collection of scientific studies on a certain topic) of randomized, placebo-controlled double blind clinical trials (RCTs) will answer the following question:
"Do taking dietary supplements make sense?" Yes for a positive conclusion and no for a negative conclusion.

One swallow does not make a summer. A famous Dutch saying that could not be any more obvious. Just because one single scientific study about a certain topic makes certain claims, it does not necessarily mean it is true. On the other hand, a review article (a collection of scientific studies on a certain topic) of cohort studies or case-control studies will answer the following question:
"Should I change my diet?".

2023:

  1. Causal relationship between sugar-sweetened beverages consumption and higher BMI and body weight

2021:

  1. High protein diets causally have beneficial effect on body weight management
  2. High circulating vitamin C level reduces metabolic syndrome
  3. Carbohydrate intake increases metabolic syndrome
  4. Poultry consumption decreases metabolic syndrome
  5. Nut consumption does not increase adiposity
  6. Obesity increases colorectal cancer in men with Lynch Syndrome
  7. A diet with low GI increases metabolic syndrome
  8. Hyperlipidemia, obesity and high alcohol consumption are risk factors of early-onset colorectal cancer
  9. Obesity is a risk factor for mortality from primary liver cancer
  10. Insufficiency of serum carotenoids increases overweight and obesity
  11. Obesity increases atrial fibrillation recurrence in patients undergoing catheter ablation
  12. Brown rice has anti-obesity effects in comparison with white rice
  13. No effect of vitamin E supplementation on weight, BMI and waist circumference
  14. Mortality is more frequently in COVID-19 patients with chronic kidney diseases and cardiovascular disease
  15. Vitamin D supplementation during pregnancy or infancy reduces adiposity in childhood

2020:

  1. Dairy products reduce causal fat mass and BMI among overweight or obese adults
  2. Pistachio supplementation lowers BMI without increasing body weight
  3. Abdominal adiposity is a risk factor in COVID-19
  4. Alpha-lipoic acid supplementation reduces weight and BMI
  5. Obesity increases severe COVID-19
  6. Coenzyme Q10 supplementation does not decrease body weight and BMI
  7. Yogurt intake is associated with a reduced risk of type 2 diabetes
  8. Fish consumption reduces metabolic syndrome
  9. Waist circumference is a significant risk factor of liver cancer

2019:

  1. A higher serum copper level increases obesity
  2. 100 g/d fruit consumption reduces metabolic syndrome
  3. 150 mg/day quercetin supplementation reduces LDL-cholesterol in obese people
  4. <2 g/d L-carnitine decreases diastolic blood pressure in participants with obesity
  5. 280 mg/d dietary calcium intake may reduce metabolic syndrome
  6. Adults with overweight/obesity benefit from probiotics
  7. ≤400 μg/d chromium supplementation reduce BMI
  8. Whole grains, fruit, nut, legume consumption reduce adiposity risk
  9. Tree nuts reduce risk of metabolic syndrome

2018:

  1. ≥75 mg/day isoflavones reduce BMI
  2. <50 g/d carbohydrates increase good cholesterol in overweight/obese adults
  3. ≥30g chocolate per day during 4-8 weeks reduce BMI
  4. Carotenoids may reduce risk of metabolic syndrome
  5. Ginger intake reduces body weight and fasting glucose among overweight and obese subjects
  6. Vegetable and fruit consumption reduce metabolic syndrome

2017:

  1. A low-fat diet reduces cholesterol level in overweight or obese people
  2. A high dietary fiber intake may reduce risk of metabolic syndrome
  3. A high fruit and/or vegetable consumption reduce risk of metabolic syndrome among Asian
  4. A high relative adipose mass reduces bone mineral density in overweight and obese populations
  5. Higher sodium increases metabolic syndrome
  6. Metabolic syndrome increases risk of ischemic stroke
  7. A higher circulating DHA is associated with a lower metabolic syndrome risk
  8. Whole flaxseed supplementation in doses ≥30 g/d during ≥12 weeks has positive effects on body composition in overweight participants
  9. n-3 PUFA supplements reduce waist circumference in overweight and obese adults
  10. Green tea decreases LDL cholesterol level in overweight or obese people
  11. Decreased vitamin D levels and increased BMI increase pediatric-onset MS
  12. CLA does not reduce fasting blood glucose and waist circumference
  13. Abdominal adiposity and higher body fat mass increase risk of atrial fibrillation

2015:

  1. Green tea consumption decreases blood pressure among overweight and obese adults

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Overweight is an increasing problem in the world. It’s called overweight when the BMI is greater than 25 and obese when the BMI is greater than 30. A healthy weight has a BMI of 18.5-25. A woman with 65 kg and 1.57 meters has a BMI of 26.4 (65/(1.57x1.57)). BMI is weight divided by height squared (weight (kg)/height2 (m)).

The best way to determine overweight in children is to calculate the BMI. In adults, beside the BMI, waist circumference should also be measured.

Everybody who wants to lose weight, wants to burn more calorie at rest and more fat. How do you achieve these two goals?

Make sure the resting metabolic rate (RMR) does not decrease when following a diet (therefore, the recommendation of dietitians is no more than 0.5-1 kg of weight loss per week). A low resting metabolic rate will result in a low calorie burning at rest. But that is not what you want. You want, when following a diet, that the body will burn more calories (at rest).
A low resting metabolic rate is often the result of the insufficient intake of carbohydrate. When the body obtains insufficient quantities of carbohydrate, it’s been forced to get energy from protein, resulting in muscle degradation. Muscle degradation will in turn result in a lower resting metabolic rate. Muscle degradation can be observed when the upper arm and calf circumference become smaller. To prevent muscle degradation, when following a diet, is recommendable to choose product with 55-70 En% carbohydrates.

To prevent muscle degradation when following a diet, the diet must contain at least 1.6 g protein per kg body weight. For a person of 65 kg means 65x1.6 = 104 kg of protein per day. 1.6 g protein per kg body weight corresponds to a diet with 20 En% protein.

To prevent muscle degradation when following a diet, it is recommendable to choose products with 20-35 En% protein and/or products with 55-70 En% carbohydrates in combination with strength training. Strength training increases the resting metabolic rate. A declined resting metabolic rate is often the cause of the yo-yo effect.

Cardio-fitness is a good way to burn fat. To be able to burn fat efficiently, you should perform cardio-fitness with the heart rate between 75 and 90% of the maximum heart rate. The maximum heart rate is calculated by 220 minus age.
For example, you are 40 years old you have to perform cardio-fitness with a heart rate between 0.75-0.9x(220-40) = 135 and 162 heart beats per minute. Stop immediately  with the exercises when you are not feeling well or have pain in the chest!

In summary, it can be said the best way to lose weight is to perform strength training with cardio-fitness in combination with a diet containing products with 20-35 En% protein and/or products with 55-70 En% carbohydrates.

The main cause of overweight is the body gets more calories than it daily burns. Through physical activities, the body will burn more calories. To gain positive effects of physical exercises the body should burn at least 2000 calories (kcal) per week or at least 150 minutes of aerobic exercise of moderate intensity, accumulated over the week, which can be split into periods of at least 10 minutes. To prevent overweight, physical activities should account for 15-30% of the daily calorie intake.

The main consequences of overweight are:

  • Cardiovascular diseases.
  • Type 2 diabetes. The main effects of type 2 diabetes are cardiovascular diseases and kidney problems.

Belly fat is bad because it increases the risk of getting type 2 diabetes and cardiovascular disease. Therefore, aim for a waist circumference of 68-80 cm for women and 79-94 cm for men. A loss of 1 cm of belly fat (e.g. 95 to 94 cm) corresponds to a loss of 1 kg of fat. 1 kg of fat corresponds to 9000 calories.

Local fat loss, such as the backside or thighs is a scientific myth.

The human body will only burn fat when it meets the following two criteria:

  1. Increased oxygen uptake (only occurs during physical exercises).
  2. Increased energy demand (only occurs during physical exercises).

We like to eat fat but our body likes to use carbohydrates as energy source.

Overweight is the result of poor knowledge about nutrition in combination with hardly physical exercises.

It is not possible to lose more than 1.8 grams of fat per week. However, at more than 1 kg of fat loss per week, the body will also break down muscle, resulting in a low resting metabolic rate and yoyo-effect.

When following a diet is favorable to minimize fat through diet. But at least 7 grams of fat per day is necessary to ensure the intake of essential fatty acids and to stimulate the production of bile salts.
7 grams of fat per day corresponds to a daily diet with 4 En% fat. However, a diet with at least 20 En% fat (and up to 35 En% fat) is necessary to prevent a deficiency of essential fatty acids and fat-soluble vitamins on long-term.

A responsible breakfast contains up to 350 kcal.
A responsible lunch contains up to 450 kcal.
A responsible evening meal contains up to 750 kcal.

Good indicators for weight loss are a decreased body fat and an increased muscle mass. The body fat and muscle mass can be measured with a body composition analyzers scale.

Recommended daily energy intake by sex and age group
Age group (years)MenWomen
Kcal per dayKcal per day
616001500
1222002000
1729002300
30-3926002000
50-5925002000
70-7923001800
Others25002000

 

Recommended fat percentage by sex and age group
Age group (years)MenWomen
17-291525
30-3917.527.5
40-492030
50+2535
A healthy adult male has a body fat percentage around 15%.
A healthy adult woman has a body fat percentage around 25%.


Dietary guidelines for overweight prevention:

  • Choose products with 20-30 En% fat, products with maximum 7 En% saturated fat, products with 20-35% protein, products with maximum 10 En% sugars, products with minimum 1.5 grams of fiber per 100 kcal and products with a GI value of 55 or lower or in other words, your daily diet (=all meals/products that you eat on a daily basis) should on average contain 20-30 En% fat, maximum 7 En% saturated fat, 20-35% protein, maximum 10 En% sugars and minimum 1.5 grams of fiber per 100 kcal.
  • Products with 20-35 En% protein in combination with 10000 steps per day and 25-30 grams of fiber per day will reduce weight in a responsible manner.
    Products with 20-35 En% protein should contain maximum 30 En% fat and maximum 7 En% saturated fat!
  • No more than 0.5-1 kg of weight loss per week. 0.5 kg of weight loss per week corresponds to a decreased intake of 350 kcal per day through diet and 150 kcal extra through physical activities.
  • To prevent a deficiency of vitamins and essential fatty acids a diet should contain a minimum of 1700 kcal per day.
  • Increase the resting metabolic rate. Strength training is the best way to increase the resting metabolic rate.
  • Use the following guideline: total energy intake per day is 25-30 kcal per kg body weight.
  • Eat 300 grams of vegetables and five servings of fruit per day or 25-30 grams of fiber per day. Dietary fiber provides a longer satiety, resulting in less meal times during the day. Furthermore, the antioxidants from fruits and vegetables reduce inflammation.
    30 grams of fiber per day corresponds to a daily diet of minimum 1.5 grams of fiber per 100 kcal.
  • Eat no more than 19 grams of saturated fat per day at 2500 kcal and 15 grams of saturated fat at 2000 kcal. The WHO advises 2000 kcal per day for women and 2500 kcal for men.
  • Aim for a healthy weight. A healthy weight has a BMI of 18.5-25. BMI is weight divided by height squared (weight (kg)/height2 (m)).
  • Spend at least 90 minutes per day on physical exercises or at least 10000 steps per day.
  • Stop smoking because smoking causes atherosclerosis. Atherosclerosis is the most important cause of cardiovascular diseases.
  • Do not go shopping on an empty stomach.
  • Do not skip breakfast.
  • Put the meal on a small plate. So it looks like there is a lot of food on the plate!
  • Eat at least 2 times (100-150 g fish per time) a week oily fishes or take daily 250-500 mg EPA and DHA.
    Oily fishes are sardines, herring, salmon, anchovies, eel and mackerel.
  • Limit alcohol to 2 glasses for men and 1 glass for women per day.
  • Eat no more than 6 grams of salt per day, corresponding to 2400 mg of sodium.
    6 grams salt per day corresponds to a daily diet with <0.3 g salt per 100 kcal.
  • Do not take weight loss supplements. They do not what they claim.
Age (years)Recommended BMI for menRecommended BMI for women
414.40-17.5514.25-17.28
514.20-17.4214.05-17.15
614.04-17.5513.90-17.34
714.02-17.9213.94-17.75
814.10-18.4414.06-18.35
914.29-19.1014.26-19.07
1014.53-19.8414.57-19.86
1114.84-20.5514.99-20.74
1215.23-21.2215.52-21.68
1315.70-21.9116.13-22.58
1416.25-22.6216.73-23.34
1516.84-23.2917.28-23.94
1617.42-23.9017.75-24.37
1717.98-24.4618.16-24.70
18 and older18-50-25.0018.50-25.00

Diabetes

Scientific studies (review articles) on the relationship between diet/nutrients and diabetes prevention:
One swallow does not make a summer. A famous Dutch saying that could not be any more obvious. Just because one single scientific study about a certain topic makes certain claims, it does not necessarily mean it is true. On the other hand, a review article (a collection of scientific studies on a certain topic) of randomized, placebo-controlled double blind clinical trials (RCTs) will answer the following question:
"Do taking dietary supplements make sense?" Yes for a positive conclusion and no for a negative conclusion.

One swallow does not make a summer. A famous Dutch saying that could not be any more obvious. Just because one single scientific study about a certain topic makes certain claims, it does not necessarily mean it is true. On the other hand, a review article (a collection of scientific studies on a certain topic) of cohort studies or case-control studies will answer the following question:
"Should I change my diet?".

2024:

  1. 20g plant protein reduce type 2 diabetes

2022:

  1. 500 mg/d dietary flavonoid intake reduces cardiovascular disease, diabetes and hypertension
  2. Vitamin D deficiency increases blindness in people with diabetes
  3. 50 g/d almond decreases causally bad cholesterol in patients with type 2 diabetes
  4. Ginger supplementation reduces blood pressure in patients with type 2 diabetes

2021:

  1. Higher concentrations of carotenoids reduce type 2 diabetes
  2. Dietary sodium restriction causally reduces blood pressure in patients with type 2 diabetes mellitus
  3. Daily 80g potato increase type 2 diabetes among Western populations
  4. Vitamin C supplements improve triglyceride and cholesterol levels in patients with type 2 diabetes mellitus
  5. Spirulina supplementation reduces bad cholesterol among type 2 diabetes patients
  6. Grapes/grape products supplementation reduces HOMA-IR values in adults
  7. Intensive glucose control slows down cognitive decline in persons with type 2 diabetes
  8. Chromium supplementation improves lipid profile in patients with type 2 diabetes mellitus
  9. Patients with diabetes mellitus should be vaccinated against herpes zoster
  10. L-arginine supplements do not reduce diabetes in adults
  11. 1.5 g/day garlic supplementation reduces adiponectin level among participants ˂30 years
  12. Mortality is more frequently in COVID-19 patients with chronic kidney diseases and cardiovascular disease
  13. Peanut butter consumption may reduce type 2 diabetes
  14. Patients older than 60 years, with hypertension, diabetes and D-dimer values above 3.17 µg/mL have higher thrombotic events due to COVID-19
  15. Diet with <30 En% carbohydrates causally increases adiponectin concentration in adults
  16. 1.5 g/day EPA + DHA improve insulin sensitivity in children
  17. Oral vitamin C supplementation may improve glycemic control and blood pressure in people with type 2 diabetes
  18. Type 1 diabetes mellitus decreases bone mineral density in children and adolescents

2020:

  1. BCG vaccine should not be used in treatment of type 1 diabetes mellitus
  2. 2-3 servings/week fish reduce all-cause mortality in patients with type 2 diabetes
  3. Most prevalent comorbidities among COVID-19 are hypertension, diabetes, cardiovascular disease, liver disease, lung disease, malignancy, cerebrovascular disease, COPD and asthma
  4. Vitamin B3 supplementation increases good cholesterol in patients with type 2 diabetes mellitus
  5. Patients with diabetes should be advised to continue taking metformin drugs despite COVID-19 infection status
  6. Daily 8.4-10 grams of inulin supplements for at least 8 weeks improve risk factors of type 2 diabetes
  7. Male, age, cardiovascular disease, hypertension and diabetes mellitus increase mortality in patients with COVID-19
  8. Diabetes mellitus is associated with severe infection and mortality in patients with COVID-19
  9. Barberry supplementation improves insulin levels
  10. Diabetes increases in-hospital mortality in patients with COVID-19
  11. Daily 40g soy consumption for <12 weeks increase IGF-1 level
  12. 100 mg/day magnesium dietary intake reduce type 2 diabetes
  13. 50g/day processed meat increase type 2 diabetes
  14. Yogurt intake is associated with a reduced risk of type 2 diabetes
  15. Hypertension, diabetes, COPD, cardiovascular disease and cerebrovascular disease are major risk factors for patients with COVID-19
  16. Hypertension, cardiovascular diseases, diabetes mellitus, smoking, COPD, malignancy and chronic kidney disease are risk factors for COVID-19 infection
  17. Omega-3 fatty acids + vitamin E or D reduce gestational diabetes
  18. Psyllium consumption improves risk factors of diabetes
  19. Soy protein dietary intake reduces type 2 diabetes

2019:

  1. Elevated serum/plasma zinc concentration increases risk of type 2 diabetes
  2. 100mg magnesium dietary intake reduce type 2 diabetes
  3. Consumption of tree nuts decreases HOMA-IR and fasting insulin levels
  4. Low-fat dairy products have a beneficial effect on HOMA-IR, waist circumference and body weight
  5. Whole grain and cereal fiber dietary intake reduce type 2 diabetes
  6. Dietary low-ratio n-6/n-3 PUFA supplementation improves insulin resistance in diabetic patients
  7. Zinc supplementation reduces diabetes mellitus
  8. Moderate plant protein decreases type 2 diabetes mellitus
  9. Probiotic and synbiotic supplementation reduce inflammation in diabetic patients
  10. Folate supplementation lowers HOMA-IR
  11. 13.1 g/day viscous fiber supplements improve glycemic control

2018:

  1. 1 serving/day potato increases risk type 2 diabetes
  2. 150 g/day French-fries consumption increases risk of hypertension
  3. Garlic increases good cholesterol in diabetic patients
  4. High intake of cereal fiber may reduce type 2 diabetes
  5. Ginger intake reduces body weight and fasting glucose among overweight and obese subjects
  6. Animal protein increases risk of type 2 diabetes
  7. ≥550 mg/day flavonoids intake reduce type 2 diabetes
  8. High-fat diets increase risk of type 2 diabetes
  9. Folic acid supplementation reduces both fasting glucose level, fasting insulin level and HOMA-IR
  10. Low-GI diet is good for patients with type 2 diabetes
  11. Vitamin K supplementation has no effect on glycemic control
  12. Daily 3 mg L-carnitine during 12 weeks reduce serum leptin concentrations in diabetic patients

2017:

  1. Each 1 mmol/L increase in serum potassium reduces type 2 diabetes mellitus by 17%
  2. Fish oil supplementation during <12 weeks improves insulin sensitivity among people with metabolic disorders
  3. Atrial fibrillation, previous stroke, myocardial infarction, hypertension, diabetes and previous TIA increase risk of post-stroke dementia
  4. Pomegranate supplementation has no favourable effect on improvements in glucose and insulin metabolism
  5. Low carbohydrate diet decreases type 2 diabetes
  6. A diet with 4.4 g/day alpha-linolenic acid during 3 months does not reduce level of HbA1c, FBG or FBI in patients with type 2 diabetes
  7. Vegetarian diet has a protective effect against diabetes risk
  8. Weekly 30-180 gram chocolate consumption reduces risk of coronary heart disease, stroke and diabetes
  9. Probiotics supplementation improves HbA1c and fasting insulin in type 2 diabetes patients
  10. Vitamin K supplementation does not reduce diabetes
  11. A higher consumption of whole grains, fruits and dairy products reduces type 2 diabetes risk
  12. A diet of below 45 En% carbohydrate during 3 to 6 months reduces HbA1c level of patients with type 2 diabetes
  13. Vitamin C supplementation for at least 30 days reduces glucose concentrations in patients with type 2 diabetes
  14. Magnesium supplementation reduces risk of cardiovascular disease among type 2 diabetes
  15. Weekly one serving of apple and pear reduces type 2 diabetes mellitus risk
  16. Reduced serum levels of folate and vitamin B12 increase peripheral neuropathy risk among patients with type 2 diabetes
  17. Vitamin C and D reduce blood pressure in patients with type 2 diabetes

2016:

  1. A higher intake of plant protein decreases risk of type 2 diabetes among women

2015:

  1. Garlic supplementation during 12 weeks reduces fasting blood glucose

2014:

  1. Exercise lowers the risk for diabetes conferred by insulin resistance
  2. 1-6 cups/day caffeinated or decaffeinated coffee is associated with reduced type 2 diabetes risk
  3. Exercise training helps to prevent and to treat type 2 diabetes in youth
  4. At least 25g dietary fiber intake per day reduces risk of type 2 diabetes
  5. Niacin supplementation reduces LDL cholesterol levels in patients with type 2 diabetes mellitus

2012:

Diabetes increases risk of dementia and mild cognitive impairment

XXXXXXXXXX

The human body wants the blood glucose (blood sugar) level maintained in a very narrow range of 4 to 8 mmol/l. Insulin and glucagon are the hormones which make this happen. Both insulin and glucagon are secreted from the pancreas.

When the blood glucose level drops below 4 mmol/l (after physical exercise or on awakening) the alpha cells of the pancreas release glucagon. Glucagon converts glycogen into glucose. The glucose is released into the bloodstream, increasing blood sugar levels.
On the other hand, when the blood glucose level rises above 8 mmol/l, whether as a result of glycogen conversion or from digestion of a meal, insulin is released from beta cells of the pancreas. This hormone causes the liver to convert more glucose into glycogen and to force about 2/3 of body cells to take up glucose from the bloodstream through the GLUT4 transporter, thus decreasing blood sugar levels.

Diabetes mellitus describes a group of chronic metabolic diseases in which the person has a high blood glucose level, either because insulin production is inadequate or because the body's cells do not respond properly to insulin (also called insulin resistance) or both. Diabetes can be divided into two types: type 1 and type 2.

Type 1 diabetes:
The human body does not produce insulin. This type of diabetes is also called insulin-dependent diabetes, juvenile diabetes or early-onset diabetes. People usually develop type 1 diabetes before their 40th year, often in early adulthood or teenage years.

Patients with type 1 diabetes will need to take insulin injections for the rest of their life. They must also ensure proper blood-glucose levels by carrying out regular blood tests and following a special diet. Type 1 diabetes is not curable and is generally a form which is less common than type 2.

Type 2 diabetes:
In type 2 diabetes the body does not respond properly to insulin. Type 2 diabetes occurs mainly in the elderly and in people who are overweight (BMI>25). The treatment of type 2 diabetes is the first of dietary advice in conjunction with achieving a healthy weight (BMI = 18.5-25). Unlike type 1, type 2 is curable. Type 2 diabetes is also referred to as non-insulin-dependent diabetes mellitus.

Approximately 90% of all cases of diabetes worldwide are of this type.

These are the consequences that many diabetics may experience:

  • Amputation of limbs
  • Depression
  • Heart diseases
  • Skin problems
  • Gastrointestinal problems
  • Kidney disease
  • Eye problems
  • Problems of the joints
  • Problems with brains
  • Sexual problems
  • Foot problems
  • Nerves disorders

Dietary guidelines for diabetes prevention:

  • Choose products with minimum 1.5 grams of fiber per 100 kcal, products with maximum 30 En% fat, products with maximum 7 En% saturated fat, products with 10-20 En% protein, products with maximum 10 En% sugars and products with a low GI value (55 or lower) or in other words, your daily diet (=all meals/products that you eat on a daily basis) should on average contain minimum 1.5 grams of fiber per 100 kcal, maximum 30 En% fat, maximum 7 En% saturated fat, 10-20 En% protein and maximum 10 En% sugars.
  • Aim for a healthy weight. A healthy weight has a BMI of 18.5-25. BMI is weight divided by height squared (weight (kg)/height2 (m)).
  • Spend at least 60-90 minutes of physical activities per day or at least 10000 steps per day.
  • Eat at least 3 times (100-150 g fish per time) a week oily fish. Oily fishes are sardines, herring, salmon, anchovies, eel and mackerel. Oily fish contains more EPA and DHA than non-oily fish.
  • Eat 300 grams of vegetables and five servings of fruit a day or 30-40 grams of fiber per day.
    40 grams of fiber per dag corresponds to a daily diet of minimum 2 grams of fiber per 100 kcal.
  • Eat plenty of whole grains, such as brown bread and oatmeal and legumes.
  • Limit to 2-3 glasses of alcohol for men and 1-2 glasses for women a day or <30 g alcohol per day.

Daily 500mg n-3 PUFA during 12 months improve cognitive functions

Objectives:
Omega-3 polyunsaturated fatty acids (n-3 PUFA) have been suggested as a cognitive enhancing agent, though their effect is doubtful. Therefore, this review article has been conducted.

Does supplementation of n-3 PUFA improve cognitive functions of non-demented individuals exclusively of middle age or older? 

Study design:
This review article included 24 RCTs with a total of 9,660 participants.
The length of intervention ranged from 3 to 36 months and the daily dose of n-3 PUFA ranged from 230 to 4000 mg/day. 
6  studies were conducted in countries where the nationwide blood levels of DHA + EPA were notably low, measuring ≤ 4% in erythrocyte equivalents. 

Results and conclusions:
The investigators found that the beneficial effect on executive function demonstrated an upward trend within the initial 12 months of intervention. 
This effect was prominently observed with a daily intake surpassing 500 mg of n-3 PUFA and up to 420 mg of eicosapentaenoic acid (EPA). 

The investigators found a descending curve following 12 months of n-3 PUFA intervention and when the dosage of EPA exceeded 420 mg/d.  

The investigators found, furthermore, these trends exhibit heightened significance in regions where the levels of blood docosahexaenoic acid (DHA) + EPA are not very low.

The investigators concluded supplementation of n-3 PUFA (a daily intake surpassing 500mg n-3 PUFA or up to 420mg of EPA during 12 months) has potential benefits to executive function in non-demented individuals exclusively of middle age or older, particularly in individuals whose dietary DHA + EPA level is not substantially diminished. 

Original title: 
The influence of n-3 polyunsaturated fatty acids on cognitive function in individuals without dementia: a systematic review and dose–response meta-analysis by Suh SW, Lim E, […], Kim KW. 

Link: 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10929146/

Additional information of El Mondo:
Find more information/studies on EPA and DHA and elderly right here. 

20g plant protein reduce type 2 diabetes

Objectives:
While clinical studies indicate that dietary protein may benefit glucose homeostasis in type 2 diabetes (T2D), the impact of dietary protein, including whether the protein is of animal or plant origin, on the risk of type 2 diabetes is uncertain. Therefore, an update of the meta-analysis has been conducted. 

 

Is there an associations between total, animal and plant protein dietary intakes and the risk of type 2 diabetes?

 

Study design:
This review article included 16 prospective cohort studies, involving 615,125 participants and 52,342 type 2 diabetes cases. Of which 11 studies reported data on intake of both animal and plant protein. 

 

Results and conclusions:
The investigators found dietary intakes of total protein were significantly associated with an increased risk of 14% for type 2 diabetes [pooled effect size = 1.14, 95% CI = 1.04 to 1.24].

 

The investigators found every increase of 20g dietary intakes of total protein were significantly associated with an increased risk of 3% for type 2 diabetes.

 

The investigators found dietary intakes of animal protein were significantly associated with an increased risk of 18% for type 2 diabetes [pooled effect size = 1.18, 95% CI = 1.09 to 1.27].

 

The investigators found every increase of 20g dietary intakes of animal protein were significantly associated with an increased risk of 7% for type 2 diabetes.

 

The investigators found, in contrast, there was no association between dietary intake of plant protein and type 2 diabetes risk [pooled effect size = 0.98, 95% CI = 0.89 to 1.08].

 

The investigators found every replacement of 20 grams animal by plant protein was 

significantly associated with a reduced risk of 20% for type 2 diabetes [pooled effect size = 0.80, 95% CI = 0.76 to 0.84].

 

The investigators concluded that long-term consumption of animal, but not plant, protein is associated with a dose-dependent increase in the risk of type 2 diabetes, with the implication that replacement of animal with plant protein intake may lower the risk of type 2 diabetes.  

 

Original title: 
Association between total, animal, and plant protein intake and type 2 diabetes risk in adults: A systematic review and dose-response meta-analysis of prospective cohort studies by Ardakani AF, Anjom-Shoae J, […], Horowitz M. 


Link: 
https://pubmed.ncbi.nlm.nih.gov/39032197/

 

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

 

15 g/day fish protein dietary intake may reduce fractures

Objectives:
Previous cohort studies have indicated that consumption of total and animal proteins are related to fracture risk; however, results were inconclusive. Therefore, this review article has been conducted.

Does a high dietary intake of protein reduce risk of fractures?

Study design:
This review article included 20 cohort studies with serious to moderate risk of bias involving 780,322 individuals. 

Results and conclusions:
The investigators found a non-statistically significant relation between intake of animal proteins and dairy products and all fracture risk. 

The investigators found, however, a significantly 43% decreased incidence of fracture per 100 g/day total protein dietary intake [RR = 0.57, 95% CI = 0.36 to 0.93]. 

The investigators found, however, a significantly 5% decreased incidence of fracture per 15 g/day fish protein dietary intake [RR = 0.95, 95% CI = 0.91 to 0.99]. 

The investigators found every 100 g/day total and animal protein dietary intake and every 15 g/day fish dietary intake were significantly linked to 48%, 50% and 5% lower hip fracture risk. 

The investigators found greater dietary animal protein intake might reduce risk of hip but not fracture at any site. 

The investigators concluded greater total protein (per 100 g/day) and fish (per 15 g/day) dietary intake may reduce risk of any or hip fracture. May reduce because the cohort studies had serious to moderate risk of bias.

Original title: 
Association between total and animal proteins with risk of fracture: A systematic review and dose-response meta-analysis of cohort studies by Zeraattalab-Motlagh S, Mortazavi AS, […], Mohammadi H.

 

Link: 
https://pubmed.ncbi.nlm.nih.gov/37855886/ 


Additional information of El Mondo:
Find more information/studies on proteins and elderly right here. 

100 grams of protein consumption per day corresponds to a diet with 20 En% protein. A diet with 20 En% protein mainly consists of products with 20 En% protein. Find here which products in the supermarket contain 20 En% protein.

 

20 En% protein means that the number of grams of protein contributes 20% to the total calorie content of the product in question.

 

Calculate here whether your daily diet contains 20 En% protein. This tab is only visible after gratis inlog. 

Causal relationship between sugar-sweetened beverages consumption and higher BMI and body weight

Objectives:
Is there a causal relationship between sugar-sweetened beverages consumption and higher BMI and body weight in both children and adults?
 
Study design:
This review article included 85 studies with 48 in children (40 cohort studies with 91,713 participants and 8 RCTs with 2,783 participants) and 37 in adults (21 cohort studies with 448,661 participants and 16 RCTs with 1,343 participants).

Results and conclusions:
The investigators found among cohort studies, each serving/day increase in sugar-sweetened beverages intake was significantly associated with a 0.07 kg/m2 [95% CI = 0.04 to 0.10 kg/m2] higher BMI in children and a 0.42 kg [95% CI = 0.26 to 0.58 kg] higher body weight in adults.

The investigators found RCTs in children indicated less BMI gain with sugar-sweetened beverages reduction interventions compared with control [MD = -0.21 kg/m2, 95% CI = -0.40 to -0.01 kg/m2].

The investigators found RCTs in adults showed randomization to addition of sugar-sweetened beverages to the diet led to greater body weight gain [MD = 0.83 kg, 95% CI = 0.47 to 1.19 kg] and subtraction of sugar-sweetened beverages led to weight loss [MD = -0.49 kg, 95% CI = -0.66 to -0.32 kg] compared with the control groups.

The investigators found a positive linear dose-response association between sugar-sweetened beverages consumption and weight gain for all outcomes assessed.

The investigators concluded there is a causal relationship between sugar-sweetened beverages consumption and higher BMI and higher body weight in both children and adults.

Original title:
Sugar-sweetened beverage consumption and weight gain in children and adults: a systematic review and meta-analysis of prospective cohort studies and randomized controlled trials by Nguyen M, Jarvis SE, [...], Malik VS.

Link:
https://pubmed.ncbi.nlm.nih.gov/36789935/

Additional information of El Mondo:
Find more information/studies on sugar-sweetened beverages consumption and obesity/overweight right here.

High selenium dietary intake reduces hip fracture

Objectives:
Previous studies have suggested that selenium as a trace element is involved in bone health, but findings related to the specific effect of selenium on bone health remain inconclusive. Therefore, this review article has been conducted.

Do both high dietary selenium intake and high serum selenium levels increase bone density?

Study design:
This review article included 8 cross-sectional studies, 7 case-control studies and 3 prospective cohort studies and 1 RCT with a total of 69,672 subjects.

The number of participants ranged from 60 to 21,939, while the mean age varied from 39.4 to 75.8 years, with mean selenium intake ranging from 41.2 to 154.4 μg/d or mean serum selenium level ranging from 66.7 to 131.1 μg/L.
All the observational studies had a NOS score ≥ 4, namely moderate- to high-quality scores.
There was no publication bias.

Results and conclusions:
The investigators found a significantly positive association between dietary selenium intake [β = 0.04, 95% CI = 0.00 to 0.07, p = 0.029, I2 = 95.91%] as well as serum selenium [β = 0.13, 95% CI = 0.00 to 0.26, p = 0.046, I2 = 86.60%] and bone mineral density.

The investigators found high dietary selenium intake significantly reduced risk of hip fracture with 56% [OR = 0.44, 95% CI = 0.37 to 0.52, p 0.001, I2 = 65.2%].

The investigators found osteoporosis patients had lower serum selenium level than healthy controls [WMD = -2.01, 95% CI = -3.91 to -0.12, p = 0.037, I2 = 0%].

The investigators concluded persons with higher dietary selenium intake and higher serum selenium have higher bone mineral density. Furthermore, high selenium dietary intake reduces hip fracture.

Original title:
The association between selenium and bone health: a meta-analysis by Xie H, Wang N, […], Wang Y.

Link:
https://boneandjoint.org.uk/article/10.1302/2046-3758.127.BJR-2022-0420.R1

Additional information of El Mondo:
Find more information/studies on selenium and preventing fractures right here.

Circulating concentration of selenium in blood (serum selenium level) can be increased by eating foods that are high in selenium and/or taking selenium supplements.

Lower serum magnesium concentrations increase fractures

Objectives:
Magnesium, an essential cation for numerous cellular processes, is a major component of bone. However, its relationship with the risk of fractures is still uncertain. Therefore, this review article has been conducted.

Do lower serum magnesium concentrations increase risk of incident fractures?

Study design:
This review article included 3 prospective cohort studies and 1 retrospective cohort study with a total of 119,755 participants and a mean follow-up duration of 79 months.
The mean age was 62 years, with a mean percentage of 33% women.
The analyses were adjusted for a mean of 15 potential confounders.
All 4 studies included in the meta-analysis were of high quality (Newcastle-Ottawa Scale of 9 for all).

Results and conclusions:
The investigators found lower serum magnesium concentrations were associated with a significantly higher risk of 58% for incident fractures [RR = 1.579, 95% CI = 1.216 to 2.051, p = 0.001, I2 = 46.9%].
The results were not affected by any heterogeneity [I2 = 31.2%, p = 0.201] nor publication bias [Egger’s test = 0.94 ± 0.43, p = 0.10]. After trimming, the recalculated effect size was only slightly reduced [RR = 1.25, 95% CI = 1.09 to 1.43].
Significant because RR of 1 was not found in the 95% CI of 1.09 to 1.43. RR of 1 means no risk/association.

The investigators concluded lower serum magnesium concentrations increase risk of incident fractures.

Original title:
Association between Serum Magnesium and Fractures: A Systematic Review and Meta-Analysis of Observational Studies by Dominguez LJ, Rodas-Regalado S, […], Barbagallo M.

Link:
https://www.mdpi.com/2072-6643/15/6/1304

Additional information of El Mondo:
Find more information/studies on magnesium and preventing fractures right here.

Circulating concentration of magnesium in blood can be increased by eating foods that are high in magnesium and/or taking magnesium supplements.

Lower blood carotenoid level is a risk factor for dementia

Objectives:
Given their potent antioxidation properties, carotenoids play a role in delaying and preventing dementia and mild cognitive impairment (MCI). However, observational studies have found inconsistent results regarding the associations between blood carotenoid levels and the risk of dementia and MCI. Therefore, this review article has been conducted.

Is a lower blood carotenoid level (like lycopene, zeaxanthin, lutein) a risk factor for dementia or mild cognitive impairment?

Study design:
This review article included 23 studies with 1,422 patients with dementia, 435 patients with mild cognitive impairment and 4,753 controls (persons without dementia or mild cognitive impairment).

Results and conclusions:
The investigators found meta-analysis showed that patients with dementia had lower blood lycopene [SMD = -0.521, 95% CI = -0.74 to -0.301], α-carotene [SMD = -0.489, 95% CI = -0.697 to -0.281] β-carotene [SMD = -0.476, 95% CI = -0.784 to -0.168], lutein [SMD = -0.516, 95% CI = -0.753 to -0.279], zeaxanthin [SMD = -0.571, 95% CI = -0.910 to -0.232] and β-cryptoxanthin [SMD = -0.617, 95% CI = -0.953 to -0.281] than the controls.

The investigators found owing to insufficient data, no similar and stable relationship between blood carotenoid levels and mild cognitive impairment was observed.

The investigators concluded lower blood carotenoid level is a risk factor for dementia.

Original title:
Low blood carotenoid status in dementia and mild cognitive impairment: A systematic review and meta-analysis by Wang L, Zhao T, […], Jiang Q.

Link:
https://pubmed.ncbi.nlm.nih.gov/36997905/

Additional information of El Mondo:
Find more information/studies on carotenoids and Alzheimer 's disease right here.

Circulating concentration of lycopene in blood can be increased by eating foods that are high in lycopene and/or taking lycopene supplements.

 

High antioxidant dietary intake reduces Alzheimer's disease

Objectives:
Does a high antioxidant dietary intake reduce risk of Alzheimer's disease and dementia?

Study design:
This review article included 17 cohort studies with 98,264 participants, of which 7,425 had dementia after 3-23 years of follow-up.

Results and conclusions:
The investigators found a high antioxidant dietary intake significantly reduced the incidence of Alzheimer's disease with 15% [RR = 0.85, 95% CI= 0.79 to 0.92, I2 = 45.5%].
However, this reduced risk was not significant for dementia [RR = 0.84, 95% CI = 0.77 to 1.19, I2 = 54.6%].
Significant because RR of 1 was not found in the 95% CI of 0.79 to 0.92. RR of 1 means no risk/association.

The investigators concluded that a high antioxidant dietary intake reduces Alzheimer's disease.

Original title:
Association of Dietary and Supplement Intake of Antioxidants with Risk of Dementia: A Meta-Analysis of Cohort Studies by Zhao R, Han X, […], You H.

Link:
https://pubmed.ncbi.nlm.nih.gov/36846999/

Additional information of El Mondo:
Find more information/studies on antioxidant and Alzheimer 's disease right here.

 

High dietary intake of vitamin E reduces dementia

Objectives:
Dementia is a chronic progressive neurodegenerative disease that can lead to disability and death in humans, but there is still no effective prevention and treatment. Due to the neuroprotective effects of vitamin E, a large number of researchers have explored whether vitamin E can reduce the risk of dementia. Some researchers believe that vitamin E can reduce the risk of dementia, while others hold the opposite conclusion. Therefore, this review article has been conducted.

Do high intakes of diet or vitamin E supplements reduce the risk of dementia?

Study design:
This review article included 13 cohort studies (46,968 participants and 6,046 dementia patients after 4-23 years of follow-up) and 2 case-control studies with (3,157 controls and 3,459 patients).
The studies included in this meta-analysis (review article) were published between 1983 and 2022.
The literary NOS quality score ranged from 6 to 8.
There was no publication bias.

Results and conclusions:
The investigators found a high intake of diet or vitamin E supplements significantly decreased the risk of dementia by 21% [OR = 0.79, 95% CI = 0.70 to 0.88, I2 = 35.0%, p = 0.071].
This decreased risk was also significant in cohort studies [OR = 0.79, 95% CI = 0.69 to 0.89], dietary intake of vitamin E [OR = 0.78, 95% CI = 0.65 to 0.95], vitamin E supplement [OR = 0.83, 95% CI = 0.73 to 0.94] and studies with NOS scores >7 [OR = 0.85, 95% CI = 0.75 to 0.97].

The investigators found a high intake of diet or vitamin E supplements significantly decreased the risk of Alzheimer's disease by 22% [OR = 0.78, 95% CI = 0.64 to 0.94, I2 = 36.9%, p = 0.123].
This decreased risk was also significant in cohort studies [OR = 0.77, 95% CI = 0.63 to 0.94].

The investigators found in sensitivity analysis the pooled ORs fluctuated within a certain range after deleting each study, indicating that the results of this meta-analysis were stable.

The investigators concluded high intakes of diet or vitamin E supplements reduce the risk of dementia. Therefore, the elderly can reduce the risk of dementia by appropriately increasing foods rich in vitamin E, but also pay attention to the toxic side effects of vitamin E. Although the results are reliable, they should be further validated by large RCTs.

Original title:
Association of vitamin E intake in diet and supplements with risk of dementia: A meta-analysis by Zhao R, Han X, [...], You H.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9376618/

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

Skim milk, poultry and non-meat animal products reduce age-related eye disease

Objectives:
Do plant-based diets improve age-related ocular outcomes among adults?

Study design:
This review article included 15 studies (n = 51,695 participants) assessed the impact of fish consumption, 8 studies (n = 28,753 participants) analyzed the effect of red meat intake and 3 studies (n = 7,723 participants) assessed the impact of omission of skim milk, poultry and non-meat animal products and the presence of disease incidence as indicated by age-related macular degeneration or cataract development.

Results and conclusions:
The investigators found in 15 studies (n = 51,695 participants) that regular consumption of fish significantly reduced the risk of age-related eye disease development among adults with 30% [odds ratio = 0.70, 95% CI = 0.62 to 0.79].
Significant means that there is an association with a 95% confidence.

The investigators found in 3 studies (n = 7,723 participants) that regular consumption of skim milk, poultry and non-meat animal products significantly reduced the risk of age-related eye disease development among adults with 30% [odds ratio = 0.70, 95% CI = 0.61 to 0.79].
Significant because odds ratio of 1 was not found in the 95% CI of 1.07 to 1.72. Odds ratio of 1 means no risk/association.

The investigators found in 8 studies (n = 28,753 participants) that regular consumption of red meat significantly increased the risk of age-related eye disease development among adults with 41% [odds ratio = 1.41, 95% CI = 1.07 to 1.86].

The investigators concluded that regular consumption of both fish and skim milk, poultry and non-meat animal products reduce the risk of age-related eye disease development among adults, while regular consumption of red meat increases the risk of age-related eye disease development among adults. Results suggest a need for more initiatives promoting a healthy and balanced diet.

Original title:
Linkage between a plant-based diet and age-related eye diseases: a systematic review and meta-analysis by Cirone C, Cirone KD and Malvankar-Mehta MS.

Link:
https://pubmed.ncbi.nlm.nih.gov/36102832/

Additional information of El Mondo:
Find more information/studies on fish, milk, meat and elderly right here.

In practice, regular fish consumption corresponds to at least twice (100-150g per time) a week.
 

800-1,000 IU/d vitamin D3 reduces fracture and fall risk among elderly

Objectives:
Although recent studies comparing various dosages and intervals of vitamin D supplementation have been published, it is yet to be elucidated whether there is an appropriate dose or interval to provide benefit regarding fracture risk. Therefore, this review article has been conducted.

What are the putative beneficial effects of vitamin D supplements on fractures and falls according to various dosages and intervals?

Study design:
This review article included 32 RCTs with a total of 104,363 patients, with a median of 3,162 patients per study (range 46 to 36,282).
The median daily dose of cholecalciferol (D3) was 800 IU/day and 8 studies reported 800 IU/day, 15 studies reported 800 to 1,000 IU/day and 9 studies reported >1,000 IU/day.
The median follow-up duration was 24 months (range 9 to 120) and the median age was 72 years (range 53 to 85).

Results and conclusions:
The investigators found vitamin D3 supplementation with daily dose of 800 to 1,000 IU was significantly associated with a lower risk of 13% for osteoporotic fracture [pooled relative risk = 0.87, 95% CI = 0.78 to 0.97, I2 = 23.5%] while studies with 800 or >1,000 IU/day did not.

The investigators found vitamin D3 supplementation with daily dose of 800 to 1,000 IU was significantly associated with a lower risk of 9% for fall [pooled relative risk = 0.91, 95% CI = 0.85 to 0.98, I2 = 70.9%] while studies with 800 or >1,000 IU/day did not.

The investigators found daily administration of vitamin D3 was associated with the reduced risk of falls, while intermittent dose was not.
Also, patients with vitamin D deficiency showed a significant risk reduction of falls after vitamin D3 supplementation.

The investigators concluded that daily vitamin D3 dose of 800 to 1,000 IU (20-25 mcg) during 24 months is the most probable way to reduce the fracture and fall risk among elderly. Further studies designed with various regimens and targeted vitamin D levels are required to elucidate the benefits of vitamin D supplements.

Original title:
Effect of Vitamin D Supplementation on Risk of Fractures and Falls According to Dosage and Interval: A Meta-Analysis by Kong SH, Jang HN, […], Shin CS.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9081312/

Additional information of El Mondo:
Find more information/studies on vitamin D and elderly right here.

Vitamin D deficiency increases blindness in people with diabetes

Objectives:
Vitamin D levels have been shown to be associated with diabetic retinopathy, however to date, no review has examined the relationship between vitamin D and sight threatening diabetic retinopathy (STDR) and non-sight threatening diabetic retinopathy (NSTDR). Therefore, this review article has been conducted. 

Does vitamin D deficiency (defined as 25(OH)D levels of 20 ng/mL) increase risk of diabetic retinopathy in patients with diabetes?

Study design:
This review article included 11 cross-sectional studies and 1 case-control study with a total of  9,057 participants.
There was no publication bias.

Results and conclusions:
The investigators found vitamin D deficiency significantly increased risk of sight threatening diabetic retinopathy with 80% [OR = 1.80, 95% CI = 1.40 to 2.30, p ≤ 0.001, I2 = 39.39%].
However, this increased risk was not found for non-sight threatening diabetic retinopathy [OR = 1.10, 95% CI = 0.90 to 1.27, p = 0.48, I2 = 30.21%].

The investigators concluded that vitamin D deficiency (defined as 25(OH)D levels of 20 ng/mL)  increases risk of sight threatening diabetic retinopathy but not non-sight threatening diabetic retinopathy. Given the well-reported associations between vitamin D deficiency and other unfavourable outcomes, it is important that vitamin D deficiency is managed appropriately and in a timely manner to reduce the risk of blindness in people with diabetes.

Original title:
Associations between vitamin D status and sight threatening and non-sight threatening diabetic retinopathy: a systematic review and meta-analysis by Trott M, Driscoll R, […], Pardhan S.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9167360/

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

Diabetic retinopathy, also known as diabetic eye disease (DED), is a complication of diabetes, caused by high blood sugar levels damaging the back of the eye (retina). It can cause blindness if left undiagnosed and untreated.

 

400 IU/day to 300,000 IU vitamin D supplementation improves handgrip strength in postmenopausal women

Objectives:
In postmenopausal women, vitamin D deficiency (as defined by the circulating level of 25(OH)D being below 20 ng/mL (50 nmol/L)) is a regular occurrence. The effect of vitamin D supplementation on the muscle function of postmenopausal women has been controversial. Therefore, this review article has been conducted.

Does vitamin D supplementation enhance the muscular strength and mobility of postmenopausal women?

Study design:
This review article included 19 RCTs between 2003 and 2021, with 5,398 participants.
The sample size of the RCTs included in multiple countries ranges from 20 to 2,347. Furthermore, the duration of vitamin D supplementation ranged from 3 to 60 months.
Vitamin D3 was applied in 12 of the 19 retrieved trials, whose dosages ranged from 400 IU/day to 300,000 IU (10 tot 7500 mcg vitamin D3) in a single oral dose.
Visual inspection of the funnel plot and Egger’s linear regression test revealed no indication of publication bias in the meta-analysis of vitamin D supplementation on handgrip strength.

Results and conclusions:
The investigators found meta-analysis of 9 RCTs (1,997 participants supplemented with vitamin D and 2,232 participants as the control group (vitamin D in low dosage or placebo)), showed that vitamin D supplementation significantly improved handgrip strength in postmenopausal women [WMD = 0.876 kg, 95% CI = 0.180 to 1.571, p = 0.014, I2 = 68.5%, p = 0.001].
Moreover, according to subgroup analysis, vitamin D supplementation substantially raised handgrip strength when compared to baseline blood vitamin D levels >75 nmol/L (30 ng/ml) [WMD = 0.478 kg, 95% CI = 0.963 to 1.918, p = 0.003], without calcium [WMD = 1.931 kg, 95% CI = 0.166 to 3.697, p = 0.032] and subject to an age of more than 60 [WMD = 1.116 kg, 95% CI = 0.433 to 1.799, p = 0.001].

The investigators concluded that 400 IU/day to 300,000 IU vitamin D supplementation during 3 to 60 months improves handgrip strength in postmenopausal women over 60 years of age who are without calcium supplementation or whose baseline vitamin D is >75 nmol/L (30 ng/mL). These findings show that future trials should focus on determining the ideal dosage and duration and taking into account the several factors that may impair muscle performance, such as exercise, calcium consumption, frailty, a history of falls or fractures and baseline vitamin D status and the relationship between muscle function and/or strength with muscle composition.

Original title:
Vitamin D Supplementation Improves Handgrip Strength in Postmenopausal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials by Zhang JL, Poon CCW, […], Zhang Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9199366/

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Higher concentration of carotenoids and vitamin E in blood reduce age-related macular degeneration

Objectives:
Data from studies support a beneficial effect of carotenoids and vitamins on an age-related macular degeneration (AMD) risk. However, studies on the relations between blood levels of these nutrients and AMD are limited and provided conflicting results. Therefore, this review article has been conducted.

Does a higher concentration of carotenoids (lutein/zeaxanthin, β-carotene, β-cryptoxanthin, lycopene) and vitamins in blood reduce age-related macular degeneration risk?

Study design:
This review article included 9 studies (1 cohort, 4 case-control and 4 cross-sectional studies) involving 15,674 participants and 2,077 AMD cases (persons with age-related macular degeneration).  
There was no evidence of publication bias.

Results and conclusions:
The investigators found in the meta-analysis that high blood lutein/zeaxanthin level significantly reduced risk of age-related macular degeneration with 47% [OR = 0.53, 95% CI = 0.40 to 0.72, p 0.001, I2 = 43.3%, p = 0.079], compared to those with low level.
Results stratified by factors yielded similar results to the main analysis.

The investigators found in the meta-analysis that high blood β-carotene level significantly reduced risk of age-related macular degeneration with 52% [OR = 0.48, 95% CI = 0.28 to 0.84, p = 0.01, I2 = 71.7%, p = 0.003], compared to those with low level.
A subgroup analysis by geographic region showed that the significant inverse association between blood β-carotene levels and risk of age-related macular degeneration was only found among the Asians.

The investigators found in the meta-analysis that high blood β-cryptoxanthin level significantly reduced risk of age-related macular degeneration with 52% [OR = 0.48, 95% CI = 0.23 to 1.00, p = 0.04, I2 = 83.5%, p 0.001], compared to those with low level.
In stratified analyses, no significant difference was observed for any subgroups.

The investigators found in the meta-analysis that high blood lycopene level significantly reduced risk of age-related macular degeneration with 30% [OR = 0.70, 95% CI = 0.54 to 0.90, p = 0.006, I2 = 0.0%, p = 0.67], compared to those with low level.

The investigators found in the meta-analysis that high blood α-tocopherol (vitamin E) level significantly reduced risk of age-related macular degeneration with 50% [OR = 0.50, 95% CI = 0.31 to 0.81, p = 0.005, I2 = 34.4%, p = 0.19], compared to those with low level.

The investigators found sensitivity analyses, that excluded one study at a time, did not change the statistical significance or the direction of the present findings, corroborating the robustness of the results.

The investigators concluded that there is a protective effect of higher concentration of carotenoids (lutein/zeaxanthin, β-carotene, β-cryptoxanthin, lycopene) and vitamin E in blood against age-related macular degeneration risk, which provides further evidence of the associations between carotenoid and vitamin status and the risk of age-related eye problems. Further randomized clinical trials are necessary for Asians to confirm such associations and to provide the most reliable direct information to base public health recommendations for age-related eye disease prevention by nutritional supplementation with carotenoids and vitamins.

Original title:
The Associations of Plasma Carotenoids and Vitamins With Risk of Age-Related Macular Degeneration: Results From a Matched Case-Control Study in China and Meta-Analysis by Jiang H, Fan  Y, […], Ma L.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8873933/

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High blood levels of beta-carotene can be obtained by consuming beta-carotene-rich foods and/or taking beta-carotene supplements.
 

50 g/d almond decreases causally bad cholesterol in patients with type 2 diabetes

Objectives:
An enhanced risk for cardiovascular disease (CVD) still exists even when patients with type 2 diabetes have tight control on blood sugar. Thus, identification of treatment approaches that address CVD risk factors may be useful for patients beyond the blood sugar management. Although emerging evidence suggests that nuts consumption have beneficial effects on cardiometabolic health, the effects of almond intake in patients with type 2 diabetes are still controversial. Therefore, this review article has been conducted. 

Does almond consumption improve risk factors (cholesterol, triglycerides, fasting plasma glucose, insulin, hemoglobin A1c (HbA1c), body mass index, weight, body fat, systolic and diastolic blood pressure and CRP) of cardiovascular disease in patients with type 2 diabetes?

Study design:
This review article included 9 RCTs.

Results and conclusions:
The investigators found there was a causal relationship between almond dietary intake and a  significant reduction in low-density lipoprotein cholesterol (LDL cholesterol or bad cholesterol) [WMD = -5.28 mg/dL, 95% CI = -9.92 to -0.64, p = 0.026] in patients with type 2 diabetes compared with the control group.
This lowering effect of LDL cholesterol was robust in subgroups with almond consumption >50 g/day and baseline LDL cholesterol level 130 mg/dL.

The investigators found, however, the effect of almond on total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL cholesterol or good cholesterol), fasting plasma glucose, insulin, HbA1c, body mass index, weight, body fat, systolic and diastolic blood pressure and CRP was not significant compared with the control group.

The investigators concluded that a dietary intake of at least 50 g/d almond decreases causally LDL cholesterol (bad cholesterol) but has no favourable effect on other cardiometabolic outcomes in patients with type 2 diabetes. Further high-quality studies are needed to firmly establish the clinical efficacy of the almond.

Original title:
Effects of almond on cardiometabolic outcomes in patients with type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials by Moosavian SP, Rahimlou M, […], Jalili C.

Link:
https://pubmed.ncbi.nlm.nih.gov/35443097/

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

Protein supplementation + exercise increase lower-extremity strength in healthy older Asian adults with sarcopenia

Objectives:
While there is growing research interest in the effects of nutrition and exercise on delaying sarcopenia, the results are inconclusive and there is scarce information on regional patterns. Therefore, this review article has been conducted.

Do protein supplements combined with exercise improve extremity strength in healthy older adults with sarcopenia?

Study design:
This review article included 14 RCTs, involving a total of 888 healthy older adults (>60 years).

4 studies in Asian countries provided data on lower-extremity strength, involving 280 participants (138 in protein supplements + exercise group and 142 in exercise group).
Lower-extremity strength was assessed using knee extension (n = 3) or leg extension (n = 1).
The intervention period of all studies was 12 weeks.
The dosage of protein ranged from 3 g/d to 40 g/d.

Results and conclusions:
The investigators found in 4 studies in Asian countries a significant increase in the lower-extremity strength in the protein supplementation + exercise group compared to the exercise group, with a SMD of 0.24 [95% CI = 0.00 to 0.47, p = 0.048, I2 = 0.0%, p = 0.513].

The investigators concluded that protein supplements (3 g/d to 40 g/d during 12 weeks) combined with exercise (knee extension and leg extension) exerts superior benefit on lower-extremity strength in healthy older adults with sarcopenia in Asian countries, when compared to exercise alone or with a placebo. However, no additional benefits from protein supplementation are observed on upper-extremity strength, muscle mass and physical performance regardless of the regions. More well-designed RCTs with information on baseline and total protein intake for longer follow-up periods are warranted to evaluate the effectiveness of protein supplementation and exercise on the prevention and management of sarcopenia in healthy older adults.

Original title:
Effects of protein supplementation and exercise on delaying sarcopenia in healthy older individuals in Asian and non-Asian countries: A systematic review and meta-analysis by Li L, He Y, […], Liu X.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8808080/

Additional information of El Mondo:
Find more information/studies on protein and elderly right here.

Upper extremity is part of the body that includes the arm, wrist and hand.

Lower extremity refers to the part of the body from the hip to the toes.

Sarcopenia is a type of muscle loss (muscle atrophy) that occurs with aging and/or immobility. Sarcopenia can affect people in their 30s and beyond.
 

Ginger supplementation reduces blood pressure in patients with type 2 diabetes

Objectives:
There is some evidence regarding the positive effects of ginger supplementation on metabolic profile in patients with type 2 diabetes (T2DM). However, they are conflicting and therefore, this review article has been conducted. 

Does ginger supplementation improve metabolic profile (FBS, HbA1c, TC, TG, LDL, HDL, SBP and DBP) in patients with type 2 diabetes?

Study design:
This review article included 10 RCTs.

Results and conclusions:
The investigators found pooled meta-analysis showed a significant reduction in fasting blood sugar (FBS) level following ginger supplementation by polling 8 effect sizes [WMD = -18.81, 95% CI = -28.70 to -8.92, I2 = 77.4%].

The investigators found pooled meta-analysis showed a significant reduction in HbA1c level following ginger supplementation by polling 7 effect sizes [WMD = -0.57, 95% CI = -0.93 to -0.20, I2 = 88.6%].

The investigators found pooled meta-analysis showed a significant reduction in systolic blood pressure (SBP) following ginger supplementation by polling 5 effect sizes [WMD = -4.20, 95% CI = -7.64 to -0.77, I2 = 97%].

The investigators found pooled meta-analysis showed a significant reduction in diastolic blood pressure (DBP) following ginger supplementation by polling 5 effect sizes [WMD = -1.61, 95% CI = -3.04 to -0.18, I2 = 93.2%].

The investigators found pooled meta-analysis showed ginger supplementation had no significant influence on lipid profile involving triglyceride (TG), total cholesterol (TC), LDL cholesterol and HDL cholesterol.

The investigators concluded supplementation with ginger reduces fasting blood sugar, HbA1c, systolic blood pressure and diastolic blood pressure in patients with type 2 diabetes. Further large RCTs are required to shed light on this issue.

Original title:
The effect of ginger supplementation on metabolic profiles in patients with type 2 diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials by Ebrahimzadeh A, Ebrahimzadeh A, […], Milajerdi A.

Link:
https://pubmed.ncbi.nlm.nih.gov/35031435/

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

High protein diets causally have beneficial effect on body weight management

Objectives:
Do diets rich in protein causually reduce body weight of adults with overweight or obesity? 

Study design:
This review article included 37 RCTs.
The diets were included during a mean of 32 weeks interventions, ranging from 8 to 104 weeks.

There was no publication bias.

Results and conclusions:
The investigators found protein intake (ranging from 18-59 energy percentage [En%]) significantly reduced body weight by 1.6 kg [95% CI = 1.2 to 2.0 kg, I2 = 56%] compared to controls (digestible carbohydrate, fiber, fat or no supplementation (no placebo used)).
This result was also found in sensitivity analysis.

The investigators found the effect size of dietary protein in body weight management was dependent on specific phenotypes, where individuals with prediabetes had more benefit compared to individuals with normoglycemia.
Furthermore, individuals without the obesity risk allele (AA genotype) had more benefit compared to individuals with the obesity risk alleles (AG and GG genotypes).

The investigators concluded that diets rich in protein (18-59 energy percentage [En%]) during 32 weeks causally have a moderate beneficial effect on body weight management of adults with overweight or obesity.

Original title:
Are Dietary Proteins the Key to Successful Body Weight Management? A Systematic Review and Meta-Analysis of Studies Assessing Body Weight Outcomes after Interventions with Increased Dietary Protein by Hansen TT, Astrup A and Sjödin A.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8468854/

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A diet rich in protein with 18-59 energy percentage [E%] or a diet with 18-59 En% protein means that the amounts of protein contribute 18 to 59% to the total calories (kcal) of the diet.
If the diet contains 2000 kcal, 90 grams of protein contribute 18% to this 2000 kcal.
1 gram of protein gives 4 kcal. Thus 90 grams of protein provide 360 kcal (90x4 kcal) and 360 kcal is 18% of 2000 kcal.

The most easy way to follow a diet rich in protein with 18-59 energy percentage is to choose only meals/products with 18-59 En% protein. Check here which products contain 18-59 En% protein.

However, the most practical way to follow a diet with 18-59 En% protein is, all meals/products that you eat on a daily basis should contain on average 18-59 En% protein.

To do this, use the 7-points nutritional profile app to see whether your daily diet contains 18-59 En% protein.

A high-protein diet is a diet with at least 20 En% protein.

 

High circulating vitamin C level reduces metabolic syndrome

Objectives:
The association between vitamin C and metabolic syndrome (MetS) has been evaluated in several epidemiological studies with conflicting results. Therefore, this review article has been conducted.

Do dietary vitamin C intake and circulating vitamin C level reduce risk of metabolic syndrome? 

Study design:
This review article included 26 cross-sectional studies and 2 cohort studies with a total number of 110,771 participants. 23 studies were related to the dietary vitamin C level.
The sample size ranged from 143 to 27,656 persons.
The dietary vitamin C level was assessed by food-frequency questionnaire (FFQ) in 4 studies, a 24-h or 3-day recall in 18 studies and a 4-day record in 1 study.

No evidence of publication bias existed according to Begg's rank correlation test [p = 0.495].

Results and conclusions:
The investigators found when compared to the lowest dietary vitamin C intake, that the highest dietary vitamin C intake significantly reduced risk of metabolic syndrome with 7% [overall multivariable-adjusted RR = 0.93, 95% CI = 0.88 to 0.97, p = 0.003, I2 = 54.5%, p = 0.003]. The above findings were confirmed in cross-sectional studies [RR = 0.92, 95% CI = 0.87 to 0.97, p = 0.001] and 24-h or 3-day recall [RR = 0.89, 95% CI = 0.86 to 0.93, p 0.001] studies.

The investigators found when compared to the lowest circulating vitamin C level, that the highest circulating vitamin C level significantly reduced risk of metabolic syndrome with 40% [overall multivariable-adjusted RR = 0.60, 95% CI = 0.49 to 0.74, p 0.001, I2 = 22.7%, p = 0.249].

The investigators concluded that both the dietary and the circulating vitamin C level reduce risk of metabolic syndrome. However, due to the limitation of the available evidence, more well-designed prospective studies are still needed.

Original title:
Vitamin C and Metabolic Syndrome: A Meta-Analysis of Observational Studies by Guo H, Ding J, [...], Zhang Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8531097/

Additional information of El Mondo:
Find more information/studies on vitamin C consumption and overweight right here.

In practice, a lot of dietary vitamin C intake amounts to 200 to 300 grams of vegetables and 2-5 pieces of fruit per day. Vitamin C is found in fruit and vegetables.

A high circulating vitamin C level can be obtained through vitamin C-rich food and/or taking vitamin C supplements.

 

Carbohydrate intake increases metabolic syndrome

Objectives:
The associations between dietary carbohydrate and diverse health outcomes remain controversial and confusing. Therefore, this review article (meta-analyse) has been conducted.

What is the association between dietary carbohydrate intake and diverse health outcomes?

Study design:
This review article included 43 meta-analyses of observational research studies with 23 health outcomes, including cancer (n = 26), mortality (n = 4), metabolic diseases (n = 4), digestive system outcomes (n = 3) and other outcomes [coronary heart disease (n = 2), stroke (n = 1), Parkinson's disease (n = 1) and bone fracture (n = 2)].

This umbrella review summarized 281 individual studies with 13,164,365 participants.

33.3% studies were considered to be of high quality and 66.7% of moderate quality.

Results and conclusions:
The investigators found highly suggestive evidence showed that dietary carbohydrate intake significantly increased risk of metabolic syndrome with 25% [adjusted summary odds ratio = 1.25, 95% CI = 1.15 to 1.37].

The investigators found suggestive evidence showed that dietary carbohydrate intake significantly decreased risk of esophageal adenocarcinoma with 43% [adjusted summary hazard ratio = 0.57, 95% CI = 0.42 to 0.78].

The investigators found suggestive evidence showed that dietary carbohydrate intake significantly increased risk of all-cause mortality with 19% [adjusted summary hazard ratio 1.19, 95% CI = 1.09 to 1.30].

The investigators concluded despite the fact that numerous systematic reviews and meta-analyses have explored the relationship between carbohydrate intake and diverse health outcomes, there is no convincing evidence of a clear role of carbohydrate intake. However, highly suggestive evidence shows carbohydrate intake is associated with higher risk of metabolic syndrome. Suggestive evidence shows carbohydrate intake is associated with higher risk of all-cause mortality and lower risk of esophageal adenocarcinoma.

Original title:
Dietary Carbohydrate and Diverse Health Outcomes: Umbrella Review of 30 Systematic Reviews and Meta-Analyses of 281 Observational Studies by Liu YS, Wu QJ […], Zhao YH.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8116488/

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Find more information/studies on carbohydrate consumption and obesity/overweight right here.

100 µg/d vitamin K2 + 1000 mg/d calcium supplements increase lumbar spine bone mineral

Objectives:
With the increasing incidence of osteoporosis, vitamin K and calcium have been linked to bone mineral density (BMD) and undercarboxylated osteocalcin (UcOC) in many studies, but the results of studies of the combined effect of vitamin K and calcium on BMD and UcOC in humans have been inconsistent. Therefore, this review article has been conducted.

Do vitamin K and calcium supplements used in combination increase bone mineral density and decrease undercarboxylated osteocalcin level?

Study design:
This review article included 10 randomized controlled trials (RCTs) with a total of 1,346 patients.

Results and conclusions:
The investigators found that the combination of vitamin K and calcium supplements was significantly associated with a higher lumbar spine bone mineral density [SMD = 0.20, 95% CI = 0.07 to 0.32, I2 = 46.9%, p = 0.049].
However, after applying trim and fill method (where correction was made for publication bias), the results were not statistically significant [estimate = 0.067, 95% CI = -0.044 to 0.178].

The investigators found that vitamin K and calcium supplementation led to a significant decrease in undercarboxylated osteocalcin [SMD = -1.71, 95% CI = - 2.45 to -0.96, I2 = 95.7%, p  0.01].
The results did not change after correcting publication bias [estimate = - 0.947, 95% CI = -1.211 to - 0.687].
The SMD in the sensitivity analysis was -0.82 [95% CI = - 1.10 to -0.55, I2 = 65.4%, p  0.01].

The investigators found in subgroup analysis that the combination of vitamin K2 and calcium supplements was significantly associated with a higher lumbar spine bone mineral density [SMD = 0.30, 95% CI = 0.10 to 0.51, I2 = 0%].

The investigators found in subgroup analysis that the combination of vitamin K and  ≤ 1000 mg/d calcium supplements was significantly associated with a higher lumbar spine bone mineral density [SMD = 0.19, 95% CI = 0.05 to 0.32, I2 = 62.3%].

The investigators found in subgroup analysis that the combination of  ≤100 µg/d vitamin K and calcium supplements was significantly associated with a higher lumbar spine bone mineral density [SMD = 0.40, 95% CI = 0.20 to 0.61, I2 = 49.9%].

The investigators found in subgroup analysis that the combination of vitamin K and calcium supplements during ≤1 year was significantly associated with a higher lumbar spine bone mineral density [SMD = 0.38, 95% CI = 0.19 to 0.57, I2 = 40%].

The investigators concluded that ≤100 µg/d vitamin K2 and ≤1000 mg/d calcium supplements used in combination are associated with a higher lumbar spine bone mineral density and a lower undercarboxylated osteocalcin level.

Original title:
The combined effect of vitamin K and calcium on bone mineral density in humans: a meta-analysis of randomized controlled trials by Hu L, Ji J, [...], Yu B.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8515712/

Additional information of El Mondo:
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Mushroom consumption reduces all-cause mortality

Objectives:
Whether mushroom consumption, which is a rich source of potent antioxidants ergothioneine and glutathione, vitamins and minerals (e.g., selenium & copper), is associated with a lower mortality risk is not well understood. Therefore, this review article (meta-analysis) has been conducted.

Does mushroom consumption reduce all-cause mortality?

Study design:
This review article included 5 prospective cohort studies with a total of 50,787 cases of deaths accrued in 601,893 men and women.

Results and conclusions:
The investigators found in a meta-analysis that mushroom consumption was significantly associated with an 6% decrease of the risk of all-cause mortality [pooled risk ratio = 0.94, 95% CI = 0.91 to 0.98].  

The investigators concluded that a meta-analysis of prospective cohort studies shows mushroom consumption reduces all-cause mortality. These findings can be used to support public health recommendations and increase awareness about the health-promoting effects of mushrooms. Large prospective cohort studies with repeated dietary data measurements are needed to replicate these findings and clarify the potential protective role of mushrooms against premature mortality.

Original title:
Prospective study of dietary mushroom intake and risk of mortality: results from continuous National Health and Nutrition Examination Survey (NHANES) 2003-2014 and a meta-analysis by Ba DM, Gao X, [...], Richie Jr JP.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8454070/

Additional information of El Mondo:
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