Nutrition and health

Objectives:
Total dietary fat intake might influence the risk of fracture; however, conflicting findings have been reported to date. Therefore, this review article has been conducted.

Is there an association between dietary fat intake and risk of fracture?

Study design:
This review article included 6 observational studies.

Results and conclusions:
The investigators found no significant association between total dietary fat intake and risk of fracture [pooled effect size = 1.31, 95% CI = 0.95-1.79, p = 0.09].

The investigators found dietary saturated fat intake significantly increased risk of fracture with 79% [pooled effect size = 1.79, 95% CI = 1.05-3.03, p = 0.03].

The investigators found dietary monounsaturated fatty acids (MUFAs) intake derived from animal sources significantly increased risk of fracture with 129% [pooled effect size = 2.29, 95% CI = 1.50-3.50, p 0.0001].

The investigators concluded that both dietary saturated fat and monounsaturated fatty acids (MUFAs) intake derived from animal sources increase risk of fracture.

Original title:
Dietary fat, saturated fatty acid, and monounsaturated fatty acid intakes and risk of bone fracture: a systematic review and meta-analysis of observational studies by Mozaffari H, Djafarian K, […], Shab-Bidar S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29947872

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

A diet high in saturated fat is a diet that is largely made up of meals/products with more than 10 En% saturated fat. Practically, this means that all meals/products that you eat on a daily basis should on average contain more than 10 En% saturated fat. Check here which products contains more than 10 En% saturated fat.
More than 10 En% saturated fat means that the total amounts of saturated fat make up for more than 10% of the total kcal of the diet.
 

Objectives:
The purpose of this review article is to review previously published meta-analyses on the effectiveness of dietary fiber on type 2 diabetes.

Study design:
This umbrella review article included 16 meta-analyses.

Results and conclusions:
The investigators found in the meta-analyses when comparing highest versus lowest dietary fiber intake, a statistically significant reduced risk of 15 to 19% [RR = 0.81-0.85] for type 2 diabetes. However, statistically significant heterogeneity was observed in all of these meta-analyses.

The investigators found in the meta-analyses when comparing highest versus lowest dietary cereal fibers, a statistically significant reduced risk of 13 to 33% [RR = 0.67-0.87] for type 2 diabetes. However, statistically significant heterogeneity was observed in all of these meta-analyses.

The investigators found in the meta-analyses of supplementation studies using β-glucan or psyllium fibers on type 2 diabetic participants, statistically significant reductions were identified in both fasting blood glucose concentrations and glycosylated hemoglobin percentages.

The investigators concluded that those consuming the highest amounts of dietary fiber, especially cereal fiber, may benefit from a reduction in the incidence of developing type 2 diabetes. May benefit because statistically significant heterogeneity was observed in all of these meta-analyses.
There also appears to be a small reduction in fasting blood glucose concentration, as well as a small reduction in glycosylated hemoglobin percentage for individuals with type 2 diabetes who add β-glucan or psyllium to their daily dietary intake.

Original title:
Dietary Fiber Intake and Type 2 Diabetes Mellitus: An Umbrella Review of Meta-analyses by McRae MP.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29628808

Additional information of El Mondo:
Find more information/studies on diabetes, meta-analyses/heterogeneity and dietary fiber right here.

 

Objectives:
Is there an association between consumption of food groups and the occurrence of age-related macular degeneration (AMD)?

Study design:
This review article included 26 prospective cohort studies with a total of 211,676 subjects and 7,154 cases of age-related macular degeneration.

Results and conclusions:
The investigators found no significant association between age-related macular degeneration and vegetables, fruit, nuts, grains, dairy products or dietary fats such as oils, butter and margarine when comparing the highest vs. the lowest consumption.

The investigators found a significantly reduced risk of 18% for total age-related macular degeneration [RR = 0.82, 95% CI = 0.75-0.90, p  0.05] when comparing the highest vs. the lowest fish consumption.

The investigators found a significantly reduced risk of 16% for early age-related macular degeneration [RR = 0.84, 95% CI = 0.73-0.97, p  0.05] when comparing the highest vs. the lowest fish consumption.

The investigators found a significantly reduced risk of 21% for late age-related macular degeneration [RR = 0.79, 95% CI = 0.70-0.90, p  0.05], when comparing the highest vs. the lowest fish consumption. 

The investigators found a significantly increased risk of 17% for early age-related macular degeneration [RR = 1.17, 95% CI = 1.02-1.34] when comparing the highest vs. the lowest meat consumption. However, no association was found for late age-related macular degeneration.

The investigators found a significantly increased risk of 20% for early age-related macular degeneration [RR = 1.20, 95% CI = 1.04-1.39] when comparing the highest vs. the lowest alcohol consumption.

The investigators concluded that high fish consumption decreases risk of age-related macular degeneration, while high intake of meat and alcohol increases risk of age-related macular degeneration.

Original title:
Food groups and risk of age-related macular degeneration: a systematic review with meta-analysis by Dinu M, Pagliai G, […], Sofi F.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29978377

Additional information of El Mondo:
Find more information/studies on fish, meat and alcohol consumption and elderly.
 

Objectives:
The association between dietary protein intake and type 2 diabetes risk has been inconsistent in the previous epidemiological studies. Therefore, this review article (meta-analysis) has been conducted.

Is there an association between dietary protein intake and type 2 diabetes risk?

Study design:
This review article included 10 prospective cohort studies with a total of 34,221 type 2 diabetes cases.
No publication bias was detected.

Results and conclusions:
The investigators found after adjustment of potential confounders, a 5% of energy (5 En%) increment from dietary total protein intake was related to a significantly 9% [95 CI = 1.04-1.13, I2 = 42.0%] higher risk of type 2 diabetes. The results were robust in sensitivity analysis.

The investigators found after adjustment of potential confounders, a 5% of energy (5 En%) increment from dietary animal protein intake was related to a significantly 12% [95 CI = 1.08-1.17, I2 = 14.0%] higher risk of type 2 diabetes. The results were robust in sensitivity analysis.

The investigators found after adjustment of potential confounders, a significant U-shaped curve was observed for plant protein intake with the most risk reduction at about 6% of energy from plant protein intake [p nonlinearity = 0.001]. The results were robust in sensitivity analysis.

The investigators concluded that the consumption of protein, particularly animal protein increases risk of type 2 diabetes.

Original title:
Dietary protein intake and risk of type 2 diabetes: a dose-response meta-analysis of prospective studies by Zhao LG, Zhang QL, [...], Xiang YB.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29858629

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

 

Objectives:
The association between coffee consumption and the level of C-reactive protein (CRP) has been evaluated in several epidemiological studies with conflicting results. Therefore, this meta-analysis (systematic review) has been conducted.

Does coffee consumption reduce level of C-reactive protein in humans?

Study design:
This review article included a total of 9 cross-sectional studies.

Results and conclusions:
The investigators found according to the combined standard mean difference (SMD) between the highest and the lowest coffee intake category, coffee consumption was associated with a significantly lower level of serum CRP level [SMD = -0.34, 95% CI = -0.62 to -0.06, p = 0.016].

The investigators found subgroup analysis for CRP marker showed that coffee consumption was associated with a significantly lower level of serum high-sensitivity CRP (hsCRP) [SMD = -0.51, 95% CI = -0.88 to -0.14, p = 0.007], but not standard CRP [SMD = 0.02, 95% CI = -0.28 to 0.32, p = 0.913].

The investigators concluded that coffee consumption is associated with a lower level of serum CRP, particularly serum high-sensitivity CRP. However, more well-designed prospective cohort studies are needed to elaborate the concerned issues further.

Original title:
Is coffee consumption associated with a lower level of serum C-reactive protein? A meta-analysis of observational studies by Zhang Y and Zhang DZ.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29405789

Additional information of El Mondo:
Find more information/studies on coffee and chronic disease right here.

 

Objectives:
Epidemiological studies exploring the role of flavonoids intake in preventing type 2 diabetes mellitus (T2DM) showed inconsistent results. Therefore, this review article (meta-analysis) has been conducted.

Does flavonoids intake decrease risk of developing type 2 diabetes?

Study design:
This review article included 10 independent cohorts published between 2002 and 2017 with a total of 312,015 participants, of which 19,953 type 2 diabetes cases were identified during the follow-up periods from 4 to 28 years.
All participants were free of type 2 diabetes at baseline (at the beginning of the study), with age ranging from 28 to 75 years.
Dietary flavonoids intake was evaluated using food-frequency questionnaire and type 2 diabetes was frequently ascertained through medical records.
In the original studies, the median intake level of total flavonoids was 8.9 to 501.8 mg/day for the lowest categories and 33.2 to 1452.3 mg/day for the highest categories.
The most commonly adjusted variables included age, sex, total energy intake, body mass index, smoking, alcohol consumption and physical activity.
All included studies had a NOS score of ≥7, with an average score of 7.9, indicating the presence of high methodological quality.

There was no indication of publication bias from visual inspection of the funnel plot, which was further confirmed by Egger test [p = 0.253].

Results and conclusions:
The investigators found when compared with the lowest intake, the highest intake of total flavonoids was associated with a significantly 9% decreased risk of type 2 diabetes [RR = 0.91, 95% CI = 0.86-0.96, I2  =  21%, p =  0.257].
In stratified analyses, the pooled RR for total flavonoids intake was not modified by sample size, sex, follow-up duration and study location.
Leave-one-out sensitivity analysis showed that no individual study had a significant influence on the final result.

The investigators found in subgroup analyses when compared with the lowest intake, the highest intake of anthocyanidins significantly decreased risk of type 2 diabetes with 11% [RR = 0.89, 95% CI = 0.82-0.95].

The investigators found in subgroup analyses when compared with the lowest intake, the highest intake of flavan-3-ols significantly decreased risk of type 2 diabetes with 14% [RR = 0.86, 95% CI = 0.78-0.95].

The investigators found in subgroup analyses when compared with the lowest intake, the highest intake of flavonols significantly decreased risk of type 2 diabetes with 14% [RR = 0.86, 95% CI = 0.80-0.94].

The investigators found in subgroup analyses when compared with the lowest intake, the highest intake of isoflavones significantly decreased risk of type 2 diabetes with 9% [RR = 0.91, 95% CI = 0.84-0.98].

The investigators found in 9 cohort studies a curvilinear relationship between total flavonoids intake and type 2 diabetes risk [p for nonlinearity = 0.042] with a significant risk reduction at an intake of ≥550 mg/day.

The investigators found when assuming a linear association, the risk of type 2 diabetes was reduced by 5% [RR = 0.95, 95% CI = 0.93-0.97] for each 300-mg/day increment in total flavonoids intake.

The investigators concluded that intakes of total flavonoids, particularly ≥550 mg/day, anthocyanidins, flavan-3-ols, flavonols and isoflavones are associated with significantly decreased risks of type 2 diabetes in the highest versus lowest analyses. Additionally, the dose-response analysis suggest a curvilinear relationship of total flavonoids intake with type 2 diabetes risk; when assuming a linear manner, the risk of type 2 diabetes is reduced by 5% for an increment of 300 mg/day in total flavonoids intake.

Original title:
Flavonoids intake and risk of type 2 diabetes mellitus: A meta-analysis of prospective cohort studies by Xu H, Luo J, [...], Wen Q.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5959406/

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

Objectives:
There is an increasing trend in the consumption of poor-quality diets worldwide, contributing to the increase of non-communicable diseases. Diet directly influences physiological composition and subsequently physical health. Studies have shown that dietary macronutrient and energy content can influence the proportion of intramuscular fat (IMF), which mediates various metabolic and endocrine dysfunction. Therefore, this review article has been conducted.

Do different types of dietary macronutrient intake increase the proportion of intramuscular fat?

Study design:
This review article included 13 trials (RCTs, quasi-RCTs, controlled trials, randomized controlled crossover trials or controlled crossover trials).

High-fat diets were diets with a proportion of fat between 38 and 85 En%. Participants in high-fat diets were all young to middle aged adults with ages varying between 18 and 50 years.

Participants in starvation diets (a decrease of 25% calorie from weight maintenance energy requirements) and hypocaloric diets (890 calories per day, until 15% weight reduction) followed the diet for 8 days with a 3-week washout period in between.

Cohen’s criteria were used to determine the effect size of SMDs, where a SMD between 0.2 and 0.5 is small, a SMD between 0.5 and 0.8 is moderate and a SMD above 0.8 is large. SMDs below 0.2 were considered unsubstantial.

Results and conclusions:
The investigators found in 6 studies with in a total of 134 participants receiving a high-fat intervention and 135 people receiving a control intervention, that high-fat diets (38 and 85 En% fat) significantly increased the proportion of intramuscular fat [SMD = 1.24, 95% CI = 0.43-2.05, p  = 0.003, I2 = 87%].  
Sensitivity analysis (excluding studies with a quality value 20, smallest sample size 8 and those that do not specify participant characteristics) showed a significantly SMD of 1.26 [95% CI = 0.23-2.28, p = 0.02]. 

The investigators found diets with an increased proportion of carbohydrates decreased the proportion of intramuscular fat.
However, increasing caloric intake with carbohydrates compared to a standardized diet (55 En% carbohydrates, 30 En% fat and 15 En% protein) increased the proportion of intramuscular fat.

The investigators found starvation diets (a decrease of 25% calorie from weight maintenance energy requirements) increased intramuscular fat stores and hypocaloric diets (890 calories per day, until 15% weight reduction) did not result in any intramuscular fat proportion changes.

The investigators concluded that high-fat diets (38 y 85 En%), excessive caloric intake in the form of carbohydrates and short-term starvation diets are associated with increases in the proportion of intramuscular fat. However, further studies are needed to assess the effects of macronutrient combinations on intramuscular fat and the influence of diet-induced intramuscular fat alterations on health outcomes. In addition, intramuscular fat poses a possibly effective clinical marker of health.

Original title:
The Effects of Diet on the Proportion of Intramuscular Fat in Human Muscle: A Systematic Review and Meta-analysis by Ahmed S, Singh D, [...], Kumbhare D.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5826234/

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

Higher intramuscular fat levels are positively associated with insulin resistance and an increased risk of developing type 2 diabetes.

Objectives:
Cardiovascular risk factors are closely linked with dementia risk, but whether heart disease predisposes to dementia is uncertain. Therefore, this review article has been conducted.

Does heart disease increase risk of dementia?

Study design:
This review article included 16 studies (1,309,483 individuals) regarding coronary heart disease and 7 studies (1,958,702 individuals) about heart failure.

Results and conclusions:
The investigators found that a history of coronary heart disease was associated with a 27% increased risk of dementia [pooled relative risk = 1.27, 95% CI = 1.07-1.50, I2 = 80%].

The investigators found that a history of heart failure was associated with a 60% increased dementia risk [pooled relative risk = 1.60, 95% CI = 1.19-2.13, I2 = 59%].

The investigators found among 9 prospective population-based cohort studies, a significantly increased risk of 26% for dementia among patients with coronary heart disease [pooled relative risk = 1.26, 95% CI = 1.06-1.49, I2 = 0%].
Significantly means that there is an association with a 95% confidence.

The investigators found among 4 prospective population-based cohort studies, a significantly increased risk of 80% for dementia among patients with heart failure [pooled relative risk = 1.80, 95% CI = 1.41-2.31, I2 = 0%].
Significantly means it can be said with a 95% confidence that heart failure really increased the risk of getting dementia with 80%. 

The investigators concluded that both coronary heart disease and heart failure are associated with an increased risk of dementia.

Original title:
Coronary heart disease, heart failure, and the risk of dementia: A systematic review and meta-analysis by Wolters FJ, Segufa RA, […], Sedaghat S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29494808

Additional information of El Mondo:
Find more information/studies on cohort/case-control study/significant, dementia and heart disease right here.
 

Objectives:
Inflammatory markers are often elevated in patients with dementia, including Alzheimer's disease (AD). However, it remains unclear whether inflammatory markers are associated with the risk of developing dementia. Therefore, this review article has been conducted.

Do inflammatory markers increase risk of dementia and Alzheimer's disease (AD)?

Study design:
This review article included 13 studies in 6 countries.

Results and conclusions:
The investigators found a significantly increased risk of 37% [HR = 1.37, 95% CI = 1.05-1.78] for all-cause dementia for the highest vs. lowest quantile of C-reactive protein. However, this increased risk was not significant for Alzheimer's disease.

The investigators found a significantly increased risk of 40% [HR = 1.40, 95% CI = 1.13-1.73] for all-cause dementia for the highest vs. lowest quantile of interleukin-6. However, this increased risk was not significant for Alzheimer's disease.

The investigators found a significantly increased risk of 54% [HR = 1.54, 95% CI = 1.14-2.80] for all-cause dementia for the highest vs. lowest quantile of α1-antichymotrypsin. However, this increased risk was not significant for Alzheimer's disease.

The investigators found a significantly increased risk of 40% [HR = 1.40, 95% CI = 1.03-1.90] for all-cause dementia for the highest vs. lowest quantile of lipoprotein-associated phospholipase A2 activity. However, this increased risk was not significant for Alzheimer's disease.

The investigators concluded that several inflammatory markers are associated with an increased risk of all-cause dementia; however, these markers are not specific for Alzheimer's disease. Whether inflammatory markers closely involved in Alzheimer's disease pathology are associated with the risk of Alzheimer's disease remains to be elucidated.

Original title:
Inflammatory markers and the risk of dementia and Alzheimer's disease: A meta-analysis by Darweesh SKL, Wolters FJ, […], Hofman A.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29605221

Additional information of El Mondo:
Find more information/studies on cohort/case-control study/significant and dementia right here.
 

Objectives:
Observationally, homocysteine is associated with higher risk of diabetes. Folate, which reduces homocysteine, is promising for the prevention and treatment of diabetes. Previous meta-analysis (review) of 3 trials suggested folate might lower hemoglobin A1c (HbA1c). Therefore, this review article (meta-analysis) has been conducted.

Have folic acid supplementation positive effects on insulin resistance and glycemic control, like HbA1c level and fasting glucose level?

Study design:
This review article included 18 RCTs with in total of 21,081 people with/without diabetes.

Results and conclusions:
The investigators found that folic acid (folate) supplementation significantly reduced fasting glucose level with 0.15 mmol/L [95% CI = -0.29 to -0.01]. Significant means that there is an association with a 95% confidence.

The investigators found that folic acid (folate) supplementation significantly reduced homeostatic model assessment-insulin resistance (HOMA-IR) with 0.83 [95% CI = -1.31 to -0.34].

The investigators found that folic acid (folate) supplementation significantly reduced fasting insulin level with 1.94 μIU/mL [95% CI = -3.28 to -0.61].

The investigators found that folic acid (folate) supplementation had no clear effect on diabetes or HbA1c level.

The investigators concluded that folic acid (folate) supplementation reduces both fasting glucose level, fasting insulin level and homeostatic model assessment-insulin resistance (HOMA-IR) but it has no effect on diabetes or HbA1c level.

Original title:
The effects of folate supplementation on glucose metabolism and risk of type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials by Zhao JV, Schooling CM and Zhao JX.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29501221

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

Patients with diabetes often have both an increased fasting glucose level, HOMA-IR value and fasting insulin level.

Objectives:
β-amyloid (Aβ) accumulates abnormally to senile plaque which is the initiator of Alzheimer's disease (AD). As one of the Aβ-degrading enzymes, insulin-degrading enzyme (IDE) remains controversial for its protein level and activity in Alzheimer's brain. Therefore, this review article has been conducted.

Is there an association between insulin-degrading enzyme protein level and risk of Alzheimer's disease (AD)?

Study design:
This review article included 7 studies for IDE protein level (Alzheimer's disease cases = 293 and controls (persons without Alzheimer's disease)  = 126), 3 for mRNA level (Alzheimer's disease cases = 138 and controls = 81) and 3 for enzyme activity (Alzheimer's disease cases = 123 and controls = 75).

Results and conclusions:
The investigators found the insulin-degrading enzyme protein level was significantly lower in Alzheimer's disease patients than in controls [SMD = -0.47, 95% CI = -0.69 to -0.24, p 0.001].
But insulin-degrading enzyme mRNA and enzyme activity had no significant difference [SMD = 0.02, 95% CI = -0.40 to 0.43 and SMD = 0.06, 95% CI = -0.41 to 0.53, respectively].

The investigators found in subgroup analyses (to get more information) that insulin-degrading enzyme protein level was decreased in both cortex and hippocampus of Alzheimer's disease patients [SMD = -0.43, 95% CI = -0.71 to -0.16, p = 0.002 and SMD = -0.53, 95% CI = -0.91 to -0.15, p = 0.006 respectively].
However, insulin-degrading enzyme mRNA was higher in cortex of Alzheimer's disease patients [SMD = 0.71, 95% CI = 0.14 to 1.29, p = 0.01] but not in hippocampus [SMD = -0.26, 95% CI [= -0.58 to 0.06].

The investigators concluded that Alzheimer's disease patients have lower insulin-degrading enzyme protein level. Further relevant studies are still needed to verify whether insulin-degrading enzyme is one of the factors affecting Aβ abnormal accumulation and throw new insights for Alzheimer's disease detection or therapy.

Original title:
Characteristics of Insulin-degrading Enzyme in Alzheimer's Disease: A Meta-analysis by Zhang H, Liu D, […], Zhou H.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29357797

Additional information of El Mondo:
Find more information/studies on cohort/case-control study/significant and dementia right here.
 

Objectives:
The increasing prevalence of diabetes in the United Kingdom and worldwide calls for new approaches to its management and diets with low glycaemic index have been proposed as a useful means for managing glucose response. However, there are conflicting reports and differences in the results of studies in terms of their effectiveness. Furthermore, the impact of low-glycaemic index diets (low GI-diets) and their long-term use in patients with type 2 diabetes remains unclear. Therefore, this review article (meta-analysis) has been conducted.

Do patients with type 2 diabetes mellitus benefit from low-GI diets?

Study design:
This review article included 6 RCTs.

Results and conclusions:
The investigators found in 2 RCTs that low-glycaemic index (low-GI) diet resulted in a significant improvement in glycated haemoglobin (HbA1c) [0.05]:
low-GI diet Δ = -0.5% [95% CI = -0.61% to -0.39%] vs. high-cereal fibre diet Δ = -0.18% [95% CI = -0.29% to -0.07%] and;
low-GI legume diet Δ = -0.5% [95% = -0.6% to -0.4%] vs. high-wheat fibre diet Δ = -0.3% [95% Cl = -0.4 to -0.2%].

The investigators found in 4 RCTs significant improvements in fasting blood glucose in low-GI diets compared to higher-GI diets or control:
low-GI diet = [150.8 ± 8.7] vs. higher-GI diet = [157.8 ± 10.4 mg/dL, mean ± SD, p = 0.43];
low-GI diet = [127.7] vs. high-cereal fibre diet = [136.8 mg/dL, p = 0.02];
low-GI diet = [6.5 (5.6-8.4)] vs. standard diabetic diet = [6.7 (6.1-7.5 mmol/L), median and interquartile range p > 0.05] and;
low-GI diet = [7.3 ± 0.3] vs. conventional carbohydrate exchange diet = [7.7 ± 0.4 mmol/L, mean ± SEM (Standard Error of Mean), p 0.05].

The investigators concluded that the low-GI diet is more effective in controlling glycated haemoglobin (HbA1c) and fasting blood glucose compared with a higher-GI diet or control in patients with type 2 diabetes. It will useful to evaluate the long-term effectiveness of low-glycaemic index diet in patients with type 2 diabetes.

Original title:
The Effect of Dietary Glycaemic Index on Glycaemia in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials by Ojo O, Ojo OO, [...], Wang XH.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5872791/

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

A low-GI diet is a diet with a lot of products/meals with a low GI.
Products/meals with a low GI are products/meals with a GI-number of 55 or less.
In daily life, products/meals with a low GI contain at least 1.5 grams fiber per 100 kcal. These products and meals contain at least 1.5 grams fiber per 100 kcal.
 

Objectives:
Type 2 diabetes mellitus (T2DM) is one of the most important public health issues. Vitamin K supplementation might have favorable effect on risk factors of T2DM. Therefore, this review article (meta-analysis) has been conducted.

Have vitamin K supplementation favorable effects on risk factors of type 2 diabetes mellitus?

Study design:
This review article included 5 RCTs with in total of 533 participants.

There was no evidence of publication bias.

Results and conclusions:
The investigators found overall, meta-analysis did not show any beneficial effect of vitamin K supplementation on both:
-fasting blood sugar levels [-0.91 mg/dL, 95% CI = -2.57 to 0.76, p = 0.28];
-fasting insulin levels [-0.35 μIU/mL, 95% CI = -1.70 to 1.00, p = 0.61];
-HOMA-IR [-0.06, 95% CI = -0.32 to -0.19, p = 0.63] and
-2-h oral glucose tolerance test [-4.00 mg/dL, 95% CI = -20.00 to 11.99, p = 0.62].

The investigators found sensitivity analysis showed that overall estimates were not affected by elimination of any study.

The investigators concluded that vitamin K supplementation has no significant effect on glycemic control in healthy subjects. However, further studies should be performed on diabetic and pre-diabetic patients to determine the effect of vitamin K supplementation on impaired glycemic control.

Original title:
Effect of Vitamin K Supplementation on Glycemic Control: A Systematic Review and Meta-Analysis of Clinical Trials by Shahdadian F, Mohammadi H and Rouhani M.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29523009

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

Objectives:
The actual effects of L-carnitine administration on leptin serum level is inconsistent. Therefore, this review article (meta-analysis) has been conducted.

Does L-carnitine supplementation reduce leptin serum level?

Study design:
This review article included 7 RCTs with 325 cases (group with L-carnitine administration) and 330 controls (group without L-carnitine administration).

Subgroup analysis to find the sources of heterogeneity showed that L-carnitine dosage [ 2 g: I2 = 00.0%, p = 0.408] and study population [diabetes: I2 = 46.7%, p = 0.153 and non-diabetes: I2 = 15.1%, p = 0.317] were the potential sources of heterogeneity.

Results and conclusions:
The investigators found that L-carnitine supplementation had no significant effect on serum leptin concentrations [WMD = -0.565 ng/mL, 95% CI = -2.417 to 1.287, p = 0.550, I2 = 84.3%, p  0.0001].

The investigators found in subgroup analysis that  ≥ 2 mg L-carnitine supplementation significantly reduced serum leptin concentrations [WMD = -2.742 ng/mL, 95% CI = -3.039 to -2.444, p  0.001].

The investigators found in subgroup analysis that L-carnitine supplementation significantly reduced serum leptin concentrations in diabetic patients [WMD = -2.946 ng/mL, 95% CI = -3.254 to -2.638, p  0.001].

The investigators found in subgroup analysis that L-carnitine supplementation during 12 weeks significantly reduced serum leptin concentrations [WMD = -2.772 ng/mL, 95% CI = -3.073 to -2.471, p  0.001].

The investigators concluded that at least 3 mg L-carnitine per day in the course of 12 weeks reduce serum leptin concentrations, especially in diabetic patients.

Original title:
The effect of L-carnitine supplementation on serum leptin concentrations: a systematic review and meta-analysis of randomized controlled trials by Nazary-Vannani A, Ghaedi E, […], Varkaneh HK.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29453657

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

L-carnitine is a non-essential amino acid, which is also found in foods.

Objectives:
Is there a dose-response association between serum 25(OH)D (vitamin D level in blood) and risk of dementia and Alzheimer's disease (AD)?

Study design:
This review article included 7 prospective cohort studies and 1 retrospective cohort study involving 1,953 cases of dementia and 1,607 cases of Alzheimer's disease among a total of 28,354 participants.

Results and conclusions:
The investigators found no association between vitamin D insufficiency (10-20 ng/mL) and risk of dementia [pooled HR = 1.09, 95% CI = 0.95 to 1.24].
No association because RR of 1 was found in the 95% CI of 0.95 to 1.24. RR of 1 means no risk/association.

The investigators found no association between vitamin D insufficiency (10-20 ng/mL) and risk of Alzheimer's disease [pooled HR = 1.19, 95% CI = 0.96 to 1.41].

The investigators found vitamin D deficiency (10 ng/mL) significantly increased risk of dementia with 33% [pooled HR = 1.33, 95% CI = 1.08 to 1.58].
Significantly means it can be said with a 95% confidence that vitamin D deficiency really increased the risk of getting dementia with 33%. 

The investigators found vitamin D deficiency (10 ng/mL) non-significantly increased risk of Alzheimer's disease with 31% [pooled HR = 1.31, 95% CI = 0.98 to 1.65].

The investigators found lower risk of dementia was observed at serum 25(OH)D of 25 ng/mL, whereas the risk of Alzheimer's disease decreased continuously along with the increase of serum 25(OH)D up to 35 ng/mL.

The investigators concluded that vitamin D (serum 25(OH)D) levels of 25 to 35 ng/mL decrease risk of dementia and Alzheimer's disease. However, there is no conclusive evidence regarding serum 25(OH)D levels of >35 ng/mL.

Original title:
Vitamin D status and risk of dementia and Alzheimer's disease: A meta-analysis of dose-response by Jayedi A, Rashidy-Pour A and Shab-Bidar S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29447107

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Objectives:
Dairy product consumption may affect the risk of hip fracture, but previous studies have reported inconsistent findings. Therefore, this review article has been conducted.

Does consumption of dairy products reduce risk of hip fracture?

Study design:
This review article included 10 cohort studies (with a total of 8,613 hip fracture events and 363,557 participants. The length of follow-up ranged from 3 to 22 years) and 8 case-control studies (3,815 hip fracture cases and 6,415 controls/subjects without hip fracture).

Results and conclusions:
The investigators found in cohort studies no association between a high milk consumption and hip fracture risk [pooled RR = 0.91, 95% CI = 0.74-1.12, I2 = 75.0%, p  0.01].
There were no significant changes to the results after using the trim-and-fill method when including 4 missing articles [adjusted random effects summary RR = 1.06, 95% CI = 0.91-1.23].

The investigators found, however, case-control studies indicated that participants in the highest categories of milk consumption had a 29% reduction in the risk of hip fracture [OR = 0.71, 95% CI = 0.55-0.91, I2 = 54%, p = 0.04].
There were no significant changes to the results after using the trim-and-fill method when including 1 missing article [adjusted random effects summary OR = 0.74, 95% CI = 0.57-0.97].

The investigators found in cohort studies no association between a high total dairy consumption and hip fracture risk [pooled RR = 1.02, 95% CI = 0.93-1.12]. No association because RR of 1 was found in the 95% CI of 0.93 to 1.12. RR of 1 means no risk/association.

The investigators found cohort studies indicated that participants in the highest categories of yoghurt consumption had a 25% reduction in the risk of hip fracture [RR = 0.75, 95% CI = 0.66-0.86].
 

The investigators found cohort studies indicated that participants in the highest categories of cheese consumption had a 32% reduction in the risk of hip fracture [RR = 0.68, 95% CI = 0.61-0.77].

The investigators found the summary RR for an increased milk consumption of 200 g/day was 1.00 [95% CI = 0.94-1.07, I2 = 87%, p heterogeneity  0.01] among cohort studies.

The investigators found in cohort studies there was a nonlinear positive association between milk consumption and hip fracture risk [p nonlinearity  0.01], with a rapid increase in risk when milk consumption increased from 0 to 600 g/d. However, there was no further increase in risk with milk consumption between 600 and 1200 g/d.

The investigators found in case-control studies there was a nonlinear association between milk consumption and hip fracture risk [p nonlinearity = 0.28], with a reduction in risk with milk consumption of 200-600 g/d. However, the confidence intervals were wide for all outcomes.

The investigators concluded that a high consumption of yogurt and cheese is associated with a lower risk of hip fracture in cohort studies.

Original title:
Dairy product consumption and risk of hip fracture: a systematic review and meta-analysis by Bian S, Hu J, [...], Ma J.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5778815/

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Objectives:
Does exercise training delay the decline in cognitive function among individuals who are at risk of/or have Alzheimer's disease?  

Study design:
This review article included 19 controlled studies with 23 interventions including 1,145 subjects with a mean age of 77.0 ± 7.5.
The studies included an exercise-only intervention and a nondiet, nonexercise control group and reported pre- and post-intervention cognitive function measurements.

Most subjects were at risk of Alzheimer's disease because they had mild cognitive impairment (64%) or a parent diagnosed with Alzheimer's disease (1%) and 35% presented with Alzheimer's disease.

Exercise interventions were performed 3.4 ± 1.4 days per week at moderate intensity (3.7 ± 0.6 metabolic equivalents) for 45.2 ± 17.0 minutes per session for 18.6 ± 10.0 weeks and consisted primarily of aerobic exercise (65%).

Results and conclusions:
The investigators found overall, there was a modest favourable effect of exercise on cognitive function [d+ = 0.47, 95% CI = 0.26 to 0.68].

The investigators found within-group analyses revealed that exercise improved cognitive function [d+w = 0.20, 95% CI = 0.11 to 0.28], whereas cognitive function declined in the control group [d+w = -0.18, 95% CI = -0.36 to 0.00].

The investigators found within-group analyses revealed that aerobic exercise had a moderate favourable effect on cognitive function [d+w = 0.65, 95% CI = 0.35 to 0.95), but other exercise types did not [d+w = 0.19, 95% CI = -0.06 to 0.43].

The investigators concluded that exercise training (3.4 days per week at moderate intensity for 45.2 minutes per session during 18.6 weeks) delays the decline in cognitive function that occurs in individuals who are at risk of/or have Alzheimer's disease, with aerobic exercise having the most favourable effect. Additional randomized controlled clinical trials that include objective measurements of cognitive function are needed to confirm these findings.

Original title:
Can Exercise Improve Cognitive Symptoms of Alzheimer's Disease? A Meta-Analysis by Panza GA, Taylor BA, […], Pescatello LS.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29363108

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Metabolic Equivalents (METs) are commonly used to express the intensity of physical activities.
MET is the ratio of a person's working metabolic rate relative to their resting metabolic rate.
One MET is defined as the energy cost of sitting quietly and is equivalent to a caloric consumption of 1 kcal/kg/hour.

Objectives:
Several studies have been conducted on the relationship between tea intake and the risk of osteoporosis. The results from these studies are, however, inconsistent. Therefore, this review article (meta-analysis) has been conducted.

Does tea intake reduce risk of osteoporosis?

Study design:
This review article included 2 prospective cohort studies, 4 cross-sectional studies and 11 case-control studies with 107,819 cases (people with osteoporosis). In the present study, the main symptom of osteoporosis was hip fracture.
10 studies - case-control and cohort studies were all of high quality - were in relative high quality (over 6 stars) with an average NOS score of 7.23.

The heterogeneity in the present review article mainly came from Asia group, female group, prospective cohort study group and case-control study group.

There was no publication bias of the meta-analysis about tea consumption and osteoporosis.

Results and conclusions:
The investigators found for the highest versus the lowest categories of tea consumption a significantly reduced risk of 38% [total OR = 0.62, 95% CI = 0.46-0.83, I2  =  94%, p   0 .01] for osteoporosis. However, when reducing heterogeneity, the overall OR [95% CI = 0.57-0.74, I2 = 30%] was still significant.
Subgroup analysis showed that tea consumption significantly reduced the risk of osteoporosis in all examined subgroups.

The investigators found stratified by categories of osteoporosis, a significantly reduced risk of 26% [OR  =  0.74, 95% BI = 0.63-0.88] for hip fracture.

The investigators found among women a significantly reduced risk of 27% [OR  =  0.73, 95% CI = 0.54-0.99] for osteoporosis.

The investigators concluded that high tea consumption reduces risk of osteoporosis, particularly hip fracture and particularly among women. However, the exact mechanism of the relationship between tea consumption and osteoporosis still needs further research.

Original title:
Association between tea consumption and osteoporosis: A meta-analysis by Sun K, Wang L, [...], Li X.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5728912/

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Objectives:
Fish oil supplementation has been shown to be associated with a lower risk of metabolic syndrome and benefit a wide range of chronic diseases, such as cardiovascular disease, type 2 diabetes and several types of cancers. However, the evidence of fish oil supplementation on glucose metabolism and insulin sensitivity is still controversial. Therefore, this review article (meta-analysis) has been conducted.

Does fish oil supplementation improve insulin sensitivity in humans?

Study design:
This review article included a total of 17 RCTs with 672 participants. One of the 17 studies was crossover design and others were parallel design.
The doses of active ingredients of fish oil (n-3 fatty acids) ranged from 1 g/d to 4 g/d. Duration of the interventions was ranged from 4 weeks to 24 weeks.
There was no suggestion of small study effect based on visual inspection of the funnel plot. Results of the Egger’s (p = 0.78) and Begg’s (p = 0.43) tests showed that there was no potential publication bias.

Results and conclusions:
The investigators found pooled analysis showed that fish oil supplementation had no effects on insulin sensitivity overall [SMD = 0.17, 95% CI = -0.15 to 0.48, p = 0.292, I2 = 58.1%, p = 0.001].

The investigators found subgroup analysis showed that fish oil supplementation significantly improved insulin sensitivity among people who were experiencing at least one symptom of metabolic disorders [SMD = 0.53, 95% CI = 0.17 to 0.88, p 0.001].

The investigators found subgroup analysis showed a positive effect of fish oil on insulin sensitivity among the short-term intervention group (12 weeks) rather than the long-term intervention group [SMD = 0.31, 95% CI = 0.01-0.61, p = 0.04].

The investigators found subgroup analysis showed that fish oil had no effects on insulin sensitivity among the healthy people or people with T2DM.

The investigators found there were no significant differences between subgroups of methods of insulin sensitivity and doses of omega-3 polyunsaturated fatty acids (n-3 PUFA) of fish oil supplementation.

The investigators found in sensitivity analysis that summary results did not differ significantly when omitting studies one at a time.

The investigators concluded that fish oil supplementation during 12 weeks improves insulin sensitivity among people who were experiencing at least one symptom of metabolic disorders.

Original title:
Fish oil supplementation and insulin sensitivity: a systematic review and meta-analysis by Gao H, Geng T, [...], Zhao Q.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5496233/

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Objectives:
Previous studies have shown that fish consumption and dietary intake of n-3 polyunsaturated fatty acids (n-3 PUFAs) are associated with hip fracture; however, findings were conflicting. Therefore, this review article (meta-analysis) has been conducted.

Do both dietary intake of fish and n-3 polyunsaturated fatty acids decrease hip fracture risk?

Study design:
This review article included 7 prospective cohort studies and 3 case-control studies with a total sample size of 29,2657 participants. The age of participants was 20 years or older.

Results and conclusions:
The investigators found combining 8 effect sizes from 4 prospective cohort studies and 2 case-control studies revealed a significant inverse association between fish consumption and risk of hip fracture [pooled effect size = 0.88, 95% CI = 0.79-0.98, p = 0.02].
Although this relationship became non-significant in prospective cohort studies, a significant inverse association was found in prospective cohort studies with sample size of 10,000 individuals or more and studies that considered body mass index as a covariate.

The investigators also found dietary intake of n-3 PUFAs significantly reduced risk of hip fracture with 12% [pooled effect size = 0.88, 95% CI = 0.80-0.98, p = 0.02].

The investigators concluded that both fish consumption and dietary intake of n-3 PUFAs have protective effects on bone health and decline the risk of hip fracture.

Original title:
Dietary intake of fish, n-3 polyunsaturated fatty acids and risk of hip fracture: A systematic review and meta-analysis on observational studies by Sadeghi O, Djafarian K, […], Shab-Bidar S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29244536

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Fatty acids in fish are all n-3 PUFAs.
 

Objectives:
There is considerable evidence of the favourable role of more physical activity (PA) in fighting against dementia. However, the shape of the dose-response relationship is still unclear. Therefore, this review article (meta-analysis) has been conducted.

Does leisure time physical activity reduce risk of all-cause dementia (ACD), Alzheimer’s disease (AD) and vascular dementia (VD) in dose-response manner?

Study design:
This review article included 15 cohort studies with 37,436 participants for all-cause dementia, with 25,031 participants for Alzheimer’s disease and with 16,797 participants for vascular dementia.
During follow-up (3-31.6 years for all-cause dementia, 3.9-31.6 years for Alzheimer’s disease and 4-11.9 years for vascular dementia), at least 2,665, 1,337 and 343 participants who were not suffering from dementia at baseline (=at the beginning of the study) were diagnosed with all-cause dementia, Alzheimer’s disease and vascular dementia, respectively.

There was no publication bias.

Results and conclusions:
The investigators found in the dose-response analysis, either all-cause dementia [p trend 0.005 and p non-linearity = 0.87] or Alzheimer’s disease [p trend 0.005 and p non-linearity = 0.10] exhibited a linear relationship with leisure time physical activity over the observed range (0-2000 kcal/week or 0-45 metabolic equivalent of task hours per week (MET-h/week)).

The investigators found for every 500 kcal or 10 MET-h increase per week, a significantly 10% [95% CI = 0.85-0.97] and 13% [95% CI = 0.79-0.96] decrease in the risk of all-cause dementia and Alzheimer’s disease, respectively.

The investigators concluded leisure time physical activity over a specific range (0-2000 kcal/week or 0-45 MET-h/week) is associated with a risk of dementia and Alzheimer’s disease in an inverse linear dose-response manner; with for every 500 kcal (calories) or 10 MET-h increase per week, a 10% and 13% decrease in the risk of all-cause dementia and Alzheimer’s disease, respectively.

Original title:
Leisure time physical activity and dementia risk: a dose-response meta-analysis of prospective studies by Xu W, Wang HF, [...], Tan L.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5665289/

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If you do a 4 MET activity for 30 minutes, you have done 4 x 30 = 120 MET-minutes or 2.0 MET-hours of physical activity.
 

Objectives:
The aim of this meta-analysis (review article) is to evaluate the influence of dietary intake and blood level of vitamin A (total vitamin A, retinol or β-carotene) on total and hip fracture risk?

Study design:
This review article included 11 prospective cohort studies and 2 nested case-control studies, involving a total of 319,077 participants over the age of 20 years (109,056 post-menopausal women).

Results and conclusions:
The investigators found higher dietary intake of retinol significantly decreased total fracture risk with 5% [RR = 0.95, 95% CI = 0.91 to 1.00, I2 = 64.64%, p = 0.04].

The investigators found higher dietary intake of retinol significantly increased hip fracture risk with 40% [RR = 1.40, 95% CI = 1.02 to 1.91, I2 = 30.01%, p = 0.40].

The investigators found higher dietary intake of vitamin A significantly decreased total fracture risk with 6% [RR = 0.94, 95% CI = 0.88 to 0.99, I2 = 35.18%, p = 0.20].

The investigators found higher dietary intake of vitamin A significantly increased hip fracture risk with 29% [RR = 1.29, 95% CI = 1.06 to 1.57, I2 = 0.00%, p = 0.60].

The investigators found lower blood level of retinol significantly increased hip fracture risk with 27% [RR = 1.27, 95% CI = 1.05 to 1.53, I2 = 0.00%, p = 0.62].

The investigators concluded that higher dietary intake of total vitamin A or retinol increases the risk of hip fracture but decreases total fracture risk. Clinical trials are warranted to confirm these results and assess the clinical applicability.

Original title:
The Effect of Vitamin A on Fracture Risk: A Meta-Analysis of Cohort Studies by Zhang X, Zhang R, [...], Chen G.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5615580/

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Vitamin A is a generic term for compounds with the biological activity of retinol. Preformed vitamin A (mainly retinol and retinyl esters) is usually found in foods derived from animal products and provitamin A (mainly β-carotene and carotenoids) is usually found in foods derived from plant products.
 

Objectives:
Vitamin D is involved in musculoskeletal health. There is no consensus on a possible association between circulating 25-hydroxyvitamin D (25OHD) concentrations and walking speed, a “vital sign” in older adults. Therefore, this meta-analysis (review article) has been conducted.

Does a high vitamin D level (expressed as circulating 25-hydroxyvitamin D (25OHD) concentrations) increase walking speed in older adults?

Study design:
This review article included 22 observational studies (17 cross-sectional and 5 longitudinal). The number of participants ranged between 54 and 4,100 (0-100% female).

Results and conclusions:
The investigators found usual walking speed was slower among participants with hypovitaminosis D, with a clinically relevant difference compared with normal vitamin D (>75 nmol/L) of -0.18m/s for severe vitamin D deficiency (≤25 nmol/L), -0.08m/s for vitamin D deficiency (≤50 nmol/L) and -0.12m/s for vitamin D insufficiency (≤75 nmol/L).

The investigators found similar results regarding the fast walking speed [mean differences = -0.04m/s for vitamin D deficiency (≤50 nmol/L) and vitamin D insufficiency (≤75 nmol/L) compared with normal vitamin D (>75 nmol/L) and Timed Up and Go test (TUG) [mean difference = 0.48s for severe vitamin D deficiency (≤25 nmol/L) compared with normal vitamin D (>75 nmol/L).

The investigators found a slow usual walking speed was positively associated with:
-severe vitamin D deficiency (≤25 nmol/L) [summary OR = 2.17, 95% CI = 1.52-3.10];
-vitamin D deficiency (≤50 nmol/L) [OR = 1.38, 95% CI = 1.01-1.89] and;
-vitamin D insufficiency (≤75nmol/L) [OR = 1.38, 95% CI = 1.04-1.83], using normal vitamin D (>75 nmol/L) as the reference.

The investigators concluded that robust evidence shows a high 25OHD concentration (vitamin D level of >75 nmol/L) increases walking speed among older adults.

Original title:
Vitamin D and walking speed in older adults: Systematic review and meta-analysis by Annweiler C, Henni S, [...], Duval GT.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29150169

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A vitamin D level of >75 nmol/L can be achieved by taking 800-1200 IU/d (800-1200 mcg/d) vitamin D3 supplements.
 

Objectives:
No quantitative assessment has been performed to specifically link the consumption of fruit and vegetables with the incident risk of cognitive disorders. Therefore, this meta-analysis (review article) has been conducted.

Does consumption of fruit and vegetables reduce risk of cognitive disorders?

Study design:
This review article included 6 cohort studies involving a total of 21,175 participants.

Results and conclusions:
The investigators found in pooled analysis that consumption of fruit and vegetables significantly reduced risk of cognitive disorders with 26% [pooled RR = 0.74, 95% BI = 0.62-0.88, I2 = 68%; the significant heterogeneity might be attributed to the ethnic difference].

The investigators concluded that consumption of fruit and vegetables reduces risk of cognitive disorders. However, further large prospective studies should be performed to quantify the potential dose-response patterns of fruit and/or vegetables intake and to explore the role of fruit or vegetables consumption separately on cognitive disorders in different populations.

Original title:
Intake of Fruit and Vegetables and the Incident Risk of Cognitive Disorders: A Systematic Review and Meta-Analysis of Cohort Studies by Wu L, Sun D and Tan Y.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29188891

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Objectives:
Currently, dementia is considered untreatable and there are many factors that cause dementia. However, previous studies were unable to identify the factors that affect directly. Therefore, this meta-analysis (review article) has been conducted.

What are the risk factors for prognostic dementia in stroke patients?

Study design:
This review article included 7 hospital-based cohorts of consecutive patients with stroke and 1 population-based cross-sectional study.

Results and conclusions:
The investigators found:
a significantly increased risk of 68% [pooled relative ratio = 1.68, 95% CI = 1.28 to 2.22, I2 = 72%] for atrial fibrillation;
a significantly increased risk of 59% [pooled relative ratio = 1.59, 95% CI = 1.33 to 1.91] for previous stroke;
a significantly increased risk of 40% [pooled relative ratio = 1.40, 95% CI = 1.23 to 1.59, I2% = 14%] for myocardial infarction;
a significantly increased risk of 36% [pooled relative ratio = 1.36, 95% CI = 1.20 to 1.53, I2 = 46%] for hypertension;
a significantly increased risk of 25% [pooled relative ratio = 1.25, 95% CI = 1.11 to 1.41, I2 = 0%] for diabetes mellitus and;
a significantly increased risk of 25% [pooled relative ratio = 1.25, 95% CI = 1.08 to 1.45, I2 = 16%] for previous transient ischemic attack (TIA).

The investigators concluded that strongly risk factors associated with increased risk of post-stroke dementia are atrial fibrillation, previous stroke, myocardial infarction, hypertension, diabetes and previous TIA. However, there are other risk factors related to dementia. Therefore, further studies are needed to investigate and develop the risk score value to forecast the dementia incident in stroke patients.

Original title:
Risk factors associated with post-stroke dementia: a systematic review and meta-analysis by Surawan J, Areemit S, […], Saensak S.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5641826/

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