Nutritional advice

Pregnancy

Scientific studies (review articles) on the relationship between diet/nutrients and pregnancy:
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 specific 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 specific topic) of cohort studies or case-control studies will answer the following question:
"Should I change my diet?".

2023:

  1. Probiotic/synbiotic supplements improve glucose and lipid metabolism in pregnant women with gestational diabetes mellitus
  2. Vitamin B6 supplements reduce nausea and vomiting during pregnancy

2022:

  1. Systolic blood pressure <130 mmHg prevents severe hypertension in pregnant women

2021:

  1. Oral magnesium supplementation does not reduce leg cramps during pregnancy
  2. Salt iodination alone is not sufficient to provide adequate iodine status to pregnant women
  3. Breastfeeding reduces ovarian cancer in women with BRCA1 or BRCA2 mutation
  4. Vitamin and mineral supplementation improves glycemic control in women with gestational diabetes mellitus
  5. Prenatal alcohol exposure increases placental abruption
  6. Preterm birth and low birthweight are strongest risk factors associated with increased case fatality of infants with spina bifida
  7. Enteral zinc supplementation enhances weight gain and linear growth in preterm infants
  8. >650 mg/day maternal or neonatal DHA and/or EPA supplements increase weight in childhood
  9. 400 μg folic acid during pregnancy reduce offspring's autism spectrum disorders
  10. Multiple-micronutrient supplementation improves birth outcomes among pregnant adolescents in low- and middle-income countries
  11. Vitamin A supplementation reduces bronchopulmonary dysplasia in premature infants
  12. CNS congenital abnormalities, intracranial calcifications, fetal loss, SGA, low birth weight and prematurity are associated with Zika virus infection
  13. A low maternal serum zinc level increases pre-eclampsia in African women
  14. Daily 100 mg cholesterol increase gestational diabetes mellitus

2020:

  1. Probiotic supplementation during pregnancy is beneficial for gestational age
  2. COVID-19 pandemic increases anxiety among women during pregnancy and perinatal period
  3. Coronavirus infection is more likely to affect pregnant women
  4. Rates of vaccine coverage immediately after birth are very low for BCG and HepB-BD in neonates in sub-Saharan Africa
  5. Artemisinin-based combination therapies should be treatment guidelines for uncomplicated falciparum malaria in pregnant women
  6. Higher levels of gestational vitamin D reduce multiple sclerosis in offspring
  7. Iron fortification increases haemoglobin concentration during pregnancy
  8. Probiotic supplementation has positive effects on outcomes of preterm infants in India
  9. No association between oral cholera vaccination and adverse pregnancy outcomes
  10. Influenza vaccination during pregnancy reduce infant influenza
  11. Probiotic supplementation improves outcomes of preterm infants in India
  12. Omega-3 fatty acids + vitamin E or D reduce gestational diabetes
  13. Maternal folic acid supplementation is associated with an increased birth weight
  14. Measles infection in pregnancy is dangerous for mother and fetus
  15. N-3 fatty acids supplementation reduces preeclampsia during pregnancy
  16. High maternal thyroid hormones during pregnancy increase neonatal birth weight

2019:

  1. 75 mg daily DHEA supplements increase fertility in women
  2. Higher plasma levels of free fatty acids increase gestational diabetes mellitus
  3. Pregnancy-associated malaria increases preterm birth and low birth weight
  4. HPV vaccination during pregnancy does not increase adverse pregnancy outcomes
  5. Maternal folic acid supplementation reduces childhood acute lymphoblastic leukaemia
  6. Multiple micronutrient supplementation generates positive health outcomes for both infants and pregnant women
  7. 0.6-2 gram calcium supplement reduce gestational hypertension
  8. Maternal vitamin D deficiency during pregnancy increases low birth weight
  9. Mother-infant skin to skin contact immediately after birth increases breastfeeding
  10. Steady-state red blood cell folate concentrations can be reached with 375-570 µg folic acid/day
  11. Breastfeeding can be improved by a combination of professional and laypersons
  12. High prenatal vitamin D level reduces risk autism-related traits later in life

2018:

  1. Probiotic supplementation during both prenatal and postnatal period reduces atopic dermatitis
  2. 2g inositol twice daily reduce preterm delivery rate
  3. Antioxidant supplements could increase sperm quality
  4. Egg into an infant’s diet between 3 and 6 months of age reduces egg allergy risk
  5. PUFA supplements do not improve intelligence in low birth weight children
  6. Kangaroo mother care increases breastfeeding
  7. Antenatal care and institutional delivery increase exclusive breastfeeding practices in Ethiopia
  8. Asian vegetarian mothers have an increased risk to deliver babies with low birth weight
  9. Low maternal iodine status in early pregnancy gives lower IQ
  10. Myo-inositol supplementation reduces risk of gestational diabetes and preterm delivery in pregnant women
  11. Anemia at the beginning of pregnancy increases a SGA baby
  12. Maternal probiotic supplements during pregnancy and lactation reduce eczema during childhood

2017:

  1. First-trimester use of artemisinin derivatives is not associated with an increased risk of miscarriage or stillbirth compared to quinine
  2. ABT results in higher efficacy than QBT in the second and third trimester of pregnancy with uncomplicated falciparum malaria
  3. Women’s groups practising participatory learning and action improve key behaviours on the pathway to neonatal mortality
  4. Breastfeeding during 6-9 months reduces risk of endometrial cancer
  5. Antenatal multiple micronutrient supplements provide greater birth-outcome benefits for infants born to undernourished and anaemic pregnant women
  6. Plasmodium falciparum malaria in pregnancy increases stillbirth risk
  7. Daily 1mg heme iron increases risk of gestational diabetes mellitus in pregnant women
  8. Childhood nutritional supplementation with ≥5 nutrients improves cognitive development of children in developing countries
  9. Pregnant women with malnutrition and malaria infection are at increased risk of having a low birthweight compared to women with only 1 risk factor or none
  10. Severe vitamin D deficiency (<20 ng/mL) increases risk of early spontaneous pregnancy loss
  11. Serum ceruloplasmin may be a useful screening and follow-up tool for developing preeclampsia
  12. High serum copper level increase risk of preeclampsia in Asian pregnant women
  13. Zinc sulfate supplementation does not reduce neonatal jaundice
  14. Fish consumption during pregnancy is not associated with risk of asthma and other allergy-related diseases from infancy to mid childhood
  15. Routine supplementation of full-term infant milk formula with LCPUFA cannot be recommended
  16. Vitamin D supplementation alone during pregnancy reduces risk of preterm birth
  17. Maternal vitamin B12 deficiency increases low birth weight in newborns

2013:

  1. Daily 10 to 66 mg iron supplementation during pregnancy improve maternal haematological status and birth weight

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Childbirth usually occurs about 38 weeks after conception; in women who have a menstrual cycle length of four weeks, this is approximately 40 weeks from the start of the last normal menstrual period. A pregnancy of 37 to 42 weeks is considered full-term. A pregnancy less than 37 weeks is considered pre-term, which is dangerous due to underdevelopment. Over 42 weeks is also dangerous due to septic poisoning.
Women generally don't begin to feel the baby moves until sometime between 16 and 22 weeks or later. In general, the gender can be determined with certainty after the fourteenth week. After 30 weeks of gestation, the baby is able to recognize a language.

The pregnancy is divided into 3 periods:

  1. The first 3 months. During these months all organs of the fetus are developed.
  2. The second three months, in which the organs further develop.
  3. The last 3 months. During these 3 months the emphasis is put on growth and the unborn child gets per day 67 mg of DHA from the mother.

A woman with a BMI of 18.5-25 will gain during pregnancy about 12 kg, of which about one third is the weight of the child.

BMI before pregnancyDesired weight gain during pregnancy
<19.8

12

.5-18

19.8-2611.5-16
26-297-11.5
>296
A woman with 65 kg and 1.57 meters has a BMI of 26.4 (65/(1.57x1.57)). BMI is kg/m2.

 

Energy requirements during pregnancy
The duration of pregnancyExtra kcal per day
The first 3 months70
The second three months260
The last 3 months500


During breastfeeding mothers need on average 500 extra calories per day. Most women need 6 months to a year after childbirth to get back to their pre-pregnancy weight.

It is not desirable to lose weight during pregnancy.

The World Health Organization shows that optimal birth weight of 3.1-3.6 kg is associated with maternal weight gains of 10-14 kg.

Dietary guidelines during pregnancy:

  • A balanced diet during pregnancy contains 18-24 kJ (4.3-5.7 kcal) per kg body weight. This diet has a low GI value and includes whole grains, fruits, beans and vegetables.
  • Your daily diet (=all meals/products that you eat on a daily basis) should on average contain maximum 30 En% fat, maximum 7-10 En% saturated fat, 15-20 En% protein, 50-55 En% carbohydrates, maximum 25 En% simple sugars, maximum 0.3 gram salt per 100 kcal, minimum 1.3 grams of fiber per 100 kcal and fish providing 500 mg of EPA and DHA (with 200 mg DHA) per day.
  • Do not drink alcohol.
  • Stop smoking.
  • Take daily 400 micrograms (mcg) of folic acid supplement for a period of at least four weeks prior to the first eight weeks of pregnancy.
    400 mcg of folic acid per day reduces the risk of getting a spina bifida and cleft palate in the unborn child.
  • Eat no more than 3000 micrograms of vitamin A per day.
  • Aim for a BMI of 18.5-25 before entering the pregnancy. Research has shown that the healthiest pregnancy is associated with a pre-pregnancy BMI of 23.
  • Eat fish, providing at least 200 mg of DHA per day. DHA is needed for the development of the brain and vision of the fetus.  
  • Do not eat raw or undercooked (pink fried) meat because the mother can be infected with toxoplasmosis. Toxoplasmosis can cause permanent damage to the brains and eyes of the unborn child. Feces of cats and sandboxes are also sources of toxoplasmosis.
  • Do not eat cheeses made from raw milk (lait au cu).The listeria bacteria are found in raw milk. Listeria can be harmful to the unborn child and can even cause miscarriage.
  • Take a multivitamin supplement.
  • Take fish oil supplements (250-500 mg of EPA and DHA per tablet) if you do not eat fish. Take only dietary supplements after consulting an expert!

Dietary guidelines during breastfeeding:

  • Do not drink alcohol.
  • Stop smoking.
  • Do not drink more than 3 cups of coffee or 3 cups of tea per day. Too much caffeine (found in coffee and tea) can make the baby restless.
  • Give 4-6 months exclusively breastfeeding because breast milk is the healthiest nutrition for the baby. After 4-6 months the baby should receive supplementary feeding because breastfeeding no longer covers the daily nutritional requirements of the growing baby.
  • Do not lose more than 0.5 kg weight per week, otherwise your baby will get through breastfeeding too much toxins. Toxins in the human body are stored in fatty tissues.

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?".

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

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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.

Probiotic/synbiotic supplements improve glucose and lipid metabolism in pregnant women with gestational diabetes mellitus

Afbeelding

Objectives:
The effect of probiotic/synbiotic supplementation on gestational diabetes mellitus (GDM) is controversial. Therefore, this review article has been conducted.

Do probiotic/synbiotic supplements improve glucose and lipid metabolism in pregnant women with gestational diabetes mellitus?

Study design:
This review article included 11 RCTs with a total of 390 women with gestational diabetes mellitus in probiotics/synbiotics group and 389 women with gestational diabetes mellitus in placebo group.

The mean age of those participants ranged from 26.4 years to 33.5 years.
The duration of intervention ranged from 4 weeks to 8 weeks.

Results and conclusions:
The investigators found compared with the placebo, probiotics/synbiotics supplements were associated with a statistically significant improvement in fasting plasma glucose (FPG) [MD = -2.33, 95% CI = -4.27 to -0.40, p = 0.02, I2 = 74%].  

The investigators found compared with the placebo, probiotics/synbiotics supplements were associated with a statistically significant improvement in the homoeostatic model assessment for insulin resistance (HOMA-IR) [MD = -0.40, 95% CI = -0.74 to -0.06, p = 0.02, I2 = 76%].  

The investigators found compared with the placebo, probiotics/synbiotics supplements were associated with a statistically significant improvement in fasting serum insulin (FSI) [MD = -2.47, 95% CI = -3.82 to -1.12, p = 0.0003, I2 =73%].  

The investigators found compared with the placebo, probiotics/synbiotics supplements were associated with a statistically significant improvement in total cholesterol (TC) [MD = -6.59, 95% CI = -12.23 to -0.95, p = 0.02].  

The investigators found subgroup analysis revealed that the kind of supplement led to heterogeneity for FPG and FSI, while heterogeneity was not found for others.

The investigators concluded probiotic/synbiotic supplements improve glucose and lipid metabolism in pregnant women with gestational diabetes mellitus. The use of specific probiotic supplementations containing Lactobacillus acidophilus and Bifidobacterium bifidum (>1 × 106 CFU/g) may be a promising prevention and therapeutic strategy for gestational diabetes mellitus, as they could directly act on the intestinal mucosal barrier and restore the gut flora balance. However, due to the heterogeneity among existing studies, further studies are warranted to address the limitations of existing evidence and better inform the management of gestational diabetes mellitus.

Original title:
The Effects of Probiotics/Synbiotics on Glucose and Lipid Metabolism in Women with Gestational Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trials by Mu J, Xian Guo X, […], Cao G.

Link:
https://www.mdpi.com/2072-6643/15/6/1375

Additional information of El Mondo:
Find more information/studies on probiotic, diabetes mellitus and pregnancy right here.

 

 Vitamin B6 supplements reduce nausea and vomiting during pregnancy

Afbeelding

Objectives:
Nausea and vomiting during pregnancy (NVP) are common symptoms in pregnancy. Although no definitive treatment option for NVP, pyridoxine (vitamin B6) supplementation has been used widely. Therefore, this review article has been conducted.

Does supplementation of pyridoxine alone as well as combined treatment of pyridoxine with an active ingredient as the intervention reduce nausea and vomiting during pregnancy?

Study design:
This review article included 8 RCTs.

Results and conclusions:
The investigators found 8 studies showed beneficial effects with pyridoxine alone as the supplementation, while 6 others found that the supplementation of pyridoxine in combination with another active substance had favourable effects.

The investigators found supplementation of pyridoxine alone as well as combined treatment of pyridoxine with an active ingredient as the intervention significantly improved the symptoms of nausea according to Rhode's score [0.78, 95% CI= 0.26 to 1.31, p = 0.003, I2 = 57%, p = 0.10] and PUQE score [0.75, 95% CI = 0.28 to 1.22, p = 0.002, I2 = 0%, p = 0.51], respectively.

The investigators concluded supplementation of pyridoxine (vitamin B6) alone as well as combined treatment of pyridoxine with an active ingredient as the intervention reduces nausea and vomiting during pregnancy.

Original title:
The effects of pyridoxine (vitamin B6) supplementation in nausea and vomiting during pregnancy: a systematic review and meta-analysis by Jayawardena R, Majeed S, […], Ranaweera P.

Link:
https://pubmed.ncbi.nlm.nih.gov/36719452/

Additional information of El Mondo:
Find more information/studies on vitamin B6 and pregnancy right here.
 

Vitamin D deficiency increases blindness in people with diabetes

Afbeelding

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.

 

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

Afbeelding

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.
 

Ginger supplementation reduces blood pressure in patients with type 2 diabetes

Afbeelding

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/

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Oral magnesium supplementation does not reduce leg cramps during pregnancy

Objectives:
Leg cramps are one of the common symptoms during pregnancy. About 30%-50% of pregnant women experience leg cramps twice a week. Leg cramps may cause severe pain and sleep disturbance, hinder performance of daily activities and may lengthen the duration of pregnancy and the type of childbirth. Therefore, this review article has been conducted.

Does oral magnesium supplementation reduce leg cramps during pregnancy?

Study design:
This review article included 4 RCTs with a total of 332 pregnant women.

Results and conclusions:
The investigators found the frequency of leg cramps during pregnancy was not significantly decreased in the magnesium group compared to the control group (group without magnesium) [WMD = -0.47, 95% CI = -1.14 to 0.20, p = 0.167].

The investigators found oral magnesium supplementation did not significantly improved the recovery from leg cramps during pregnancy compared to the control group [OR = 0.47, 95% CI = 0.14 to 1.52, p = 0.207].

The investigators found oral magnesium supplementation had no significant side effects in the treatment group (group with magnesium) compared to the control group [OR = 1.82, 95% CI = 0.90 to 3.69, p = 0.094].

The investigators concluded that oral magnesium supplementation is not effective in the treatment of leg cramps during pregnancy.

Original title:
Effect of oral magnesium supplementation for relieving leg cramps during pregnancy: A meta-analysis of randomized controlled trials by Liu J, Song G, [...], Meng T.

Link:
https://pubmed.ncbi.nlm.nih.gov/34247796/

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Higher concentrations of carotenoids reduce type 2 diabetes

Afbeelding

Objectives:
Previous meta-analysis studies have indicated inverse associations between some carotenoids and risks of metabolic syndrome, cardiovascular disease, cancer and all-cause mortality. However, the results for associations between carotenoids and type 2 diabetes (T2D) remain inconsistent and no systematic assessment has been done on this topic. Therefore, this review article (meta-analysis) has been conducted.

Do higher dietary intakes and circulating concentrations of carotenoids reduce risk of type 2 diabetes?

Study design:
This review article included 13 studies.

Results and conclusions:
The investigators found for the the highest versus the lowest categories of dietary intake of β-carotene a significantly reduced risk of 22% for type 2 diabetes [pooled RR = 0.78, 95% CI = 0.70 to 0.87, I2 = 13.7%, n = 6].
This significantly reduced risk was also found for total carotenoids (n = 2), α-carotene (n = 4), and lutein/zeaxanthin (n = 4), with pooled RRs ranging from 0.80 to 0.91, whereas no significant associations were observed for β-cryptoxanthin and lycopene.

The investigators found for the the highest versus the lowest categories of circulating concentration of β-carotene a significantly reduced risk of 40% for type 2 diabetes [pooled RR = 0.60, 95% CI = 0.46 to 0.78, I2 = 56.2%, n = 7].
This significantly reduced risk was also found for total carotenoids (n = 3), lycopene (n = 4), and lutein (n = 2), with pooled RRs ranging from 0.63 to 0.85, whereas no significant association was found for circulating concentrations of α-carotene and zeaxanthin when comparing extreme categories.

The investigators found dose-response analysis indicated that nonlinear relations were observed for circulating concentrations of α-carotene, β-carotene, lutein and total carotenoids [all p-nonlinearity 0.05], but not for other carotenoids or dietary exposures.

The investigators concluded that higher dietary intakes and circulating concentrations of total carotenoids, especially β-carotene, are associated with a lower risk of type 2 diabetes. More studies are needed to confirm the causality and explore the role of foods rich in carotenoids in prevention of type 2 diabetes.

Original title:
Dietary Intake and Circulating Concentrations of Carotenoids and Risk of Type 2 Diabetes: A Dose-Response Meta-Analysis of Prospective Observational Studies by Jiang YW, Sun ZH, [...], Pan A.

Link:
https://pubmed.ncbi.nlm.nih.gov/33979433/

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Vitamin and mineral supplementation improves glycemic control in women with gestational diabetes mellitus

Afbeelding

Objectives:
The effects of vitamin and mineral supplementation on women with gestational diabetes mellitus (GDM) have not been well established. Therefore, this review article has been conducted.

Does vitamin and mineral supplementation improve glycemic control (like, fasting plasma glucose, serum insulin, homeostasis model assessment-insulin resistance and homeostasis model of assessment for β cell function) and decrease risk of inflammation and oxidative stress in women with gestational diabetes mellitus?

Study design:
This review article included 12 RCTs with 698 patients.

Patients included were in the age range of 18-40 years and all reported gestational diabetes mellitus screening was conducted between 24 weeks and 28 weeks gestation.

All trials gave vitamin and mineral supplementation orally.

Types, doses, dose regimens and duration of vitamin and mineral supplementation were as follows: magnesium (100-250 mg), zinc (4-233 mg), selenium (200 μg), calcium (400-1000 mg) and vitamin E (400 IU) every day for 6 weeks, vitamin D (200-50000 IU) every day or every 2 or 3 weeks for 6 weeks. Magnesium, zinc, selenium, calcium, vitamin D or E was given separately or in different combinations: magnesium and vitamin E; zinc and vitamin E; calcium and vitamin D; magnesium, zinc, calcium and vitamin D.

All trials used placebo as control intervention.

Among the 12 trials, 8 were judged to be at low risk of bias and 4 as being at unclear risk of bias. Unclear risks were related to attrition bias and other bias.

No significant publication bias was found for the effect of vitamin and mineral supplementation on all 8 outcomes.

Results and conclusions:
The investigators found magnesium, zinc, selenium, calcium, vitamin D and E (alone or in combination) supplementation significantly improved glycemic control in women with gestational diabetes mellitus compared to those receiving placebos:
-fasting plasma glucose (FPG) [MD = - 9.02, 95% CI = -12.09 to -5.96, p   0.00001];
-serum insulin [MD = -4.33, 95% CI = -5.35 to -3.32, p  0.00001];
-homeostasis model assessment-insulin resistance (HOMA-IR) [MD = -1.34, 95% CI = -1.60 to -1.07, p  0.00001] and;
-homeostasis model of assessment for β cell function (HOMA-B) [MD = - 15.58, 95% CI = -23.70 to -7.46, p = 0.0002].
Significantly because the calculated p-value of 0.0002 was less than the p-value of 0.05.

The investigators found vitamin and mineral supplementation (magnesium, zinc, selenium, calcium, vitamin D and E (alone or in combination)) significantly decreased risk of inflammation and oxidative stress through decreasing high-sensitivity C-reactive protein (hs-CRP) [MD = -1.29, 95% CI = -1.82 to -0.76, p  0.00001], malondialdehyde (MDA) [MD = -0.71, 95% CI = -0.97 to -0.45, p  0.00001] and increasing total antioxidant capacity (TAC) [MD = 45.55, 95% CI = 22.02 to 69.08, p = 0.0001].

The investigators concluded that vitamin and mineral supplementation improves glycemic control and decreases risk of inflammation and oxidative stress in women with gestational diabetes mellitus.

Original title:
The effects of vitamin and mineral supplementation on women with gestational diabetes mellitus by Li D, Cai Z, [...], Zhang J.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8145819/

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Dietary sodium restriction causally reduces blood pressure in patients with type 2 diabetes mellitus

Afbeelding

Objectives:
Although current guidelines recommend reduction of salt intake in patients with diabetes, the benefits of reducing salt intake in people with type 2 diabetes mellitus (T2DM) lack clear evidence. Therefore, this review articles has been conducted.

Does dietary sodium restriction causally reduce blood pressure in patients with type 2 diabetes mellitus (T2DM)?

Study design:
This review article included 8 RCTs with 10 trials (7 cross-over and 3 parallel designs).
No publication bias was found from Begg's and Egger's tests.

Results and conclusions:
The investigators found compared with ordinary sodium intake, dietary sodium restriction significantly decreased 24-hour urine sodium level [WMD = -38.430 mmol/24h, 95% CI = -41.665 mmol/24h to -35.194 mmol/24h].

The investigators found dietary sodium restriction significantly lowered systolic blood pressure [WMD = -5.574 mm Hg, 95% CI = -8.314 to -2.834 mm Hg, I2 = 0.0%] and diastolic blood pressure [WMD = -1.675 mm Hg, 95% CI = -3.199 to -0.150 mm Hg, I2 = 0.0%].

The investigators concluded that dietary sodium restriction causally reduces systolic blood pressure and diastolic blood pressure in patients with type 2 diabetes mellitus (T2DM).

Original title:
Effect of dietary sodium restriction on blood pressure in type 2 diabetes: A meta-analysis of randomized controlled trials by Ren Y, Liqiang Qin L, […], Ma Y.

Link:
https://pubmed.ncbi.nlm.nih.gov/33838996/

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Salt consists of sodium and chloride. So a dietary sodium restriction means a reduction in dietary salt intake.

A diet with dietary salt restriction is a diet with maximum 0.2 grams of salt per 100 kcal.

The easiest way to follow this diet is to choose only products/meals with maximum 0.2 grams of salt per 100 kcal. These products from the supermarket contain maximum 0.2 grams of salt per 100 kcal.

However, the most practical way to follow this diet is, all your daily consumed products/meals should contain on average maximum 0.2 grams of salt per 100 kcal.
To do this, use the 7-points nutritional profile app to see if your daily diet contains maximum 0.2 grams of salt per 100 kcal.

Daily 80g potato increase type 2 diabetes among Western populations

Afbeelding

Objectives:
Evidence regarding associations between potato consumption and type 2 diabetes (T2D) and gestational diabetes mellitus (GDM) risks is accumulating. Therefore, this review article has been conducted.

Does a high potato intake increase type 2 diabetes and gestational diabetes mellitus (diabetes mellitus during pregnancy) risk?

Study design:
This review article included 19 studies (13 for type 2 diabetes and 6 for gestational diabetes mellitus) with a total of 21,357 type 2 diabetes cases among 323,475 participants and 1,516 gestational diabetes mellitus cases among 29,288 pregnancies.

Results and conclusions:
The investigators found meta-analysis showed a significantly increased risk of 19% [RR = 1.19, 95% CI = 1.06 to 1.34] for type 2 diabetes for total potato intakes among Western populations.

The investigators found meta-analysis showed a significantly increased risk of 8% [RR = 1.08, 95% CI = 1.00 to 1.16] for type 2 diabetes for baked/boiled/mashed potato intakes among Western populations.

The investigators found meta-analysis showed a significantly increased risk of 33% [RR = 1.33, 95% CI = 1.03 to 1.70] for type 2 diabetes for French fries/fried potato intakes among Western populations.

The investigators found dose-response meta-analysis demonstrated a significantly increased type 2 diabetes risk by 10% [95% CI = 1.07 to 1.14, p for trend 0.001], 2% [95% CI = 1.00 to 1.04, p for trend = 0.02] and 34% [95% CI = 1.24 to 1.46, p for trend 0.001] among Western populations for each 80 g/day (serving) increment in total potato, unfried potato and fried potato intakes, respectively.

The investigators found dose-response meta-analysis demonstrated a significantly increased gestational diabetes mellitus risk by 22% [95% CI = 1.06 to 1.42, p for trend 0.007] among Western populations for each 80 g/day (serving) increment in total potato intakes.

The investigators found dose-response meta-analysis demonstrated a significantly increased gestational diabetes mellitus risk by 26% [95% CI = 1.07 to 1.48, p for trend = 0.006] among Western populations for each 80 g/day (serving) increment in unfried potato intakes.

The investigators concluded that higher potato intake (at least 80g per day) is associated with higher type 2 diabetes risk among Western populations. The positive relationship presents a significant dose-response manner. Wisely controlled potato consumption may confer potential glucometabolic benefits.

Original title:
Dietary potato intake and risks of type 2 diabetes and gestational diabetes mellitus by Guo F, Zhang Q, [...], Ma L.

Link:
https://pubmed.ncbi.nlm.nih.gov/34130021/

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Vitamin C supplements improve triglyceride and cholesterol levels in patients with type 2 diabetes mellitus

Afbeelding

Objectives:
Does vitamin C supplementation improve triglyceride and cholesterol levels in patients with type 2 diabetes mellitus?

Study design:
This review article included 15 studies with 872 participants.

Results and conclusions:
The investigators found, findings from 15 studies indicated that vitamin C supplementation significantly decreased triglyceride (TG) levels [WMD= -16.48 mg/dL, 95% CI = -31.89 to -1.08, p 0.001] and total cholesterol (TC) levels [WMD = -13.00 mg/dL, 95% CI = -23.10 to -2.91, p 0.001] in patients with type 2 diabetes mellitus.

The investigators found, however, vitamin C supplementation failed to improve LDL (bad cholesterol) and HDL cholesterol (good cholesterol) levels. 

The investigators found the meta-regression analysis suggested that lipid profile improvement was affected by duration of vitamin C treatment.

The investigators found dose-response analysis showed that vitamin C supplementation changed LDL cholesterol significantly based on vitamin C dose.

The investigators concluded that vitamin C supplementation improves lipid profile via decreases in triglyceride and total cholesterol levels in patients with type 2 diabetes mellitus. It appears that vitamin C supplementation is more beneficial to lipid profile in long-term vs. short term interventions.

Original title:
Does vitamin C supplementation exert profitable effects on serum lipid profile in patients with type 2 diabetes? A systematic review and dose-response meta-analysis by Namkhah Z, Ashtary-Larky D, […], Asbaghi O.

Link:
https://pubmed.ncbi.nlm.nih.gov/33984490/

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Spirulina supplementation reduces bad cholesterol among type 2 diabetes patients

Afbeelding

Objectives:
Does spirulina supplementation improve glycemic related markers (like, fasting blood glucose, post prandial blood sugar and HbA1c levels) and lipid profile (like, triglyceride and cholesterol levels) among type 2 diabetes patients?

Study design:
This review article included 8 RCTs (9 arms).

Results and conclusions:
The investigators found, spirulina supplementation significantly reduced fasting blood glucose levels [-17.88 mg/dL, 95% CI = -26.99 to -8.78, I2 = 25%] among type 2 diabetes patients.

The investigators found, spirulina supplementation significantly reduced triglyceride levels [-30.99 mg/dL, 95% CI = -45.20 to -16.77, I2 = 50%] among type 2 diabetes patients.

The investigators found, spirulina supplementation significantly reduced total cholesterol levels [-18.47 mg/dL, 95% CI = -33.54 to -3.39, I2 = 73%] among type 2 diabetes patients.

The investigators found, spirulina supplementation significantly reduced LDL cholesterol (bad cholesterol) levels [-20.04 mg/dL, 95% CI = -34.06 to -6.02, I2 = 75%] among type 2 diabetes patients.

The investigators found, spirulina supplementation significantly reduced VLDL cholesterol levels [-6.96 mg/dL, 95% CI = -9.71 to -4.22, I2 = 33%] among type 2 diabetes patients.

The investigators found, spirulina supplementation significantly increased HDL cholesterol (good cholesterol) levels among type 2 diabetes patients.

The investigators found no significant effect on HbA1C or post prandial blood sugar among type 2 diabetes patients following spirulina supplementation.

The investigators concluded that spirulina supplementation has beneficial effects on fasting blood glucose and blood lipid profiles among type 2 diabetes patients.

Original title:
The effect of spirulina on type 2 diabetes: a systematic review and meta-analysis by Hatami E, Ghalishourani SS, […], Mansour-Ghanaei F.

Link:
https://pubmed.ncbi.nlm.nih.gov/34178867/

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Grapes/grape products supplementation reduces HOMA-IR values in adults

Objectives:
Does grapes/grape products supplementation improve glycemic indices (like HOMA-IR, Hb1Ac and fasting insulin level) in adults or in other words, does eating grapes or grape products causally improve glycemic indices in adults?

Study design:
This review article included 29 RCTs with a total of 1,297 participants.

Results and conclusions:
The investigators found, overall, the grapes/grape products supplementation significantly reduced homeostatic model assessment of insulin resistance (HOMA-IR) [WMD = -0.54, 95% CI = -0.91 to -0.17, p = 0.004] in adults.   
Significantly because the calculated p-value of = 0.004 was less than the p-value of 0.05.

The investigators found, however, the grapes/grape products supplementation did not affect fasting insulin levels [WMD = -0.90 μIU/mL, 95% CI = -1.04 to 2.84, p = 0.362] and hemoglobin A1c (Hb1Ac) percentage [WMD = 0.00%, 95% CI = -0.10 to 0.11, p = 0.916] in the main analyses.
Did not affect because the calculated p-value of 0.916 was larger than the p-value of 0.05.

The investigators concluded that the grapes/grape products supplementation reduces homeostatic model assessment of insulin resistance (HOMA-IR) in adults. Further, large-scale RCTs with longer duration are required to confirm these results.

Original title:
The effect of grapes/grape products on glycemic response: A systematic review and meta-analysis of randomized controlled trials by Moodi V, Abedi S, […], Miraghajani M.

Link:
https://pubmed.ncbi.nlm.nih.gov/33893683/

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Homeostatic model assessment of insulin resistance (HOMA-IR) is a method for assessing β-cell function and insulin resistance (IR) from basal (fasting) glucose and insulin or C-peptide concentrations. HOMA-IR is an indicator of insulin resistance in diabetic patients. The higher the value, the more resistant you are to insulin. Diabetic patients often have a high HOMA-IR value.

Chromium supplementation improves lipid profile in patients with type 2 diabetes mellitus

Afbeelding

Objectives:
Does chromium supplementation improve lipid profile (serum levels of triglyceride and cholesterol) in patients with type 2 diabetes mellitus (T2DM)?

Study design:
This review article included  24 RCTs (with 28 effect sizes).

Results and conclusions:
The investigators found that chromium supplementation resulted in a significant decrease in serum levels of triglyceride (TG) in patients with type 2 diabetes mellitus [MD = -6.54 mg/dL, 95 % CI = -13.08 to -0.00, p = 0.050].
Significant means that there is an association with a 95% confidence.

The investigators found that chromium supplementation resulted in a significant decrease in serum levels of total cholesterol (TC) in patients with type 2 diabetes mellitus [WMD = -7.77 mg/dL, 95 % CI = -11.35 to -4.18, p 0.001].

The investigators found that chromium supplementation significantly increased high-density lipoprotein cholesterol (HDL cholesterol or good cholesterol) in patients with type 2 diabetes mellitus [WMD = 2.23 mg/dL, 95 % CI = 0.07 to 4.40, p = 0.043] level.

The investigators found, however, chromium supplementation did not have significant effects on low-density lipoprotein cholesterol (LDL cholesterol or bad cholesterol) in patients with type 2 diabetes mellitus [WMD = -8.54 mg/dL, 95 % CI = -19.58 to 2.49, p = 0.129] level.

The investigators concluded that chromium supplementation decreases serum levels of triglyceride (TG) and total cholesterol (TC) and increases HDL cholesterol (good cholesterol) levels in patients with type 2 diabetes mellitus. It should be noted that the lipid-lowering properties of chromium supplementation are small and may not reach clinical importance.

Original title:
Effects of chromium supplementation on lipid profile in patients with type 2 diabetes: A systematic review and dose-response meta-analysis of randomized controlled trials by Asbaghi O, Naeini F, […], Naeini AA.

Link:
https://pubmed.ncbi.nlm.nih.gov/33813266/

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>650 mg/day maternal or neonatal DHA and/or EPA supplements increase weight in childhood

Afbeelding

Objectives:
Do high maternal or neonatal DHA and/or EPA levels increase offspring birth weight and weight in childhood?

Study design:
This review article included 27 RCTs with 6,408 infants and 14 observational studies.

Results and conclusions:
The investigators found in RCTs that >650 mg/day DHA and/or EPA supplementation significantly increased birth weight [MD = 87.5g, 95% CI = 52.3 to 122.6, n = 3,831 participants, moderate quality].

The investigators found in RCTs that >650 mg/day DHA and/or EPA supplementation significantly increased combined BMI and BMI z score at 5-10 years [SMD = 0.11, 95% CI = 0.04 to 0.18, n = 3,220 participant, moderate quality].

The investigators found results from the observational studies were generally inconsistent. High trans fatty acids levels during pregnancy seemed to be associated with lower birth weight.

The investigators concluded this review and meta-analysis support a relationship between high maternal or neonatal DHA and/or EPA levels and higher offspring birth weight and weight in childhood. More high-quality long-term studies are still needed.

Original title:
Systematic Literature Review and Meta-Analysis of the Relationship Between Polyunsaturated and Trans Fatty Acids During Pregnancy and Offspring Weight Development by Ren X, Vilhjálmsdóttir BL, […], Specht  IO.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8027310/

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400 μg folic acid during pregnancy reduce offspring's autism spectrum disorders

Afbeelding

Objectives:
Does intake of folic acid during pregnancy reduce risk of offspring's autism spectrum disorders?

Study design:
This review article included 10 studies with 23 sub-studies (9,795 autism spectrum disorders cases).

Results and conclusions:
The investigators found folic acid supplementation during early pregnancy significantly reduced risk of offspring's autism spectrum disorders with 43% [OR = 0.57, 95% CI = 0.41 to 0.78].

The investigators found the consumption of a daily amount of at least 400 μg folic acid from dietary sources and supplements significantly reduced risk of offspring's autism spectrum disorders with 45% [OR = 0.55, 95% CI = 0.36 to 0.83].

The investigators concluded that the consumption of a daily amount of at least 400 μg (400 mcg) folic acid from dietary sources and supplements during pregnancy reduces risk of offspring's autism spectrum disorders.

Original title:
Prenatal Folic Acid Supplements and Offspring's Autism Spectrum Disorder: A Meta-analysis and Meta-regression by Liu X, Zou M, [...], Chen WX.

Link:
https://pubmed.ncbi.nlm.nih.gov/33743119/

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L-arginine supplements do not reduce diabetes in adults

Afbeelding

Objectives:
Does L-arginine supplementation improve biomarkers (fasting blood sugar, insulin, HbA1c and HOMA-IR values) of glycemic control in adults?

Study design:
This review article included 12 randomised clinical trials (RCTs).

Results and conclusions:
The investigators found L-arginine supplementation had no significant effect on serum fasting blood sugar (FBS) [weighted mean difference (WMD) = -3.38 mg/dL, 95% CI = -6.79 to 0.04, p = 0.53], serum insulin [WMD = -0.12 Hedges' g, 95% CI = -0.33 to 0.09, p = 0.27], glycated haemoglobin A1c (HbA1c) [WMD = -0.04%, 95% CI = -0.25 to 0.17, p = 0.71] and homeostasis model assessment for insulin resistance (HOMA-IR) [WMD = -0.48, 95% CI = -1.15 to 0.19, p = 0.15].
No significant because the calculated p-value of 0.15 was larger than the p-value of 0.05.

The investigators concluded although several animal studies have proposed that L-arginine supplementation might improve blood glucose control, the present review article could not confirm this benefit in humans.

Original title:
Effects of L-arginine supplementation on biomarkers of glycemic control: a systematic review and meta-analysis of randomised clinical trials by Karimi E, Hatami E, […], Askari G.

Link:
https://pubmed.ncbi.nlm.nih.gov/33426939/

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Arginine is classified as a semiessential or conditionally essential amino acid, depending on the developmental stage and health status of the individual, that helps the body build protein. L-arginine is also found in most protein-rich foods, including fish, red meat, poultry, soy, whole grains, beans and dairy products.
 

1.5 g/day garlic supplementation reduces adiponectin level among participants ˂30 years

Afbeelding

Objectives:
Does garlic supplementation reduce adiponectin and leptin serum levels?

Study design:
This review article included 5 RCTs.

Results and conclusions:
The investigators found that garlic supplementation did not significantly affect adiponectin [Hedges's = 0.20, 95% CI = -0.06 to 0.47, p = 0.12] and leptin [Hedges's = 0.08, 95% CI = -0.26 to 0.41, p = 0.65] concentrations in comparison with placebo.

The investigators found, however, in the subgroup analysis, significantly increased serum adiponectin level was seen following garlic supplementation in trials with a mean age of participants ˂30 years [Hedges's = 0.44, 95% CI = 0.01 to 0.87, p = 0.04], the doses ˂1.5 g/day [Hedges's = 0.38, 95% CI = 0.02 to 0.71, p = 0.04] and trials with duration ≥8 weeks [Hedges's = 0.48, 95% CI = 0.08 to 0.89, p = 0.02].

The investigators concluded that ˂1.5 g/day garlic supplementation during ≥8 weeks reduces adiponectin level among participants ˂30 years.

Original title:
Systematic review and meta-analysis of randomized, controlled trials on the effects of garlic supplementation on serum adiponectin and leptin levels by Shekarchizadeh-Esfahani P, Hassani B, […], Soraya N.

Link:
https://pubmed.ncbi.nlm.nih.gov/33792129/

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Adiponectin is a fat-derived hormone that appears to play a crucial role in protecting against insulin resistance/diabetes and atherosclerosis (atherosclerosis is the dominant cause of cardiovascular disease (CVD)). Decreased adiponectin levels are thought to play a central role in the development of obesity, cardiovascular disease and type 2 diabetes in humans.

Peanut butter consumption may reduce type 2 diabetes

Objectives:
Previous meta-analyses, with some methodological controversies, have assessed the relation between nut consumption and type 2 diabetes (T2D) risk and pointed to contradictory results. Therefore, this review article has been conducted.

Does nut consumption reduce risk of type 2 diabetes?

Study design:
This review article included 5 prospective cohort studies and 3 cross-sectional studies.
The certainty of the evidence using NutriGrade was very low for all the exposures.

Results and conclusions:
The investigators found meta-analyses of cross-sectional studies and prospective cohort studies, comparing the highest with the lowest categories, revealed a nonsignificant association between total nut consumption and type 2 diabetes.
Nonsignificant means that there is no association with a 95% confidence.

The investigators found meta-analyses of prospective cohort studies showed that peanut butter consumption significantly reduced type 2 diabetes incidence with 13% [RR = 0.87, 95% CI = 0.77 to 0.98, I2 = 50.6%, p = 0.16], whereas no association was observed between peanuts or tree nuts and type 2 diabetes.

The investigators found there was no evidence of a linear dose-response or nonlinear dose-response gradient for total nut and peanut consumption in prospective cohort studies.

The investigators concluded peanut butter consumption may reduce type 2 diabetes incidence. May reduce because the certainty of the evidence using NutriGrade was very low.

Original title:
Nut consumption and type 2 diabetes risk: a systematic review and meta-analysis of observational studies by Becerra-Tomás N, Paz-Graniel I, […], Salas-Salvadó J.

Link:
https://pubmed.ncbi.nlm.nih.gov/33471083/

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Peripheral neuropathy is associated with lowered plasma vitamin B12 levels

Afbeelding

Objectives:
Peripheral neuropathy (PN) is common in patients with diseases that are in turn associated with deficiency of the B-vitamins, and vitamin treatment has shown mixed results. Therefore, this review article has been conducted.

Does a low vitamin B level increase the risk of peripheral neuropathy?

Study design:
This review article included 46 observational studies and 7 interventional studies.

Results and conclusions:
The investigators found the presence of peripheral neuropathy was significantly associated with lowered B12 levels [1.51, 95% CI = 1.23 to 1.84, n = 34, I2 = 43.3%, p = 0.003].

The investigators found the presence of peripheral neuropathy was significantly associated with elevated methylmalonic acid levels [2.53, 95% CI = 1.39 to 4.60, n = 9, I2 = 63.8%, p = 0.005].

The investigators found the presence of peripheral neuropathy was significantly associated with elevated homocysteine levels [3.48, 95% CI = 2.01 to 6.04, n = 15, I2 = 70.6%, p 0.001].

The investigators found treatment with vitamin B1 was associated with a significant improvement in symptoms of peripheral neuropathy [5.34, 95% CI = 1.87 to 15.19, n = 3, I2 = 64.6%, p = 0.059].

The investigators found B12 treatment (vs. the comparators) showed a non-significant association with symptom improvement [1.36, 95% CI = 0.66 to 2.79, n = 4, I2 = 28.9%].

The investigators found analysis of 7 trials combined showed a non-significant higher odds ratio for improvement under treatment with the B-vitamins [2.58, 95% CI = 0.98 to 6.79, I2 = 80.0%, p 0.001].

The investigators concluded peripheral neuropathy is associated with lowered plasma vitamin B12 and elevated methylmalonic acid and homocysteine levels. Well-designed studies, especially in non-diabetes peripheral neuropathy, are needed.

Original title:
Association between neuropathy and B-vitamins: A systematic review and meta-analysis by Stein J, Geisel J and Obeid R.

Link:
https://pubmed.ncbi.nlm.nih.gov/33619867/

Additional information of El Mondo:
Find here more information/studies about review article/significant, vitamin B1 y B12 and chronic diseases.

Peripheral neuropathy refers to the conditions that result when nerves that carry messages to and from the brain and spinal cord from and to the rest of the body are damaged or diseased.

Increased methylmalonic acid levels are a sensitive indicator of mild vitamin B12 deficiency.
 

Vitamin A supplementation reduces bronchopulmonary dysplasia in premature infants

Afbeelding

Objectives:
Does vitamin A supplementation reduce risk of bronchopulmonary dysplasia (BPD) in premature infants?

Study design:
This review article included 9 RCTs with 709 infants received vitamin A treatment (intervention group) and 700 infants did not receive vitamin A treatment (control group).
The dose of vitamin A regimens varied from 1500 to 10,000 IU (450 to 3,003 micrograms) and the treatment durations generally lasted for 4 weeks.

The funnel plots for all synthesized outcomes remained symmetrical, indicating that there was no significant publication bias.

Results and conclusions:
The investigators found when compared to the control group, vitamin A supplementation significantly reduced the incidence of bronchopulmonary dysplasia in premature infants with 33% [OR  =  0.67, 95% CI = 0.52 to 0.88].
The sensitivity analyses were performed by excluding single RCT one by one. The results of sensitivity analysis of all outcomes had indicated no substantial result changes among the overall estimates.

The investigators concluded that vitamin A supplementation is beneficial to reduce bronchopulmonary dysplasia in premature infants.  

Original title:
Vitamin A supplementation prevents the bronchopulmonary dysplasia in premature infants: A systematic review and meta-analysis by Ding Y, Chen Z and Lu Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7837939/

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Find more information/studies on vitamin A and pregnancy right here.

Bronchopulmonary dysplasia is a form of chronic lung disease that develops in preterm neonates treated with oxygen and positive-pressure ventilation.
 

Diet with <30 En% carbohydrates causally increases adiponectin concentration in adults

Afbeelding

Objectives:
Does a low-carbohydrate diet (LCD) causally increase adiponectin concentration in adults?

Study design:
This review article included 11 RCTs with 534 participants in low-carbohydrate diet group and 513 participants in control group (group without a low-carbohydrate diet).
Proportion of carbohydrate from calorie was from 4 to 34% (4-34 En%).
Time of the follow-up varied between studies and ranged from 6 to 152 weeks.
Meta-regression analysis revealed that age [β = 0.04, p = 0.15], baseline BMI [β= -0.15, p = 0.15], time of follow-up [β = 0.01, p = 0.17], energy percentage of carbohydrates [β = 0.004, p = 0.90], energy percentage of protein [β = -0.12, p = 0.08], energy percentage of fat [β = 0.20, p = 0.61] and baseline adiponectin [β = 0.001, p = 0.97] are not sources of heterogeneity

Results and conclusions:
The investigators found low-carbohydrate diet significantly increased adiponectin concentration [0.02 µg/mL, 95% CI = 0.01 to 0.03, p 0.001].

The investigators found dose-response analysis indicated a nonlinear association between the percentage of carbohydrate and change in adiponectin level from baseline [p = 0.04].

The investigators found in subgroup analysis based on the proportion of carbohydrate from calorie, there was a significant increase in adiponectin concentration in studies that prescribed 30% of calorie from carbohydrates [0.12 µg/mL, 95% CI = 0.07 to 0.18].
In contrast, diets which consisted ≥30% of carbohydrates had no significant effect on adiponectin [0.50 µg/mL, 95% CI = -0.46 to 1.48].

The investigators concluded that a diet with 30% of calorie from carbohydrates (diet with 30 En% carbohydrates) causally increases adiponectin concentration in adults.

Original title:
Effect of low-carbohydrate diet on adiponectin level in adults: a systematic review and dose-response meta-analysis of randomized controlled trials by Shemirani F, Golzarand M, […], Mahmoudi M.

Link:
https://pubmed.ncbi.nlm.nih.gov/33455438/

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Find more information/studies on carbohydrate consumption, diabetes and cardiovascular diseases right here.

The most easy way to follow a diet with maximum 30% of calorie from carbohydrates (diet with 30 En% carbohydrates) is to choose only meals/products with maximum 30 En% carbohydrates. Check here which products contain maximum 30 En% carbohydrates. However, the most practical way to follow a diet with maximum 30 En% carbohydrates is, all meals/products that you eat on a daily basis should on average contain maximum 30 En% carbohydrates.
30 En% carbohydrates means that the total amounts of carbohydrates make up for a 30% of the total kcal of the diet.

Adiponectin is a protein hormone produced and secreted exclusively by adipocytes (fat cells) that regulates the metabolism of lipids and glucose. Adiponectin influences the body's response to insulin. Adiponectin also has antiinflammatory effects on the cells lining the walls of blood vessels.
 

1.5 g/day EPA + DHA improve insulin sensitivity in children

Afbeelding

Objectives:
Fish oil has been shown to reduce the risk of metabolic disorders. However, the effects of fish oil intervention on glucose metabolism and insulin sensitivity are still controversial, especially in children. Therefore, this review article has been conducted.

Do fish oil supplements (EPA + DHA) improve insulin sensitivity in children?

Study design:
This review article included 13 RCTs with 567 children in placebo group (group without fish oil supplements) and 565 in fish oil group (intervention group).

No heterogeneity was found for the pooled and subgroup analyses.

Results and conclusions:
The investigators found compared with the placebo group, fish oil intervention had beneficial effects on insulin sensitivity in the pooled analysis [WMD = -0.219, 95% CI = -0.392 to -0.046, p = 0.013].

These beneficial effects were also found in subgroup analyses, when the fish oil intervention period was short-term (≤6 months) low dose (eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA) dose 1.5 g/day) and high ratio (eicosapentaenoic acid to docosahexaenoic acid ≥1).

The investigators concluded fish oil supplements, especially 1.5 g/day EPA + DHA during 6 months, improve insulin sensitivity in children.

Original title:
Effect of Fish Oil on Insulin Sensitivity in Children: A Systematic Review and Meta-Analysis of Randomized, Controlled Trials by Hou M, Zhou W, [...], Lv H.

Link:
https://pubmed.ncbi.nlm.nih.gov/33388274/

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Find more information/studies on EPA + DHA and diabetes right here.