Nutritional Advice El Mondo

Nutritional advice

Elderly

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

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

2023:

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

2022:

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

2021:

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

2020:

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

2019:

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

2018:

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

2017:

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

2015:

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

2013:

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

2012:

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

2011:

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

2009:

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

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

  • High blood pressure
  • Cardiovascular disease
  • Cancer
  • Mobility and falls
  • Dementia
  • Osteoporosis
  • Decreased vision
  • Pneumonia
  • Deterioration of hearing
  • Loss of appetite and thirst
  • Muscle loss
  • Malnutrition

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

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

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

Dietary guidelines for elderly:

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

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.

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

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.

 

High selenium dietary intake reduces hip fracture

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

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

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

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

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

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

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

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

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

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

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

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

Lower serum magnesium concentrations increase fractures

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

Do lower serum magnesium concentrations increase risk of incident fractures?

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

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

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

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

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

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

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

Lower blood carotenoid level is a risk factor for dementia

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

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

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

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

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

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

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

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

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

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

 

 Vitamin B6 supplements reduce nausea and vomiting during pregnancy

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/

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High antioxidant dietary intake reduces Alzheimer's disease

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

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

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

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

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

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

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High dietary intake of vitamin E reduces dementia

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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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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Mushroom consumption reduces all-cause mortality

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

Does mushroom consumption reduce all-cause mortality?

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

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

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

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

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

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200-700 g/d fruits and vegetables consumption decreases frailty

Objectives:
Does fruits and vegetables (FVs) consumption reduce risk of frailty?

Study design:
This review article included 10 cohort studies and 4 cross-sectional studies with 18,616 subjects with frailty and 101,969 controls (persons without frailty).

Based on the NutriGrade score, the quality of evidence for a protective effect of fruits and vegetables consumption on frailty was "moderate".

Results and conclusions:
The investigators found in 7 cohort studies for the highest versus lowest category of fruits and vegetables consumption a significantly reduced risk of 35% for frailty [RR = 0.65, 95% CI = 0.50 to 0.84, I2 = 81%].

The investigators found that every 200g per day increment in fruits and vegetables consumption was significantly associated with a 14% lower risk of frailty.
The risk of frailty decreased linearly up to fruits and vegetables consumption of 700 g/d, with flattening the curve at higher intake.

The investigators found that pooled analysis regarding fruits and vegetables separately did not indicate a significant association with the risk of frailty.

The investigators concluded that 200-700 g/d fruits and vegetables consumption decreases risk of frailty. Further large-scale prospective cohort studies are needed to reach more confident conclusions.

Original title:
Fruit and vegetable intake and risk of frailty: A systematic review and dose response meta-analysis by Ghoreishy SM, Asoudeh F, […], Mohammadi H.

Link:
https://pubmed.ncbi.nlm.nih.gov/34534684/

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Monounsaturated fatty acids dietary intake reduces all-cause mortality

Objectives:
Findings on the link between dietary intakes of monounsaturated fatty acids (MUFA) and risk of mortality are conflicting. Therefore, this review article has been conducted.

Does monounsaturated fatty acids dietary intake reduce risk of mortality?

Study design:
This review article included 17 prospective cohort studies with a total of 1022,321 participants aged ≥ 20 years, of which 191,283 all-cause deaths, 55,437 cardiovascular diseases (CVD) deaths and 64,448 cancer deaths.

Results and conclusions:
The investigators found combining 15 effect sizes from 11 studies, monounsaturated fatty acids dietary intake was significantly associated with a reduced risk of 6% for all-cause mortality [RR = 0.94, 95% CI = 0.90 to 0.98, I2 = 55.5%, p = 0.005].
Significantly because RR of 1 was not found in the 95% CI of 0.90 to 0.98. RR of 1 means no risk/association.

The investigators found based on 17 effect sizes from 11 studies, no significant association between monounsaturated fatty acids dietary intake and risk of cardiovascular diseases mortality [RR = 0.95, 95% CI = 0.89 to 1.01, I2 =37.0%, p = 0.06].
No significant means that there is no association with a 95% confidence.

The investigators found when combining 10 effect sizes from 6 studies, monounsaturated fatty acids dietary intake was not significantly associated with cancer mortality [RR = 0.99, 95% CI = 0.96 to 1.03, I2 = 13.3%, p = 0.32].  
Not significantly because RR of 1 was found in the 95% CI of 0.96 to 1.03. RR of 1 means no risk/association.

The investigators found an additional 5% of energy (5 En%) from monounsaturated fatty acids was significantly associated with a 3% reduced risk of all-cause mortality [RR = 0.97, 95% CI = 0.96 to 0.98], but not with cardiovascular diseases [RR = 0.98, 95% CI = 0.95 to 1.01] and cancer mortality [RR = 0.99, 95% CI = 0.97 to 1.01].

The investigators concluded that monounsaturated fatty acids dietary intake reduces risk of all-cause mortality.

Original title:
Dietary intakes of monounsaturated fatty acids and risk of mortality from all causes, cardiovascular disease and cancer: A systematic review and dose-response meta-analysis of prospective cohort studies by Lotfi K, Salari-Moghaddam A, […], Esmaillzadeh A.

Link:
https://pubmed.ncbi.nlm.nih.gov/34560281/

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

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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Intensive glucose control slows down cognitive decline in persons with type 2 diabetes

Objectives:
Despite growing evidence that type 2 diabetes is associated with dementia, the question of whether intensive glucose control can prevent or arrest cognitive decline remains unanswered. Therefore, this review articles (meta-analysis) has been conducted.

Does intensive glucose control slow down cognitive decline in persons with type 2 diabetes?

Study design:
This review article included 5 cohort studies with 16,584 participants.
The mean follow-up duration ranged from 3.5 to 10 years.
The mean age of participants in the studies included in the current meta-analysis was 65.6 years at the initiation of the studies and the proportion of women was 40.8%.
All quality assessment scores fell in the range of 8 or 9, indicating high quality.
There was no publication bias.

Results and conclusions:
The investigators found a significantly poorer decline in cognitive function in the intensive glucose control group [β = -0.03, 95% CI = -0.05 to -0.02] than in the conventional glucose control group.

The investigators found, subgroup analysis showed a significant difference in the change in cognitive performance in composite cognitive function [β = -0.03, 95% CI = -0.05 to -0.01] and memory [β = -0.13, 95% CI = -0.25 to -0.02].

The investigators concluded that intensive glucose control in persons with type 2 diabetes slows down cognitive decline, especially the decline in composite and memory function. The impact of intensive glucose control on the brain structural abnormalities and risk of dementia needs further rigorously designed studies to validate these findings. Also, replicating and validating these findings is warranted.

Original title:
Impact of Intensive Glucose Control on Brain Health: Meta-Analysis of Cumulative Data from 16,584 Patients with Type 2 Diabetes Mellitus by Tang X, Cardoso MA, […], Simó R.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7947088/

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

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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Supplementation with 320-729 mg/d magnesium may improve sleep in older adults with insomnia

Objectives:
Magnesium supplementation is often purported to improve sleep; however, as both an over-the-counter sleep aid and a complementary and alternative medicine, there is limited evidence to support this assertion. Therefore, this review article (meta-analysis) has been conducted.

Does magnesium supplementation improve sleep in older adults with insomnia?

Study design:
This review article included 3 randomized control trials (RCTs), comparing oral magnesium to placebo in 151 older adults in 3 countries.

All 3 RCTs were at moderate-to-high risk of bias and outcomes were supported by low to very low quality of evidence.

Daily elemental magnesium intake ranged from 320 mg to 729 mg taken 2 to 3 times per day using 2 formulations (magnesium oxide and magnesium citrate tablets).
Duration of follow-up for outcome assessment ranged from 20 days to 8 weeks.

Results and conclusions:
The investigators found pooled analysis showed that post-intervention sleep onset latency time was significantly 17.36 min less [95% CI = -27.27 to -7.44, p = 0.0006] after magnesium supplementation compared to placebo.
Significantly because the calculated p-value of = 0.0006 was less than the p-value of 0.05.

The investigators found pooled analysis showed that total sleep time improved by 16.06 min in the magnesium supplementation group but was statistically insignificant [95% CI = - 5.99 to 38.12, p = 0.15].
Insignificant because the calculated p-value of 0.15 was larger than the p-value of 0.05.

The investigators concluded that RCT evidence may support oral magnesium supplements (less than 1 g quantities given up to 3 times a day) for insomnia symptoms in older adults. May support because all 3 RCTs are at moderate-to-high risk of bias and outcomes are supported by low to very low quality of evidence.

Original title:
Oral magnesium supplementation for insomnia in older adults: a Systematic Review & Meta-Analysis by Mah J and Pitre T.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8053283/

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Magnesium oxide contains 60% elemental magnesium and magnesium citrate contains 16% elemental magnesium.
So if you want to get 320 mg elemental magnesium from magnesium supplements, you have to take 534 mg magnesium oxide supplements or 2000 mg magnesium citrate.

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

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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<11 g/day alcohol and <2.8 cups/day coffee reduce cognitive deficits

Objectives:
Lifestyle interventions are an important and viable approach for preventing cognitive deficits. However, the results of studies on alcohol, coffee and tea consumption in relation to cognitive decline have been divergent, likely due to confounds from dose-response effects. Therefore, this review article (meta-analysis) has been conducted.

Does alcohol, coffee or tea consumption reduce the risk of cognitive deficits (such as dementia or Alzheimer's disease)?

Study design:
This review article included 29 prospective cohort studies from America, Japan, China and some European countries (131,777 participants for alcohol, 333,843 participants for coffee and 20,411 participants for tea).

The NOS score was 8.

Results and conclusions:
The investigators found dose-response relationships showed that compared to non-drinkers, low consumption (11 g/day) of alcohol significantly reduced the risk of cognitive deficits or only dementias, but there was no significant effect of heavier drinking (>11 g/day).

The investigators found dose-response relationships showed that compared to non-drinkers, low consumption of coffee significantly reduced the risk of any cognitive deficit (2.8 cups/day) or dementia (2.3 cups/day).
However, coffee drinking was not a significant protective factor for cognitive deficits in groups of average age 60 years.

The investigators found dose-response relationships showed that compared to non-drinkers, every cup of green tea per day significantly reduced risk of cognitive deficits with 6% [relative risk = 0.94, 95% CI = 0.92 to 0.97].  

The investigators concluded that light consumption of alcohol (11 g/day) and coffee (2.8 cups/day) reduces risk of cognitive deficits. Cognitive benefits of green tea consumption increases with the daily consumption.

Original title:
Alcohol, coffee and tea intake and the risk of cognitive deficits: a dose-response meta-analysis by Ran LS, Liu WH, […], Wang W.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8061189/

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