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).

Sport nutrition

Scientific studies (review articles) on the relationship between diet/nutrients and sport performance:
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?".

2021:

  1. Chair-based exercise programmes improve upper extremity and lower extremity function in older adults
  2. Supplementation with L‐arginine alone increases VO2 max in healthy people
  3. Whey protein supplementation increases lean body mass in adults
  4. Protein quality has significant impact on indices of muscle protein anabolism in young and older adults
  5. Tart cherry supplementation improves recovery from strenuous exercise
  6. Physical activity enhances immune system and increases potency of vaccination
  7. 3 times per week 30-60 min high-intensity interval training causally reduce visceral adipose tissue

2020:

  1. High-load and low-load resistance training have similar effects on femoral neck and lumbar spine bone mineral density
  2. 10-12 g/d arginine during 8 weeks improve sport performance
  3. Physical exercise offers benefits to patients with chronic kidney disease
  4. 30 min/day light-intensity physical activity reduce cancer mortality
  5. Protein supplementation increases lean body mass in adults
  6. Whole-body vibration improves bone mineral density in postmenopausal women

2019:

  1. Strength training decreases inflammation in adults
  2. Creatine supplementation does not induce renal damage
  3. Exercise intervention in kidney transplant recipients improves quality of life
  4. 3 mg creatine/kg/day for 14 days improve anaerobic performance in soccer players
  5. Physical activity reduces lung cancer among smokers

2018:

  1. 1-6g/d taurine supplementation improves human endurance performance
  2. 10,000 steps a day do not decrease blood pressure in healthy adults
  3. Milk protein supplements + resistance training increase fat-free mass in older adults
  4. Aerobic exercise benefits global cognition in mild cognitive impairment patients

2017:

  1. Every 500 kcal increase per week reduce Alzheimer’s disease with 13%
  2. No more than 1.62 g/kg/day dietary protein supplementation augments resistance exercise training induced gains in muscle mass and strength in healthy adults
  3. High levels of physical activity reduce risk of breast cancer in postmenopausal women with a BMI until 30
  4. Resistance training reduces blood pressure in prehypertensive and hypertensive subjects
  5. It is probably better to consume a low-glycemic-index carbohydrate meal before endurance performance
  6. 688mg polyphenol supplementation for at least 7 days increases sport performance
  7. Decreased walking pace increases risk of dementia in elderly populations
  8. Creatine supplementation is effective in upper limb strength performance for exercise of maximum 3 minutes

2016:

  1. Aerobic exercise performed in the fasted state induces higher fat oxidation than exercise performed in the fed state

2014:

  1. Exercise lowers the risk for diabetes conferred by insulin resistance
  2. Exercise training helps to prevent and to treat type 2 diabetes in youth
  3. Recreational physical activity reduces risk of gastric cancer

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Athletes who have a healthy, balanced diet, do not need vitamin and/or mineral supplements. Vitamin and mineral supplements cannot directly enhance sports performance. However, they can shorten the recovery period between training sessions and therefore, enhancing indirectly sports performance.

When you still want to take dietary supplements, it is good to know that:

  • The positive effect of the supplement is dependent on the dosage and duration.
  • The bioavailability is never 100%. For example, the bioavailability of L-carnitine supplement is 15-20%, meaning when 300 mg of L-carnitine supplement is taken, the body can only absorbed 45-60 mg.
  • Dietary supplements are not always free of doping.
  • The supplement only works when a positive conclusion was found in a review of randomized placebo-controlled, double-blind clinical trials (RCTs).
  • Do not take supplements during physical exercises because they can adversely affect the sports performance.

It has been scientifically proven that water, carbohydrates, creatine and caffeine intake during physical exercises can increase sports performance.

A diet with less than 55 En% carbohydrates and/or less than 20 En% fat has negative effects on the sports performance.

It can take 2-3 days to restore the muscle glycogen level after physical exercises when a low-carbohydrate diet (<5 grams of carbohydrate per kg body weight) was taken.

The loading phase of carbohydrates and creatine:  
During physical exercises athletes get mainly energy from carbohydrates, stored in the body as glycogen. Creatine is also an important energy supplier during physical exercises, which need a lot of energy in a very short time. Therefore, it is recommendable to increase the glycogen and creatine body stores just prior to a competition.

The loading phase of glycogen consists of reducing the training frequency while increasing the carbohydrate intake, 3 days before a competition. The carbohydrate intake during these 3 days is 7-10 grams per kg body weight per day.

Increasing muscle creatine stores can be done in 2 phases: the loading and maintenance phase. The 2 ways to increase muscle creatine stores are:

  1. 0.3 grams of creatine per kg body weight per day (5-7 grams of creatine each time with an interval of 3-4 hours) and 3-7 days long. After that, 3-5 grams of creatine per day for 4-10 weeks.
  2. 2-3 grams of creatine a day for 30 days.

The glycogen resynthesis (to restore the glycogen body stores after physical exercises) takes quickly place within 30-60 minutes after physical exercises. The speed of the glycogen resynthesis reaches its maximum at 0.8 grams of carbohydrate per kg body weight per hour.

The muscle and bone building phase take place during 24-48 hours after physical exercises.

It is a misconception to think isotonic sports drink is absorbed faster than hypotonic sports drink.

Rehydration drinks should have an osmolality of below 500 mOsm/l, preferably below 300 and a sugar content of 40-80 grams per liter. Rehydration is the replenishment of moisture during physical exercises.

Isotonic sports drink has an osmolality of about 300 mOsm/l and a sugar content of 40-80 grams per liter. During physical exercises, isotonic sports drink is recommended and hypertonic sports drinks (>80 grams of sugar per liter) must be avoided. The osmolality of human blood is approximately 275-300 mOsm/l.

Sports drinks with 40-80 grams of carbohydrates and 280-660 mg of sodium per liter are quickly absorbed in the body. This is the ideal isotonic sports drink. Sports drink is recommended in moderate physical exercises with a duration longer than 60-90 minutes.

It is internationally recommended to take 250 ml of liquid (or 1000 ml of fluid per hour) per 15 minutes during the competition in order to prevent dehydration, but also to maintain the sports performance. Furthermore, it is a scientific fact that the body can break down maximum 60 grams of carbohydrates per hour during the competition.

When you are feeling energetic during physical exercises, meaning that you have taken enough carbohydrates.

The best period to eat is 2-4 hours before physical exercises.

The common nutritional deficiencies among athletes are a deficiency of calcium, vitamin D and iron (especially under women athletes).

Dietary guidelines for athletes:

  • The last meal should be 2-4 hours before physical exercises.
  • Professional athletes are advised to choose products with 60-70 En% (minimum 55 En%) carbohydrate, products with 20-30 En% fat and products with 15-25 En% protein or your daily diet (=all meals/products that you eat on a daily basis) should on average contain 60-70 En% (minimum 55 En%) carbohydrate, products with 20-30 En% fat and products with 15-25 En% protein.
  • Take dietary supplements only under expert guidance!
  • 0.5 mg of vitamin B1 per 1000 kcal.
  • 0.6 mg of vitamin B2 per 1000 kcal.
  • 0.02 milligrams of vitamin B6 per gram of protein consumed.
  • The recommended daily allowance is 6 mg of magnesium per kg body weight.
  • The recommended daily allowance is 5-7 grams of carbohydrates per kg body weight per day.
  • The recommended daily allowance of protein for athletes is 1.2-1.8 grams per kg body weight, for strength athletes is 1.5 grams per kilogram of body weight during the maintenance phase and 2.0 g per kg body weight during the loading phase.

Before physical exercises:

  • Take 2 hours before the competition 500-1000 ml of fluid.
  • Take 5 to 30 minutes before the competition 50 grams of sugars.
  • Take 10 grams of protein just before the competition because it promotes the recovery of muscle damage.
  • Take 3-5 minutes before the competition 150-300 ml of water or thirst quencher. This is called prehydration.

During physical exercises:

  • Take during the competition no more than 35 grams of fructose per liter because fructose is slowly absorbed and therefore will give gastrointestinal complaints.
  • Take during the competition 125-250 ml of fluid per 15 minutes.
  • Take during the competition no more than 15 grams of sugars per 15 minutes.
  • The optimal sports drink during the competition is a sports drink with 6 g sugars per 100 ml.
  • Choose a sports drink during the competition with an osmolality around 300 or below 500 mOsm/l.
  • Avoid during the competition hypertonic sports drinks.
  • Take during the competition water, isotonic or hypotonic sports drinks.
  • Take during the competition no coffee because you will lose more moisture.

After physical exercises:

  • After the competition, there are 2 ways to restore the glycogen body stores:
    1. Take immediately (within 30 minutes) after the competition 1.2 grams carbohydrate (preferably simple sugars, such as glucose) per kg body weight. Repeat this every hour for 4-6 hours.
    2. 0.8 g carbohydrate per kg body weight + 0.4 grams of protein or amino acids per kg body weight per hour. Repeat this every hour for 4-6 hours.
  • It is advisable to take after the competition 1.5 times the amount of water lost during the competition.
  • Take 10 grams of protein within 30 minutes after the competition because it promotes the recovery of muscle damage.

High selenium dietary intake reduces hip fracture

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

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

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

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

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

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

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

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

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

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

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

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

Lower serum magnesium concentrations increase fractures

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

Do lower serum magnesium concentrations increase risk of incident fractures?

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

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

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

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

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

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

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

Lower blood carotenoid level is a risk factor for dementia

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

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

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

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

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

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

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

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

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

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

 

High antioxidant dietary intake reduces Alzheimer's disease

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

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

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

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

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

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

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

 

High dietary intake of vitamin E reduces dementia

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Additional information of El Mondo:
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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/

Additional information of El Mondo:
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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/

Additional information of El Mondo:
Find more information/studies on meta-analysis/cohort, carotenoids, vitamin E and elderly right here.

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/

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Does mushroom consumption reduce all-cause mortality?

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

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

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

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

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

Additional information of El Mondo:
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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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Chair-based exercise programmes improve upper extremity and lower extremity function in older adults

Objectives:
Do chair-based exercise programmes improve upper extremity and lower extremity function in older adults?

Study design:
This review article included 25 studies with a total of 1,388 participants.
19 studies were randomised controlled trials (RCTs).

The chair exercises included chair-based yoga, seated tai chi and rocking chair. The interventions lasted between 2 and 72 weeks, with the most common duration being 12 weeks, delivering 2 to 14 sessions per week. Sessions lasted between 15 and 110 minutes.

There was considerably heterogeneity in the age range of participants included.
The mean age of participants in studies ranges from 55 to 88 years.
17 studies had a low risk of bias and 5 had a high risk of bias.

Results and conclusions:
The investigators found that chair-based exercise programmes significantly improved upper extremity [handgrip strength: MD = 2.10, 95% CI = 0.76 to 3.43, I2 = 42% and 30 s arm curl test: MD = 2.82, 95% CI = 1.34 to 4.31, I2 = 71%] and lower extremity function [30 s chair stand: MD = 2.25, 95% CI = 0.64 to 3.86, I2 = 62%].

The investigators found no significant differences in the Berg balance scale, timed up and go test or gait speed between the intervention and control groups. Similarly, no significant differences were observed for self-reported activities of daily living or for falls efficacy, which were analyzed using standardised mean difference between the intervention and control groups as there were different instruments used to measure each outcome.

The investigators concluded that chair-based exercise programmes improve upper extremity (handgrip strength and 30 s arm curl test) and lower extremity (30 s chair stand) function in older adults. These changes are observed in short (12 weeks) and medium term (12 weeks to 6 months) interventions.

Original title:
The Effect of Chair-Based Exercise on Physical Function in Older Adults: A Systematic Review and Meta-Analysis by Klempel N, Blackburn NE, […], Tully MA.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7920319/

Additional information of El Mondo:
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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.

Supplementation with L‐arginine alone increases VO2 max in healthy people

Objectives:
The efficacy and safety of L‐arginine supplements and their effect on maximal oxygen uptake (VO2 max) remained unclear. Therefore, this review article has been conducted.

Does supplementation with arginine increase VO2 max in healthy people?

Study design:
This review article included 11 RCTs.
The different types of arginine supplements were L‐arginine, arginine aspartate, arginine alpha‐ketoglutarate and arginine in combination with antioxidants.
There was no publication bias.

Results and conclusions:
The investigators found subgroup analysis showed that arginine in the form of L‐arginine significantly increased VO2 max compared to the other forms [weighted mean difference = 0.11 L/min, I2 = 0.0%, p = 0.485].

The investigators concluded that supplementation with L‐arginine alone increases VO2 max compared to the other types of arginine or combined with other metabolites or supplements. Future homogeneous and well‐designed randomized clinical trials are needed to a deep understand of the effects of L‐arginine on VO2 max in healthy human subjects.

Original title:
The effect of L-arginine supplementation on maximal oxygen uptake: A systematic review and meta-analysis by Rezaei S, Gholamalizadeh M, […], Doaei S.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7883807/

Additional information of El Mondo:
Find here more information/studies on protein and sport nutrition. 

VO2 max is the maximum amount of oxygen your body can utilize during exercise. The more oxygen your body can use, the more your muscles can work.

Prenatal alcohol exposure increases placental abruption

Objectives:
Does prenatal alcohol exposure have adverse effects on pregnancy and birth outcomes?

Study design:
This review article included 33 studies.
The quality assessment identified that 61% of studies were high quality, 30% were average quality and 9% were low quality.

Results and conclusions:
The investigators found that prenatal alcohol exposure significantly increased the likelihood of placental abruption with 48% [odds ratio = 1.48, 95% CI = 1.37 to 1.60].

The investigators found no association between prenatal alcohol exposure and placenta previa [odds ratio = 1.14, 95% CI = 0.84 to 1.34].

The investigators found that prenatal alcohol exposure significantly reduced placental weight with 51g [95% CI = -82.8g to -19.3g].

The investigators found reports of altered placental vasculature, placental DNA methylation, and gene expression following prenatal alcohol exposure.

The investigators concluded prenatal alcohol exposure increases the likelihood of placental abruption and is associated with decreased placental weight, altered placental vasculature, DNA methylation and molecular pathways. Given the critical role of the placenta in determining pregnancy outcomes, further studies investigating the molecular mechanisms underlying alcohol-induced placental dysfunction are required. Sex-specific placental adaptations to adverse conditions in utero have been well documented; thus, future studies should examine prenatal alcohol exposure-associated placental outcomes separately by sex.

Original title:
Prenatal alcohol consumption and placental outcomes: a systematic review and meta-analysis of clinical studies by Steane SE, Young SL, […], Moritz KM.

Link:
https://pubmed.ncbi.nlm.nih.gov/34181895/

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Whey protein supplementation increases lean body mass in adults

Objectives:
Essential amino acids (EAAs) promote the process of regulating muscle synthesis. Thus, whey protein that contains higher amounts of essential amino acids can have a considerable effect on modifying muscle synthesis. However, there is insufficient evidence regarding the effect of soya and whey protein supplementation on body composition. Therefore, this review article has been conducted.

Does whey protein or soya protein supplementation improve body composition parameters (like lean body mass, body mass, fat mass and body fat percentage) in adults?

Study design:
This review article included 10 RCTs with 596 participants.

Results and conclusions:
The investigators found a significant increase in lean body mass after whey protein supplementation [WMD = 0.91, 95% CI = 0.15 to 1.67, p = 0.019].
This significant increase was not found for soya protein supplementation.

The investigators found no significant change between whey protein supplementation and body mass, fat mass and body fat percentage.

The investigators found no significant change between soya protein supplementation and body mass, fat mass and body fat percentage.

The investigators concluded that whey protein supplementation improves body composition via increases in lean body mass, without influencing fat mass, body mass and body fat percentage in adults.

Original title:
Comparison of the effect of soya protein and whey protein on body composition: a meta-analysis of randomised clinical trials by Damaghi MP, Mirzababaei A, […], Mirzaei K.

Link:
https://pubmed.ncbi.nlm.nih.gov/33971994/

Additional information of El Mondo:
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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/

Additional information of El Mondo:
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Protein quality has significant impact on indices of muscle protein anabolism in young and older adults

Objectives:
There is much debate regarding the source/quality of dietary proteins in supporting indices of skeletal muscle anabolism. Therefore, this review article has been conducted.

What is the effect of protein source/quality on acute muscle protein synthesis (MPS) and changes in lean body mass (LBM) and strength, when combined with resistance exercise (RE)?  

Study design:
This review article included 27 studies that compared the effects of ≥2 dose-matched, predominantly isolated protein sources of varying "quality”, in young (18-35 y) and older (≥60 y) adults.

3 separate models were employed as follows: 1) protein feeding alone on muscle protein synthesis, 2) protein feeding combined with a bout of resistance exercise on muscle protein synthesis and 3) protein feeding combined with longer-term resistance exercise training (RET) on lean body mass and strength.  

The mean age for the young groups across all 3 models ranged between 20 and 29 y and the older groups were between 61 and 75 y.

Results and conclusions:
The investigators found analysis revealed an effect favoring higher-quality protein for postprandial muscle protein synthesis at rest [mean difference (MD) = 0.014%/h, 95% CI = 0.006 to 0.021, p 0.001] and following resistance exercise [MD = 0.022%/h, 95% CI = 0.014 to 0.030, p 0.00001] in young [model 1 = 0.016%/h, 95% CI = -0.004 to 0.036, p = 0.12. Model 2 = 0.030%/h, 95% CI = 0.015 to 0.045, p 0.0001] and older [model 1 = 0.012%/h, 95% CI = 0.006 to 0.018, p 0.001. Model 2 = 0.014%/h, 95% CI = 0.007 to 0.021, p 0.001] adults.  

The investigators found, however, although higher protein quality was significantly associated with superior strength gains with resistance exercise training [standardized mean difference (SMD) = 0.24 kg, 95% CI = 0.02 to 0.45, p = 0.03], no effect was observed on changes to lean body mass [SMD = 0.05 kg, 95% CI = -0.16 to 0.25, p = 0.65].

The investigators concluded that protein quality provides a small but significant impact on indices of muscle protein anabolism in young and older adults. However, further research is warranted to elucidate the importance of protein source/quality on musculoskeletal aging, particularly in situations of low protein intake.

Original title:
Protein Source and Quality for Skeletal Muscle Anabolism in Young and Older Adults: A Systematic Review and Meta-Analysis by Morgan PT, Harris DO, […], Breen L.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8245874/

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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.

<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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Tart cherry supplementation improves recovery from strenuous exercise

Objectives:
Does tart cherry (TC) supplementation improve recovery following strenuous exercise?

Study design:
This review article included 14 studies.

Results and conclusions:
The investigators found tart cherry supplementation had a small significant beneficial effect in reducing muscle soreness [effect size (ES) = -0.44, 95% CI = -0.87 to -0.02].

The investigators found a moderate significant beneficial effect was observed for recovery of muscular strength [ES = -0.78, 95% CI = -1.11 to -0.46] for tart cherry supplementation.

The investigators found a moderate significant effect was observed for muscular power [ES = -0.53, 95% CI = -0.77 to -0.29] for tart cherry supplementation.
A further subgroup analysis on this variable indicated a large significant effect of tart cherry supplementation on recovery of jump height [ES = -0.82, 95% CI = -1.18 to -0.45] and a small significant effect of tart cherry supplementation on sprint time [ES = -0.32, 95% CI = -0.60 to -0.04]. 

The investigators found a small significant effect was observed for both C-reactive protein [ES = -0.46, 95% CI = -0.93 to -0.00] and Interleukin-6 [ES = -0.35, 95% CI = -0.68 to -0.02] for tart cherry supplementation.

The investigators found no significant effects were observed for creatine kinase and tumor necrosis factor alpha (TNF-α) for tart cherry supplementation. 

The investigators concluded that tart cherry supplementation improves aspects of recovery from strenuous exercise.

Original title:
Tart Cherry Supplementation and Recovery From Strenuous Exercise: A Systematic Review and Meta-Analysis by Hill JA, Keane KM, […], Howatson G.

Link:
https://pubmed.ncbi.nlm.nih.gov/33440334/

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