Nutrition and health

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

Afbeelding

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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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

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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

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

Afbeelding

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

Afbeelding

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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100 mg/d dietary magnesium intakes reduce cancer mortality

Objectives:
Do magnesium intakes reduce risk of all-cause, cancer and cardiovascular disease (CVD) mortality?

Study design:
This review article included 19 prospective cohort studies with a total of 1,168,756 participants (52,378 deaths from all causes (all-cause mortality), 23,478 from cardiovascular disease (CVD) and 11,408 from cancer).
The follow-up period was 3.5 to 32 years.

Results and conclusions:
The investigators found dietary magnesium intake was significantly associated with a lower risk of 13% for all-cause mortality [pooled effect size (ES) = 0.87, 95% CI = 0.79 to 0.97, p = 0.009, I2 = 70.7%, p 0.001].

The investigators found dietary magnesium intake was significantly associated with a lower risk of 20% for cancer mortality [pooled ES = 0.80, 95% CI = 0.67 to 0.97, p = 0.023, I2 = 55.7%, p = 0.027].

The investigators found for supplemental and total magnesium intakes, no significant associations with risks of all-cause, cardiovascular disease and cancer mortality.

The investigators found, however, linear dose-response meta-analysis indicated that each additional intake of 100 mg/d of dietary magnesium was significantly associated with a 6% and 5% reduced risk of all-cause and cancer mortality, respectively.

The investigators concluded that higher intake of dietary magnesium (at least 100 mg/d of dietary magnesium) is associated with a reduced risk of all-cause and cancer mortality, but not cardiovascular disease mortality. Supplemental and total magnesium intakes are not associated with the risk of all-cause, cardiovascular disease and cancer mortality. These findings indicate that consumption of magnesium from dietary sources may be beneficial in reducing all-cause and cancer mortality and thus have practical importance for public health.  

Original title:
Total, Dietary, and Supplemental Magnesium Intakes and Risk of All-Cause, Cardiovascular, and Cancer Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies by Bagheri A, Naghshi S, […], Esmaillzadeh A.

Link:
https://pubmed.ncbi.nlm.nih.gov/33684200/

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Higher plasma DHA and EPA levels reduce advanced age-related macular degeneration

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Objectives:
Previous population studies on the associations between dietary fatty acids (FAs), plasma FAs levels and the risk of age-related macular degeneration (AMD) have yielded inconclusive results. Therefore, this review article (meta-analysis) has been conducted.

Do higher dietary fatty acids (EPA and DHA) intakes or higher plasma fatty acids levels reduce risk of age-related macular degeneration?

Study design:
This review article included 11 prospective cohort studies with 167,581 participants. During the follow-up periods (ranging from 3 to 28 years), 6,318 cases of age-related macular degeneration were recorded.

Results and conclusions:
The investigators found that each 1 g/day increment of dietary intake of docosahexaenoic acid (DHA) and eicosatetraenoic acid (EPA) combined significantly reduced risk of early age-related macular degeneration with 33% [RR = 0.67, 95% CI = 0.51 to 0.88].
Significantly means that there is an association with a 95% confidence.

The investigators found that each 1 g/day increment of dietary intake of docosahexaenoic acid (DHA) significantly reduced risk of early age-related macular degeneration with 50% [RR = 0.50, 95% CI = 0.32 to 0.78].
Significantly means it can be said with a 95% confidence that each 1 g/day increment of dietary intake of docosahexaenoic acid (DHA) really reduces risk of early age-related macular degeneration with 50%.

The investigators found that each 1 g/day increment of dietary intake of eicosatetraenoic acid (EPA) significantly reduced risk of early age-related macular degeneration with 60% [RR = 0.40, 95% CI = 0.18 to 0.87].
Significantly because RR of 1 was not found in the 95% CI of 0.18 to 0.87. RR of 1 means no risk/association.

The investigators found that higher plasma docosahexaenoic acid (DHA) levels significantly reduced risk of advanced age-related macular degeneration with 28% [RR = 0.72, 95% CI = 0.55 to 0.95].

The investigators found that higher plasma eicosatetraenoic acid (EPA) levels significantly reduced risk of advanced age-related macular degeneration with 43% [RR = 0.57, 95% CI = 0.40 to 0.81].

The investigators concluded that 1 g/day of dietary intake DHA and 1 g/day of dietary intake EPA and higher plasma DHA and EPA levels are associated with a reduced risk of age-related macular degeneration.

Original title:
Dietary fatty acid intake, plasma fatty acid levels, and the risk of age-related macular degeneration (AMD): a dose-response meta-analysis of prospective cohort studies by Zhong Y, Wang K, [...], Yao K.

Link:
https://pubmed.ncbi.nlm.nih.gov/33469697/

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A high plasma EPA and DHA content can be obtained by eating a lot of oily fish and/or by taking EPA and DHA supplements (fish oil supplements).
Oily fish contains more EPA and DHA than non-oily fish.

Early age-related macular degeneration: most people do not experience adverse symptoms or vision loss in the early stage of age-related macular degeneration, but night vision problems are often reported. Though no pigmentary abnormalities are apparent upon examination, medium-sized drusen (>63 μm and ≤125 μm) are present.

Alcohol consumption increases risk of any fractures

Objectives:
Previous studies on the association between alcohol intake and risk of fracture have reached conflicting findings. Therefore, this review article has been conducted.

Does alcohol consumption increase risk of fractures?

Study design:
This review article included 38 prospective cohort studies with a total sample size of 5,053,117 participants and 169,560 cases of fracture.

Results and conclusions:
The investigators found in a random-effects meta-analysis, that alcohol consumption significantly increased risk of total fractures with 35% [RR = 1.35, 95% CI = 1.01 to 1.81] and any fractures with 24% [RR= 1.24, 95% CI = 1.11 to 1.38].
Significant because RR of 1 was not found in the 95% CI of 1.01 to 1.81. RR of 1 means no risk/association.

The investigators found, however, no significant association between alcohol intake and risk of hip fractures [RR = 1.19, 95% CI = 0.96 to 1.48], osteoporotic fractures [RR = 2.01, 95% CI = 0.76 to 5.34], vertebral fractures [RR = 0.98, 95% CI = 0.68 to 1.40] and wrist fractures [RR = 0.99, 95% CI = 0.85 to 1.16].
No significant because RR of 1 was found in the 95% CI of 0.85 to 1.06. RR of 1 means no risk/association.

The investigators concluded that alcohol consumption is positively associated with risk of total fractures and any fractures.

Original title:
A systematic review and meta-analysis of prospective cohort studies on the association between alcohol intake and risk of fracture by Asoudeh F, Salari-Moghaddam A, […], Esmaillzadeh A.

Link:
https://pubmed.ncbi.nlm.nih.gov/33596741/

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0.5-50 mg/d carotenoid supplementation improves cognitive performance among healthy adults

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Objectives:
Recent evidence suggests that diet can modify the risk of future cognitive impairment and dementia. A biologically plausible rationale and initial clinical data indicate that the antioxidant activities of dietary carotenoids may assist the preservation of cognitive function. Therefore, this review article has been conducted.

Does carotenoid supplementation improve cognitive performance among healthy adults?

Study design:
This review article included 9 RCTs, involving 2,228 subjects in the treated group (group with carotenoid supplementation) and 2,174 subjects in control group (group without carotenoid supplementation).
The age of all participants varied from 45 to 78 years.
The majority of clinical trials assessed the effect of xanthophylls such as lutein, zeaxanthin, and astaxanthin, whereas only 1 study determined the effects of β-carotene.
The duration of carotenoid supplementation ranged from 2 weeks to 12 months.
The dosage of carotenoids administered in the studies ranged from 0.5 mg/d to 50 mg/d.
There was no evidence of publication bias.

Results and conclusions:
The investigators found results of the pooled meta-analysis showed a significant effect of carotenoid intervention on cognitive outcomes [Hedge's g = 0.14, 95% CI = 0.08 to 0.20, p 0.0001, I2 = 0.00%].
The sensitivity analysis did not change the overall findings obtained from the primary analysis.

The investigators concluded that these results highlight the potential role of carotenoids (0.5 mg/d to 50 mg/d) in the protection of mental functions even in subjects (healthy participants aged 45-78 years) without cognitive impairment. This is particularly important because the population is aging and preservation of cognitive function is crucial for individual autonomy and quality of life, even in non-demented subjects. Further well-powered and long-term trials are required to determine treatment duration, type of carotenoid and optimal dosage.

Original title:
Carotenoids and Cognitive Outcomes: A Meta-Analysis of Randomized Intervention Trials by Davinelli S, Ali S, […], Corbi G.

Link:
https://www.mdpi.com/2076-3921/10/2/223/htm

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Daily egg consumption have beneficial effects on macular pigment optical density

Afbeelding

Objectives:
Increasing macular pigment optical density (MPOD) as a result of increased macular concentration of lutein and zeaxanthin may reduce the risk of age-related macular degeneration (AMD). Therefore, this review article has been conducted.

Have daily egg consumption beneficial effects on macular pigment optical density and serum lutein levels?

Study design:
This review article included 5 RCTs with a total of 296 participants.
There was no heterogeneity between studies.

Results and conclusions:
The investigators found that egg consumption significantly increased macular pigment optical density [WMD = +0.037, 95% CI = 0.004 to 0.069, p = 0.027] and serum lutein levels [WMD = +0.150 μmol/L, 95% CI = 0.037 to 0.263, p = 0.009].

The investigators found subgroup analyses showed that egg consumption had a larger effect on macular pigment optical density in studies with a parallel design and increased serum lutein levels to a greater extent in a healthy population.

The investigators concluded daily egg consumption have beneficial effects on macular pigment optical density and serum lutein level is inversely associated with reduced age-related macular degeneration progression. Further clinical trials are required to confirm the results of this review article.

Original title:
A positive effect of egg consumption on macular pigment and healthy vision: a systematic review and meta-analysis of clinical trials by Sikaroudi MK, Saraf-Bank S, […], Soltani S.

Link:
https://pubmed.ncbi.nlm.nih.gov/33491232/

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A high dietary intake of β-cryptoxanthin reduce osteoporosis and hip fracture

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Objectives:
Does a high dietary intake of β-cryptoxanthin reduce the risk of osteoporosis and hip fracture?

Study design:
This review article included 7 cohort studies, 4 case-control studies and 4 cross-sectional studies with a total of 100,496 individuals.
The methodological qualities of all studies were rated as “fair” to “good”.
The number of populations in each study ranged from 59 to 25,566.

Results and conclusions:
The investigators found that a high dietary intake of β-cryptoxanthin significantly reduced risk of osteoporosis with 24% [OR = 0.76, 95% CI = 0.66 to 0.88, p = 0.0002, I2 = 36%, p = 0.11].

The investigators found in subgroup analysis that a high dietary intake of β-cryptoxanthin significantly reduced risk of osteoporosis with 28% [OR = 0.72, 95% CI = 0.58 to 0.91, p = 0.005, I2 = 59%] among women.

The investigators found in subgroup analysis that a high dietary intake of β-cryptoxanthin significantly reduced risk of osteoporosis with 20% [OR = 0.80, 95% CI = 0.65 to 1.00, p = 0.005, I2 = 11%] among men.

The investigators found that a high dietary intake of β-cryptoxanthin significantly reduced risk of hip fracture with 28% [OR = 0.72, 95% CI = 0.60 to 0.87, p = 0.0008, I2 = 55%].

The investigators found in subgroup analysis that a high dietary intake of β-cryptoxanthin significantly reduced risk of hip fracture with 29% [OR = 0.71, 95% CI = 0.54 to 0.94, p = 0.02, I2 = 71%] among women. 

The investigators concluded that a high dietary intake of β-cryptoxanthin reduces the risk of osteoporosis and hip fracture. Further longitudinal studies are needed to validate the causality of current findings.

Original title:
Effects of β-Cryptoxanthin on Improvement in Osteoporosis Risk: A Systematic Review and Meta-Analysis of Observational Studies by Kim SJ, Anh NH, […], Kwon SW.

Link:
https://www.mdpi.com/2304-8158/10/2/296/htm

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Alzheimer's disease patients have a low plasma vitamin E level

Objectives:
Is there a relationship between the levels of vitamin C, vitamin E and β-carotene in the plasma and Alzheimer's disease risk?

Study design:
This review article included studies with data of levels of vitamin C, vitamin E and β-carotene in the plasma of Alzheimer's disease patients.

Results and conclusions:
The investigators found meta-analysis showed that, compared with the control group, the level of vitamin E in the plasma of Alzheimer's disease patients declined significantly [SMD = -1.49 μmol/L, 95% CI = -2.08 to -0.89 μmol/L, p 0.001].

However, no differences were determined in the levels of the plasma vitamin C and β-carotene between the two groups [vitamin C: SMD = -1.43 μmol/L, 95% CI = -3.05 to 0.19 μmol/L, p = 0.083 and β-carotene: SMD = -0.61 μmol/L, 95% CI = -1.40 to 0.18 μmol/L, p = 0.131].

The investigators concluded increasing vitamin E level in the plasma through vitamin E riched diet is useful to prevent Alzheimer's disease. However, it is not yet believed the beneficial role on Alzheimer's disease to increase vitamin C and β-carotene.

Original title:
Meta-analysis of vitamin C, vitamin E and β-carotene levels in the plasma of Alzheimer's disease patients by Dong R, Yang Q, […], Zhao H.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30081996  

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Dietary intake of vitamin A, C and green leafy vegetables reduce glaucoma risk

Afbeelding

Objectives:
Although several studies have been conducted on the association of vitamins with glaucoma, it is often noticed that the results are conflicting leaving physicians and patients in doubt about the effect of vitamins on glaucoma. Therefore, this review article has been conducted.

Does dietary vitamin intake reduce risk of the eye disease glaucoma? 

Study design:
This review article included 5 cohort studies with a total of 940 open-angle glaucoma (OAG) cases and 123,697 controls (persons without open-angle glaucoma).

Results and conclusions:
The investigators found a significantly reduced risk of 55% [pooled OR = 0.45, 95% CI = 0.30-0.68, I2 = 0%] for open-angle glaucoma for dietary intake of vitamin A.

The investigators found a significantly reduced risk of 61% [pooled OR = 0.39, 95% CI = 0.23-0.67, I2 = 0%] for open-angle glaucoma for dietary intake of vitamin C.

The investigators found a significantly reduced risk of 61% [pooled OR = 0.39, 95% CI = 0.22-0.70, I2 = 0%] for open-angle glaucoma for dietary intake of green leafy vegetables (a source for vitamin A, C and nitrate).

The investigators concluded dietary intake of vitamin A, C and green leafy vegetables show a beneficial association with the eye disease open-angle glaucoma.

Original title:
The Effect of Vitamins on Glaucoma: A Systematic Review and Meta-Analysis by Ramdas WD, Schouten JSAG and Webers CAB.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5872777/

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A diet with high antioxidant properties reduces all-cause mortality risk

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Objectives:
The associations of various dietary or circulating antioxidants with the risk of all-cause mortality in the general population have not been established yet. Therefore, this review article has been conducted.

Do dietary or circulating antioxidants reduced risk of all-cause mortality in the general population?

Study design:
This review article included 41 prospective observational studies with a total of 507,251 participants and 73,965 cases of all-cause mortality.

Results and conclusions:
The investigators found for the highest compared with the lowest category of circulating total carotenes concentrations a significantly reduced risk of 40% [RR = 0.60, 95% CI = 0.46 to 0.74] for all-cause mortality.  

The investigators found for the highest compared with the lowest category of circulating vitamin C concentrations a significantly reduced risk of 39% [RR = 0.61, 95% CI = 0.53 to 0.69] for all-cause mortality.  

The investigators found for the highest compared with the lowest category of circulating selenium concentrations a significantly reduced risk of 38% [RR = 0.62, 95% CI = 0.45 to 0.79] for all-cause mortality.  

The investigators found for the highest compared with the lowest category of circulating β-carotene concentrations a significantly reduced risk of 37% [RR = 0.63, 95% CI = 0.57 to 0.70] for all-cause mortality.  

The investigators found for the highest compared with the lowest category of circulating α-carotene concentrations a significantly reduced risk of 32% [RR = 0.68, 95% CI = 0.58 to 0.78] for all-cause mortality.  

The investigators found for the highest compared with the lowest category of circulating total carotenoids concentrations a significantly reduced risk of 32% [RR = 0.68, 95% CI = 0.56 to 0.80] for all-cause mortality.  

The investigators found for the highest compared with the lowest category of circulating lycopene concentrations a significantly reduced risk of 25% [RR = 0.75, 95% CI = 0.54 to 0.97] for all-cause mortality.  

The investigators found for the highest compared with the lowest category of circulating α-tocopherol concentrations a significantly reduced risk of 16% [RR = 0.84, 95% CI = 0.77 to 0.91] for all-cause mortality.  

The investigators found for the highest compared with the lowest category of dietary intakes of total carotenoids a significantly reduced risk of 24% [RR = 0.76, 95% CI = 0.66 to 0.85] for all-cause mortality.  

The investigators found for the highest compared with the lowest category of dietary intakes of total antioxidants a significantly reduced risk of 23% [RR = 0.77, 95% CI = 0.73 to 0.81] for all-cause mortality.  

The investigators found for the highest compared with the lowest category of dietary intakes of selenium a significantly reduced risk of 21% [RR = 0.79, 95% CI = 0.73 to 0.85] for all-cause mortality.  

The investigators found for the highest compared with the lowest category of dietary intakes of α-carotene a significantly reduced risk of 21% [RR = 0.79, 95% CI = 0.63 to 0.94] for all-cause mortality.  

The investigators found for the highest compared with the lowest category of dietary intakes of β-carotene a significantly reduced risk of 18% [RR = 0.82, 95% CI = 0.77 to 0.86] for all-cause mortality.  

The investigators found for the highest compared with the lowest category of dietary intakes of vitamin C a significantly reduced risk of 12% [RR = 0.88, 95% CI = 0.83 to 0.94] for all-cause mortality.  

The investigators found for the highest compared with the lowest category of dietary intakes of total carotenes a significantly reduced risk of 11% [RR = 0.89, 95% CI = 0.81 to 0.97] for all-cause mortality.  

The investigators found for the highest compared with the lowest category a nonsignificant inverse association between dietary zinc, zeaxanthin, lutein and vitamin E and all-cause mortality risk.

The investigators found in nonlinear dose-response meta-analyses a linear inverse association in the analyses of dietary β-carotene and total antioxidant capacity, as well as in the analyses of circulating α-carotene, β-carotene, selenium, vitamin C and total carotenoids.

The investigators found the association appeared to be U-shaped in the analyses of serum lycopene and dietary vitamin C.

The investigators concluded that a diet with high antioxidant properties reduces the risk of all-cause mortality. These findings confirm current recommendations that promote higher intake of antioxidant-rich foods such as fruit and vegetables.

Original title:
Dietary Antioxidants, Circulating Antioxidant Concentrations, Total Antioxidant Capacity, and Risk of All-Cause Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Observational Studies by Jayedi A, Rashidy-Pour A, […], Shab-Bidar S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30239557

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All-cause mortality risk is lowest with a diet with 50-55 En% carbohydrates

Objectives:
Low carbohydrate diets, which restrict carbohydrate in favour of increased protein or fat intake, or both, are a popular weight-loss strategy. However, the long-term effect of carbohydrate restriction on mortality is controversial and could depend on whether dietary carbohydrate is replaced by plant-based or animal-based fat and protein. Therefore, this review article has been conducted.

Is there a relationship between carbohydrate diet and all-cause mortality?

Study design:
This review article included 8 cohort studies with a total of 432,179 participants, of which 40,181 deaths.

Results and conclusions:
The investigators found in the meta-analysis of 8 cohort studies, low carbohydrate consumption (40 En%) significantly increased all-cause mortality risk with 20% [pooled HR = 1.20, 95% CI = 1.09-1.32].

The investigators found in the meta-analysis of 8 cohort studies, high carbohydrate consumption (>70 En%) significantly increased all-cause mortality risk with 23% [pooled HR = 1.23, 95% CI = 1.11-1.36].

The investigators found, however, results varied by the source of macronutrients: all-cause mortality increased when carbohydrates were exchanged for animal-derived fat or protein [HR = 1.18, 95% CI = 1.08-1.29] and all-cause mortality decreased when the substitutions were plant-based [HR = 0.82, 95% CI = 0.78-0.87].

The investigators found a U-shaped relationship between carbohydrate intake and all-cause mortality, with minimum risk observed with 50-55% of energy from carbohydrate.

The investigators concluded that both high (>70 En%) and low percentages of carbohydrate diets (40 En%) are associated with increased all-cause mortality, with minimal risk observed at 50-55 En% carbohydrate intake. Low carbohydrate dietary patterns favouring animal-derived protein and fat sources, from sources such as lamb, beef, pork and chicken, are associated with higher all-cause mortality, whereas those that favoured plant-derived protein and fat intake, from sources such as vegetables, nuts, peanut butter and whole-grain breads, are associated with lower all-cause mortality, suggesting that the source of food notably modifies the association between carbohydrate intake and all-cause mortality.

Original title:
Dietary carbohydrate intake and mortality: a prospective cohort study and meta-analysis by Seidelmann SB, Claggett B, […], Solomon SD.

Link:
https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30135-X/fulltext

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The most easy way to follow a diet with 50-55 En% carbohydrates is to choose only meals/products with 50-55 En% carbohydrates.
However, the most practical way to follow a diet with 50-55 En% carbohydrates is all meals/products that you eat on a daily basis should contain on average 50-55 En% carbohydrates. Check here which products contain 50-55 En% carbohydrates.
 

A low selenium level in the brain increases Alzheimer’s disease

Objectives:
Oxidative stress has been found to be implicated in the development of Alzheimer's disease (AD). Therefore, this review article has been conducted.

Is there an association between selenium level in the brain and Alzheimer’s disease? 

Study design:
This review article included 14 studies with 40 observations on selenium concentrations in Alzheimer’s disease and control brains (persons without Alzheimer’s disease).

The effect size as standardized mean difference (SMD) was generated using review manager 5.3.

The funnel plot with Egger's [p = 0.88] and Begg's tests [p = 0.24] detected no significant publication bias.

Results and conclusions:
The investigators found random-effects meta-analysis indicated a decrease [SMD = - 0.42] in brain tissue selenium levels in patients with Alzheimer’s disease as compared to non-Alzheimer’s disease controls.
The results of sensitivity analysis indicated that no single study/observation had significantly influenced the overall outcome.

The investigators found the subgroup meta-analysis demonstrated that the selenium levels were decreased in the temporal, hippocampal and cortex regions of the brains in patients with Alzheimer’s disease.
The results of sensitivity analysis indicated that no single study/observation had significantly influenced the overall outcome.

The investigators concluded there is consolidated evidence for a significant decrease of selenium status in Alzheimer’s disease brains compared to controls (persons without Alzheimer’s disease). In line with the evidence supporting selenium's antioxidant role and the involvement of oxidative stress in Alzheimer’s disease development, these findings support new therapeutic strategies aimed at brain tissue selenium homeostasis in Alzheimer’s disease.

Original title:
Brain Selenium in Alzheimer's Disease (BRAIN SEAD Study): a Systematic Review and Meta-Analysis by Varikasuvu SR, Prasad VS, [...], Manne M.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30171594

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Monounsaturated fatty acids intake derived from animal sources increase risk of fracture

Afbeelding

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

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

Study design:
This review article included 6 observational studies.

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

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

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

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

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

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

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

High fish consumption decreases risk of age-related macular degeneration

Afbeelding

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

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

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

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

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

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

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

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

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

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

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

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Coronary heart disease and heart failure increase risk of dementia

Afbeelding

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

Does heart disease increase risk of dementia?

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

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

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

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

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

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

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

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

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Inflammatory markers are associated with an increased risk of all-cause dementia

Afbeelding

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

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

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

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

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

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

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

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

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

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

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Insulin-degrading enzyme protein level is lower in Alzheimer's disease patients

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

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

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

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

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

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

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

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

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Vitamin D level of 25 to 35 ng/mL decreases risk of dementia and Alzheimer's disease

Afbeelding

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

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

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

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

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

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

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

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

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

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

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A high consumption of yogurt and cheese reduces hip fracture

Afbeelding

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

Does consumption of dairy products reduce risk of hip fracture?

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

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

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

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

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

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

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

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

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

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

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

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

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