Nutritional Advice El Mondo

Nutritional advice

Overweight

Scientific studies (review articles) on the relationship between diet/nutrients and overweight 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. Causal relationship between sugar-sweetened beverages consumption and higher BMI and body weight

2021:

  1. High protein diets causally have beneficial effect on body weight management
  2. High circulating vitamin C level reduces metabolic syndrome
  3. Carbohydrate intake increases metabolic syndrome
  4. Poultry consumption decreases metabolic syndrome
  5. Nut consumption does not increase adiposity
  6. Obesity increases colorectal cancer in men with Lynch Syndrome
  7. A diet with low GI increases metabolic syndrome
  8. Hyperlipidemia, obesity and high alcohol consumption are risk factors of early-onset colorectal cancer
  9. Obesity is a risk factor for mortality from primary liver cancer
  10. Insufficiency of serum carotenoids increases overweight and obesity
  11. Obesity increases atrial fibrillation recurrence in patients undergoing catheter ablation
  12. Brown rice has anti-obesity effects in comparison with white rice
  13. No effect of vitamin E supplementation on weight, BMI and waist circumference
  14. Mortality is more frequently in COVID-19 patients with chronic kidney diseases and cardiovascular disease
  15. Vitamin D supplementation during pregnancy or infancy reduces adiposity in childhood

2020:

  1. Dairy products reduce causal fat mass and BMI among overweight or obese adults
  2. Pistachio supplementation lowers BMI without increasing body weight
  3. Abdominal adiposity is a risk factor in COVID-19
  4. Alpha-lipoic acid supplementation reduces weight and BMI
  5. Obesity increases severe COVID-19
  6. Coenzyme Q10 supplementation does not decrease body weight and BMI
  7. Yogurt intake is associated with a reduced risk of type 2 diabetes
  8. Fish consumption reduces metabolic syndrome
  9. Waist circumference is a significant risk factor of liver cancer

2019:

  1. A higher serum copper level increases obesity
  2. 100 g/d fruit consumption reduces metabolic syndrome
  3. 150 mg/day quercetin supplementation reduces LDL-cholesterol in obese people
  4. <2 g/d L-carnitine decreases diastolic blood pressure in participants with obesity
  5. 280 mg/d dietary calcium intake may reduce metabolic syndrome
  6. Adults with overweight/obesity benefit from probiotics
  7. ≤400 μg/d chromium supplementation reduce BMI
  8. Whole grains, fruit, nut, legume consumption reduce adiposity risk
  9. Tree nuts reduce risk of metabolic syndrome

2018:

  1. ≥75 mg/day isoflavones reduce BMI
  2. <50 g/d carbohydrates increase good cholesterol in overweight/obese adults
  3. ≥30g chocolate per day during 4-8 weeks reduce BMI
  4. Carotenoids may reduce risk of metabolic syndrome
  5. Ginger intake reduces body weight and fasting glucose among overweight and obese subjects
  6. Vegetable and fruit consumption reduce metabolic syndrome

2017:

  1. A low-fat diet reduces cholesterol level in overweight or obese people
  2. A high dietary fiber intake may reduce risk of metabolic syndrome
  3. A high fruit and/or vegetable consumption reduce risk of metabolic syndrome among Asian
  4. A high relative adipose mass reduces bone mineral density in overweight and obese populations
  5. Higher sodium increases metabolic syndrome
  6. Metabolic syndrome increases risk of ischemic stroke
  7. A higher circulating DHA is associated with a lower metabolic syndrome risk
  8. Whole flaxseed supplementation in doses ≥30 g/d during ≥12 weeks has positive effects on body composition in overweight participants
  9. n-3 PUFA supplements reduce waist circumference in overweight and obese adults
  10. Green tea decreases LDL cholesterol level in overweight or obese people
  11. Decreased vitamin D levels and increased BMI increase pediatric-onset MS
  12. CLA does not reduce fasting blood glucose and waist circumference
  13. Abdominal adiposity and higher body fat mass increase risk of atrial fibrillation

2015:

  1. Green tea consumption decreases blood pressure among overweight and obese adults

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Overweight is an increasing problem in the world. It’s called overweight when the BMI is greater than 25 and obese when the BMI is greater than 30. A healthy weight has a BMI of 18.5-25. A woman with 65 kg and 1.57 meters has a BMI of 26.4 (65/(1.57x1.57)). BMI is weight divided by height squared (weight (kg)/height2 (m)).

The best way to determine overweight in children is to calculate the BMI. In adults, beside the BMI, waist circumference should also be measured.

Everybody who wants to lose weight, wants to burn more calorie at rest and more fat. How do you achieve these two goals?

Make sure the resting metabolic rate (RMR) does not decrease when following a diet (therefore, the recommendation of dietitians is no more than 0.5-1 kg of weight loss per week). A low resting metabolic rate will result in a low calorie burning at rest. But that is not what you want. You want, when following a diet, that the body will burn more calories (at rest).
A low resting metabolic rate is often the result of the insufficient intake of carbohydrate. When the body obtains insufficient quantities of carbohydrate, it’s been forced to get energy from protein, resulting in muscle degradation. Muscle degradation will in turn result in a lower resting metabolic rate. Muscle degradation can be observed when the upper arm and calf circumference become smaller. To prevent muscle degradation, when following a diet, is recommendable to choose product with 55-70 En% carbohydrates.

To prevent muscle degradation when following a diet, the diet must contain at least 1.6 g protein per kg body weight. For a person of 65 kg means 65x1.6 = 104 kg of protein per day. 1.6 g protein per kg body weight corresponds to a diet with 20 En% protein.

To prevent muscle degradation when following a diet, it is recommendable to choose products with 20-35 En% protein and/or products with 55-70 En% carbohydrates in combination with strength training. Strength training increases the resting metabolic rate. A declined resting metabolic rate is often the cause of the yo-yo effect.

Cardio-fitness is a good way to burn fat. To be able to burn fat efficiently, you should perform cardio-fitness with the heart rate between 75 and 90% of the maximum heart rate. The maximum heart rate is calculated by 220 minus age.
For example, you are 40 years old you have to perform cardio-fitness with a heart rate between 0.75-0.9x(220-40) = 135 and 162 heart beats per minute. Stop immediately  with the exercises when you are not feeling well or have pain in the chest!

In summary, it can be said the best way to lose weight is to perform strength training with cardio-fitness in combination with a diet containing products with 20-35 En% protein and/or products with 55-70 En% carbohydrates.

The main cause of overweight is the body gets more calories than it daily burns. Through physical activities, the body will burn more calories. To gain positive effects of physical exercises the body should burn at least 2000 calories (kcal) per week or at least 150 minutes of aerobic exercise of moderate intensity, accumulated over the week, which can be split into periods of at least 10 minutes. To prevent overweight, physical activities should account for 15-30% of the daily calorie intake.

The main consequences of overweight are:

  • Cardiovascular diseases.
  • Type 2 diabetes. The main effects of type 2 diabetes are cardiovascular diseases and kidney problems.

Belly fat is bad because it increases the risk of getting type 2 diabetes and cardiovascular disease. Therefore, aim for a waist circumference of 68-80 cm for women and 79-94 cm for men. A loss of 1 cm of belly fat (e.g. 95 to 94 cm) corresponds to a loss of 1 kg of fat. 1 kg of fat corresponds to 9000 calories.

Local fat loss, such as the backside or thighs is a scientific myth.

The human body will only burn fat when it meets the following two criteria:

  1. Increased oxygen uptake (only occurs during physical exercises).
  2. Increased energy demand (only occurs during physical exercises).

We like to eat fat but our body likes to use carbohydrates as energy source.

Overweight is the result of poor knowledge about nutrition in combination with hardly physical exercises.

It is not possible to lose more than 1.8 grams of fat per week. However, at more than 1 kg of fat loss per week, the body will also break down muscle, resulting in a low resting metabolic rate and yoyo-effect.

When following a diet is favorable to minimize fat through diet. But at least 7 grams of fat per day is necessary to ensure the intake of essential fatty acids and to stimulate the production of bile salts.
7 grams of fat per day corresponds to a daily diet with 4 En% fat. However, a diet with at least 20 En% fat (and up to 35 En% fat) is necessary to prevent a deficiency of essential fatty acids and fat-soluble vitamins on long-term.

A responsible breakfast contains up to 350 kcal.
A responsible lunch contains up to 450 kcal.
A responsible evening meal contains up to 750 kcal.

Good indicators for weight loss are a decreased body fat and an increased muscle mass. The body fat and muscle mass can be measured with a body composition analyzers scale.

Recommended daily energy intake by sex and age group
Age group (years)MenWomen
Kcal per dayKcal per day
616001500
1222002000
1729002300
30-3926002000
50-5925002000
70-7923001800
Others25002000

 

Recommended fat percentage by sex and age group
Age group (years)MenWomen
17-291525
30-3917.527.5
40-492030
50+2535
A healthy adult male has a body fat percentage around 15%.
A healthy adult woman has a body fat percentage around 25%.


Dietary guidelines for overweight prevention:

  • Choose products with 20-30 En% fat, products with maximum 7 En% saturated fat, products with 20-35% protein, products with maximum 10 En% sugars, products with minimum 1.5 grams of fiber per 100 kcal and products with a GI value of 55 or lower or in other words, your daily diet (=all meals/products that you eat on a daily basis) should on average contain 20-30 En% fat, maximum 7 En% saturated fat, 20-35% protein, maximum 10 En% sugars and minimum 1.5 grams of fiber per 100 kcal.
  • Products with 20-35 En% protein in combination with 10000 steps per day and 25-30 grams of fiber per day will reduce weight in a responsible manner.
    Products with 20-35 En% protein should contain maximum 30 En% fat and maximum 7 En% saturated fat!
  • No more than 0.5-1 kg of weight loss per week. 0.5 kg of weight loss per week corresponds to a decreased intake of 350 kcal per day through diet and 150 kcal extra through physical activities.
  • To prevent a deficiency of vitamins and essential fatty acids a diet should contain a minimum of 1700 kcal per day.
  • Increase the resting metabolic rate. Strength training is the best way to increase the resting metabolic rate.
  • Use the following guideline: total energy intake per day is 25-30 kcal per kg body weight.
  • Eat 300 grams of vegetables and five servings of fruit per day or 25-30 grams of fiber per day. Dietary fiber provides a longer satiety, resulting in less meal times during the day. Furthermore, the antioxidants from fruits and vegetables reduce inflammation.
    30 grams of fiber per day corresponds to a daily diet of minimum 1.5 grams of fiber per 100 kcal.
  • 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.
  • 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 90 minutes per day on physical exercises or at least 10000 steps per day.
  • Stop smoking because smoking causes atherosclerosis. Atherosclerosis is the most important cause of cardiovascular diseases.
  • Do not go shopping on an empty stomach.
  • Do not skip breakfast.
  • Put the meal on a small plate. So it looks like there is a lot of food on the plate!
  • Eat at least 2 times (100-150 g fish per time) a week oily fishes or take daily 250-500 mg EPA and DHA.
    Oily fishes are sardines, herring, salmon, anchovies, eel and mackerel.
  • Limit alcohol to 2 glasses for men and 1 glass for women per day.
  • Eat no more than 6 grams of salt per day, corresponding to 2400 mg of sodium.
    6 grams salt per day corresponds to a daily diet with <0.3 g salt per 100 kcal.
  • Do not take weight loss supplements. They do not what they claim.
Age (years)Recommended BMI for menRecommended BMI for women
414.40-17.5514.25-17.28
514.20-17.4214.05-17.15
614.04-17.5513.90-17.34
714.02-17.9213.94-17.75
814.10-18.4414.06-18.35
914.29-19.1014.26-19.07
1014.53-19.8414.57-19.86
1114.84-20.5514.99-20.74
1215.23-21.2215.52-21.68
1315.70-21.9116.13-22.58
1416.25-22.6216.73-23.34
1516.84-23.2917.28-23.94
1617.42-23.9017.75-24.37
1717.98-24.4618.16-24.70
18 and older18-50-25.0018.50-25.00

Causal relationship between sugar-sweetened beverages consumption and higher BMI and body weight

Objectives:
Is there a causal relationship between sugar-sweetened beverages consumption and higher BMI and body weight in both children and adults?
 
Study design:
This review article included 85 studies with 48 in children (40 cohort studies with 91,713 participants and 8 RCTs with 2,783 participants) and 37 in adults (21 cohort studies with 448,661 participants and 16 RCTs with 1,343 participants).

Results and conclusions:
The investigators found among cohort studies, each serving/day increase in sugar-sweetened beverages intake was significantly associated with a 0.07 kg/m2 [95% CI = 0.04 to 0.10 kg/m2] higher BMI in children and a 0.42 kg [95% CI = 0.26 to 0.58 kg] higher body weight in adults.

The investigators found RCTs in children indicated less BMI gain with sugar-sweetened beverages reduction interventions compared with control [MD = -0.21 kg/m2, 95% CI = -0.40 to -0.01 kg/m2].

The investigators found RCTs in adults showed randomization to addition of sugar-sweetened beverages to the diet led to greater body weight gain [MD = 0.83 kg, 95% CI = 0.47 to 1.19 kg] and subtraction of sugar-sweetened beverages led to weight loss [MD = -0.49 kg, 95% CI = -0.66 to -0.32 kg] compared with the control groups.

The investigators found a positive linear dose-response association between sugar-sweetened beverages consumption and weight gain for all outcomes assessed.

The investigators concluded there is a causal relationship between sugar-sweetened beverages consumption and higher BMI and higher body weight in both children and adults.

Original title:
Sugar-sweetened beverage consumption and weight gain in children and adults: a systematic review and meta-analysis of prospective cohort studies and randomized controlled trials by Nguyen M, Jarvis SE, [...], Malik VS.

Link:
https://pubmed.ncbi.nlm.nih.gov/36789935/

Additional information of El Mondo:
Find more information/studies on sugar-sweetened beverages consumption and obesity/overweight right here.

High protein diets causally have beneficial effect on body weight management

Objectives:
Do diets rich in protein causually reduce body weight of adults with overweight or obesity? 

Study design:
This review article included 37 RCTs.
The diets were included during a mean of 32 weeks interventions, ranging from 8 to 104 weeks.

There was no publication bias.

Results and conclusions:
The investigators found protein intake (ranging from 18-59 energy percentage [En%]) significantly reduced body weight by 1.6 kg [95% CI = 1.2 to 2.0 kg, I2 = 56%] compared to controls (digestible carbohydrate, fiber, fat or no supplementation (no placebo used)).
This result was also found in sensitivity analysis.

The investigators found the effect size of dietary protein in body weight management was dependent on specific phenotypes, where individuals with prediabetes had more benefit compared to individuals with normoglycemia.
Furthermore, individuals without the obesity risk allele (AA genotype) had more benefit compared to individuals with the obesity risk alleles (AG and GG genotypes).

The investigators concluded that diets rich in protein (18-59 energy percentage [En%]) during 32 weeks causally have a moderate beneficial effect on body weight management of adults with overweight or obesity.

Original title:
Are Dietary Proteins the Key to Successful Body Weight Management? A Systematic Review and Meta-Analysis of Studies Assessing Body Weight Outcomes after Interventions with Increased Dietary Protein by Hansen TT, Astrup A and Sjödin A.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8468854/

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

A diet rich in protein with 18-59 energy percentage [E%] or a diet with 18-59 En% protein means that the amounts of protein contribute 18 to 59% to the total calories (kcal) of the diet.
If the diet contains 2000 kcal, 90 grams of protein contribute 18% to this 2000 kcal.
1 gram of protein gives 4 kcal. Thus 90 grams of protein provide 360 kcal (90x4 kcal) and 360 kcal is 18% of 2000 kcal.

The most easy way to follow a diet rich in protein with 18-59 energy percentage is to choose only meals/products with 18-59 En% protein. Check here which products contain 18-59 En% protein.

However, the most practical way to follow a diet with 18-59 En% protein is, all meals/products that you eat on a daily basis should contain on average 18-59 En% protein.

To do this, use the 7-points nutritional profile app to see whether your daily diet contains 18-59 En% protein.

A high-protein diet is a diet with at least 20 En% protein.

 

High circulating vitamin C level reduces metabolic syndrome

Objectives:
The association between vitamin C and metabolic syndrome (MetS) has been evaluated in several epidemiological studies with conflicting results. Therefore, this review article has been conducted.

Do dietary vitamin C intake and circulating vitamin C level reduce risk of metabolic syndrome? 

Study design:
This review article included 26 cross-sectional studies and 2 cohort studies with a total number of 110,771 participants. 23 studies were related to the dietary vitamin C level.
The sample size ranged from 143 to 27,656 persons.
The dietary vitamin C level was assessed by food-frequency questionnaire (FFQ) in 4 studies, a 24-h or 3-day recall in 18 studies and a 4-day record in 1 study.

No evidence of publication bias existed according to Begg's rank correlation test [p = 0.495].

Results and conclusions:
The investigators found when compared to the lowest dietary vitamin C intake, that the highest dietary vitamin C intake significantly reduced risk of metabolic syndrome with 7% [overall multivariable-adjusted RR = 0.93, 95% CI = 0.88 to 0.97, p = 0.003, I2 = 54.5%, p = 0.003]. The above findings were confirmed in cross-sectional studies [RR = 0.92, 95% CI = 0.87 to 0.97, p = 0.001] and 24-h or 3-day recall [RR = 0.89, 95% CI = 0.86 to 0.93, p 0.001] studies.

The investigators found when compared to the lowest circulating vitamin C level, that the highest circulating vitamin C level significantly reduced risk of metabolic syndrome with 40% [overall multivariable-adjusted RR = 0.60, 95% CI = 0.49 to 0.74, p 0.001, I2 = 22.7%, p = 0.249].

The investigators concluded that both the dietary and the circulating vitamin C level reduce risk of metabolic syndrome. However, due to the limitation of the available evidence, more well-designed prospective studies are still needed.

Original title:
Vitamin C and Metabolic Syndrome: A Meta-Analysis of Observational Studies by Guo H, Ding J, [...], Zhang Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8531097/

Additional information of El Mondo:
Find more information/studies on vitamin C consumption and overweight right here.

In practice, a lot of dietary vitamin C intake amounts to 200 to 300 grams of vegetables and 2-5 pieces of fruit per day. Vitamin C is found in fruit and vegetables.

A high circulating vitamin C level can be obtained through vitamin C-rich food and/or taking vitamin C supplements.

 

Carbohydrate intake increases metabolic syndrome

Objectives:
The associations between dietary carbohydrate and diverse health outcomes remain controversial and confusing. Therefore, this review article (meta-analyse) has been conducted.

What is the association between dietary carbohydrate intake and diverse health outcomes?

Study design:
This review article included 43 meta-analyses of observational research studies with 23 health outcomes, including cancer (n = 26), mortality (n = 4), metabolic diseases (n = 4), digestive system outcomes (n = 3) and other outcomes [coronary heart disease (n = 2), stroke (n = 1), Parkinson's disease (n = 1) and bone fracture (n = 2)].

This umbrella review summarized 281 individual studies with 13,164,365 participants.

33.3% studies were considered to be of high quality and 66.7% of moderate quality.

Results and conclusions:
The investigators found highly suggestive evidence showed that dietary carbohydrate intake significantly increased risk of metabolic syndrome with 25% [adjusted summary odds ratio = 1.25, 95% CI = 1.15 to 1.37].

The investigators found suggestive evidence showed that dietary carbohydrate intake significantly decreased risk of esophageal adenocarcinoma with 43% [adjusted summary hazard ratio = 0.57, 95% CI = 0.42 to 0.78].

The investigators found suggestive evidence showed that dietary carbohydrate intake significantly increased risk of all-cause mortality with 19% [adjusted summary hazard ratio 1.19, 95% CI = 1.09 to 1.30].

The investigators concluded despite the fact that numerous systematic reviews and meta-analyses have explored the relationship between carbohydrate intake and diverse health outcomes, there is no convincing evidence of a clear role of carbohydrate intake. However, highly suggestive evidence shows carbohydrate intake is associated with higher risk of metabolic syndrome. Suggestive evidence shows carbohydrate intake is associated with higher risk of all-cause mortality and lower risk of esophageal adenocarcinoma.

Original title:
Dietary Carbohydrate and Diverse Health Outcomes: Umbrella Review of 30 Systematic Reviews and Meta-Analyses of 281 Observational Studies by Liu YS, Wu QJ […], Zhao YH.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8116488/

Additional information of El Mondo:
Find more information/studies on carbohydrate consumption and obesity/overweight right here.

Poultry consumption decreases metabolic syndrome

Objectives:
What is the association between red meat and poultry consumption and the risk of metabolic syndrome?

Study design:
This review article included 9 prospective cohort studies, which involved a total of 21,869 participants.
Among them, 8 studies were identified for red meat consumption.

No publication bias was observed according to the Begg's rank-correlation test and the Egger's test.  

Results and conclusions:
The investigators found that red meat consumption was significantly associated with a higher risk of 35% for metabolic syndrome [multi-variable adjusted RR = 1.35, 95% CI = 1.13 to 1.62, p = 0.001, I2 = 54.4%, p = 0.032].  
The same results were obtained in subgroup analysis for >5 years follow-up [RR = 1.36, 95% CI = 1.09 to 1.7, p = 0.006], non-National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP III) [RR = 1.34, 95% CI = 1.12 to 1.62, p = 0.002], Non-Asia [RR = 1.51, 95% CI = 1.29 to 1.77, p 0.001], adjustment of BMI [RR = 1.4, 95% CI = 1.23 to 1.6, p 0.001] and physical activity studies [RR = 1.48, 95% CI = 1.29 to 1.71, p 0.001].

The investigators found that unprocessed red meat consumption was significantly associated with a higher risk of 32% for metabolic syndrome [multi-variable adjusted RR = 1.32, 95% CI = 1.14 to 1.54, p = 0.0003, I2 = 0%, p = 0.397].  

The investigators found that processed red meat consumption was significantly associated with a higher risk of 48% for metabolic syndrome [multi-variable adjusted RR = 1.48, 95% CI = 1.11 to 1.97, p = 0.007, I2 = 64.7%, p = 0.097].  

The investigators found that poultry consumption was significantly associated with a lower risk of 15% for metabolic syndrome [multi-variable adjusted RR = 0.85, 95% CI = 0.75 to 0.97, p = 0.02, I2 = 0%, p = 0.707].  

The investigators concluded that red meat (processed and unprocessed) consumption is associated with a higher risk of metabolic syndrome, whereas, poultry consumption is associated with a lower risk of metabolic syndrome. More well-designed randomized controlled trials are still needed to address the issues further.

Original title:
Association of Red Meat and Poultry Consumption With the Risk of Metabolic Syndrome: A Meta-Analysis of Prospective Cohort Studies by Guo H, Ding J, [...], Zhang Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8295459/

Additional information of El Mondo:
Find more information/studies on meat consumption and obesity/overweight right here.

Nut consumption does not increase adiposity

Objectives:
Nuts are recommended for cardiovascular health, yet concerns remain that nuts may contribute to weight gain due to their high energy density. Therefore, this review article has been conducted.

Does nut consumption contribute to an increased adiposity risk?

Study design:
This review article included 6 prospective cohort studies with 569,910 participants and 86 RCTs with 114 comparisons and 5,873 participants.

Results and conclusions:
The investigators found nuts consumption was significantly associated with a lower risk of 7% for incidence of overweight/obesity [RR = 0.93, 95% CI = 0.88 to 0.98, p 0.001, moderate certainty of evidence] in prospective cohort studies.

The investigators found RCTs showed no adverse effect of nuts on body weight [MD = 0.09 kg, 95% CI = -0.09 to 0.27 kg, p 0.001, high certainty of evidence].

The investigators found meta-regression showed that higher nut intake was significantly associated with reductions in body weight and body fat.

The investigators concluded that current evidence demonstrates the concern that nut consumption contributes to increased adiposity appears unwarranted.

Original title:
Are fatty nuts a weighty concern? A systematic review and meta-analysis and dose-response meta-regression of prospective cohorts and randomized controlled trials by Nishi SK, Viguiliouk E, [...], Sievenpiper JL.

Link:
https://pubmed.ncbi.nlm.nih.gov/34494363/

Additional information of El Mondo:
Find more information/studies on nut consumption and obesity/overweight right here.

A diet with low GI increases metabolic syndrome

Objectives:
Diets with high glycemic index (GI) or high glycemic load (GL) have been linked to important risk factors associated with the development of metabolic syndrome (MetS), such as dyslipidemia, higher blood glucose and insulin concentrations. However, the role of GI and GL in relation to metabolic syndrome is still understudied and controversial. Therefore, this review article has been conducted.

Does high dietary GI or GL increase risk of metabolic syndrome?

Study design:
This review article included 1 cohort study and 11 cross-sectional studies with a total sample size of 36,295 subjects.

Results and conclusions:
The investigators found, the pooled effect sizes from the 9 studies indicated high versus low dietary GI was significantly associated with increased risk of 5% for metabolic syndrome [OR = 1.05, 95% CI = 1.01 to 1.09, I2 = 58.1%, p = 0.004].
This finding was supported by all subgroup analyses except where studies used 24-h recalls for dietary assessment.

The investigators found, additionally, a linear dose-response investigation revealed that each 5-point increment in GI was associated with 2% increase in the risk of metabolic syndrome [OR = 1.02, 95% CI = 1.01 to 1.02].
Howver, non-linear pattern was insignificant [p-nonlinearity = 0.63].

The investigators found, moreover, pooled effect sizes from 10 studies suggested that no association was found between the GL and metabolic syndrome with results remaining consistent in all subgroup analyses.

The investigators concluded that high dietary GI increases risk of metabolic syndrome. Nutrition policy and clinical practices should encourage a diet with low GI. Future studies should include both GI and GL and different criteria of metabolic syndrome to provide a better comparison.

Original title:
Glycemic index, but not glycemic load, is associated with an increased risk of metabolic syndrome: Meta-analysis of observational studies by Askari M, Dehghani A, […], Alizadeh S.

Link:
https://pubmed.ncbi.nlm.nih.gov/33928722/

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

A diet with low GI is a diet with GI of 55 or lower.

Insufficiency of serum carotenoids increases overweight and obesity

Objectives:
Excess body weight, including overweight and obesity, is one of the major factors influencing human health and plays an important role in the global burden of disease. Carotenoids serve as precursors of vitamin A-related retinoids and are considered to have potential effects on many diseases. However, the influence of carotenoids on people with excess body weight is unclear. Therefore, this review article has been conducted.

Does carotenoid supplementation reduce risk of overweight and obesity in overweight or obese subjects?

Study design:
This review article included 7 randomized controlled trials (RCTs) and 8 observational studies with 28,944 subjects and data on multiple carotenoid subgroups, including lycopene, astaxanthin, cryptoxanthin, α-carotene, and β-carotene.

In all included RCTs, the intervention duration was 20 days at the shortest and 16 weeks at the longest and the range of intervention doses was 1.2-60 mg/d.

Results and conclusions:
The investigators found that the insufficiency of serum carotenoids significantly increased risk of overweight and obesity with 73% [OR = 1.73, 95% CI = 1.57 to 1.91, p 0.001].

The investigators found, moreover, carotenoid supplementation was significantly associated with body weight reductions [SMD = -2.34 kg, 95% CI = -3.80 to -0.87 kg, p 0.001], body mass index decrease [SMD = -0.95 kg/cm2, 95% CI = -1.88 to -0.01 kg/cm2, p 0.001] and waist circumference losses [SMD = -1.84 cm, 95% CI = -3.14 to -0.54 cm, p 0.001].

The investigators concluded that 1.2-60 mg/d carotenoid supplementation reduces risk of overweight and obesity in overweight or obese subjects. Furthermore, an insufficiency of serum carotenoids is a risk factor for overweight and obesity. Additional data from large clinical trials are needed.

Original title:
The association between carotenoids and subjects with overweight or obesity: a systematic review and meta-analysis by Yao N, Yan S, […], Cui W.

Link:
https://pubmed.ncbi.nlm.nih.gov/33977977/

Additional information of El Mondo:
Find more information/studies on carotenoid consumption and obesity/overweight right here.

Am I overweight?
 

Obesity increases atrial fibrillation recurrence in patients undergoing catheter ablation

Objectives:
The evidence on the association between obesity and atrial fibrillation (AF) recurrence was equivocal. Therefore, this review article (meta-analysis) has been conducted.

Does obesity increase risk of atrial fibrillation recurrence in patients undergoing catheter ablation?

Study design:
This review article included 20 studies with 52,771 patients.

Results and conclusions:
The investigators found that obesity was significantly associated with higher atrial fibrillation recurrence [OR = 1.30, 95% C = 1.16 to 1.47, p 0.001, I2 = 72.7%] and similar rate of adverse events [OR = 1.21, 95% CI = 0.87 to 1.67, p = 0.264, I2 = 23.9%] in patients undergoing catheter ablation.

The investigators found meta-regression showed that the association varied by age [coefficient = -0.03, p = 0.024].

The investigators found meta-analysis of highest versus lowest BMI showed that the highest group had higher atrial fibrillation recurrence [OR = 1.37, 95% CI = 1.18 to 1.58, p 0.001, I2 = 64.9%] and adverse events [OR = 2.02, 95% CI = 1.08 to 3.76, p = 0.028, I2 = 49.5%] in patients undergoing catheter ablation.

The investigators found the dose-response relationship for BMI and atrial fibrillation recurrence was nonlinear [p nonlinearity 0.001], the curve became steeper at 30-35 kg/m2.

The investigators found for adverse events, an increase of 1% for every 1 kg/m2 increase in BMI [OR = 1.01, 95% CI = 1.00 to 1.02, p = 0.001], the relationship was nonlinear [p nonlinearity = 0.001].

The investigators concluded that obesity is associated with higher atrial fibrillation recurrence in patients undergoing catheter ablation. High BMI is associated with a higher risk for adverse events.

Original title:
BMI and atrial fibrillation recurrence post catheter ablation: A dose-response meta-analysis by Pranata R, Henrina J, […], Munawar M.

Link:
https://pubmed.ncbi.nlm.nih.gov/33544873/

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Catheter ablation is a procedure that uses radiofrequency energy (similar to microwave heat) to destroy a small area of heart tissue that is causing rapid and irregular heartbeats. Destroying this tissue helps restore your heart’s regular rhythm. Catheter ablation is also called radiofrequency ablation.

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Brown rice has anti-obesity effects in comparison with white rice

Objectives:
A few randomized controlled trials (RCTs) have assessed the effect of brown rice consumption on metabolic parameters (such as, weight, height, waist circumference, fasting glucose, LDL, HDL, total cholesterol, triglycerides and blood pressure) compared to white rice, with inconsistent findings. Therefore, this review article has been conducted.

Is the effect of brown rice on adiposity indices (such as, weight, height and waist circumference), lipid profile (such as, LDL, HDL, total cholesterol and triglycerides) and glycemic markers (such as, fasting blood glucose) higher compared to white rice in adult subjects?

Study design:
This review article included 13 RCTs.
In accordance with Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, the certainly of the included evidence was low and very low.

Results and conclusions:
The investigators found brown rice significantly reduced:
weight by -1.63 kg [95% CI = -2.15 to -1.11, I2 = 97%, n = 6];
body mass index (BMI) by -0.58 kg/m2 [95% CI = -0.78 to -0.37, I2 = 96%, n = 6] and;
waist circumference by -2.56 cm [95% CI = -4.86 to -0.26, I2 = 88%, n = 5] compared with white rice.

The investigators found, moreover, brown rice had no significant effect on lipid profile and glycemic markers.

The investigators found pre-germinated brown rice significantly declined:
weight by -1.75 kg [95% CI = -2.70 to -0.81, I2 = 99%, n = 4];
total cholesterol by -24.22 mg/dL [95% CI = -33.03 to -15.41, I2 = 78%, n = 5];
triglyceride (TG) by -43.28 mg/dL [95% CI = -74.05 to -12.50, I2 = 90%, n = 5];
low-density lipoprotein (LDL or bad cholesterol) by -20.05 mg/dL [95% CI = -29.57 to -10.52, I2 = 71%, n = 5] and;
fasting blood glucose (FBG) by -15.83 mg/dL [95% CI = -25.20 to -6.46, I2 = 91%, n = 5] compared to white rice.

The investigators concluded brown rice has anti-obesity effects in comparison with white rice. However, it has no beneficial effects on lipid profile and glycemic markers. Furthermore, pre-germinated brown rice has better functional effects on promoting lipid profile and fasting blood glucose compared to brown rice.

Original title:
The effect of brown rice compared to white rice on adiposity indices, lipid profile, and glycemic markers: a systematic review and meta-analysis of randomized controlled trials by Golzarand M, Toolabi K, […], Mirmiran P.

Link:
https://pubmed.ncbi.nlm.nih.gov/33905269

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No effect of vitamin E supplementation on weight, BMI and waist circumference

Objectives:
Several mechanisms have been proposed for the effect of vitamin E on weight loss. Yet various interventional studies with wide ranges of doses and durations have reported contradictory results. Therefore, this review article has been conducted.

Does vitamin E supplementation reduce overweight?

Study design:
This review article included 24 RCTs.

Results and conclusions:
The investigators found there was no significant effect of vitamin E supplements on weight [WMD = 0.15, 95% CI = -1.35 to 1.65, p = 0.847], body mass index (BMI) [WMD = 0.04, 95% CI = -0.29 to 0.37, p = 0.815] and waist circumference (WC) [WMD = -0.19 kg, 95% CI = -2.06 to 1.68, p = 0.842], respectively.

The investigators found, however, subgroup analysis revealed that vitamin E supplementation in studies conducted on participants with normal BMI (18.5-24.9) had increasing impact on BMI [p = 0.047].  

The investigators concluded there is no significant effect of vitamin E supplementation on weight, BMI and waist circumference (WC). However, vitamin E supplementation increases BMI in participants with normal BMI (18.5-24.9).

Original title:
Can vitamin E supplementation affect obesity indices? A systematic review and meta-analysis of twenty-four randomized controlled trials by Emami MR, Jamshidi S, […], Aryaeian N.

Link:
https://pubmed.ncbi.nlm.nih.gov/33632535/

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Daily 700-1000 mg dietary calcium intake increases cardiovascular disease in healthy postmenopausal women

Objectives:
Recent systematic reviews and meta-analyses of randomized, double-blind, placebo-controlled trials (double-blind, placebo-controlled RCTs) have reported controversial findings regarding the associations between calcium supplements on the risk of cardiovascular disease (CVD). Therefore, this review article has been conducted.

Do calcium supplements increase risk of cardiovascular disease (CVD)?

Study design:
This review article included 13 RCTs with 28,935 participants in an intervention group (group with calcium supplements) and 14,243 in a control group (group without calcium supplements).

The mean age of the study participants was 66.3 years (range: 35 to 97 years) and 92.8% of those were women.
Publication bias was not observed.

Results and conclusions:
The investigators found calcium supplements significantly increased the risk of cardiovascular disease with 15% in healthy postmenopausal women [RR = 1.15, 95% CI = 1.06 to 1.25, I2 = 0.0%, n = 14].

The investigators found calcium supplements significantly increased the risk of coronary heart disease with 16% in healthy postmenopausal women [RR = 1.16, 95% CI = 1.05 to 1.28, I2 = 0.0%, n = 9].

The investigators found in the subgroup meta-analysis, dietary calcium intake of 700-1000 mg per day or supplementary calcium intake of 1000 mg per day significantly increased the risk of cardiovascular disease and coronary heart disease.

The investigators concluded that the use of calcium supplements (1000 mg per day) is significantly associated with the increased risk of cardiovascular disease and coronary heart disease by 15%, specifically in postmenopausal women. These findings should be explicitly confirmed by conducting further RCTs with cardiovascular disease outcome measures as well as the incidence of osteoporosis or fractures as the primary endpoints.

Original title:
Calcium Supplements and Risk of Cardiovascular Disease: A Meta-Analysis of Clinical Trials by Myung SK, Kim HB, […], Oh SW.

Link:
https://pubmed.ncbi.nlm.nih.gov/33530332/

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Vitamin D supplementation during pregnancy or infancy reduces adiposity in childhood

Objectives:
Vitamin D deficiency during pregnancy or infancy is associated with adverse growth in children. No systematic review has been conducted to summarize available evidence on the effect of vitamin D supplementation in pregnancy and infancy on growth and body composition in children. Therefore, this review article has been conducted.

Does vitamin D supplementation during pregnancy or infancy increase adiposity (severe or morbid overweight) risk in childhood?

Study design:
This review article included 12 RCTs with a total of 4,583 participants.
The doses of vitamin D in the intervention group (group with vitamin D supplements) were 60,000 IU/4 weeks (1,500 mcg/4 weeks) or 60,000 IU/8 weeks and in the control group (group without vitamin D supplements) was 400 IU/day.

Results and conclusions:
The investigators found vitamin D supplementation during pregnancy was associated with higher triceps skinfold thickness (mm) [MD = 0.33, 95% CI = 0.12 to 0.54, I2 = 34%] in neonates.

The investigators found vitamin D supplementation during pregnancy or infancy was associated with significantly increased length for age z-score in infants at 1 year of age [MD = 0.29, 95% CI = 0.03 to 0.54, I2 = 0%].

The investigators found vitamin D supplementation during pregnancy or infancy was associated with lower body mass index (BMI) (kg/m2) [MD = -0.19, 95% CI = -0.34 to -0.04, I2 = 0%] and body mass index z-score (BMIZ) [MD = -0.12, 95% CI = -0.21 to -0.04, I2 = 0%] in offspring at 3-6 years of age.

The investigators found vitamin D supplementation during early life was not observed to be associated with children’s bone, lean or fat mass.

The investigators concluded vitamin D supplementation during pregnancy or infancy is associated with reduced adiposity (severe or morbid overweight) in childhood. Future large well-designed double blinded RCTs are needed to assess the effectiveness of vitamin D supplementation in early life on children’s bone health, lean mass and adiposity.

Original title:
Effect of Vitamin D Supplementation in Early Life on Children's Growth and Body Composition: A Systematic Review and Meta-Analysis of Randomized Controlled Trials by Ma K, Wei SQ, [...], Wen SW.

Link:
https://www.mdpi.com/2072-6643/13/2/524/htm

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Dairy products reduce causal fat mass and BMI among overweight or obese adults

Objectives:
Is there a causal relationship between dairy products or calcium supplements and the reduction in fat mass and BMI among overweight or obese adults?

Study design:
This review article included 10 and 14 RCTs with ≥ 12 weeks interventions of calcium supplements and dairy products among overweight (BMI>25) or obese (BMI>30) adults aged ≥18.

Results and conclusions:
The investigators found that dairy products significantly reduced fat mass among overweight or obese adults [SMD = -0.40, 95% CI = -0.77 to -0.02].
This reduction was also significant in the analysis of RCTs with low risk of bias scores.

The investigators found that dairy products significantly reduced BMI among overweight or obese adults [SMD = -0.46 kg/m2, 95% CI = -0.67 to -0.26].
This reduction was also significant in the analysis of RCTs with low risk of bias scores.

The investigators found that calcium supplements significantly reduced fat mass among overweight or obese adults [SMD = -0.15, 95% CI = -0.28 to -0.02].
However, this reduction was not significant in the analysis of RCTs with low risk of bias scores.

The investigators concluded there is a causal relationship between dairy products without distinction of fat percentage and the reduction in fat mass and BMI among overweight or obese adults.

Original title:
Meta-analysis of randomized controlled trials on calcium supplements and dairy products for changes in body weight and obesity indices by Hong JY, Lee JS, [...], Kim MK.

Link:
https://pubmed.ncbi.nlm.nih.gov/33292017/

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Pistachio supplementation lowers BMI without increasing body weight

Objectives:
Does pistachio supplementation reduce obesity risk?

Study design:
This review article included 11 randomized controlled trials (RCTs) with 1,593 subjects.

The assigned pistachio intake was below 50 g/d in 3 studies.
Intervention times were shorter than 12 weeks in 4 studies.
There was no significant publication bias.

Results and conclusions:
The investigators found compared to the control diet group, the pistachio supplementation regimen significantly decreased BMI [-0.18 kg/m2, 95% CI = -0.26 to -0.11 kg/m2, p 0.001, I2 = 29.8%, p = 0.180].

The investigators found compared to the control diet group, the pistachio supplementation regimen did not significantly change waist circumference [net change = 0.76 cm, 95% CI = -0.11 to 1.63 cm, p = 0.087, I2 = 7.0%, p = 0.340].

The investigators found compared to the control diet group, the pistachio supplementation regimen had no effect on body weight [net change = 0.22 kg, 95% CI = -0.50 to 0.07 kg, p = 0.141, I2 = 0.0%, p = 0.962].

The investigators concluded compared to a controlled dietary intake, an adequate amount of pistachio supplementation lowers BMI without increasing body weight, which supports the view that pistachio consumption is beneficial for human health.

Original title:
The relationship between pistachio (Pistacia vera L) intake and adiposity: A systematic review and meta-analysis of randomized controlled trials by Xia K, Yang T, […], Chen XZ.

Link:
https://journals.lww.com/md-journal/Fulltext/2020/08210/The_relationship_between_pistachio__Pistacia_vera.7.aspx

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Alpha-lipoic acid supplementation reduces weight and BMI

Objectives:
There are numerous trials reported the effect of alpha-lipoic acid (ALA) on obesity measurements; while no summarised dose-response meta-analysis is available to address the effects of dose and duration of ALA supplementation on obesity measurements. Therefore, this review article has been conducted.

Does alpha-lipoic acid supplementation improve obesity measurements including weight, body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) and fat mass (FM)?

Study design:
This review article included 18, 21 and 8 RCTs of ALA-weight, ALA-BMI, ALA-WC, respectively.

Results and conclusions:
The investigators found in two-class meta-analysis, alpha-lipoic acid supplementation significantly reduced weight [WMD = -2.29 kg, 95% CI = -2.98 to -1.60, p 0.01] and BMI [WMD = -0.49 g/m2, 95% CI = -0.83 to -0.15, p = 0.005] but had no effect on waist circumference [WMD = -2.57 cm, 95% CI = -8.91 to 3.76, p = 0.426].

The investigators found while the dose-response meta-analysis revealed that the duration of alpha-lipoic acid supplementation was a significant factor affecting waist circumference reduction [p non-linearity = 0.047].
While no evidence of departure from linearity was observed for other variables; moreover, subgrouping also revealed that gender could be an important factor affecting the alpha-lipoic acid impact on waist circumference, which was significant among women [WMD = -4.099, 95%CI = -7.837 to -0.361, p = 0.032].

The investigators concluded that alpha-lipoic acid supplementation reduces BMI, weight in a two-class meta-analysis without evidence of departure from linearity in terms of dose or duration. While the association of alpha-lipoic acid supplementation on waist circumference is dependent to the duration of the study. Although further trials evaluating the other obesity measurements specially central obesity will be helpful to infer a more reliable result.

Original title:
Alpha-lipoic acid supplementation significantly reduces the risk of obesity in an updated systematic review and dose response meta-analysis of randomised placebo-controlled clinical trials by Vajdi M and Farhangi MA.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32091656

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Coenzyme Q10 supplementation does not decrease body weight and BMI

Objectives:
Does coenzyme Q10 supplementation reduce body weight and body mass index (BMI) of patients in randomized controlled clinical trial studies (RCTs)?

Study design:
This review article included 17 RCTs.

Results and conclusions:
The investigators found results of random-effect size meta-analysis showed that supplementation with coenzyme Q10 had no significant decreasing effects on body weight [WMD = 0.28 kg, 95% CI = -0.91 to 1.47, p = 0.64] and BMI [WMD = -0.03, 95% CI = -0.4 to 0.34, p = 0.86] of study participants.
No significant because the calculated p-value of 0.64 was larger than the p-value of 0.05.
Subgroup analysis revealed that dosage of Q10 and trial duration could not differ the results of Q10 supplementation.

The investigators concluded that coenzyme Q10 supplementation has no decreasing effects on body weight and BMI.

Original title:
Effect of Q10 supplementation on body weight and body mass index: A systematic review and meta-analysis of randomized controlled clinical trials by Saboori S, Rad EY, […], Falahi E.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31336462

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Fish consumption reduces metabolic syndrome

Objectives:
Results regarding the association between fish intake and risk of metabolic syndrome (MetS) are ambiguous. Therefore, this review article has been conducted.

Does fish consumption reduce risk of metabolic syndrome?

Study design:
This review article included 10 cross-sectional studies and 6 cohort studies.

Results and conclusions:
The investigators found fish consumption significantly reduced risk of metabolic syndrome with 20% [OR = 0.80, 95% CI = 0.66 to 0.96, p = 0.017, I2 = 62.9%] in cohort studies.
However, this reduced risk was not significant in cross-sectional studies [OR = 0.80, 95% CI = 0.70 to 1.02, p = 0.085, I2 = 50.1%].
Significantly because OR of 1 was not found in the 95% CI of 0.6 to 0.96. OR of 1 means no risk/association.

The investigators found a significant non-linear association between fish intake levels and risk of metabolic syndrome [p for non-linearity = 0.010].

The investigators concluded that fish consumption reduces risk of metabolic syndrome when combining data from prospective cohort studies. Further studies are needed to confirm such an effect.

Original title:
A systematic review and meta-analysis of the association between fish consumption and risk of metabolic syndrome by Karimi G, Heidari Z, [...], Haghighatdoost F.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32127332

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6 months genistein reduces blood pressure among metabolic syndrome patients

Objectives:
Genistein (4',5,7-trihydroxyisoflavone) is a phytoestrogen with potential health benefits in the prevention of cardiovascular disease. However, the evidence regarding its effects on hypertension has not been conclusive. Therefore, this review article has been conducted.

Do genistein supplements reduce blood pressure?

Study design:
This review article included 4 RCTs (4 treatment arms).

Results and conclusions:
The investigators found genistein supplements did not show any significant reduction of systolic blood pressure [WMD = -5.32 mmHg, 95% CI = -14.59 to 3.96] and diastolic blood pressure [WMD = -2.06 mmHg, 95% CI = -6.41 to 2.28] compared to that of the placebo group.

The investigators found, however, subgroup analysis by intervention duration showed that more than 6 months genistein supplementation in metabolic syndrome patients significantly decreased systolic blood pressure [WMD = -13.73 mmHg, 95% CI = -18.10 to -9.37] and diastolic blood pressure [WMD = -5.18 mmHg, 95% CI = -6.62 to -3.74].

The investigators concluded genistein supplementation of more than 6 months reduces blood pressure among metabolic syndrome patients.

Original title:
Effects of genistein on blood pressure: A systematic review and meta-analysis by Hemati N, Asis M, […], Abdollahi M.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31955737

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A higher serum copper level increases obesity

Objectives:
The relationship between serum copper (Cu) level and overweight/obesity remains controversial. Therefore, this review article (meta-analysis) has been conducted.

Does a high serum copper level increase overweight/obesity risk?

Study design:
This review article included 21 articles.

Results and conclusions:
The investigators found compared with controls, serum copper level was significantly higher in obese children [SMD = 0.74, 95% CI = 0.16 to 1.32] and in obese adults [SMD = 0.39, 95% CI = 0.02 to 0.76].

The investigators found no significant difference in serum copper level between overweight and control groups in children [SMD = 1.52, 95% CI = -0.07 to 3.12] and in adults [SMD = 0.16, 95% CI = -0.06 to 0.38].

The investigators found subgroup analysis revealed a higher serum copper level in obese children [SMD = 0.90, 95% CI = 0.36 to 1.45] and obese adults [SMD = 0.47, 95% CI = 0.05 to 0.88] compared with healthy weight controls.

The investigators found the SMD differed significantly between obese children diagnosed by weight-for-height and controls [SMD = 1.56, 95% CI = 0.57 to 2.55] and there was a significant difference of serum copper level between obese adults diagnosed by BMI (WHO) and controls [SMD = 0.54, 95% CI = 0.08 to 1.01].

The investigators concluded that a higher serum copper level increases risk of obesity in children and adults and these findings need to be further confirmed.

Original title:
The Relationship Between Serum Copper and Overweight/Obesity: a Meta-analysis by Gu K, Li X, […], Jiang X.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31300957

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100 g/d fruit consumption reduces metabolic syndrome

Objectives:
Does consumption of fruit or vegetables reduce risk of metabolic syndrome (MetS)?

Study design:
This review article included 9 observational studies (7 cross-sectional studies and 2 cohort studies).

Results and conclusions:
The investigators found in a dose-response analysis of 2 cohort studies and 7 cross-sectional studies, that an increase of 100 g/d in fruit consumption significantly reduced risk of metabolic syndrome with 3% [OR = 0.97, 95% CI = 0.95 to 0.99, I2 = 26.7%], whereas an increase of 100 g/d in vegetable consumption (9 studies) was not associated with a reduction in the metabolic syndrome [OR = 0.98, 95% CI = 0.96 to 1.01, I2 = 54.6%].

The investigators concluded 100 g/d fruit consumption reduces risk of metabolic syndrome. However, prospective studies or randomised clinical trials are needed to identify the effects of fruits by variety on the risk of the metabolic syndrome.

Original title:
Fruit and vegetable consumption and the metabolic syndrome: a systematic review and dose-response meta-analysis by Lee M, Lim M and Kim J.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31514758

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150 mg/day quercetin supplementation reduces LDL-cholesterol in obese people

Objectives:
The lipid distribution in people who are overweight and obese is directly related to metabolic diseases. Quercetin supplementation may be an appropriate approach for reducing the risk factors of metabolic diseases in people who are obese. Therefore, this review article has been conducted.

Does quercetin supplementation reduce risk factors of metabolic diseases in people who are obese?

Study design:
This review article included 5 RCTs.

Results and conclusions:
The investigators found ≥150 mg/day quercetin supplementation during >6 weeks significantly reduced LDL-cholesterol (bad cholesterol) levels in people who are obese [SMD = -0.8, 95% CI = -1.21 to -0.39, p 0.00001].

The investigators concluded ≥150 mg/day quercetin supplementation during >6 weeks reduces LDL-cholesterol levels in people who are obese.

Original title:
Quercetin Actions on Lipid Profiles in Overweight and Obese Individuals: A Systematic Review and Meta-analysis by Guo W, Gong X and Li M.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31465275

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<2 g/d L-carnitine decreases diastolic blood pressure in participants with obesity

Objectives:
L-carnitine plays a fundamental biological role in the metabolism of lipids and may positively affect blood pressure by decreasing insulin resistance, although the latter remains less clear. Therefore, this review article has been conducted.

Does L-carnitine supplementation reduce blood pressure?

Study design:
This review article included 10 RCTs using a random-effects model to estimate the pooled effect sizes of L-carnitine supplementation on systolic (SBP) and diastolic blood pressure (DBP).

Results were expressed as weighted mean difference (WMD) and 95% confidence intervals (CI).

No evidence of publication bias was observed about the effects of L-carnitine supplementation on systolic blood pressure [p = 0.307] and diastolic blood pressure [p = 0.729], as evidenced by the results of the Egger's test.

Results and conclusions:
The investigators found L-carnitine supplementation decreased diastolic blood pressure [WMD = -1.162 mmHg, 95% CI = -2.020 to -0.303, p = 0.008] without changing systolic blood pressure levels [WMD = -0.085 mmHg, 95% CI = -1.455 to 1.285, p = 0.903].

The investigators found results of subgroup analyses revealed L-carnitine supplementation decreased diastolic blood pressure levels in participants with overweight and obesity [WMD = -1.232 mmHg, 95% CI = -2.297 to -0.167, p = 0.023] and with doses of 2 g/d [WMD = -1.639 mmHg, 95% CI = -3.038 to -0.240, p = 0.022].

The investigators concluded that 2 g/d L-carnitine supplementation decreases diastolic blood pressure in participants with overweight and obesity. However, more research is required to determine the molecular mechanism underlying the relationship between of L-carnitine on blood pressure.

Original title:
Effects of L-carnitine supplementation on blood pressure: a systematic review and meta-analysis of randomized controlled trials by Askarpour M, Hadi A, […], Ghaedi E.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31481697

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280 mg/d dietary calcium intake may reduce metabolic syndrome

Objectives:
Epidemiological investigations evaluating the association of dietary calcium intake with metabolic syndrome (MetS) risk have yielded controversial results. Therefore, this review article has been conducted.

Does dietary calcium intake reduce risk of metabolic syndrome?

Study design:
This review article included a total 15 cross-sectional studies for dietary calcium intake.

Results and conclusions:
The investigators found for the highest versus lowest category of dietary calcium intake, a significantly reduced risk of 20% [combined OR = 0.80, 95% CI = 0.70 to 0.91] for metabolic syndrome.

The investigators found in dose-response analysis, a non-linear relationship between dietary intake of calcium and risk of metabolic syndrome [p non-linearity > 0.001].

The investigators found 280 mg/d dietary calcium intake significantly reduced risk of metabolic syndrome with 13% [OR = 0.87, 95% CI = 0.82 to 0.93].

The investigators concluded 280 mg/d dietary calcium intake may reduce risk of metabolic syndrome. May reduce because this review article only included cross-sectional studies and no cohort studies. Therefore, these findings should need to be further confirmed by larger prospective cohort studies.

Original title:
Dietary calcium intake and the risk of metabolic syndrome: evidence from observational studies by Cheng L, Hu D and Jiang W.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30846011

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