Nutritional Advice El Mondo

Nutritional advice

Pregnancy

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

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

2023:

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

2022:

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

2021:

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

2020:

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

2019:

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

2018:

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

2017:

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

2013:

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

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

The pregnancy is divided into 3 periods:

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

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

BMI before pregnancyDesired weight gain during pregnancy
<19.8

12

.5-18

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

 

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


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

It is not desirable to lose weight during pregnancy.

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

Dietary guidelines during pregnancy:

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

Dietary guidelines during breastfeeding:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

 Vitamin B6 supplements reduce nausea and vomiting during pregnancy

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

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

Study design:
This review article included 8 RCTs.

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

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

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

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

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

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

Oral magnesium supplementation does not reduce leg cramps during pregnancy

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

Does oral magnesium supplementation reduce leg cramps during pregnancy?

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

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

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

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

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

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

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

Additional information of El Mondo:
Find more information/studies on review article/meta-analysis/significantly, magnesium and pregnancy right here.

 

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

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

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

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

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

All trials gave vitamin and mineral supplementation orally.

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

All trials used placebo as control intervention.

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

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

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

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

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

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

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

Additional information of El Mondo:
Find more information/studies on review article/meta-analysis/significantly, vitamins, minerals and pregnancy right here.
 

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

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

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

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

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

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

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

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

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

Additional information of El Mondo:
Find more information/studies on review article/meta-analysis/significantly, DHA&EPA and pregnancy right here.

 

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

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

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

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

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

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

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

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

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

 

Vitamin A supplementation reduces bronchopulmonary dysplasia in premature infants

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

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

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

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

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

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

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

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

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

Daily 100 mg cholesterol increase gestational diabetes mellitus

Objectives:
Does a high dietary cholesterol intake increase risk of gestational diabetes mellitus?

Study design:
This review article included 3 cohort studies, 4 cross-sectional studies and 2 case-control studies involving 30,123 participants and 3,237 women with gestational diabetes mellitus (diabetes mellitus in pregnancy).

Results and conclusions:
The investigators found comparing highest versus lowest category of dietary cholesterol intake, that the highest dietary cholesterol intake significantly increased risk of gestational diabetes mellitus with 49% [pooled RR = 1.49, 95% CI = 1.18 to 1.88].

The investigators found in dose-response analysis that the risk of gestational diabetes mellitus significantly increased by 32% [RR = 1.32, 95% CI = 1.20 to 1.45] for every increase of 100 mg per day in dietary cholesterol intake.

The investigators concluded a high dietary cholesterol intake (at least 100 mg per day) increases risk of gestational diabetes mellitus.

Original title:
Dietary Cholesterol Intake and Risk of Gestational Diabetes Mellitus: A Meta-Analysis of Observational Studies by Gao F and Cui CY.

Link:
https://pubmed.ncbi.nlm.nih.gov/33416437/

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

Probiotic supplementation during pregnancy is beneficial for gestational age

Objectives:
Probiotics are being used increasingly in pregnant women, whereas the efficiency on pregnancy outcomes is yet lacking. Therefore, this review article has been conducted.

Have probiotic supplements during pregnancy positive effects on pregnancy outcomes, such as eczema, gestational age?

Study design:
This review article included 18 RCTs with a total of 4,356 pregnant women.

Results and conclusions:
The investigators found probiotic supplementation during pregnancy significantly decreased risk of atopic eczema with 32% [RR = 0.68, 95% CI = 0.58 to 0.81, p 0.001, without significant heterogeneity].

The investigators found probiotic supplementation during pregnancy significantly decreased risk of eczema with 21% [RR = 0.79, 95% CI = 0.68 to 0.91, p = 0.002, without significant heterogeneity].

The investigators found probiotic supplementation during pregnancy was associated with a prolonged gestational age [WMD = 0.09, 95 % CI = 0.04 to 0.15, p = 0.001 with insignificant heterogeneity].
However, probiotic supplementation during pregnancy had no significant effect on birth weight [p = 0.851].

The investigators found probiotic supplementation during pregnancy significantly decreased risk of death with 66% [RR = 0.34, 95% CI = 0.13 to 0.91, p = 0.031, without evidence of heterogeneity].

The investigators found probiotic supplementation during pregnancy significantly decreased risk of necrotising enterocolitis (NEC) with 62% [RR = 0.38, 95% CI = 0.18 to 0.11, p = 0.012, without evidence of heterogeneity].

The investigators concluded probiotic supplementation in pregnant women is beneficial for atopic eczema, eczema, gestational age, death and necrotising enterocolitis.

Original title:
Effect of probiotic supplementation in pregnant women: a meta-analysis of randomised controlled trials by Kuang L and Jiang Y.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31856928

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

Necrotizing enterocolitis (NEC) is a devastating disease that affects mostly the intestine of premature infants. The wall of the intestine is invaded by bacteria, which cause local infection and inflammation that can ultimately destroy the wall of the bowel (intestine). Such bowel wall destruction can lead to perforation of the intestine and spillage of stool into the infant’s abdomen, which can result in an overwhelming infection and death.
 

Higher levels of gestational vitamin D reduce multiple sclerosis in offspring

Objectives:
Do higher gestational vitamin D levels (vitamin D levels of the mother during pregnancy) decrease risk of multiple sclerosis (MS) in offspring?

Study design:
This review article included 4 case-control studies of moderate to low risk of bias.

Factors identified as determinants of heterogeneity were the definitions of vitamin D deficiency, the characteristics of study participants and the quality of the study.

Results and conclusions:
The investigators found that higher levels of gestational vitamin D significantly reduced risk of multiple sclerosis in offspring with 37% [OR = 0.63, 95% CI = 0.47 to 0.84] in random effects models and in a stratified analysis based on study quality.

The investigators concluded higher levels of gestational vitamin D reduce risk of multiple sclerosis in offspring.

Original title:
Gestational vitamin D and offspring risk of multiple sclerosis: a systematic review and meta-analysis by Jasper EA, Nidey NL, […], Ryckman KK.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32014337

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

 

Iron fortification increases haemoglobin concentration during pregnancy

Objectives:
Micronutrients’ deficiency is a common phenomenon among a majority of the population residing in the low- and middle-income countries (LMICs) especially among women and children. Given the widespread prevalence of micronutrients’ deficiency in LMICs, iron-fortified foods could be of potential benefits for both the mother and the development of fetus. Therefore, this review article has been conducted.

Does iron fortification increase hemoglobin (Hb) concentration during pregnancy and have iron fortification positive effects on specific maternal and pregnancy outcomes?

Study design:
This review article included 12 RCTs (n = 3,872).

The weighted mean difference (WMD) and relative risk (RR) were calculated using random-effects models. Sources of heterogeneity were explored through meta-regression.

The funnel plot was symmetrical, indicating that there was absence of any publication bias which was confirmed using Egger's weighted regression method [Egger test, ρ = 0.69].

Results and conclusions:
The investigators found the mean change in hemoglobin concentration was significantly higher in the group of mothers with iron fortification when compared with the control group [WMD = 4.45 g/L, 95% CI = 2.73 to 6.17 g/L, I2 = 83%, ρ 0.00001].

The investigators found in meta-regression analysis that the duration of feeding was positively associated with the effect size.

The investigators concluded iron fortification increases hemoglobin (Hb) concentration during pregnancy. Further research is required to explore the benefits of iron fortification on maternal and neonatal health outcomes during pregnancy.

Original title:
Meta-analysis Approach on Iron Fortification and Its Effect on Pregnancy and Its Outcome Through Randomized, Controlled Trials by Athe R, Dwivedi R, […], Banset U.  

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7114015/

Additional information of El Mondo:
Find more information/studies food fortification and iron right here.

Omega-3 fatty acids + vitamin E or D reduce gestational diabetes

Objectives:
Omega-3 fatty acid and vitamin E or D co-supplementation may be an important approach to improve metabolic status in gestational diabetes, but the results are conflicting. Therefore, this review article has been conducted.

Do omega-3 fatty acid and vitamin E or D co-supplementation improve metabolic status in gestational diabetes?

Study design:
This review article included 4 RCTs.

Results and conclusions:
The investigators found omega-3 fatty acid and vitamin E or D co-supplementation was associated with a significantly reduced fasting plasma glucose level [MD = -10.47, 95% CI = -15.33 to -5.61, p  0.0001], homeostasis model of assessment-insulin resistance level [MD = -1.6, 95% CI= -2.44 to -0.77, p = 0.0002], malondialdehyde level [MD = -1.00, 95% CI = -1.05 to -0.95, p  0.00001] and triglycerides level [MD = 26.22, 95% CI = -38.94 to -13.51, p  0.0001].

The investigators found omega-3 fatty acid and vitamin E or D co-supplementation was associated with a significantly increased antioxidant capacity level [MD = 173.51, 95% CI = 164.72-182.30, p  0.00001].

The investigators found omega-3 fatty acid and vitamin E or D co-supplementation showed no effect on nitric oxide level [MD = 5.95, 95% CI = -7.48 to 19.37, p = 0.39] or total cholesterol level [MD = 1.63, 95% CI = -13.46 to 16.72, p = 0.83].

The investigators concluded omega-3 fatty acid and vitamin E or D co-supplementation have a favourable effect on metabolic status in gestational diabetes.

Original title:
Influence of omega-3 fatty acid and vitamin co-supplementation on metabolic status in gestational diabetes: A meta-analysis of randomized controlled studies by Li F, Pei L, […], Ye H.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32145487

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N-3 fatty acids supplementation reduces preeclampsia during pregnancy

Objectives:
The efficacy of n-3 fatty acids supplementation on the prevention of pregnancy-induced hypertension or preeclampsia remains unclear. Therefore, this meta-analysis (systematic review) has been conducted.

Does n-3 fatty acids supplementation (EPA and/or DHA and/or ALA) decrease risk of pregnancy-induced hypertension and preeclampsia during pregnancy?

Study design:
This review article included 14 RCTs.

Results and conclusions:
The investigators found that n-3 fatty acids supplementation significantly reduced risk of preeclampsia with 18% [RR = 0.82, 95% CI = 0.70 to 0.97, p = 0.024. I2 = 19.0%].
However, n-3 fatty acids supplementation did not associated with a reduced risk of pregnancy-induced hypertension [RR = 0.98, 95% CI = 0.90 to 1.07, p = 0.652, I2 = 0%].

The investigators concluded n-3 fatty acids supplementation (EPA and/or DHA and/or ALA)  reduces risk of preeclampsia during pregnancy.

Original title:
Efficacy of n-3 fatty acids supplementation on the prevention of pregnancy induced-hypertension or preeclampsia: A systematic review and meta-analysis by Bakouei F, Delavar MA, […], Taheri Z.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32039806

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75 mg daily DHEA supplements increase fertility in women

Objectives:
Does dehydroepiandrosterone (DHEA) supplementation improve the outcomes of in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) in women with diminished ovarian reserve (DOR) and/or poor ovarian response (POR)?

Study design:
This review article included 9 RCTs, published between 2010 and 2017.
The sample sizes ranged from 24 to 208, with a total of 862 patients.
All of included patients had been diagnosed with diminished ovarian reserve (DOR) and/or poor ovarian response (POR).

The treatment intervention was 75 mg daily DHEA versus placebo.

The lack of significant asymmetry of funnel plot indicated the lack of potential publication bias in the included studies.

Results and conclusions:
The investigators found in a pooled analysis using the random effects model revealed a statistically significant increase in retrieved oocytes in the DHEA group, compared to the control group [MD = 0.91, 95% CI = 0.23 -1.59, p = 0.009, I2  = 53%, p = 0.06].

The investigators found in 8 studies (405 in the DHEA group and 415 in the control group) a statistically significant increase in the clinical pregnancy rate in the DHEA group compared to the control group [RR = 1.27, 95% CI = 1.01 -1.61, p = 0.04, I2 = 0%, p = 0.57].

The investigators found in 5 studies (189 in the DHEA group and 190 in the control group) a statistically significant increase in the live birth rate in the DHEA group, compared to the control group [RR = 1.76, 95% CI = 1.17 -2.63, p = 0.006, I2  = 0%, p = 0.43].

The investigators found in 3 studies (96 in the DHEA group and 99 in the control group) no significant difference in the miscarriage rates between the DHEA and control groups [RR = 0.37, 95% CI = 0.12-1.13, p = 0.08, I2 = 25%, p = 0.26].

The investigators concluded 75 mg daily DHEA supplementation increases the retrieved oocytes, clinical pregnancy rate and live birth rate in women with diminished ovarian reserve and/or poor ovarian response, who are undergoing in vitro fertilization or intracytoplasmic sperm injection.

Original title:
The Effect of Dehydroepiandrosterone (DHEA) Supplementation on IVF or ICSI: A Meta-Analysis of Randomized Controlled Trials by Xu L, Hu C, […], Li Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6620181/

Additional information of El Mondo:
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Your body naturally produces the hormone dehydroepiandrosterone (DHEA) in the adrenal gland. In turn, DHEA helps produce other hormones, like testosterone and estrogen. Natural dehydroepiandrosterone levels peak in early adulthood and then slowly fall as you age.

 

Higher plasma levels of free fatty acids increase gestational diabetes mellitus

Objectives:
Free fatty acids, also known as nonesterified fatty acids, are proinflammatory molecules that induce insulin resistance in nonpregnant individuals. Nevertheless, the concentration of these molecules has not been systematically addressed in pregnant women. Therefore, this review article has been conducted.

Do higher plasma levels of free fatty acids increase risk of gestational diabetes mellitus?

Study design:
This review article included 12 case-control studies with a total of 2,426 women, from these, 21% (507/2,426) had a diagnosis of having gestational diabetes.

The mean gestational age at inclusion was 30.3 weeks of gestation.
The mean maternal age was 29 years.
No significant publication bias was found nor a trend towards greater results in small studies.

Results and conclusions:
The investigators found in random-effects model, when compared to controls, women with gestational diabetes had higher levels of free fatty acids [SMD = 0.86, 95% CI = 0.54-1.18, p 0.001, I2 = 91%].
Pooled results showed higher plasma levels of free fatty acid among women with gestational diabetes mellitus during the second trimester of pregnancy [SMD = 1.05 vs. 0.75].

The investigators found meta-regression analysis showed that the gestational age at inclusion was the only cofactor influencing the mean levels of free fatty acids, indicating a trend towards lower plasma levels of free fatty acids later in gestation [estimate = -0.074, 95% CI = -0.143 to -0.004, p = 0.036].

The investigators concluded that plasma levels of free fatty acids are higher in women diagnosed with gestational diabetes mellitus and that this difference is higher during the second trimester of pregnancy. However, more investigation is needed to assess the potential role of free fatty acids in the prediction of gestational diabetes earlier in pregnancy.

Original title:
Plasma Levels of Free Fatty Acids in Women with Gestational Diabetes and Its Intrinsic and Extrinsic Determinants: Systematic Review and Meta-Analysis by Villafan-Bernal JR, Acevedo-Alba M, […], Martinez-Portilla RJ.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6721400/

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

Maternal folic acid supplementation reduces childhood acute lymphoblastic leukaemia

Objectives:
Maternal folic acid supplementation is considered mandatory in almost every country in the world to prevent congenital malformations. However, little is known about the association of maternal folic acid intake with the occurrence of childhood cancer. Therefore, this review article has been conducted.

Does maternal folic acid supplementation during pregnancy reduce risk of childhood cancer?

Study design:
This review article included 17 case-control studies.

Results and conclusions:
The investigators found in random-effects model, maternal folic acid supplementation during pregnancy significantly reduced risk of childhood acute lymphoblastic leukaemia with 25% [OR = 0.75, 95% CI = 0.66 to 0.86].
Significantly because OR of 1 was not found in the 95% CI of 0.66 to 0.86. OR of 1 means no risk/association.

The investigators found in random-effects model, there was no significant association between maternal folic acid supplementation during pregnancy and acute myeloid leukaemia [OR = 0.70, 95% CI = 0.46 to 1.06] or childhood brain tumours [OR = 1.02, 95% CI = 0.88 to 1.19].
No significant because OR of 1 was found in the 95% CI of 0.88 to 1.19. OR of 1 means no risk/association.

The investigators concluded maternal folic acid supplementation during pregnancy reduces risk of childhood acute lymphoblastic leukaemia. Thus, healthcare professionals are recommended to provide regular health education and health promotion to the community on the benefits of folic acid supplementation during pregnancy.

Original title:
The Protective Effect of Maternal Folic Acid Supplementation on Childhood Cancer: A Systematic Review and Meta-analysis of Case-control Studies by Wan Ismail WR, Abdul Rahman R, […],Nawi AM.

Link:
https://www.jpmph.org/journal/view.php?doi=10.3961/jpmph.19.020

Additional information of El Mondo:
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0.6-2 gram calcium supplement reduce gestational hypertension

Objectives:
Does calcium supplement with or without other drugs reduce risk of preeclampsia and gestational hypertension?

Study design:
This review article included 27 RCTs, with 28,492 pregnant women.

Results and conclusions:
The investigators found calcium supplement significantly reduced risk of preeclampsia with 49% [RR = 0.51, 95% CI = 0.40 to 0.64].

The investigators found calcium supplement significantly reduced risk of gestational hypertension with 30% [RR = 0.70, 95% CI = 0.60 to 0.82].

The investigators found sub-analyses revealed high-dose (1.2-2 g/day), moderate-dose (0.6-1.2 g/day) and low-dose (0.6 g/day) of calcium supplement significantly reduced risk of preeclampsia.

The investigators found sub-analyses revealed high-dose (1.2-2 g/day) and moderate-dose (0.6-1.2 g/day) of calcium supplement significantly reduced risk of gestational hypertension.

The investigators concluded high-dose (1.2-2 g/day) and moderate-dose (0.6-1.2 g/day) of calcium supplement reduced both risk of preeclampsia and gestational hypertension. However, further studies with direct comparison of different dose of calcium supplementation are needed to explore the ideal dose of calcium supplementation to prevent preeclampsia and gestational hypertension.

Original title:
The association between calcium supplement and preeclampsia and gestational hypertension: a systematic review and meta-analysis of randomized trials by Sun X, Li H, [...], Zhang X.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30935246

Additional information of El Mondo:
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≤400 μg/d chromium supplementation reduce BMI

Objectives:
The role of chromium as a weight loss agent remains questionable and although previous meta-analyses findings have reported small reductions in body weight in individuals with overweight/obesity following chromium supplementation, there have been significant limitations with these findings. Therefore, this review article has been conducted.

Do individuals with overweight/obesity benefit from chromium supplementation?

Study design:
This review article included 21 RCTs with a total of 1,316 participants.

Results and conclusions:
The investigators found pooled analysis showed significant reductions in anthropometric indices associated with body composition for:
-weight loss [WMD = -0.75 kg, 95% CI = -1.04 to -0.45, p  0.001];
-body mass index (BMI) [WMD = -0.40, 95% CI = -0.66 to -0.13, p = 0.003] and;
-body fat percentage [WMD = -0.68%, 95% CI = -1.32 to -0.03, p = 0.04] in individuals with overweight/obesity following chromium supplementation. No changes were detected in controls.

The investigators found subgroup analysis showed significant improvements in weight loss and body fat percentage, particularly for study durations ≤12 weeks and doses ≤400 μg/d chromium.

The investigators concluded ≤400 μg/d chromium supplementation during ≤12 weeks is associated with some improvements in body composition in subjects with obesity/overweight. The effect size was medium and the clinical relevance of chromium as a weight loss aid remains uncertain. Therefore, further investigation from larger and well-designed randomized controlled studies, especially in patients with diabetes, is warranted.

Original title:
A meta-analysis of the effect of chromium supplementation on anthropometric indices of subjects with overweight or obesity by Tsang C, Taghizadeh M, […], Jafarnejad S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31115179

Additional information of El Mondo:
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Steady-state red blood cell folate concentrations can be reached with 375-570 µg folic acid/day

Objectives:
The threshold for population-level optimal red blood cell (RBC) folate concentration among women of reproductive age for the prevention of neural tube defects has been estimated at 906 nmol/L. However, the dose-response relationship between folic acid intake and blood folate concentrations is uncharacterized. Therefore, this review article has been conducted.

Is there dose-response relationship between folic acid intake and blood folate concentrations?

Study design:
This review article included 23 articles for red blood cell folate and by 97 articles for serum/plasma folate.

Results and conclusions:
The investigators found in 17 studies red blood cell (RBC) folate concentration increased 1.78 fold [95% CI = 1.66 to 1.93] from baseline to steady-state at 375-570 µg folic acid/day and it took a median of 36 weeks of folic acid intake [95% CI = 27 to 52] to achieve steady-state red blood cell folate concentrations.

The investigators found for every 100 µg/day folic acid intake, serum/plasma folate concentrations increased 11.6% [95% CI = 8.4 to 14.9] from baseline to steady-state, over a median of 13 weeks [95% CI = 10 to 16].

The investigators concluded that there is a dose-response relationship between folic acid intake and changes in blood folate concentrations. At 375-570 µg folic acid/day, red blood cell folate concentrations increase 1.78 fold from baseline to steady-state, over a median of 36 weeks. For every 100 µg/day folic acid intake, serum/plasma folate concentrations increase 11.6% from baseline to steady-state, over a median of 13 weeks. These results can inform how much additional folic acid intake is needed among populations of women whose red blood cell folate concentrations are below the optimal threshold.

Original title:
Systematic Review and Bayesian Meta-analysis of the Dose-response Relationship between Folic Acid Intake and Changes in Blood Folate Concentrations by Crider KS, Devine O, […], Berry RJ.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6356991/

Additional information of El Mondo:
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High prenatal vitamin D level reduces risk autism-related traits later in life

Objectives:
Diverse studies have investigated the impact of prenatal exposure to vitamin D levels on brain development. However, evidence in humans has never been systematically reviewed. Therefore, this meta-analysis (systematic review) has been conducted.

Has a high prenatal vitamin D level positive effect on brain development of the born child?

Study design:
This review article included 25 studies.

Results and conclusions:
The investigators found comparing with the lowest category of prenatal 25(OH)D levels (vitamin D level in blood), the highest prenatal 25(OH)D levels had no significant effects on cognition [pooled beta coefficients = 0.95, 95% CI = -0.03 to 1.93, p = 0.05].

The investigators found comparing with the lowest category of prenatal 25(OH)D levels (vitamin D level in blood), the highest prenatal 25(OH)D levels had no significant effects on psychomotor development [pooled beta coefficients = 0.88, 95% CI = -0.18 to 1.93, p = 0.10].

The investigators found comparing with the lowest category of prenatal 25(OH)D levels (vitamin D level in blood), the highest prenatal 25(OH)D levels significantly reduced risk of ADHD of the born child with 28% [pooled relative risk = 0.72, 95% CI = 0.59 to  0.89, p = 0.002].

The investigators found comparing with the lowest category of prenatal 25(OH)D levels (vitamin D level in blood), the highest prenatal 25(OH)D levels significantly reduced risk of autism-related traits of the born child with 58% [pooled odds ratio = 0.42, 95% CI = 0.25 to 0.71, p = 0.001].

The investigators found there was little evidence for protective effects of high prenatal 25(OH)D for language development and behaviour difficulties of the born child.

The investigators concluded this meta-analysis provides supporting evidence that increased prenatal exposure to 25(OH)D levels is associated with reduced risk of ADHD and autism-related traits of the born child later in life. Associations represent a potentially high public health burden given the current prevalence of vitamin D deficiency and insufficiency among childbearing aging and pregnant women.

Original title:
Neurodevelopmental effects of prenatal vitamin D in humans: systematic review and meta-analysis by García-Serna AM and Morales E.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30696940

Additional information of El Mondo:
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Probiotic supplementation during both prenatal and postnatal period reduces atopic dermatitis

Objectives:
Probiotic supplementation in early life may be effective in preventing atopic dermatitis (AD); however, results regarding efficacy have been controversial. Therefore, this meta-analysis (systematic review) has been conducted.

Does probiotic supplementation in early life prevent atopic dermatitis in infants and children?

Study design:
This review article included 28 RCTs.

Results and conclusions:
The investigators found compared with controls, probiotic supplementation of mother was associated with a significantly reduced risk of 31% for atopic dermatitis in infants and children [OR = 0.69, 95% CI = 0.58-0.82, p  0.0001].

The investigators found compared with controls, the use of probiotics of mother during both the prenatal and the postnatal period significantly reduced the incidence of atopic dermatitis in infants and children with 33% [OR = 0.67, 95% CI = 0.54-0.82].
However, analysis of studies of probiotics given prenatally only or postnatally only did not reach statistical significance.

The investigators concluded that probiotic supplementation of mother during both the prenatal and the postnatal period reduces the incidence of atopic dermatitis in infants and children. These findings suggest that starting probiotic treatment during gestation and continuing through the first 6 months of the infant's life may be of benefit in the prevention of atopic dermatitis.

Original title:
Probiotic Supplementation for Prevention of Atopic Dermatitis in Infants and Children: A Systematic Review and Meta-analysis by Li L, Han Z, […], He C.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30465329

Additional information of El Mondo:
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2g inositol twice daily reduce preterm delivery rate

Objectives:
Inositol (ISL) embraces a family of simple carbohydrates with insulin-sensitizing properties, whose most common isoforms are Myo-inositol (MYO) and D-chiro inositol (DCI). Therefore, this meta-analysis (systematic review) has been conducted.

Does inositol supplementation reduce gestational diabetes (GDM)?

Study design:
This review article included 5 RCTs with a total of  965 participants.
The primary outcome was the preventive effect on gestational diabetes, defined as the rate of gestational diabetes in women without a prior diagnosis of gestational diabetes.
Pooled results were expressed as odds ratio (OR) with a 95% confidence interval (95% CI).
No adverse effects were reported for inositol supplementation.

Results and conclusions:
The investigators found inositol supplementation significantly reduced risk of gestational diabetes with 51% [OR = 0.49, p = 0.01]. However, this reduced risk was only significant in patients receiving 2g inositol twice daily.

The investigators found inositol supplementation significantly reduced risk of preterm delivery with 65% [OR = 0.35, 95% CI = 0.17-0.74, p = 0.006]. However, this reduced risk was only significant in patients receiving 2g inositol twice daily.

The investigators concluded double administration of inositol 2g per day reduces gestational diabetes rate and preterm delivery rate. Therefore, inositol supplementation may represent a novel strategy for gestational diabetes prevention.

Original title:
Inositol for the prevention of gestational diabetes: a systematic review and meta-analysis of randomized controlled trials by Vitagliano A, Saccone G, […], Berghella V.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30564926

Additional information of El Mondo:
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Antioxidant supplements could increase sperm quality

Objectives:
Infertility, which affects ∼15% of the world's population, is a global public health issue recognized by the WHO. Therefore, it is of major clinical and public health importance to investigate whether modifiable lifestyle factors,such as stress, drug use, smoking, alcohol intake and diet may influence human fertility. Therefore, this meta-analysis (systematic review) has been conducted.

What is the effect of supplementation of nutrients on sperm quality parameters?

Study design:
This review article included 28 articles (RCTs) for qualitative analysis and 15 for quantitative meta-analysis.

Results and conclusions:
The investigators found total sperm concentrations were significantly increased by:
-selenium [MD = 3.91 × 106 spz/mL, 95% CI = 3.08 to 4.73 spz/mL];
-zinc [MD = 1.48 × 106 spz/mL, 95% CI = 0.69 to 2.27 spz/mL];
-omega 3 fatty acids [MD = 10.98 × 106 spz/mL, 95% CI = 10.25 to 11.72 spz/mL] and
-coenzyme Q10 [MD = 5.93 × 106 spz/mL, 95% CI = 5.36 to 6.51 spz/mL].

The investigators found sperm counts were significantly increased by:
-omega 3 fatty acids [MD = 18.70 × 106 spz/mL, 95% CI = 16.89 to 20.51 spz/mL] and
-coenzyme Q10 [MD = 10.15 × 106 spz/mL, 95% CI = 8.34 to 11.97 spz/mL].

The investigators found sperm total motility was significantly increased by:
-selenium [MD = 3.30%, 95% CI = 2.95% to 3.65%];
-zinc [MD = 7.03%, 95% CI = 6.03% to 8.03%];
-omega 3 fatty acids [MD = 7.55%, 95% CI = 7.09% to 8.01%];
-coenzyme Q10 [MD = 5.30%, 95% CI = 4.98% to 5.62%] and
-carnitines [MD = 7.84%, 95% CI = 6.54% to 9.13%].

The investigators found sperm progressive motility significantly increased by supplementation with carnitines [MD = 7.45%, 95% CI = 6.24% to 8.67%].

The investigators found sperm morphology was significantly enhanced by:
-selenium [MD = 1.87%, 95% CI = 1.50% to 2.24%];
-omega 3 fatty acid [MD = 0.91%, 95% CI = 0.69% to 1.13%];
-coenzyme Q10 [MD = 1.06%, 95% CI = 0.72% to 1.41%] and
-carnitine [MD = 4.91%, 95% CI = 3.68% to 6.15%].

The investigators concluded evidence from RCTs shows that some dietary supplements beneficially modulate sperm quality parameters and affect male fertility. However, results must be cautiously interpreted due to the limited sample size of the meta-analyzed studies and the considerable observed interstudy heterogeneity.

Original title:
The Effect of Nutrients and Dietary Supplements on Sperm Quality Parameters: A Systematic Review and Meta-Analysis of Randomized Clinical Trials by Salas-Huetos A, Rosique-Esteban N, […], Salas-Salvadó J.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30462179

Additional information of El Mondo:
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Egg into an infant’s diet between 3 and 6 months of age reduces egg allergy risk

Objectives:
The timing of the introduction of egg to an infant's diet is of current interest, as new evidence raises questions regarding the benefit of delaying egg introduction. Therefore, this meta-analysis (systematic review) has been conducted.

Does early introduction of egg into an infant’s diet reduce risk of egg allergy?

Study design:
This review article included 6 RCTs with a total of 3,032 participants.
The RCTs compared early (between 3 and 6 months of age) egg introduction to no early introduction. The primary outcome was the development of egg allergy.

Results and conclusions:
The investigators found compared early (between 3 and 6 months of age) egg introduction to no early introduction, early introduction of egg significantly reduced risk of egg allergy with 40% [RR = 0.60, 95% CI = 0.44-0.82, p = 0.002, I2 = 23%, low to moderate level of evidence].

The investigators found the absolute risk reduction for a population with an incidence of egg allergy was 9.3% or 37 fewer cases [95% CI = 17-52] per 1,000 people.

The investigators found consumption of 4,000 mg/week of egg protein had a greater preventive effect than a higher dose.

The investigators concluded that introduction of egg into an infant’s diet between 3 and 6 months of age reduces risk of egg allergy, particularly for 4,000 mg/week of egg protein. Furthermore, the nature and dose of egg protein exposure may play a role. These findings should be addressed in the context of primary studies.

Original title:
Early Introduction of Egg and the Development of Egg Allergy in Children: A Systematic Review and Meta-Analysis by Al-Saud B and Sigurdardóttir ST.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30184525

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