Nutritional advice

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:
Find more information/studies on protbiotics and pregnancy right here.
 

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:
Find more information/studies on inositol and pregnancy right here.
 

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:
Find more information/studies on mineral, antioxidants and pregnancy right here.

 

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

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

Objectives:
Low birth weight infant (LBWIs) are prone to mental and behavioural problems. As an important constituent of the brain and retina, long chain polyunsaturated fatty acids are essential for foetal infant mental and visual development. The effect of lactation supplemented with long chain polyunsaturated fatty acids (LCPUFA) on the improvement of intelligence in low birth weight children requires further validation. Therefore, this meta-analysis (systematic review) has been conducted.

Do long chain polyunsaturated fatty acids (LCPUFA or PUFA) supplements improve intelligence in low birth weight children?

Study design:
This review article included 10 studies with a total of 1,793 individuals, of which 908 cases in the intervention group (group with LCPUFA supplements) and 885 controls (group without LCPUFA supplements).

The mean birth weights in 8 studies were less than 1500g and those in 2 studies were more than 1500g. None of the included studies had infants with birth weight less than 750g.

LCPUFA supplements were DHA+AA, DHA+EPA+DPA or DHA+AA+EPA.

There was no evidence of publication bias.

Results and conclusions:
The investigators found that the long chain polyunsaturated fatty acids supplemented group did not have significantly higher mental development index (MDI) scores than the group without supplementation [SMD = 0.07, 95% CI = -0.05 to 0.19, I2 = 23.8%, p = 0.222].
Subgroup analysis showed that the long chain polyunsaturated fatty acids supplementation groups did not have significantly higher mental development index scores than the control groups.

The investigators found that the long chain polyunsaturated fatty acids supplemented group did not have significantly higher psychomotor development index (PDI) scores than the group without supplementation [SMD = -0.01, 95% CI = -0.23 to 0.21, I2 = 60.5%, p = 0.906].
Subgroup analysis showed that the long chain polyunsaturated fatty acids supplementation groups did not have significantly higher psychomotor development index scores than the control groups.

The investigators found that the long chain polyunsaturated fatty acids supplemented group did not have significantly higher full scale intelligence quotient (FSIQ) scores than the group without supplementation [SMD = 0.00, 95% CI = -0.14 to 0.14, I2 = 0.00%, p = 0.991].

The investigators found that the long chain polyunsaturated fatty acids supplemented group did not have significantly higher verbal intelligence quotient (VIQ) scores than the group without supplementation [SMD = 0.01, 95% CI = -0.15 to 0.12, I2 = 42.2%, p = 0.844].

The investigators found that the long chain polyunsaturated fatty acids supplemented group did not have significantly higher performance intelligence quotient (PIQ) scores than the group without supplementation [SMD = -0.01, 95% CI = -0.15 to 0.13, I2 = 0.00, p = 0.877].

The investigators concluded that long chain polyunsaturated fatty acids (LCPUFA or PUFA) supplements do not improve intelligence in low birth weight children. Therefore, whether long-chain polyunsaturated fatty acids supplements are beneficial for LBWIs has not been shown conclusively.

Original title:
The effect of long chain polyunsaturated fatty acid supplementation on intelligence in low birth weight infant during lactation: A meta-analysis by Song Y, Liu Y, […], Li D.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5892917/

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

 

Objectives:
Despite the World Health Organization recommendation of exclusive breastfeeding (EBF) for the first six months of life, the rate remains low both in developed and developing countries. In Ethiopia, findings regarding the prevalence of exclusive breastfeeding have been highly variable. Antenatal care and institutional delivery are the most important factors contributing to the practice of exclusive breastfeeding. However, their effect has not been investigated in Ethiopia. Therefore, this review article has been conducted.

Do antenatal care and institutional delivery increase exclusive breastfeeding?

Study design:
This review article included 32 studies (published between 2007 to 2017) with a total of 23,543 breastfeeding women. 29 (71.8%) of the studies are cross-sectional study design. The sample size of the studies ranged from 119 to 5, 227.

Results and conclusions:
The investigators found the result of 32 included studies indicated that the pooled prevalence of exclusive breastfeeding in Ethiopia was 59.3% [95% CI = 53.8 to 64.8%].

The investigators found subgroup analysis indicated that the highest prevalence was observed in Afar region (65.6%), followed by SNNP (63.8%) and then by Oromia (61.8%).

The investigators found mothers who attended antenatal visits were 2.1 times more likely to practice exclusive breastfeeding compared to their counterparts [OR = 2.1, 95% CI = 1.5 to 2.8).

The investigators found, moreover, mothers who gave birth at a health institution were 2.2 times more likely to practice exclusive breastfeeding compared to mothers who gave birth at home [OR = 2.2, 95% CI = 1.3 to 3.5].

The investigators concluded exclusive breastfeeding in Ethiopia is significantly lower than the global recommendations. Mothers who attended antenatal visits and who gave birth at health institutions have better exclusive breastfeeding practices. Based on these findings, it is strongly recommended that the utilization of antenatal care and institutional delivery should be improved through health extension workers.

Original title:
Exclusive breastfeeding practice in Ethiopia and its association with antenatal care and institutional delivery: a systematic review and meta-analysis by Alebel A, Tesma C, […], Kibret GD.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6048887/

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

Objectives:
Whether a vegetarian diet is appropriate for pregnancy remains unclear. Therefore, this review article has been conducted.

What is the association between vegetarian diet during pregnancy and various maternal-fetal outcomes?

Study design:
This review article included 19 observational studies.

Results and conclusions:
The investigators found in pooled analysis no association between vegetarian pregnancy and low birth weight (LBW) [RR = 1.27, 95% CI = 0.98-1.65, p = 0.07, I2 = 0%].

The investigators found, however, in subgroup analysis that Asian (India/Nepal) vegetarian mothers exhibited a significantly increased risk of 33% to deliver a baby with low birth weight [RR = 1.33, 95% CI = 1.01-1.76, p = 0.04, I2 = 0%]. But, the WMD of neonatal birth weight in 5 studies suggested no difference between vegetarians and omnivores.

Given the high heterogeneity of the included studies, lack of high-quality evidence and limited studies included for each category, the investigators failed to reach conclusive results regarding the risks of hypospadias, intrauterine growth retardation, maternal anemia and gestational diabetes mellitus.

The investigators concluded that Asian vegetarian mothers have an increased risk to deliver babies with low birth weight than those of omnivores. Large-scale prospective studies focusing on pre- and/or early gestational nutrition will help clarify the correlation between vegetarian diet and various pregnancy outcomes.

Original title:
Is a vegetarian diet safe to follow during pregnancy? A systematic review and meta-analysis of observational studies by Tan C, Zhao Y and Wang S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29621406

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

 

Objectives:
The efficacy of myo-inositol supplementation to prevent gestational diabetes onset remains controversial. Therefore, this meta-analysis (systematic review) has been conducted.

Does myo-inositol supplementation reduce risk of gestational diabetes in pregnant women?

Study design:
This review article included 5 RCTs.

Results and conclusions:
The investigators found compared with control group in pregnant women, myo-inositol supplementation significantly reduced risk of gestational diabetes with 57% [risk ratio = 0.43, 95% CI = 0.21-0.89, p = 0.02].

The investigators found compared with control group in pregnant women, myo-inositol supplementation significantly reduced risk of preterm delivery with 64% [risk ratio = 0.36, 95% CI = 0.17-0.73, p = 0.005].

The investigators found compared with control group in pregnant women, no association between myo-inositol supplementation and 2-h glucose oral glucose tolerance test (OGTT) [mean difference = -6.90, 95% CI = -15.07 to 1.27, p = 0.10].

The investigators found compared with control group in pregnant women, no association between myo-inositol supplementation and gestational age at birth [MD = 0.74, 95% CI = -1.06 to 2.54, p = 0.42].

The investigators found compared with control group in pregnant women, no association between myo-inositol supplementation and birth weight [MD = -5.50, 95% CI = -116.99 to 105.99, p = 0.92].

The investigators found compared with control group in pregnant women, no association between myo-inositol supplementation and macrosomia (a newborn with an excessive birth weight (≥4 kg)) [RR = 0.65, 95% CI = 0.20-2.11, p = 0.47].

The investigators concluded that myo-inositol supplementation reduces the incidence of gestational diabetes and preterm delivery in pregnant women.

Original title:
The efficacy of myo-inositol supplementation to prevent gestational diabetes onset: a meta-analysis of randomized controlled trials by Zhang H, Lv Y, […], Guo W.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29343138

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

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.

Objectives:
Anemia is a major public health and nutritional problem in the world. Studies have reported the relationship between anemia during pregnancy and small for gestational age (SGA). Therefore, this meta-analysis (systematic review) has been conducted.

Does maternal anemia during pregnancy increase risk of SGA?

Study design:
This review article included 10 studies with a total of 620,080 pregnant women.

Results and conclusions:
The investigators found the overall relationship between maternal anemia during pregnancy and SGA was not significant [RR = 1.11, 95% CI = 0.99-1.24, p = 0.074].
Not significant means that there is no association with a 95% confidence.

The investigators found, however, a significantly increased risk of 11% [RR = 1.11, 95% CI = 1.00-1.22, p = 0.044] of SGA for materal anemia during first trimester. But this relationship was not significant in the second trimester [RR = 1.11, 95% CI = 0.85-1.18, p = 0.91].

The investigators concluded maternal anemia in the first trimester of pregnancy increases risk of small for gestational age (SGA).

Original title:
Maternal anemia during pregnancy and small for gestational age: a systematic review and meta-analysis by Badfar G, Shohani M, […], Azami M.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29183181

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