Nutrition and health

Objectives:
Due to the high incidence of liver disease and the severity of adverse outcomes, liver disease has become a serious public health problem, bringing a huge disease burden to individuals, families and society. Most studies have shown significant differences in serum carotenoid content and dietary carotenoid intake between liver disease patients and non-liver disease patients, but some studies have reported contrary results.Therefore, this review article has been conducted.

Do higher serum concentrations of carotenoids (such as, α-carotene, β-carotene, lycopene, cryptoxanthin and lutein/zeaxanthin) or higher dietary intakes of carotenoids reduces the risk of liver disease?

Study design:
This review article included 3 RCT studies, 6 cohort studies, 11 case-control studies, 9 cross-sectional studies and 1 RCT-combined cross-sectional study.

The Egger test showed no publication bias.

Results and conclusions:
The investigators found pooled meta-analysis showed that higher serum α-carotene [SMD = -0.58, 95% CI = -0.83 to -0.32, p < 0.001], β-carotene [SMD = -0.81, 95% CI = -1.13 to -0.49, p < 0.001] and lycopene [SMD = -1.06, 95% CI = -1.74 to -0.38, p < 0.001] significantly reduced the risk and severity of liver disease. 

The investigators found, however, no significant difference was observed between serum β-cryptoxanthin [SMD = 0.02, 95% CI = -0.41 to 0.45, p = 0.92] and lutein/zeaxanthin [SMD = 0.62, 95% CI = -1.20 to 2.45, p = 0.502] and the risk and severity of liver disease. 

The investigators found dietary β-carotene intake [SMD = -0.22, 95% CI = -0.31 to -0.13, p < 0.001] significantly reduced the risk of liver disease. 

The investigators found an intake of more than 6 mg of carotenoids on an energy-restricted diet can effectively alleviate the symptoms of NAFLD. 

The investigators concluded that higher serum concentrations of α-carotene, β-carotene and lycopene reduce risk of liver disease. Meanwhile, dietary intake of β-carotene reduces the incidence of liver disease. 

Original title: 
A systematic review of dietary and circulating carotenoids and liver disease by Hu B, Sui J, […], Xia H. 

 

Link:
https://pubmed.ncbi.nlm.nih.gov/39229651/

Additional information of El Mondo:
Find more information/studies on cohort studies/significantly, carotenoids and chronic disease right here. 

Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease worldwide.

Objectives:
Omega-3 polyunsaturated fatty acids (n-3 PUFA) have been suggested as a cognitive enhancing agent, though their effect is doubtful. Therefore, this review article has been conducted.

Does supplementation of n-3 PUFA improve cognitive functions of non-demented individuals exclusively of middle age or older? 

Study design:
This review article included 24 RCTs with a total of 9,660 participants.
The length of intervention ranged from 3 to 36 months and the daily dose of n-3 PUFA ranged from 230 to 4000 mg/day. 
6  studies were conducted in countries where the nationwide blood levels of DHA + EPA were notably low, measuring ≤ 4% in erythrocyte equivalents. 

Results and conclusions:
The investigators found that the beneficial effect on executive function demonstrated an upward trend within the initial 12 months of intervention. 
This effect was prominently observed with a daily intake surpassing 500 mg of n-3 PUFA and up to 420 mg of eicosapentaenoic acid (EPA). 

The investigators found a descending curve following 12 months of n-3 PUFA intervention and when the dosage of EPA exceeded 420 mg/d.  

The investigators found, furthermore, these trends exhibit heightened significance in regions where the levels of blood docosahexaenoic acid (DHA) + EPA are not very low.

The investigators concluded supplementation of n-3 PUFA (a daily intake surpassing 500mg n-3 PUFA or up to 420mg of EPA during 12 months) has potential benefits to executive function in non-demented individuals exclusively of middle age or older, particularly in individuals whose dietary DHA + EPA level is not substantially diminished. 

Original title: 
The influence of n-3 polyunsaturated fatty acids on cognitive function in individuals without dementia: a systematic review and dose–response meta-analysis by Suh SW, Lim E, […], Kim KW. 

Link: 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10929146/

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Objectives:
Do dietary choline and betaine increase mortality risk?

Study design:
This review article included 6 cohort studies comprising 482,778 total participants, 57,235 all-cause, 9,351 cardiovascular disease and 4,400 stroke deaths.

Results and conclusions:
The investigators found linear dose-response analysis showed that each 100 mg/day increase in dietary choline intake was significantly associated with 6% increases in risk of all-cause mortality [RR = 1.06, 95% CI = 1.03 to 1.10, I2 = 83.7%, p < 0.001].

The investigators found linear dose-response analysis showed that each 100 mg/day increase in dietary choline intake was significantly associated with 11% increases in risk of cardiovascular diseases mortality [RR = 1.11, 95% CI = 1.06 to 1.16, I2 = 54.3%, p = 0.02].

The investigators found the result of the nonlinear dose-response analysis showed a significant relationship between dietary betaine intake and stroke mortality at the dosages of 50 to 250 mg/day [p non-linearity= 0.0017]. 

The investigators concluded 100 mg/day of choline consumption is associated with a 6% and 11% higher risk of all-cause and cardiovascular disease mortality, respectively. In addition, a positive relationship between betaine dietary intake and stroke mortality at doses of 50 to 250 mg/day is observed. Due to the small number of the included studies and heterogeneity among them more well-designed prospective observational studies considering potential confounding variables are required. 

Original title: 
Higher dietary choline intake is associated with increased risk of all-cause and cause-specific mortality: A systematic review and dose-response meta-analysis of cohort studies by Sharifi-Zahabi E, Soltani S, […], Shidfar F. 
 

Link:
https://pubmed.ncbi.nlm.nih.gov/39341000/

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Find here more information/studies about RCTs/significant, choline, and stroke. 

Betaine-rich foods are

• American Indian/Alaska native foods
• Baked products
• Beef products
• Cereal grains and pasta
• Restaurant foods
• Snacks
• Vegetables and vegetable products

Objectives:
The relationship between beverage consumption and risk of cardiovascular disease has been extensively examined in cross-sectional studies. However, limited studies have investigated beverage consumption as a longer-term habitual behavior, which is important owing to potential cumulative harmful or beneficial cardiovascular effects. Therefore, this review article has been conducted.

What is the relationship between sex-specific long-term consumption of beverages [sugar-sweetened beverages (SSBs) or artificial-sweetened beverages (ASBs), tea, coffee, fruit juices, energy drinks and alcohol] and cardiovascular disease-related mortality? 

Study design:
This review article included 20 prospective cohort studies. The length of follow-up ranged from 5.5 years to 40 years. 
There was no publication bias. 

Results and conclusions:
The investigators found long-term coffee consumption of 2-6 cups per day significantly reduced cardiovascular disease-related mortality with 37% in males [pooled HR = 0.63, 95% CI = 0.46 to 0.87, p = 0.005, I2 = 0%] but not in females [HR = 0.78, 95% CI = 0.60 to 1.02, p = 0.07]. 

The investigators found long-term higher intake of tea was significantly associated with a 19% lower risk of cardiovascular disease-related mortality in all adults [pooled HR = 0.81, 95% CI = 0.72 to 0.92, p ≤ 0.001]. 

The investigators found higher alcohol intake was significantly associated with a 44% higher stroke in males [pooled HR = 1.44, 95% CI = 1.06 to 1.94, p = 0.02] and a 126% higher stroke in females [pooled HR = 2.26, 95% CI = 1.34 to 3.81, p = 0.002]. 

The investigators found higher sugar-sweetened beverage was significantly associated with a 31% higher risk in cardiovascular disease-related mortality [pooled HR = 1.31, 95% CI = 1.16 to 1.46, p ≤ 0.0001]. 
However, no effect was found between artificial-sweetened beverages and cardiovascular disease-related mortality while comparing the highest intake with lowest intake [pooled HR = 1.05, 95% CI = 0.87 to 1.26, p = 0.61, I2 = 61%].
 
The investigators concluded long-term habitual coffee consumption (2-6 cups per day) is beneficial for males and tea consumption is beneficial for all adults. Long-term high alcohol and sugar-sweetened beverage consumption increased risk of cardiovascular disease-related mortality for both males and females. However, it is not possible to draw conclusions on the potential benefit or harm of the long-term consumption of fruit juice and energy drinks on cardiovascular disease-related mortality owing to the limited number of studies available.

Original title: 
Long-Term Consumption of 6 Different Beverages and Cardiovascular Disease-Related Mortality: A Systematic Review and Meta-Analysis of Prospective Cohort Studies by Bhandari B, Zeng L, […], Xu X. 

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10904171/

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Find more information/studies on RCT’s/sensitivity analysis, coffee, alcohol and cardiovascular diseases right here. 

Objectives:
Previous studies suggest that dietary vitamin C is inversely associated with gastric cancer (GC), but most of them did not consider intake of fruit and vegetables. Therefore, this review article has been conducted.

Do higher dietary vitamin C intakes reduce gastric cancer risk after adjusting for intake of fruit and vegetables?

Study design:
This review article included 14 case-control studies with in total 5,362 cases (persons with gastric cancer) and 11,497 controls (persons without gastric cancer).

More cases were male (61.88% vs. 54.64%), older than 60 years (63.37% vs. 57.87%) and had low socioeconomic status (57.29% vs. 45.66%) compared with controls. 
In addition, a higher proportion of cases than controls were obese (21.34% vs. 19.06%), current smokers (26.58% vs. 24.14%) and ever drinkers (64.85 vs. 63.29%). 
Similarly, H. pylori seropositivity (63.82% vs. 61.86%) was more common among cases than among controls when considering only participants from the 7 studies with available information. 
A larger proportion of controls reported high intake of fruit and vegetables compared with cases. 
Most cases were of noncardia (57.03%) and intestinal type gastric cancer (33.01%). 
Cases had a lower median intake of vitamin C and fewer of them were in the highest quartiles of intake compared with controls.

Results and conclusions:
The investigators found individuals in the highest quartile of dietary vitamin C intake had a significantly reduced risk of 36% for gastric cancer compared with those in the lowest quartile [OR = 0.64, 95% CI = 0.58 to 0.72]. 

The investigators found, however, when additionally adjusting for BMI and intake of fruit and vegetables, the observed association was attenuated and the OR for the highest versus lowest quartile of dietary vitamin C was 0.85 [95% CI = 0.73 to 0.98].

The investigators found a significant inverse association for noncardia gastric cancer, as well as for both intestinal and diffuse types of the disease. 

The investigators found dose-response analysis showed decreasing ORs of gastric cancer up to 150-200 mg/day of vitamin C [OR = 0.54, 95% CI = 0.41 to 0.71], whereas ORs for higher intakes were close to 1.0. 

The investigators concluded that consumption of 150-200 mg/day of vitamin C reduce gastric cancer risk. However, further well-designed prospective studies, aimed at disentangling the complex relationships between intake of fruit and vegetables, vitamins and other antioxidants and gastric cancer, are warranted to prove causality of the observed relationship between vitamin C and gastric cancer.

Original title: 
Dietary intake of vitamin C and gastric cancer: a pooled analysis within the Stomach cancer Pooling (StoP) Project by Sassano M, Seyyedsalehi  MS, […], Boffetta P. 

 

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11016516/

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Find more information/studies on cohort studies/significantly, viamin C and cancer right here. 

Objectives:
While clinical studies indicate that dietary protein may benefit glucose homeostasis in type 2 diabetes (T2D), the impact of dietary protein, including whether the protein is of animal or plant origin, on the risk of type 2 diabetes is uncertain. Therefore, an update of the meta-analysis has been conducted. 

Is there an associations between total, animal and plant protein dietary intakes and the risk of type 2 diabetes?

 

Study design:
This review article included 16 prospective cohort studies, involving 615,125 participants and 52,342 type 2 diabetes cases. Of which 11 studies reported data on intake of both animal and plant protein. 

 

Results and conclusions:
The investigators found dietary intakes of total protein were significantly associated with an increased risk of 14% for type 2 diabetes [pooled effect size = 1.14, 95% CI = 1.04 to 1.24].

The investigators found every increase of 20g dietary intakes of total protein were significantly associated with an increased risk of 3% for type 2 diabetes.

The investigators found dietary intakes of animal protein were significantly associated with an increased risk of 18% for type 2 diabetes [pooled effect size = 1.18, 95% CI = 1.09 to 1.27].

The investigators found every increase of 20g dietary intakes of animal protein were significantly associated with an increased risk of 7% for type 2 diabetes.

The investigators found, in contrast, there was no association between dietary intake of plant protein and type 2 diabetes risk [pooled effect size = 0.98, 95% CI = 0.89 to 1.08].

The investigators found every replacement of 20 grams animal by plant protein was 

significantly associated with a reduced risk of 20% for type 2 diabetes [pooled effect size = 0.80, 95% CI = 0.76 to 0.84].

The investigators concluded that long-term consumption of animal, but not plant, protein is associated with a dose-dependent increase in the risk of type 2 diabetes, with the implication that replacement of animal with plant protein intake may lower the risk of type 2 diabetes.  

Original title: 
Association between total, animal, and plant protein intake and type 2 diabetes risk in adults: A systematic review and dose-response meta-analysis of prospective cohort studies by Ardakani AF, Anjom-Shoae J, […], Horowitz M. 

Link: 
https://pubmed.ncbi.nlm.nih.gov/39032197/

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Find more information/studies on protein and diabetes right here.

 

Objectives:
The association between soy product consumption and cancer risk varies among studies. Therefore, this review article has been conducted.

Do higher soy product consumption reduce cancer risk?

Study design:
This review article included 17 cohort studies and 35 case-control studies with a total of 861,372 participants and 44,932 cases (persons with cancer). 

Regarding quality assessment, the case-control studies achieved an average score of 6.7. The mean score of the cohort study was 7.2, which satisfied the criterion of high quality. 
All analyses adjusted for age and most studies adjusted for smoking status (n = 38), drinking status (n = 29), total energy intake (n = 27), BMI (n = 26) and education level (n = 26). 

Results and conclusions:
The investigators found in pooled analysis of cohort studies and case-control studies that higher consumption of total soy products significantly reduced risk of cancer with 31% [RR = 0.69, 95% CI = 0.60 to 0.80, I2 = 82.7%, p < 0.001]. 
However, this reduced risk was not significant in cohort studies (RR = 0.90, 95% CI = 0.80 to 1.01].

The investigators found higher tofu consumption significantly reduced cancer risk in both men and women.

The investigators found higher consumption of total soy products significantly reduced risk of cancer amond women with 24% [RR = 0.76, 95% CI = 0.65 to 0.89].

The investigators found in subgroup analysis that higher consumption of total soy products was significantly associated with a reduced risk for gastrointestinal cancer [RR = 0.74, 95% CI = 0.61 to 0.89], prostate cancer [RR = 0.47, 95% CI = 0.31 to 0.71], lung cancer [RR = 0.67, 95% CI = 0.52 to 0.86], upper aerodigestive tract cancer [RR = 0.33, 95% CI = 0.22 to 0.49] and multiple myeloma [RR = 0.10, 95% CI = 0.01 to 0.97], but not in bladder or liver cancer.

The investigators found in pooled analysis of cohort studies and case-control studies that higher consumption of tofu significantly reduced risk of cancer with 22% [RR = 0.78, 95% CI = 0.70 to 0.86, I2 = 47.9%, p = 0.004]. 
However, this reduced risk was not significant in cohort studies [RR = 0.89, 95% CI = 0.78 to 1.01, p = 0.186].

The investigators found in pooled analysis of cohort studies and case-control studies that higher consumption of soymilk significantly reduced risk of cancer with 25% [RR = 0.75, 95% CI = 0.60 to 0.86, I2 = 47.9%, p = 0.004]. 
However, this reduced risk was not significant in cohort studies [RR = 1.10, 95% CI = 0.76 to 1.58].

The investigators found a 54g per day increment of total soy products significantly reduced cancer risk by 11%, a 61g per day increment of tofu significantly reduced cancer risk by 12%, and a 23g per day increment of soymilk significantly reduced cancer risk by 28%, while none of the other soy products were associated with cancer risk. 

The investigators concluded that daily consumption of 54g total soy products, 61g tofu or 23g soymilk is associated with a lower cancer risk. More prospective cohort studies are still needed to confirm the causal relationship between soy product consumption and cancer risk.

Original title: 
Soy Product Consumption and the Risk of Cancer: A Systematic Review and Meta-Analysis of Observational Studies by Wang C, Ding K, […], Hong H. 

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11013307/

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Find more information/studies on cohort studies/significantly, soy and cancer right here. 

Objectives:
Previous cohort studies have indicated that consumption of total and animal proteins are related to fracture risk; however, results were inconclusive. Therefore, this review article has been conducted.

Does a high dietary intake of protein reduce risk of fractures?

Study design:
This review article included 20 cohort studies with serious to moderate risk of bias involving 780,322 individuals. 

Results and conclusions:
The investigators found a non-statistically significant relation between intake of animal proteins and dairy products and all fracture risk. 

The investigators found, however, a significantly 43% decreased incidence of fracture per 100 g/day total protein dietary intake [RR = 0.57, 95% CI = 0.36 to 0.93]. 

The investigators found, however, a significantly 5% decreased incidence of fracture per 15 g/day fish protein dietary intake [RR = 0.95, 95% CI = 0.91 to 0.99]. 

The investigators found every 100 g/day total and animal protein dietary intake and every 15 g/day fish dietary intake were significantly linked to 48%, 50% and 5% lower hip fracture risk. 

The investigators found greater dietary animal protein intake might reduce risk of hip but not fracture at any site. 

The investigators concluded greater total protein (per 100 g/day) and fish (per 15 g/day) dietary intake may reduce risk of any or hip fracture. May reduce because the cohort studies had serious to moderate risk of bias.

Original title: 
Association between total and animal proteins with risk of fracture: A systematic review and dose-response meta-analysis of cohort studies by Zeraattalab-Motlagh S, Mortazavi AS, […], Mohammadi H.

 

Link: 
https://pubmed.ncbi.nlm.nih.gov/37855886/ 

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Find more information/studies on proteins and elderly right here. 

100 grams of protein consumption per day corresponds to a diet with 20 En% protein. A diet with 20 En% protein mainly consists of products with 20 En% protein. Find here which products in the supermarket contain 20 En% protein.

20 En% protein means that the number of grams of protein contributes 20% to the total calorie content of the product in question.

Calculate here whether your daily diet contains 20 En% protein. This tab is only visible after gratis inlog. 

Objectives:
Hypertension (HTN) is regarded as a serious public health issue throughout the world. High blood pressure (BP) may be improved by carotenoid supplementation; however, randomized controlled trials (RCTs) provide conflicting evidence. Therefore, this review article has been conducted.

Do carotenoid supplements reduce blood pressure?

Study design:
This review article included 19 RCTs involving 1,151 participants.
Evidence for all systolic blood pressure, diastolic blood pressure and heart rate values was high quality.

Results and conclusions:
The investigators found carotenoid supplementation significantly reduced the systolic blood pressure (SBP) [WMD = -2.492 mmHg, 95% CI = -4.52 to -0.47, p = 0.016] and diastolic blood pressure (DBP) [MD = -1.60 mmHg, 95% CI = -2.73 to -0.47, p = 0.005]. 

The investigators found greater effects were observed in Asian participants, those aged >50 years, nonhealthy participants and participants with a baseline systolic blood pressure ≥130 mmHg and diastolic blood pressure ≥80 mmHg and at carotenoid dose >10 mg. 

The investigators found dose-response analysis showed that carotenoid supplementation decreased systolic blood pressure and diastolic blood pressure levels at doses of, respectively, 0-25 and 0-20 mg/d. 

The investigators concluded daily 10-25 mg carotenoid supplementation decrease blood pressure, especially in nonhealthy study participants with high blood presurre baseline levels.

Original title: 
Effect of carotenoid supplementation on blood pressure in adults: a GRADE-assessed systematic review and dose-response meta-analysis of randomized controlled trials by Behzadi M, Akbarzadeh M, […], Bideshki MV. 

Link:
https://pubmed.ncbi.nlm.nih.gov/38219250/

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Find more information/studies on RCT’s/sensitivity analysis, carotenoids and cardiovascular diseases right here.

Heart patients are advised to choose low fat, low salt and fiber rich products. These products can be found here. 

Patients with a high blood pressure are advised to choose low salt products. These products can be found here. 

Coenzyme Q10 supplements improve endothelial function 

Objectives:
Coenzyme Q10 (CoQ10) has gained attention as a potential therapeutic agent for improving endothelial function. Several randomized clinical trials (RCTs) have investigated CoQ10 supplementation's effect on endothelial function. However, these studies have yielded conflicting results. Therefore, this review article has been conducted.

Do coenzyme  Q10 supplements improve endothelial function?

Study design:
This review article included 12 RCTs comprising 489 subjects.

Results and conclusions:
The investigators found significant increases in Flow Mediated Dilation (FMD) after CoQ10 supplementation [WMD = 1.45, 95% CI = 0.55 to 2.36, p < 0.02], but there was no increase in Vascular cell adhesion protein (VCAM) and Intercellular adhesion molecule (ICAM) following Q10 supplementation. 

The investigators found the sensitivity analysis showed that the effect size was robust in FMD and VCAM. 

The investigators found in meta-regression, changes in FMD percent were significantly associated with the dose of supplementation [slope = 0.01, 95% CI = 0.004 to 0.03, p = 0.006].

The investigators concluded coenzyme Q10 supplementation has a positive effect on Flow Mediated Dilation (FMD) in a dose-dependent manner.  

Original title: 
Effect of Coenzyme Q10 Supplementation on Vascular Endothelial Function: A Systematic Review and Meta-Analysis of Randomized Controlled Trials by Daei S, Ildarabadi A, […], Mohamadi-Sartang M. 

Link:
https://pubmed.ncbi.nlm.nih.gov/38630421/

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Endothelial function can be assessed non-invasively using the flow-mediated dilation (FMD) technique. Flow-mediated dilation (FMD) refers to dilation (widening) of an artery when blood flow increases in that artery.

Heart patients are recommended to choose high-fiber, low-fat and low-salt products.

High-fiber, low-fat and low-salt products are products with minimum 1.5 grams of fiber per 100 kcal, maximum 30 En% fat and maximum 0.2 grams salt per 100 kcal. 
Find here which products are suitable for heart patients.

Calculate here whether your daily diet meets the requirements for heart patients.

Calculate here whether your diet for the past six months meets the requirements for heart patients.

Objectives:
Carotenoids appear to have anticancer effects. Prospective evidence for the relation between serum carotenoids and breast cancer is controversial. Therefore, this review article has been conducted.

Do higher carotenoids levels (likes, α-carotene, β-carotene, β-cryptoxanthin, lycopene, zeaxanthin and lutein) reduce breast cancer risk among women?

Study design:
This review article included 17 nested case-control studies and 1 cohort study, published between 1984 and 2016 with a total of 20,188 participants. 
Median follow-up ranged from 8 months to 21 years during which 7,608 breast cancer cases were reported. 
All studies assessed circulating carotenoids using high-performance liquid chromatography. The majority of studies carried out on circulating carotenoids and the risk of breast cancer were adjusted for the following variables: BMI (n = 9), dietary variables (n = 8), age (n = 9), alcohol (n = 6), age at menarche (n = 6) and age at first birth (n = 8). 
According to the quality assessment, except for 2 studies, other publications had high quality. 

There was no publication bias. 

Results and conclusions:
The investigators found that the highest levels of total carotenoids compared to the lowest were significantly related to a 24% lower risk of breast cancer [relative risk (RR) = 0.76, 95% CI = 0.62 to 0.93, I2 = 45.6%, p = 0.075]. 
According to the sensitivity analysis, no study affected the overall RR. 

The investigators found according to linear dose-response analysis, the risk of breast cancer decreased by 2% for every 10 μg/dL of total carotenoids [RR = 0.98, 95% CI = 0.97 to 0.99]. A steady drop in the risk of breast cancer was observed for total carotenoid concentrations <1200 μg/dL followed by a plateau. The level of evidence was graded as low.

The investigators found that the highest levels of α-carotene compared to the lowest were significantly related to a 23% lower risk of breast cancer [relative risk (RR) = 0.77, 95% CI = 0.68 to 0.87, I2 = 0.0%, p = 0.48]. 
According to the sensitivity analysis, no study affected the overall RR. 

The investigators found according to linear dose-response analysis, the risk of breast cancer decreased by 22% for every 10 μg/dL of α-carotene [RR = 0.78, 95% CI = 0.66 to 0.93]. 
No evidence for nonlinear association was found. The level of evidence was graded as low. 

The investigators found that the highest levels of β-carotene compared to the lowest were significantly related to a 20% lower risk of breast cancer [relative risk (RR) = 0.80, 95% CI = 0.65 to 0.98, I2 = 56.5%, p = 0.004]. 
According to the sensitivity analysis, no study affected the overall RR. 

The investigators found according to linear dose-response analysis, the risk of breast cancer decreased by 4% for every 10 μg/dL of β-carotene [RR = 0.96, 95% CI = 0.93 to 0.99]. No evidence for nonlinear association was found. The level of evidence was graded as low. 

The investigators found that the highest levels of β-cryptoxanthin compared to the lowest were significantly related to a 15% lower risk of breast cancer [relative risk (RR) = 0.85, 95% CI = 0.74 to 0.96, I2 = 0.0%, p = 0.80]. 
According to the sensitivity analysis, no study affected the overall RR. 

The investigators found according to linear dose-response analysis, the risk of breast cancer decreased by 10% for every 10 μg/dL of β-cryptoxanthin [RR = 0.90, 95% CI = 0.82 to 0.99]. 

The investigators found that the highest levels of lycopene compared to the lowest were significantly related to a 14% lower risk of breast cancer [relative risk (RR) = 0.86, 95% CI = 0.76 to 0.98, I2 = 0.0%, p = 0.46]. 
According to the sensitivity analysis, no study affected the overall RR. 

The investigators found that the highest levels of lutein compared to the lowest were significantly related to a 30% lower risk of breast cancer [relative risk (RR) = 0.70, 95% CI = 0.52 to 0.93, I2 = 17.1%, p = 0.30]. 
According to the sensitivity analysis, no study affected the overall RR. 

The investigators concluded that higher levels of carotenoids, α-carotene, β-carotene, β-cryptoxanthin, lycopene and lutein are related to a decreased risk of breast cancer. Additionally, each 10 μg/dL of total carotenoids, α-carotene, β-carotene and β-cryptoxanthin reduce breast cancer risk with 2%, 22%, 4% and 10%, respectively. 

Original title: 
The Association between Circulating Carotenoids and Risk of Breast Cancer: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies by Dehnavi MK, Ebrahimpour-Koujan S, […], Azadbakht L.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10694674/ 

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Find more information/studies on cohort studies/significantly, carotenoids and breast cancer right here. 

Objectives:
Epidemiological evidences regarding the association between physical activity and the risk of lung cancer are still controversial. Therefore, this review article has been conducted.

Does physical activity reduce risk of lung cancer?

Study design:
This review article included 20 cohort studies with a total of 2,965,811 participants and 31,807 lung cancer cases.

The study population were adults with age of >18 years.
Most studies were adjusted for major confounders including age, sex, smoking status and body mass index, etc.

The quality scores ranged from 5 to 9 with a median score of 8.
3 studies were evaluated with a score of 7 and others with a score of ≥7. Thus, the majority of the studies included in the meta-analysis were assessed as high-quality studies.

There might be little indication of publication bias in this meta-analysis.

Results and conclusions:
The investigators found compared with the low level of physical activity, the high level of physical activity significantly reduced risk of lung cancer with 17% [pooled RR = 0.83, 95% CI = 0.77 to 0.90, I2 = 62.6%, p heterogeneity 0.001].

The investigators found in subgroup analyses, compared with the low level of physical activity, the high level of physical activity significantly reduced risk of lung cancer among women with 10% [pooled RR = 0.90, 95% CI = 0.82 to 0.99].

The investigators found in subgroup analyses compared with the low level of physical activity, the high level of physical activity significantly reduced risk of lung cancer among men with 19% [pooled RR = 0.81, 95% CI = 0.73 to 0.90].

The investigators found smokers with a high level of physical activity were associated with a 10% lower risk for lung cancer [RR = 0.90, 95% CI = 0.84 to 0.97], while the association was not significant among non-smokers [RR = 0.95, 95% CI = 0.88 to 1.03].

Subgroups analysis stratified by whether the studies adjusted for smoking intensity and durations yielded the same magnitude of RR.

However, the RR for subgroups without adjustment for dietary factors was 0.74 [95% CI = 0.71 to 0.77], which was significantly lower than that with dietary factors adjusted [RR = 0.89, 95% CI = 0.84 to 0.95].

The investigators found in sensitivity analyses, the pooled RRs ranged from 0.82 [95% CI = 0.76 to 0.89] to 0.86 [95% CI = 0.81 to 0.92]. The trend was generally similar with the overall analysis.

The investigators concluded a high level of physical activity reduces risk of lung cancer among smokers. Large interventional studies are expected to further verify these findings. If the inverse association, as well as the effect modification by smoking status, reflects a causal relation, future precision prevention of lung cancer by increased physical activity may be more effective when targeting to smokers rather than non-smokers.

Original title:
Association Between Physical Activity and Lower Risk of Lung Cancer: A Meta-Analysis of Cohort Studies by Liu Y, Li Y, […], Fan XX.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6349707/

Additional information of El Mondo:
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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:
The impact of deworming on parasite load, nutritional status and other health outcomes of non-pregnant adolescent girls and adult women is uncertain. Therefore, this review article has been conducted.

Have deworming beneficial effects on health outcomes of non-pregnant adolescent girls and adult women 10 to 49 years old?

Study design:
This review article included 4 RCTs of mass deworming involving 1,086 participants.
Outcomes of interest included parasite load, reinfection, anaemia, severe anaemia, iron deficiency, diarrhoea or all-cause morbidity.
Risk of bias was assessed using the Cochrane risk of bias tool.

The WHO guideline was used for severe anaemia, defined by haemoglobin levels  80 g/L.
None of the included studies assessed screen and treat deworming or reported reinfection, diarrhoea or adverse events.

Results and conclusions:
The investigators found compared to the control group, mass deworming significantly reduced risk of roundworm infection with 71% [RR = 0.29, 95% CI = 0.14 to 0.62, 2 trials, 1,498 participants, moderate certainty evidence].
Significantly because RR of 1 was not found in the 95% CI of 0.14 to 0.62. RR of 1 means no risk/association.

The investigators found compared to the control group, mass deworming significantly reduced risk of hookworm infection with 68% [RR = 0.32, 95% CI = 0.18 to 0.59, 2 trials, 1,498 participants, moderate certainty evidence].
Significantly means that there is an association with a 95% confidence.

The investigators found compared to the control group, mass deworming significantly reduced risk of whipworm infection with 23% [RR = 0.77, 95% CI = 0.65 to 0.91, 2 trials, 1,498 participants, moderate certainty evidence].

The investigators found compared to the control group, mass deworming non-significantly reduced risk of anaemia with 18% [RR = 0.82, 95% CI = 0.60 to 1.11, 3 studies, 683 participants, low certainty evidence].
Non-significantly because RR of 1 was found in the 95% CI of 0.60 to 1.11. RR of 1 means no risk/association.

The investigators found compared to the control group, mass deworming non-significantly reduced risk of iron-deficiency with 11% [RR = 0.89, 95% CI = 0.64 to 1.23, 1 study, 186 participants, low certainty evidence].
Non-significantly means that there is no association with a 95% confidence.

The investigators found there was uncertainty whether deworming reduced the prevalence of severe anaemia compared to control as the certainty of evidence was very low.

The investigators concluded mass deworming reduces the prevalence of soil-transmitted helminth infections but has no effect on anaemia and iron-deficiency in adolescent girls and non-pregnant women 10 to 49 years old.

Original title:
Deworming in non-pregnant adolescent girls and adult women: a systematic review and meta-analysis by Tanjong Ghogomu E, Suresh S, […], Welch V.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6300900/

Additional information of El Mondo:
Find more information/studies on deworming and iron right here.

Objectives:
Taurine is central to many physiological processes, some of which are augmented by exogenous supply and have the potential to facilitate endurance performance; however, its independent effects on performance have not been systematically analyzed. Therefore, this review article has been conducted.

Does supplementation of taurine improve human endurance performance?

Study design:
This review article included 10 peer-reviewed articles. A sub-analysis of time-to-exhaustion (TTE) trials (n = 7) was also performed.

The doses of taurine ranged from 1 to 6 g/day and were provided in single doses and for up to 2 weeks among a range of subjects.

Results and conclusions:
The investigators found that taurine supplementation significantly improved overall endurance performance [Hedges' g = 0.40, 95% CI = 0.12-0.67, p = 0.004], which was similar in TTE trials [Hedges' g = 0.43, 95% CI = 0.12-0.75, p = 0.007].

The investigators found no differences between acute or chronic supplementation for the full sample [p = 0.897] or the TTE group [p = 0.896].

The investigators found that the dose of taurine did not moderate its effect on endurance performance [p > 0.05].

The investigators concluded that human endurance performance can be improved by orally ingesting a single dose of taurine in varying amounts (1-6 g).

Original title:
The Effects of an Oral Taurine Dose and Supplementation Period on Endurance Exercise Performance in Humans: A Meta-Analysis by Waldron M, Patterson SD, […], Jeffries O.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29546641

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Find here more information/studies about sport nutrition, protein and elderly.

Objectives:
Stunting (length-for-age z score -2) before 2 years of age has shown associations with poor child developmental indicators, but information at the population level is scarce in South Asia, the region with the highest burden of stunting. Therefore, this review article has been conducted.

Does undernutrition (i.e., stunting [HAZ -2], wasting [WHZ -2] and underweight [WAZ -2]) associate with poor learning/cognition and social-emotional development among children 36-59 months of age in South Asia?

Study design:
This review article included data from Multiple Indicator Cluster Surveys in Bangladesh (n = 8,659), Bhutan (n = 2,038), Nepal (n = 2,253), and Pakistan (Punjab n = 11,369 and Sindh n = 6,718).
Children were considered developmentally "on-track" in learning/cognition or social-emotional domains if they met specific early child development criteria.
Meta-analysis was conducted to examine regional associations, adjusting for socio-economic status, early childhood education and quality of care.

Results and conclusions:
The investigators found in pooled analysis, that on-track learning/cognition development was positively associated with HAZ [OR = 1.17, 95% CI =1.07 to 1.27] and WAZ [OR = 1.18, 95% CI = 1.07 to 1.31].

The investigators found in pooled analysis, that on-track learning/cognition development significantly reduced risk of stunting with 28% [OR = 0.72, 95% CI = 0.60 to 0.86].
Significantly means that there is an association with a 95% confidence.

The investigators found in pooled analysis, that on-track learning/cognition development significantly reduced risk of underweight with 25% [OR = 0.75, 95% CI = 0.66 to 0.86].

The investigators found in pooled analysis, that on-track learning/cognition development was not associated with WHZ or wasting.

The investigators found in pooled analysis on-track development of social-emotional domain was not associated with any z scores or undernutrition indicators.

The investigators found that across several countries of South Asia, stunted children were less likely to be developmentally "on track" for learning/cognition.

The investigators concluded that interventions that prevent stunting have benefit effects on child development, leading to significant individual and societal gains given the large burden of child stunting in regions like South Asia.

Original title:
Association between stunting and early childhood development among children aged 36-59 months in South Asia by Kang Y, Aguayo VM, […], West KP Jr.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30499257

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

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

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

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

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

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

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

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

Additional information of El Mondo:
Find more information/studies on vitamin E, C, β-carotene and dementia right here.
 

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

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

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

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

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

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

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

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

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

Additional information of El Mondo:
Find more information/studies on vitamin A and C, vegetables and elderly right here.
 

Objectives:
Protein-energy malnutrition is a major health concern in home-dwelling older adults, particularly in the context of an ageing population. Therefore, this review article has been conducted.

What is the prevalence of malnutrition among older adults living independently in the community according to geographical region, sampling frame, rurality and sex?

Study design:
This review article included 111 studies from 38 countries (n = 69,702 participants, with a mean age of ≥65 years).
Meta-regression was used to explore predictors of malnutrition prevalence in pooled statistics with high heterogeneity.

Results and conclusions:
The investigators found the pooled prevalence of malnutrition in the older community setting ranged from 0.8% [95% CI = 0.2-1.7%] in Northern Europe to 24.6% [95% CI = 0.0-67.9%] in South-East Asia.

The investigators found of all sampling frames, participants receiving homecare services had the highest prevalence at 14.6% [95% CI = 9.9-20.0%].

The investigators found malnutrition prevalence in rural communities [9.9%, 95% CI = 4.5-16.8%] was double that in urban communities [5.7%, 95% CI = 4.2-7.3%] and higher among females than males [odds ratio = 1.45, 95% CI = 1.27-1.66, p 0.00001].

The investigators concluded that the prevalence of malnutrition among older adults living in South-East Asia is very high (24.6%), particularly among rural communities and females. These findings provide strategic insight to develop public and community health priorities for preventing malnutrition and associated poor health outcomes.

Original title:
A systematic review, meta-analysis and meta-regression of the prevalence of protein-energy malnutrition: associations with geographical region and sex by Crichton M, Craven D, […], Marshall S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30188972

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

Objectives:
Diabetes prevention is a public health priority. Vitamin D supplementation may help prevent the development of diabetes in persons at increased risk. Therefore, this review article has been conducted.

Does vitamin D supplementation reduce risk of type 2 diabetes?

Study design:
This review article included 28 RCTs with 3,848 participants.

The sample size varied from 23 to 511.
The mean age of participants ranged from 26 years to 71 years.
The duration of follow-up across studies ranged from 2 months to 5 years, with a median follow-up of 22 weeks [interquartile range (IQR): 14 to 48 weeks], a duration long enough to detect changes in measured outcomes.

The average vitamin D supplementation dose of 88 µg/d (3500 IU/d).
All included trials measured the effect of vitamin D supplementation on serum 25(OH)D concentrations.

Results and conclusions:
The investigators found overall, serum 25(OH)D concentrations in the treated arms (vitamin D-supplemented groups) significantly improved by 45.1 nmol/L [95% CI = 41.3 to 48.9, p 0.001, I2 = 97.4%].

The investigators found compared with the control group, vitamin D supplementation significantly reduced HbA1c level by -0.48% [95% CI = -0.79 to -0.18, p = 0.002, I2 = 92.1%].
However, after adjusting the effect size for potential publication bias using the “trim and fill” method, 4 potentially missing studies were imputed in the funnel plot and the effect size increased from -0.48% [95% CI = -0.79 to -0.18] to -0.71% [95% CI = -1.02 to -0.39].

The investigators found compared with the control group, vitamin D supplementation significantly reduced fasting plasma glucose level by -0.46 mmol/L [95% CI = -0.74 to -0.19, p = 0.001, I2 = 92.4%].  
However, after adjusting the effect size for potential publication bias using the “trim and fill” method, 6 potentially missing studies were imputed in the funnel plot and the effect size increased -0.46 mmol/L [95% CI = -0.74 to ­0.19] to -0.72 mmol/L [95% CI =-1.02 to -0.42].

The investigators found compared with the control group, vitamin D supplementation significantly reduced HOMA-IR level by -0.39 [95% CI = -0.68 to -0.11, p = 0.007, I2 = 91.3%].
However, after adjusting the effect size for potential publication bias using the “trim and fill” method, 5 potentially missing studies were imputed in the funnel plot and the effect size increased from -0.39 [95% CI = -0.68 to -0.11] to -0.62 [95% CI = -0.92 to -0.32].

The investigators found in subgroup analysis both HbA1c and HOMA-IR showed a greater reduction over time among overweight/obese individuals compared with prediabetics [HbA1c = -0.98 ± 0.45 vs -0.29 ± 0.14, p = 0.1 and HOMA-IR = -0.62 ± 0.23 vs -0.07 ± 0.16, p = 0.05].

The investigators found in subgroup analysis vitamin D supplementation significantly decreased HbA1c [p = 0.05], fasting plasma glucose level [p = 0.05] and HOMA-IR [p = 0.1] to a greater extent when serum 25(OH)D concentration achieved was above 86 nmol/L.

The investigators found in subgroup analysis vitamin D supplementation for less than 6 months provided a larger effect size on HbA1c in comparison with long durations [-0.75 ± 0.33 vs -0.25 ± 0.11, p = 0.1].

The investigators found in subgroup analysis HbA1c showed greater improvement in populations with a mean age younger than 45 years in comparison with older populations [-1.15 ± 0.6 vs -0.30 ± 0.1, p = 0.05].

The investigators found in subgroup analysis greater reductions were found within HbA1c and fasting plasma glucose levels when baseline (at the beginning of the study) mean serum 25(OH)D concentration was ≥50 nmol/L, whereas the lowering effect was significantly less in the subgroup with baseline mean 25(OH)D 50 nmol/L [HbA1c = -0.79 ± 0.25 vs -0.14 ± 0.13, p = 0.04 and fasting plasma glucose level = -0.69 ± 0.21 vs -0.11 ± 0.10, p = 0.05].

The investigators concluded 88 µg/d vitamin D supplementation during 22 weeks improves glycemic measures and insulin sensitivity and may be useful as part of a preventive strategy for type 2 diabetes, particularly among overweight/obese individuals younger than 45 years.

Original title:
Vitamin D Supplementation, Glycemic Control, and Insulin Resistance in Prediabetics: A Meta-Analysis by Mirhosseini N, Vatanparast H, [...], Kimball SM.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6016617/

Additional information of El Mondo:
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HbA1c, FPG, HOMA-IR and plasma glucose after 2-hour oral glucose tolerance test (2HPG) are different parameters associated with (pre)diabetes.

 

Objectives:
Has flavonoid supplementation potential against obesity?

Study design:
This review article included 58 RCTs.
Analysis endpoints were calculated as the mean difference between baseline and post-treatment.
Flavonoids were in subclasses of flavanols, flavonols, isoflavones, flavanones, anthocyanins and proanthocyanidins. They were mostly in the form of supplements and dosages varying from 40 to 1300 mg/day.

Results and conclusions:
The investigators found among flavonoid subclasses, flavanols showed potential for decreasing BMI, in the overall population [MD = -0.28 kg/m², p = 0.04, n = 21] and in the subgroups of Asians [MD = -0.42 kg/m², p = 0.046, n = 13], ages 50 years [MD = -0.50 kg/m², p = 0.008, n = 14], BMI ≥25 kg/m² [MD = -0.30 kg/m², p = 0.049, n = 15] and at doses ≥500 mg/day [MD = -0.36 kg/m², p = 0.049, n = 12].

The investigators found among flavonoid subclasses, isoflavones also significantly decreased BMI of non-Asian populations [MD = -0.26 kg/m², p = 0.035, n = 13] and doses ≥75 mg/day [MD = -0.34 kg/m², p = 0.027, n = 8].

The investigators found in the overall assessment, flavanols also significantly decreased waist circumference [MD = -0.60 cm, p = 0.02, n = 18] but had no significant effect on body fat percentage.

The investigators found the available trials did not reveal significant effects from flavonols, flavanones and anthocyanins on the specified anthropometric measures.

The investigators concluded that flavanols, particularly ≥500 mg/day and isoflavones, particularly ≥75 mg/day have potential against obesity.

Original title:
Flavanols are potential anti-obesity agents, a systematic review and meta-analysis of controlled clinical trials by Akhlaghi M, Ghobadi S, […], Mohammadian F.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29759310

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

Objectives:
Findings from observational studies on the associations between vitamin E intake and stroke risk remain controversial and the dose-response relationship between vitamin E intake and risk of stroke remains to be determined. Therefore, this review article has been conducted.

Does dietary vitamin E intake reduce risk of stroke?

Study design:
This review article included 9 prospective cohort studies involving 3,284 cases of stroke among 220,371 participants.

Results and conclusions:
The investigators found high dietary vitamin E intake significantly reduced risk of overall stroke with 17% [RR = 0.83, 95% CI = 0.73 to 0.94].
Omission of any single study (=sensitivity analysis) did not alter the summary result.

The investigators found high dietary vitamin E intake significantly reduced risk of overall stroke with 16% [RR = 0.84, 95% CI = 0.72 to 0.91] among individuals who were followed-up for 10 years.

The investigators found a non-linear association between dietary vitamin E intake and stroke risk [p = 0.0249].

The investigators concluded that a higher dietary vitamin E intake is associated with a lower stroke risk.

Original title:
Vitamin E intake and risk of stroke: a meta-analysis by Cheng P, Wang L, [...], Zhu J.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30401005

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

Objectives:
In the literature conflicting opinions are detectable on the onset of adverse events as autoimmune disease post HPV vaccine and often case reports describes the onset of one of these events, but don’t emerge a clear relationship and we don’t have data to support it. Therefore, this review article has been conducted.

Does HPV vaccine increase risk of autoimmune diseases/disorders?

Study design:
This review article included 6 RCT’s (3 used a bivalent vaccine and 3 a quadrivalent vaccine), comprising 243,289 in vaccine group and 248,820 in control group.

The age of the enrolled subjects in the studies varied from 9 to 26 years and all studies reported the number of subjects who experienced a specific autoimmune disease.

4 of the 6 trials had a Jadad score of 3 or 4 indicating an adequate trial quality.

The most frequent autoimmune diseases observed across the 6 studies were musculoskeletal, CNS conditions and endocrinological conditions.

Results and conclusions:
The investigators found no correlation between autoimmune disorders and HPV vaccines [pooled OR = 1.038, 95% CI = 0.689-1.562].

The investigators concluded there is no correlation between autoimmune disorders and bivalent and quadrivalent HPV vaccines. It's therefore essential to correctly inform the general population in order to try to increase both Italian and international vaccination coverage.

Original title:
HPV vaccine and autoimmune diseases: systematic review and meta-analysis of the literature by Genovese C, LA Fauci V, […], Squeri R.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196376/

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