Nutrition and health

Higher carotenoids blood concentration reduce liver disease

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/


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

Daily 500mg n-3 PUFA during 12 months improve cognitive functions

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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50 to 250 mg/day dietary betaine intake increase stroke mortality

 

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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Betaine-rich foods are

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

 

Higher alcohol intake increases stroke

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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Daily 150-200mg dietary vitamin C reduce gastric cancer

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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20g plant protein reduce type 2 diabetes

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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Daily 61g tofu reduce cancer

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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15 g/day fish protein dietary intake may reduce fractures

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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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. 

25 mg carotenoid supplements decrease blood pressure

Afbeelding
Carotenoidensupplementen en blloeddruk

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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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

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.

Higher carotenoids levels reduce breast cancer

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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Purified anthocyanin supplements reduce cardiovascular risk

Afbeelding

Objectives:
The associations between intake of anthocyanins and anthocyanin-rich berries and cardiovascular risks remained to be established. Therefore, this review article has been conducted.

Do purified anthocyanin supplements and dietary intakes of anthocyanin-rich berries reduce cardiovascular risk?

Study design:
This review article included 44 eligible RCTs consisting of 52 comparison groups and 2,353 subjects and 15 prospective cohort studies with 5,54,638 subjects (persons).

7 of the 44 RCTs were crossover trials with the rest parallel-designed.
15 of the included studies investigated the effects of purified anthocyanins, all of which were produced from berries. For the remaining anthocyanin-rich berry studies, interventions were blueberry in 13 studies, cranberry in 12 studies, bilberry in 3 studies and blackcurrant in 1 study.
The intervention durations ranged from 2 weeks to 24 months with a median of 8 weeks.
24 of the 44 RCTs were rated as high quality with the others as low to moderate quality.

The follow-up periods of 15 cohort studies ranged from 4.3 to 24 years with a median of 12 years. Most of the included cohort studies used FFQ to assess dietary anthocyanin intake and only 3 of them used dietary records.
12 of the 15 cohort studies were rated as high quality.

There was no publication bias, except for the effects of purified anthocyanins on HDL cholestrerol levels [Begg's p = 0.016].

Results and conclusions:
The investigators found pooled analysis of RCTs showed that purified anthocyanin supplements significantly reduced blood LDL cholesterol (bad cholesterol) concentrations [WMD = -5.43 mg/dL, 95% CI = -8.96 to -1.90 mg/dL, p = 0.003]. 

The investigators found pooled analysis of RCTs showed that purified anthocyanin supplements significantly reduced triglyceride concentrations [WMD = -6.18 mg/dL, 95% CI = -11.67 to -0.69 mg/dL, p = 0.027, I2 = 0%]. 

The investigators found pooled analysis of RCTs showed that purified anthocyanin supplements significantly increased HDL cholesterol (good cholesterol) concentrations [WMD = 2.76 mg/dL, 95% CI = 1.34 to 4.18 mg/dL, p 0.001, I2 = 43.5%].
Subgroup analysis showed that the effects on HDL cholesterol concentrations were not significantly influenced by study duration, health status of subjects, anthocyanin doses, study quality and funding source.

The investigators found pooled analysis of RCTs showed that purified anthocyanin supplements significantly reduced tumor necrosis factor alpha concentrations [WMD = -1.62 pg/mL, 95% CI = -2.76 to -0.48 pg/mL, p = 0.005, I2 = 0%].

The investigators found pooled analysis of RCTs showed that purified anthocyanin supplements significantly reduced C-reactive protein concentrations [WMD = -0.028 mg/dL, 95% CI = -0.050 to -0.005 mg/dL, p = 0.014, I2 = 26%].

The investigators found pooled analysis of RCTs showed administration of anthocyanin-rich berries (blueberry, cranberry, bilberry and blackcurrant) significantly reduced blood total cholesterol concentrations [WMD = -4.48 mg/dL, 95% CI = -8.94 to -0.02 mg/dL, p = 0.049]. 

The investigators found pooled analysis of RCTs showed administration of anthocyanin-rich berries (blueberry, cranberry, bilberry and blackcurrant) significantly reduced C-reactive protein concentrations [WMD = -0.046 mg/dL, 95% CI = -0.070 to -0.022 mg/dL, p 0.001, I2 = 0%].

The investigators found pooled analysis of cohort studies showed high dietary anthocyanins intakes significantly reduced risk of coronary heart disease (CHD) with 17% [relative risk = 0.83, 95% CI = 0.72 to 0.95, p = 0.009, I2 = 51.2%].

The investigators found pooled analysis of cohort studies showed high dietary anthocyanins intakes significantly reduced risk of total cardiovascular disease incidence with 27% [relative risk = 0.73, 95% CI = 0.55 to 0.97, p = 0.03, I2 = 76.7%].

The investigators found pooled analysis of cohort studies showed high dietary anthocyanins intakes significantly reduced risk of cardiovascular disease deaths with 9% [relative risk = 0.91, 95% CI = 0.87 to 0.96, p 0.001, I2 = 0%].

Subgroup analysis revealed that the protective roles of dietary anthocyanins against cardiovascular disease deaths was only found in women [RR = 0.89, 95% CI = 0.82 to 0.96, p = 0.003, I2 = 0.0%] and not in men [RR = 0.92, 95% CI = 0.79 tot 1.07, p = 0.263, I2 = 0.0%].

The investigators concluded current clinical and epidemiological evidence show the protective roles of purified anthocyanin supplements during 8 weeks and anthocyanin-rich berries (blueberry, cranberry, bilberry and blackcurrant) on cardiovascular health. These results suggest that regular consumption of either purified anthocyanins or anthocyanin-rich berries could prevent cardiovascular disease through their lipid-lowering and anti-inflammatory properties. Therefore, anthocyanins and anthocyanin-rich berries should be taken into consideration when formulating cardioprotective diets in the future.

Original title:
Anthocyanins, Anthocyanin-Rich Berries, and Cardiovascular Risks: Systematic Review and Meta-Analysis of 44 Randomized Controlled Trials and 15 Prospective Cohort Studies by Xu L, Tian Z, […], Yang Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8714924/

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HDL cholesterol level under 2.33 mmol/L reduces cardiovascular disease mortality

Afbeelding

Objectives:
Previous studies have not fully described the relationship between high-density lipoprotein cholesterol (HDL-C) and death risks from all cause and cardiovascular disease (CVD). Therefore, this review article has been conducted.

Does a high HDL cholesterol level (good cholesterol) reduce all cause and cardiovascular disease mortality risk?

Study design:
This review article included 32 prospective cohort studies with a total of 369,904 participants and 33,473 total deaths (9,426 cardiovascular disease deaths or cardiovascular disease mortality).

Results and conclusions:
The investigators found compared to the lowest HDL cholesterol level, the highest HDL cholesterol level significantly reduced all cause mortality risk by 18% [RR = 0.82, 95% CI = 0.73 to 0.93].
The lowest all cause mortality risk was observed at approximately 1.34 mmol/L.

The investigators found compared to the lowest HDL cholesterol level, the highest HDL cholesterol level significantly reduced cardiovascular disease mortality risk by 36% [RR = 0.64, 95% CI = 0.46 to 0.89].
The lowest cardiovascular disease mortality risk was observed at approximately 1.55 mmol/L.

The investigators found every increment of HDL cholesterol level with 1 mmol/L significantly reduced all cause mortality risk by 15% [RR = 0.85, 95% CI = 0.79 to 0.92].
Significant means that there is an association with a 95% confidence.

The investigators found every increment of HDL cholesterol level with 1 mmol/L significantly reduced cardiovascular disease mortality risk by 23% [RR = 0.77, 95% CI = 0.69 to 0.87].

The investigators found evidence of nonlinear and negative dose-response associations of HDL cholesterol level with all cause and cardiovascular disease mortality risk [p nonlinearity 0.001].

The investigators concluded HDL cholesterol level (good cholesterol) reduces all cause and cardiovascular disease mortality risk under approximately 2.05 and 2.33 mmol/L, respectively. Optimal doses require investigation via clinical practice or high-quality research.

Original title:
A dose-response meta-analysis to evaluate the relationship between high-density lipoprotein cholesterol and all-cause and cardiovascular disease mortality by Liu L, Han M, […], Hong F.

Link:
https://pubmed.ncbi.nlm.nih.gov/34676492/

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High protein diets causally have beneficial effect on body weight management

Afbeelding

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

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

There was no publication bias.

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

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

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

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

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

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

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

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

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

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

 

High CRP levels are a biomarker for early detection and monitoring of malaria severity

Afbeelding

Objectives:
Are high CRP levels a biomarker for the early detection and monitoring of malaria severity?

Study design:
This review article included 29 studies. All included studies reported the quantitative data of CRP in patients were published between 1989 and 2021.
Among the included studies, there were 731 cases of severe malaria, 1,600 cases of uncomplicated malaria, 1,697 cases of asymptomatic malaria and 3,658 cases of healthy/febrile controls.

The quality of the included studies was assessed using the NOS, which has a maximum total of 7 stars. 16 studies were rated 7 stars in total, while 14 studies were rated 6 stars in total as febrile patients had been used as a control group.

Results and conclusions:
The investigators found in meta-analysis that mean CRP levels in patients with severe malaria were significantly higher compared with uncomplicated malaria [SMD = 1.52, 95% CI = 0.91 to 2.12, p 0.001, I2 = 95.1%].

The investigators found in meta-analysis that mean CRP levels in patients with uncomplicated malaria were significantly higher compared with asymptomatic malaria [SMD = 1.65, 95% CI = 0.67 to 2.62, p = 0.001, I2 = 96.7%].

The investigators found in meta-analysis that mean CRP levels in patients with uncomplicated malaria were significantly higher compared with febrile/healthy controls [SMD = 2.38, 95% CI = 1.37 to 3.40, p 0.001, I2 = 98.5%].

The investigators found in meta-analysis that mean CRP levels in patients with asymptomatic malaria were significantly higher compared with febrile/healthy controls [SMD = 2.55, 95% CI = 1.60 to 3.50, p 0.001, I2 = 99.2%].

The investigators concluded that high CRP levels are a biomarker for the early detection and monitoring of malaria severity.

Original title:
C-reactive protein as an early biomarker for malaria infection and monitoring of malaria severity: a meta-analysis by Wilairatana P, Mahannop P, […], Kotepui M.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8585865/

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High circulating vitamin C level reduces metabolic syndrome

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

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

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

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

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

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

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

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

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

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

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

 

Carbohydrate intake increases metabolic syndrome

Afbeelding

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

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

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

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

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

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

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

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

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

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

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

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600 mg/d vitamin E supplementation decreases chemotherapy-induced peripheral neuropathy

Objectives:
Chemotherapy-induced peripheral neuropathy (CIPN) is a common symptom, but prophylactic measures cannot still be carried out effectively. In addition, the efficacy of vitamin E in preventing peripheral neurotoxicity caused by chemotherapy is inconclusive. Therefore, this review article has been conducted.

Does vitamin E supplementation decrease risk of chemotherapy-induced peripheral neuropathy?

Study design:
This review article included 8 RCTs with a total of 488 patients.
The number of participants in each arm ranged from 13 to 96.
The experimental intervention was vitamin E supplementation as an adjuvant to cisplatin, paclitaxel and other chemotherapies.
There was no publication bias.

Results and conclusions:
The investigators found patients who received vitamin E supplementation of 600 mg/day had a significantly lower incidence of chemotherapy-induced peripheral neuropathy of 69% [risk ratio = 0.31, 95% CI = 0.14 to 0.65, p = 0.002, I2 = 0%] than the placebo group (group without vitamin E).

The investigators found patients in the cisplatin chemotherapy group who received vitamin E supplementation had a significantly lower incidence of chemotherapy-induced peripheral neuropathy of 72% [risk ratio = 0.28, 95% CI = 0.14 to 0.54, p = 0.0001, I2 = 0%]  than the placebo group.

The investigators found, moreover, vitamin E supplementation significantly decreased patients’ sural amplitude after 3 rounds of chemotherapy [MD = -2.66, 95% CI = -5.09 to -0.24, p = 0.03, I2 = 0%] in contrast with that of placebo supplementation, while no significant difference was observed when patients were treated with vitamin E after 6 rounds of chemotherapy [MD = -1.28, 95% CI = -3.11 to 0.54, p = 0.17, I2 = 40%].

The investigators found, in addition, the vitamin E-supplemented group had better improvement in the neurotoxicity score and lower incidence of reflexes and distal paraesthesias than the control group.

The investigators concluded that vitamin E supplementation of 600 mg/day decreases risk of chemotherapy-induced peripheral neuropathy, particularly in the cisplatin chemotherapy group. More high-quality trials with standardized reporting of clinical outcomes about peripheral neuropathy are needed to explore the exact role of vitamin E in the prevention of chemotherapy-induced peripheral neuropathy.

Original title:
Protective Effects of Vitamin E on Chemotherapy-Induced Peripheral Neuropathy: A Meta-Analysis of Randomized Controlled Trials by Miao H, Li R [...], Wen Z.

Link:
https://www.karger.com/Article/FullText/515620

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

Afbeelding

Objectives:
With the increasing incidence of osteoporosis, vitamin K and calcium have been linked to bone mineral density (BMD) and undercarboxylated osteocalcin (UcOC) in many studies, but the results of studies of the combined effect of vitamin K and calcium on BMD and UcOC in humans have been inconsistent. Therefore, this review article has been conducted.

Do vitamin K and calcium supplements used in combination increase bone mineral density and decrease undercarboxylated osteocalcin level?

Study design:
This review article included 10 randomized controlled trials (RCTs) with a total of 1,346 patients.

Results and conclusions:
The investigators found that the combination of vitamin K and calcium supplements was significantly associated with a higher lumbar spine bone mineral density [SMD = 0.20, 95% CI = 0.07 to 0.32, I2 = 46.9%, p = 0.049].
However, after applying trim and fill method (where correction was made for publication bias), the results were not statistically significant [estimate = 0.067, 95% CI = -0.044 to 0.178].

The investigators found that vitamin K and calcium supplementation led to a significant decrease in undercarboxylated osteocalcin [SMD = -1.71, 95% CI = - 2.45 to -0.96, I2 = 95.7%, p  0.01].
The results did not change after correcting publication bias [estimate = - 0.947, 95% CI = -1.211 to - 0.687].
The SMD in the sensitivity analysis was -0.82 [95% CI = - 1.10 to -0.55, I2 = 65.4%, p  0.01].

The investigators found in subgroup analysis that the combination of vitamin K2 and calcium supplements was significantly associated with a higher lumbar spine bone mineral density [SMD = 0.30, 95% CI = 0.10 to 0.51, I2 = 0%].

The investigators found in subgroup analysis that the combination of vitamin K and  ≤ 1000 mg/d calcium supplements was significantly associated with a higher lumbar spine bone mineral density [SMD = 0.19, 95% CI = 0.05 to 0.32, I2 = 62.3%].

The investigators found in subgroup analysis that the combination of  ≤100 µg/d vitamin K and calcium supplements was significantly associated with a higher lumbar spine bone mineral density [SMD = 0.40, 95% CI = 0.20 to 0.61, I2 = 49.9%].

The investigators found in subgroup analysis that the combination of vitamin K and calcium supplements during ≤1 year was significantly associated with a higher lumbar spine bone mineral density [SMD = 0.38, 95% CI = 0.19 to 0.57, I2 = 40%].

The investigators concluded that ≤100 µg/d vitamin K2 and ≤1000 mg/d calcium supplements used in combination are associated with a higher lumbar spine bone mineral density and a lower undercarboxylated osteocalcin level.

Original title:
The combined effect of vitamin K and calcium on bone mineral density in humans: a meta-analysis of randomized controlled trials by Hu L, Ji J, [...], Yu B.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8515712/

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Dendritic cell vaccine provides no benefits for newly diagnosed glioblastoma

Afbeelding

Objectives:
The efficacy of dendritic cell vaccine for newly diagnosed glioblastoma remains controversial. Therefore, this review article has been conducted.

Does dendritic cell vaccine provide benefits for the newly diagnosed glioblastoma?

Study design:
This review article included 3 randomized controlled trials (RCTs).

Results and conclusions:
The investigators found overall, compared with control group for newly diagnosed glioblastoma, dendritic cell vaccine showed no substantial effect on:
-median overall survival [SMD = 0.11, 95% CI = -0.18 to 0.41, p = 0.45];
-median progression-free survival [SMD = 0.12, 95% CI = -0.24 to 0.48, p = 0.50];
-progression-free survival rate [risk ratio = 1.29, 95% CI = 0.82 to 2.04, p = 0.27];
-overall survival rate [risk ratio = 1.29, 95% CI = 0.61 to 2.72, p = 0.50] or;
-nervous system disorders [risk ratio = 0.80, 95% CI= 0.59 to 1.08, p = 0.14].

The investigators concluded dendritic cell vaccine provides no obvious benefits for the newly diagnosed glioblastoma.

Original title:
The Efficacy of Dendritic Cell Vaccine for Newly Diagnosed Glioblastoma: A Meta-analysis of Randomized Controlled Studies by Tan L, Peng J, […], Wu Q.

Link:
https://pubmed.ncbi.nlm.nih.gov/34767325/

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Dendritic cells (DCs) are professional antigen-presenting cells that link innate and adaptive immunity and are critical for the induction of protective immune responses against pathogens.

Glioblastoma is an aggressive type of cancer that can occur in the brain or spinal cord.

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/

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Salt iodination alone is not sufficient to provide adequate iodine status to pregnant women

Objectives:
What is the prevalence of insufficient iodine intake in pregnant women from different regions of the world?

Study design:
This review article included 61 observational articles with a total of 163,021 pregnant women adults and adolescents.

Results and conclusions:
The investigators found the overall prevalence of insufficient iodine intake was 53% [95% CI = 47 to 60, I2 = 99.8%].

The investigators found pregnant women who live in insufficient iodine status country had a higher prevalence [86%, 95% CI = 78 to 93, I2 = 97.0%] of inadequate iodine nutritional status than to those living in country considered sufficient [51%, 95% IC = 45 to 57, I2 = 99.8%].

The investigators concluded despite the progress in iodine fortification policies and periodic monitoring of the iodine nutritional status of the population worldwide, salt iodination alone may not be sufficient to provide adequate iodine status to pregnant women. Thus, other actions may be necessary to improve the nutritional clinical care of pregnant group.

Original title:
Prevalence of insufficient iodine intake in pregnancy worldwide: a systematic review and meta-analysis by Patriota ESO, Lima ICC, […], Pizato N.

Link:
https://pubmed.ncbi.nlm.nih.gov/34545212/

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Find more information/studies on RCTs/cohort/significantly/review article, iodine, pregnancy, food fortification and malnutrition right here.

The iodine levels in blood can be increased through eating iodine fortified foods, like salt and/or taking iodine supplements.

Higher sodium and lower potassium reduce in a dose-response manner cardiovascular risk

Afbeelding

Objectives:
The relation between sodium intake and cardiovascular disease remains controversial, owing in part to inaccurate assessment of sodium intake. Assessing 24-hour urinary excretion over a period of multiple days is considered to be an accurate method. Therefore, this review article has been conducted.

Do higher sodium and lower potassium dietary intakes, as measured in multiple 24-hour urine samples, reduce in a dose-response manner cardiovascular risk?

Study design:
This review article included 6 prospective cohort studies with a total of 10,709 healthy adults (54.2% women), of whom, 571 cardiovascular events were ascertained during a median study follow-up of 8.8 years (incidence rate: 5.9 per 1000 person-years).

The mean (±SD) age was 51.5±12.6 years.

Results and conclusions:
The investigators found that the median 24-hour urinary sodium excretion was 3,270 mg (10th to 90th percentile, 2099 to 4899).

The investigators found higher sodium excretion, lower potassium excretion and a higher sodium-to-potassium ratio were all significantly associated with a higher cardiovascular risk in analyses that were controlled for confounding factors [p ≤ 0.005 for all comparisons].

The investigators found in analyses that compared quartile 4 of the urinary biomarker (highest) with quartile 1 (lowest), the hazard ratios were 1.60 [95% CI = 1.19 to 2.14] for sodium excretion, 0.69 [95% CI = 0.51 to 0.91] for potassium excretion and 1.62 [95% CI = 1.25 to 2.10] for the sodium-to-potassium ratio.

The investigators found each daily increment of 1,000 mg in 24-hour urinary sodium excretion was significantly associated with an 18% increase in cardiovascular risk [hazard ratio = 1.18, 95% CI = 1.08 to 1.29].

The investigators found each daily increment of 1,000 mg in 24-hour urinary potassium excretion was significantly associated with an 18% decrease in cardiovascular risk [hazard ratio = 0.82, 95% CI = 0.72 to 0.94].

The investigators concluded higher sodium and lower potassium dietary intakes, as measured in multiple 24-hour urine samples, reduce in a dose-response manner cardiovascular risk. These findings may support reducing sodium intake and increasing potassium intake from current levels.

Original title:
24-Hour Urinary Sodium and Potassium Excretion and Cardiovascular Risk by Ma Y, He FJ, […], Hu FB.

Link:
https://pubmed.ncbi.nlm.nih.gov/34767706/

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A 24-hour urine sample is simply a collection of all urine passed over a 24-hour period of time. The test is used to check kidney function.
The normal range for 24-hour urine volume is 800 to 2,000 milliliters per day (with a normal fluid intake of about 2 liters per day).

Mushroom consumption reduces all-cause mortality

Objectives:
Whether mushroom consumption, which is a rich source of potent antioxidants ergothioneine and glutathione, vitamins and minerals (e.g., selenium & copper), is associated with a lower mortality risk is not well understood. Therefore, this review article (meta-analysis) has been conducted.

Does mushroom consumption reduce all-cause mortality?

Study design:
This review article included 5 prospective cohort studies with a total of 50,787 cases of deaths accrued in 601,893 men and women.

Results and conclusions:
The investigators found in a meta-analysis that mushroom consumption was significantly associated with an 6% decrease of the risk of all-cause mortality [pooled risk ratio = 0.94, 95% CI = 0.91 to 0.98].  

The investigators concluded that a meta-analysis of prospective cohort studies shows mushroom consumption reduces all-cause mortality. These findings can be used to support public health recommendations and increase awareness about the health-promoting effects of mushrooms. Large prospective cohort studies with repeated dietary data measurements are needed to replicate these findings and clarify the potential protective role of mushrooms against premature mortality.

Original title:
Prospective study of dietary mushroom intake and risk of mortality: results from continuous National Health and Nutrition Examination Survey (NHANES) 2003-2014 and a meta-analysis by Ba DM, Gao X, [...], Richie Jr JP.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8454070/

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Lactoferrin supplementation reduces respiratory illness

Afbeelding

Objectives:
Lactoferrin (Lf) is one of the key immunomodulatory substances found naturally in various body fluids, such as saliva, tears  and breast milk and forms a vital part of the innate defense against invading pathogens. Various studies have demonstrated antibacterial, antifungal and antiviral properties of Lf and its protective role against respiratory tract infections (RTIs). Therefore, this review article has been conducted.

Does lactoferrin supplementation reduce risk of respiratory illness?

Study design:
This review article included 9 RCTs with a total of 1,194 participants.

Results and conclusions:
The investigators found meta-analysis revealed a significantly reduced risk of 43% for developing respiratory infections with the use of lactoferrin relative to the control [pooled odds ratio = 0.57, 95% CI = 0.44 to 0.74], with sufficient evidence against the hypothesis of 'no significant difference' at the current sample size.

The investigators concluded that the administration of lactoferrin (Lf) shows promising efficacy in reducing the risk of respiratory tract infections (RTIs). Current evidence also favours Lf fortification of infant formula. Lf may also have a beneficial role in managing symptoms and recovery of patients suffering from RTIs and may have potential for use as an adjunct in COVID-19, however this warrants further evidence from a large well-designed RCT.

Original title:
Lactoferrin reduces the risk of respiratory tract infections: A meta-analysis of randomized controlled trials by Ali AS, Hasan SS, […], Merchant HA.

Link:
https://pubmed.ncbi.nlm.nih.gov/34620326/

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Lactoferrin is a natural iron-binding glycoprotein found in cow milk and human milk. Colostrum, the first milk produced after a baby is born, contains about seven times more lactoferrin than is found in milk produced later on. Lactoferrin's main functions in the body include binding with and transporting iron.