Nutrition and health

High maternal thyroid hormones during pregnancy increase neonatal birth weight

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Objectives:
Are growth parameters at birth associated with maternal urinary iodine concentration (UIC) or normal ranges of thyroid hormones during pregnancy?

Study design:
This review article included 11 studies.

The pooled mean birth weight, length and head circumference values and 95% confidence intervals were estimated in newborns born to women with UIC  150 μg/L and UIC ≥150 μg/L during pregnancy.

Results and conclusions:
The investigators found pooled mean birth weight, length and head circumference in newborns whose mothers had UIC  150 μg/L vs UIC ≥150 μg/L were 2,898g vs 2,900g [p = 0.970], 49.6 cm vs 49.4 cm [p = 0.880] and 34.0 cm vs 34.1 cm [p = 0.933], respectively.

The investigators found dose-response meta-analyses revealed no significant linear or nonlinear associations between maternal urinary iodine concentration during pregnancy and anthropometric measures at birth.

The investigators found high vs normal values of maternal free thyroxine and thyrotropin during pregnancy were inversely associated with neonatal birth weight.

The investigators concluded that birth weight is affected by even mild variations in the normal concentrations of maternal thyroid hormones. However, in the current meta-analysis, birth anthropometric measures are not associated with maternal urinary iodine concentration during pregnancy.

Original title:
Do maternal urinary iodine concentration or thyroid hormones within the normal range during pregnancy affect growth parameters at birth? A systematic review and meta-analysis by Nazeri P, Shab-Bidar S, […], Shariat M.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31923312

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

Lead increases ALS

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Objectives:
Lead is a known risk factor for amyotrophic lateral sclerosis (ALS). However, the results of studies exploring the relationship between lead exposure and the occurrence of ALS are inconsistent. Therefore, this review article has been conducted.

Does a high lead exposure increase risk of ALS?

Study design:
This review article included 11 case-control studies.

Results and conclusions:
The investigators found a high lead exposure significantly increased risk of ALS with 28% [OR = 1.28, 95% CI = 1.02 to 1.63].
Subgroup and sensitivity analyses showed stable results.

The investigators concluded a high lead exposure increases risk of ALS.

Original title:
Population-based study of environmental/occupational lead exposure and amyotrophic lateral sclerosis: a systematic review and meta-analysis by Meng E, Mao Y, […], Jin W.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31578652

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Low-carbohydrate diet reduces cardiovascular disease

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Objectives:
Low-carbohydrate diets are associated with cardiovascular risk factors; however, the results of different studies are inconsistent. Therefore, this review article has been conducted.

Do low-carbohydrate diets (diets with less than 40 En% carbohydrates) reduce cardiovascular risk factors?

Study design:
This review article included 12 RCTs with a total of 820 in the observation group (intervention group or low carbohydrate group) and 820 in the control group. The largest sample size was 403 cases and the smallest was 42 cases. The patients’ ages ranged from 31 to 65 years old.
The intervention was a diet with less than 40 En% carbohydrates in the observation group and a diet with 45 En% to 55 En% carbohydrates in the control group.

Results and conclusions:
The investigators found compared with the control group, the triglyceride levels of the low-carbohydrate group (less than 40 En% carbohydrates) significantly decreased by 0.15 mmol/L [95% CI = -0.23 to -0.07, I2 = 75%, p = 0.001].
The results remained unchanged in the sensitivity analysis (after subtracting each of the included studies individually).

The results of the publication bias analysis showed that the funnel plot was not symmetric. The asymmetry of the funnel plot may have been caused by publication bias and other issues.

The investigators found in subgroup analyses, low-carbohydrate diet interventions lasting less than 6 months significantly decreased the triglyceride levels by 0.23 mmol/L [95% CI = -0.32 to -0.15] and those of 12-23 months decreased the levels by 0.17 mmol/L [95% CI = -0.32 to -0.01].

The investigators found compared with the control group, the plasma HDL-cholesterol level (good cholesterol) of the low-carbohydrate group significantly increased by 0.1 mmol/L [95% CI = 0.08 to 0.12, I2 = 41%, p = 0.02].
The results remained unchanged in the sensitivity analysis (after subtracting each of the included studies individually).

The investigators found in subgroup analyses, the increase in plasma HDL-cholesterol levels was 0.08 mmol/L [95% CI = 0.27 to 0.57] for interventions lasting less than 6 months, 0.12 mmol/L [95% CI = 0.09 to 0.15] for those lasting 6-11 months, 0.12 mmol/L [95% CI = 0.08 to 0.15] for those lasting 12-23 months and 0.08 mmol/L [95% CI = 0.04 to 0.12] for those lasting 24 months. 

The investigators found compared with the control group, the serum total cholesterol level of the low-carbohydrate group significantly increased by 0.13 mmol/L [95% CI = 0.08 to 0.19].
The results remained unchanged in the sensitivity analysis (after subtracting each of the included studies individually).

The investigators found compared with the control group, the plasma LDL-cholesterol level (bad cholesterol) of the low-carbohydrate group significantly increased by 0.11 mmol/L [95% CI = 0.02 to 0.19, I2 = 71%, p = 0.0001].
The results remained unchanged in the sensitivity analysis (after subtracting each of the included studies individually).

The investigators found compared with the control group, the body weight of the low-carbohydrate group significantly decreased by 1.58 kg [95% CI = -1.58 to -0.75, I2 = 49%, p = 0.01].
The results remained unchanged in the sensitivity analysis (after subtracting each of the included studies individually).

The investigators found in subgroup analyses, the decrease in body weight was 1.14 kg [95% CI = -1.65 to -0.63] for interventions lasting less than 6 months and 1.73 kg [95% CI = -2.7 to -0.76] for those lasting 6-11 months.

The investigators found compared with the control group, the overall systolic blood pressure of the low-carbohydrate group significantly decreased by 1.41 mmHg [95% CI = -2.26 to -0.56, I2 = 0%, p = 0.84].
The results remained unchanged in the sensitivity analysis (after subtracting each of the included studies individually).

The investigators found in subgroup analyses, the overall systolic blood pressure significantly decreased by 2.97 mmHg [95% CI = -4.62 to -1.31] in the group that received interventions lasting less than 6 months.

The investigators found compared with the control group, the diastolic blood pressure of the low-carbohydrate group significantly decreased by 1.71 mmHg [95% CI = -2.36 to -1.06, I2 = 14%, p = 0.29].
The results remained unchanged in the sensitivity analysis (after subtracting each of the included studies individually).

The investigators found in subgroup analyses, the diastolic blood pressure significantly decreased by 2.76 mmHg [95% CI = -4.07 to -1.46] in the group that received interventions lasting less than 6 months and 2.11 mmHg [95% CI = -3.28 to -0.93] for those lasting 6-11 months.

The investigators concluded low-carbohydrate diets (diets less than 40 En% carbohydrates) have beneficial effects on cardiovascular risk factors at less than 6 months and 6-11 months, but after 2 years of a low-carbohydrate diet, there is no significant effect on cardiovascular risk factors.

Original title:
The effects of low-carbohydrate diets on cardiovascular risk factors: A meta-analysis by Dong T, Guo M, [...], Chen B.

Link:
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0225348

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Find more information/studies on carbohydrate consumption and cardiovascular diseases right here.

40 En% carbohydrates means that the total amounts of carbohydrate make up for a 40% of the total kcal of the diet. The easiest way to follow this diet is to choose only meals/products that also contain 40 En% carbohydrates. These products in the supermarket contain 40 En% carbohydrates.

 

Soy protein dietary intake reduces type 2 diabetes

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Objectives:
Previous findings on the associations of legume and soy intake with the risk of type 2 diabetes are conflicting. Therefore, this review article (meta-analysis) has been conducted.

Does legume or soy dietary intake reduce risk of type 2 diabetes?

Study design:
This review article included 15 unique cohort studies with a total of 565,810 individuals and 32,093 incident cases (persons with type 2 diabetes).

Overall quality of evidence was rated as moderate for total legumes and low for total soy and soy subtypes.

Results and conclusions:
The investigators found no association between total legumes dietary intake and risk of type 2 diabetes [summary RR = 0.95, 95% CI = 0.79 to 1.14, I2 = 84.8%].
No association because RR of 1 was found in the 95% CI of 0.79 to 1.14. RR of 1 means no risk/association.

The investigators found no association between total soy dietary intake and risk of type 2 diabetes [summary RR = 0.83, 95% CI = 0.68 to 1.01, I2 = 90.8%].

The investigators found no association between soy milk dietary intake and risk of type 2 diabetes [summary RR = 0.89, 95% CI = 0.71 to 1.11, I2 = 91.7%].

The investigators found tofu dietary intake significantly reduced risk of type 2 diabetes with 8% [summary RR = 0.92, 95% CI = 0.84 to 0.99].
Significantly because RR of 1 was not found in the 95% CI of 0.84 to 0.99. RR of 1 means no risk/association.

The investigators found soy protein dietary intake significantly reduced risk of type 2 diabetes with 16% [summary RR = 0.84, 95% CI = 0.75 to 0.95].

The investigators found soy isoflavones dietary intake significantly reduced risk of type 2 diabetes with 12% [summary RR = 0.88, 95% CI = 0.81 to 0.96].

The investigators found in dose-response analysis, significant linear inverse associations for tofu, soy protein and soy isoflavones [all p 0.05].

The investigators concluded dietary intakes of tofu, soy protein and soy isoflavones reduce incident type 2 diabetes. These findings support recommendations to increase intakes of certain soy products for the prevention of type 2 diabetes. However, the overall quality of evidence was low and more high-quality evidence from prospective studies is needed.

Original title:
Legume and soy intake and risk of type 2 diabetes: a systematic review and meta-analysis of prospective cohort studies by Tang J, Wan Y, […], Feng F.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31915830

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

Middle-aged people with diabetes are at higher risk of developing dementia

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Objectives:
Which factors increase risk of dementia?

Study design:
This review article included 34 prospective cohort studies, among which 24 were eligible for meta-analysis. A total of 159,594 non-demented adults were enrolled at baseline before 65 years and 13,540 people were diagnosed with dementia after follow-up.

Results and conclusions:
The investigators found obesity significantly increased risk of dementia with 78% [RR = 1.78, 95% CI = 1.31-2.41].

The investigators found diabetes mellitus significantly increased risk of dementia with 69% [RR = 1.69, 95% CI = 1.38-2.07].

The investigators found current smoking significantly increased risk of dementia with 61% [RR = 1.61, 95% CI = 1.32-1.95].

The investigators found hypercholesterolemia significantly increased risk of dementia with 57% [RR = 1.57, 95% CI = 1.19-2.07].
However, the sensitivity analyses showed that the result of hypercholesterolemia was not reliable, which need to be confirmed by more high-quality studies.

The investigators found hypertension significantly increased risk of dementia with 41% [RR = 1.41, 95% CI = 1.23-1.62] for borderline blood pressure.

The investigators found hypertension significantly increased risk of dementia with 72% [RR = 1.72, 95% CI = 1.25-2.37] for high systolic blood pressure.
However, the sensitivity analyses showed that the result of high systolic blood pressure was not reliable, which need to be confirmed by more high-quality studies.

The investigators found hyperhomocysteinemia, psychological stress and heavy drinking were also associated with elevated dementia risk.

The investigators found, in addition, physical exercise, a healthy diet and hormone therapy in middle age were associated with the reduction of dementia risk.

The investigators concluded middle-aged people with obesity or diabetes and current smokers in midlife are at higher risk of developing dementia later in life.

Original title:
Midlife Modifiable Risk Factors for Dementia: A Systematic Review and Meta-analysis of 34 Prospective Cohort Studies by Li XY, Zhang M, [...], Tan L.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31902364

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Find more information/studies on obesity, diabetes, hypertension and dementia right here.
 

Meat is not a risk factor for asthma in children

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Objectives:
Many studies have been reported that dietary meat intake may be associated with the risk of asthma in children, but the results are inconsistent. Therefore, this review article has been conducted.

Does dietary meat intake increase asthma in children?

Study design:
This review article included a total of 9 articles.

No publication bias was detected.

Results and conclusions:
The investigators found dietary meat intake 3 or more times per week compared with never/occasionally intake had no significant association with asthma risk among children [OR = 1.27, 95% CI  =  0.80-2.01, p =  0.308].
Not significant because OR of 1 was found in the 95% CI of 0.80 to 2.01. OR of 1 means no risk/association.

The investigators found, similarly, daily dietary intake of meat did not affect the risk of asthma in children when compared with never/occasionally intake [OR  =  1.13, 95% CI  =  0.93-1.37, p  =  0.234].

The investigators concluded dietary meat intake is not a risk factor for asthma in children. Due to some limitations that exist in this review article, more studies are needed to further assess the association between dietary meat intake and asthma risk in children.

Original title:
Dietary meat intake and risk of asthma in children: evidence from a meta-analysis by Zhang D, Cao L, [...], Wang Z.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31895767

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Garlic could reduce risk of colorectal cancer

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Objectives:
Does dietary intake of garlic reduce risk of colorectal cancer?

Study design:
This review article included 11 studies involving 12,558 cases (persons with colorectal cancer).

There was no notable evidence of publication bias.

Results and conclusions:
The investigators found for the highest versus the lowest garlic consumption categories, a significantly reduced risk of 20% [integrated relative risk = 0.80, 95% CI = 0.69 to 0.91] for colorectal cancer.
The sensitivity analysis revealed no notable alterations of the integrated results.
Significant means that there is an association with a 95% confidence.

The investigators found in case-control studies for the highest versus the lowest garlic consumption categories, a significantly reduced risk of 29% [relative risk = 0.71, 95% CI = 0.60 to 0.84] for colorectal cancer.
Significant because relative risk of 1 was not found in the 95% CI of 0.60 to 0.84. Relative risk of 1 means no risk/association.

The investigators found in cohort studies for the highest versus the lowest garlic consumption categories, a non-significantly reduced risk of 1% [relative risk = 0.99, 95% CI = 0.80 to 1.23] for colorectal cancer.
Non-significantly because relative risk of 1 was found in the 95% CI of 0.80 to 1.23. Relative risk of 1 means no risk/association.

The investigators concluded that dietary intake of garlic could reduce risk of colorectal cancer. Could reduce because the risk was not significant in cohort studies.

Original title:
Garlic intake and the risk of colorectal cancer: A meta-analysis by Zhou X, Qian H, […], Zeng L.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31895803

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Find more information/studies on significantly/cohort studies, garlic consumption and colorectal cancer right here.

 

Alzheimer's disease patients have higher levels of copper

Objectives:
There is an ongoing debate on the involvement of systemic copper (Cu) dysfunctions in Alzheimer's disease (AD) and clinical studies comparing Cu levels in serum, plasma and cerebrospinal fluid (CSF) of AD patients with those of healthy controls have delivered non-univocal and often conflicting results. Therefore, this review article has been conducted.

Does blood level of copper increase in Alzheimer’s disease?

Study design:
This review article included 26 studies including a pooled total of 761 AD subjects and 664 controls for serum Cu studies, 205 AD subjects and 167 controls for plasma Cu and of 116 AD subjects and 129 controls for CSF Cu.

Results and conclusions:
The investigators found Alzheimer's disease patients have higher levels of serum copper than healthy controls. Plasma data did not allow conclusions, due to their high heterogeneity, but the meta-analysis of the combined serum and plasma studies confirmed higher copper levels in Alzheimer's disease patients. 

The investigators found the analysis of CSF data revealed no difference between Alzheimer's disease patients and controls.

The investigators concluded Alzheimer's disease patients have higher levels of serum and plasma copper than healthy controls.

Original title:
Copper in Alzheimer's disease: a meta-analysis of serum, plasma, and cerebrospinal fluid studies by Bucossi S, Ventriglia M, […], Squitti R.

Link:
http://www.ncbi.nlm.nih.gov/pubmed/21187586

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Find more information/studies on copper and dementia right here.

Daily dietary intake of 1.6g potassium decreases risk of stroke

Objectives:
The aim of this review article was to assess the relation between the level of habitual potassium intake and the incidence of cardiovascular disease (CVD).

Study design:
This review article included 15 cohort studies involving a total of 247510 male and female participants, 7,066 strokes, 3,058 coronary heart disease (CHD) events and 2,497 total CVD events.
The weighted average follow-up time was 12.2 years (range 5 to 19 years).
There was significant heterogeneity among studies in terms of sample size, duration of observation, number of events and difference in dietary potassium intake between the groups being compared. This heterogeneity led to a reduced statistical power in detecting a possible association between dietary potassium and coronary heart disease and cardiovascular disease.

There was no evidence of publication bias by the Egger test.

Potassium intake was assessed by 24-h dietary recall (n = 2), food frequency questionnaire (n = 6) or 24-h urinary excretion (n = 3).

Results and conclusions:
The investigators found in a pooled analysis, a dietary intake of 1.64g (42 mmol) potassium per day was significantly associated with a 21% lower risk of stroke [RR = 0.79, 95% CI = 0.68 to 0.90, p = 0.0007]. Significant means it can be said with a 95% confidence that a daily intake of 1.64g potassium really decreased the risk of having a stroke.

The investigators found a trend toward an inverse association between higher potassium intake (average weighted difference = 1.38g or 35.3 mmol/day) and risk of coronary heart disease [RR = 0.92, 95% CI = 0.81 to 1.04], which was not statistically significant [p = 0.18].
Not significant means it cannot be said with a 95% confidence that a daily intake of 1.38g potassium really decreased the risk of coronary heart disease with 8%. 

The investigators found a trend toward an inverse relationship between higher potassium intake (average weighted difference = 1.30g or 33.4 mmol/day) and cardiovascular disease risk [RR = 0.85, 95% CI = 0.62 to 1.16], which was not statistically significant [p = 0.31].

The investigators found a trend toward lower risk of CHD [RR = 0.93, 95% CI = 0.87 to 0.99, p = 0.03] and total CVD [RR = 0.74, 95% CI = 0.60 to 0.91, p = 0.0037] that attained statistical significance after the exclusion of a single cohort, based on sensitivity analysis.

The results of meta-regression analyses indicated that potassium intake difference, length of follow-up, quality score, recruitment year and population potassium intake at baseline were not significant sources of heterogeneity in the relationship of the potassium intake effect on the risk of CHD.

The results of meta-regression analyses indicated that the length of follow-up (coefficient: -0.064, 95% CI = -0.112 to -0.015, p = 0.01) and quality score (coefficient: -0.165, 95% CI = -0.287 to -0.043, p = 0.01) were significant sources of heterogeneity.

The investigators concluded that 1.64g dietary potassium per day decreases the risk of having a stroke and might also reduce the risk of coronary heart disease and total cardiovascular disease. This result applies to the general population, not only to specific subgroups at higher risk.
The favorable effects of dietary potassium were documented at least to some extent independently of other factors.
The results of this meta-analysis support recommendations for higher consumption of potassium-rich foods to prevent vascular diseases.

Original title:
Potassium Intake, Stroke, and Cardiovascular Disease : A Meta-Analysis of Prospective Studies by D'Elia L, Barba G, [...], Strazzullo P.

Link:
http://www.sciencedirect.com/science/article/pii/S0735109710049764

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The protective effect of potassium against the risk of stroke may conceivably relate to its blood pressure lowering effect.


 

Olive oil consumption probably reduces breast cancer and cancer of the digestive system

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Objectives:
There is no published systematic review and meta-analysis regarding the effect of olive oil consumption on cancer occurrence. Therefore, this review article has been conducted.

Does olive oil consumption reduce cancer risk?

Study design:
This review article included 19 case-control studies (13800 cancer patients and 23340 controls).

Random effects meta-analysis was applied in order to evaluate the research hypothesis.
Heterogeneity of the effect-size measures was observed in studies performed in the Mediterranean region (n = 15, p = 0.0002), whereas no heterogeneity was observed in non-Mediterranean studies (n = 4, p = 0.12).

Results and conclusions:
The investigators found when comparing with the lowest, the highest category of olive oil consumption was significantly associated with lower odds of having any type of cancer [log odds ratio = -0.41, 95% CI = -0.53 to -0.29, Cohran's Q = 47.52, p = 0.0002, I2 = 62%].

The investigators found both Mediterranean and non-Mediterranean people reported olive oil intake were less likely to have developed any type of cancer.

The investigators found olive oil consumption was significantly associated with lower odds of developing breast cancer [logOR = -0.4,  95% CI = -0.78 to -0.12] and a cancer of the digestive system [logOR = -0.36, 95% CI = -0.50 to -0.21] compared with the lowest intake.

The investigators concluded olive oil consumption probably reduces risk of any type of cancer, especially breast cancer and cancer of the digestive system. Probably, because this review article only included case-control studies and there was heterogeneity.
The reduced risk is similar to studies performed in Mediterranean as well as non-Mediterranean countries. However, it is still unclear whether olive oil's monounsaturated fatty acid content or its antioxidant components are responsible for its beneficial effects.

Original title:
Olive oil intake is inversely related to cancer prevalence: a systematic review and a meta-analysis of 13800 patients and 23340 controls in 19 observational studies by Psaltopoulou T, Kosti RI, […], Panagiotakos DB.

Link:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3199852/

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