Nutritional advice

Objectives:
Systematic reviews of case-control studies evaluating the relationship between dietary salt intake and gastric cancer showed a positive association, however a quantitative analysis of longitudinal cohort studies is lacking. Therefore, this review article has been conducted.

Does a high salt intake increase gastric cancer risk?

Study design:
This review article contained 10 cohort studies with 268,718 participants, of which 1,474 gastric cancer events and a follow-up of 6-15 years.

Meta-regression analyses did not detect specific sources of heterogeneity.

There was no evidence of publication bias.

Results and conclusions:
The investigators found for high vs low salt intake a significantly increased risk of 68% for gastric cancer [RR = 1.68, 95% CI = 1.17 to 2.41, p = 0.005].

The investigators found for moderate vs low salt intake a significant increased risk of 41% for gastric cancer [RR = 1.41, 95% CI = 1.03 to 1.93, p = 0.032].

The investigators found the association was stronger in the Japanese population and higher consumption of selected salt-rich foods was also associated with greater risk.

The investigators concluded high salt intake is directly associated with an increased risk of gastric cancer in prospective population studies, with progressively increasing risk across consumption levels.

Original title:
Habitual salt intake and risk of gastric cancer: A meta-analysis of prospective studies by D’Elia L, Rossi G, […], Strazzullo P.

Link:
http://www.clinicalnutritionjournal.com/article/S0261-5614%2812%2900005-2/abstract

Additional information of El Mondo:
Find here more studies/information on sodium/salt and  cancer right here.

According to WHO, a high salt intake is a salt intake of more than 5 grams salt per day.

A diet with more than 5 grams salt per day is a diet with mainly products/meals with more than 0.25 grams salt per 100 kcal. Check here which products contain maximum 5 grams salt per 100 kcal.
Use the 7-points nutritional profile app to see whether your daily diet contains maximum 5 grams salt per 100 kcal.
 

Objectives:
What is the effect of aerobic exercise performed in the fasted versus fed states on fat and carbohydrate metabolism in adults?

Study design:
This review article included 27 studies with a total of 273 participants.

Results and conclusions:
The investigators found a significant increase in fat oxidation during aerobic exercise (duration ≤120 min) performed in the fasted state compared with fed state [WMD = -3.08 g, 95% CI = -5.38 to -0.79, I2 = 39.1%].

The investigators found the weighted mean difference of onesterified fatty acids (NEFA) concentrations was not significantly different between states [WMD = 0.00 mmol/L, 95 % CI = -0.07 to 0.08, I2 = 72.7 %].

The investigators found, however, the weighted mean differences of glucose [WMD = 0.78 mmol/L, 95% CI = 0.43 to 1.14, I2 = 90.8%] and insulin concentrations [WMD = 104.5 pmol/L, 95% CI = 70.8 to 138.2, I2 = 94.5%] were significantly higher for aerobic exercise (duration ≤120 min) performed in the fed state.

The investigators concluded that aerobic exercise (duration ≤120 min) performed in the fasted state induces higher fat oxidation than aerobic exercise performed in the fed state.

Original title:
Effects of aerobic exercise performed in fasted v. fed state on fat and carbohydrate metabolism in adults: a systematic review and meta-analysis by Vieira AF, Costa RR, […], Kruel LF.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/27609363

Additional information of El Mondo:
Find more studies/information on physical activity and energy right here.

Aerobic exercise is any exercise that raises the heart rate and increases respiration (breathing). Examples of aerobic exercise are:

• Cross-country skiing
• Cycling
• Dancing
• Fast walking
• Hiking
• Jogging or running
• Swimming
   

Objectives:
Is there a relationship between serum 25(OH)D (vitamin D blood level) and mortality risk in the general population?

Study design:
This review article included 14 prospective cohort studies that involved 5562 deaths out of 62548 individuals.
In the parametric model, which is based on 11 studies and 59231 individuals, the lowest quantile as the reference category has been used.

Evidence of heterogeneity for the RR was apparent when highest were compared with lowest categories [p = 0.008, I2 = 58%].

There was no evidence of publication bias.

Results and conclusions:
The investigators found for “highest compared with lowest” categories of 25(OH)D, a significant reduced risk of 29% for mortality [RR = 0.71, 95% CI = 0.50-0.91].

The investigators found in the parametric model, the estimated summary RRs of mortality were 0.86 [95% CI = 0.82-0.91], 0.77 [95% CI = 0.70-0.84] and 0.69 [95% CI = 0.60-0.78] for individuals with an increase of 12.5, 25 and 50 nmol 25(OH)D serum values/L, respectively, from a median reference category of ∼27.5 nmol/L.
However, no significant decrease in mortality was found above ∼87.5 nmol/L.

The investigators concluded there is a nonlinear decrease in mortality risk as circulating 25(OH)D increases, with optimal concentrations ∼75-87.5 nmol/L. Because many adults do not achieve these 25(OH)D values, large prospective randomized trials are urgently needed to investigate whether vitamin D supplementation is able to reduce mortality risk in the general population.

Original title:
Vitamin D deficiency and mortality risk in the general population: a meta-analysis of prospective cohort studies by Zittermann A, Iodice S, [...], Gandini S.

Link:
http://ajcn.nutrition.org/content/95/1/91.full

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

Objectives:
Low glycaemic index (GI) diets are beneficial in the management of hyperglycemia. Cardiovascular diseases are the major cause of mortality in diabetes therefore it is important to understand the effects of GI on blood lipids. Therefore, this review article has been conducted.

Does a low GI diet lower the cholesterol levels?

Study design:
This review article included 28 RCTs comparing low with high GI diets over at least 4 weeks. These 28 RCTs contained 1272 participants with studies ranged from 6 to 155 participants, one was powered on blood lipids and 3 had adequate allocation concealment.

Results and conclusions:
The investigators found that compared to high GI diet low GI diet significantly reduced total cholesterol by 0.13 mmol/L [95% CI = -0.22 to -0.04, p = 0.004, 27 trials, 1441 participants]. Significantly means, it can be said with 95% confidence that low GI diet really lowered the total cholesterol levels with 0.13 mmol/L.

The investigators found that compared to high GI diet low GI diet significantly reduced LDL-cholesterol by 0.16 mmol/L [95% CI = -0.24 to -0.08, p 0.0001, 23 studies, 1281 participants]. Significantly, because the p-value was less than 0.05.

The investigators found subgroup analyses suggested that reductions in LDL-cholesterol were greatest in studies of shortest duration and greatest magnitude of GI reduction. Furthermore, lipid improvements appeared greatest and most reliable when the low GI intervention was accompanied by an increase in dietary fiber.

The investigators found sensitivity analyses, removing studies without adequate allocation concealment, lost statistical significance but retained suggested mean falls of 0.10 mmol/L in both.

The investigators found no effects on HDL-cholesterol [MD = -0.03 mmol/L, 95% CI = -0.06 to 0.00, I2 = 0%], or triglycerides [MD was 0.01 mmol/L, 95% CI = -0.06 to 0.08, I2 = 0%].

The researchers concluded that low GI diets reduce total and LDL-cholesterol (bad cholesterol) but had no effect on HDL-cholesterol (good cholesterol) or triglycerides.

Original title:
Low glycemic index diets and blood lipids: A systematic review and meta-analysis of randomized controlled trials by Goff LM, Cowland DE, [...], Frost GS.

Link:
http://www.sciencedirect.com/science/article/pii/S0939475312001524

Additional information of El Mondo:
Find more information/studies on cholesterol and cardiovascular disease right here.

High LDL-cholesterol levels and high triglyceride levels increase the risk of getting cardiovascular diseases whereas high HDL-cholesterol levels decrease the risk of getting cardiovascular diseases.

A low GI diet is a diet with a GI value of 55 or lower.

Objectives:
Does soy isoflavone reduce the frequency and severity of hot flashes?

Study design:
This review article included 19 trials (13 included hot flash frequency, of which 10 for severity and 3 for composite scores).
17 trials were selected for meta-analyses to clarify the effect of soybean isoflavones on hot flash frequency (13 trials) and severity (9 trials).

Results and conclusions:
The investigators found intake of soy isoflavones (median = 54 mg aglycone equivalents) for 6 weeks to 12 months significantly reduced the frequency (combined fixed-effect and random effects model) of hot flashes by 20.6% [95% CI = -28.38 to -12.86, p 0.00001] compared with placebo [p heterogeneity = 0.0003, I2 = 67% for random effects model].

The investigators also found isoflavones significantly reduced hot flash severity by 26.2% [95% CI = -42.23 to -10.15, p = 0.001] compared with placebo [p heterogeneity 0.00001, I2 = 86% for random effects model].

The investigators found isoflavone supplements providing more than 18.8 mg of genistein (the median for all studies) were more than twice as potent at reducing hot flash frequency than lower genistein supplements.

The investigators concluded soy isoflavone supplements (54 mg per day for 6 weeks to 12 months), derived by extraction or chemical synthesis, are significantly more effective than placebo in reducing the frequency and severity of hot flashes. Additional studies are needed to further address the complex array of factors that may affect efficacy, such as dose, isoflavone form, baseline hot flash frequency and treatment duration.

Original title:
Extracted or synthesized soybean isoflavones reduce menopausal hot flash frequency and severity: systematic review and meta-analysis of randomized controlled trials by Taku K, Melby MK, […], Messina M.

Link:
http://journals.lww.com/menopausejournal/Abstract/2012/07000/Extracted_or_synthesized_soybean_isoflavones.11.aspx

Additional information of El Mondo:
Find more studies/information on elderly and isoflavones right here.
 

Objectives:
In view of the vital role of oxidative stress in the pathogenesis of Alzheimer's disease (AD), the potential of antioxidant supplements to prevent AD have gained much interest, while there are conflicting results on this topic in recent years. Therefore, this review article has been conducted.

Does dietary intake of vitamin C and E and β-carotene decrease risk of Alzheimer's disease?

Study design:
This review article included 7 articles (dietary intake, but no supplements).

Results and conclusions:
The investigators found a significant decreased risk for Alzheimer disease of 24% [pooled relative risk = 0.76 95% CI = 0.67-0.84] for dietary intake of vitamin E and of 17% [pooled relative risk = 0.83, 95% CI = 0.72-0.94] for dietary intake of vitamin C.

However, the investigators found a non-significant decreased risk of 12% [pooled relative risk = 0.88, 95% CI = 0.73-1.03] for dietary intake of β-carotene.

The investigators concluded dietary intakes of vitamin C and E lower the risk of Alzheimer's disease, with vitamin E exhibiting the most pronounced protective effects. The findings will be of significance to the prevention and interventional treatment of Alzheimer's disease.

Original title:
Dietary intakes of vitamin E, vitamin C, and β-carotene and risk of Alzheimer's disease: a meta-analysis by Li FJ, Shen L and Ji HF.

Link:
http://www.ncbi.nlm.nih.gov/pubmed/22543848

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

Objectives:
Does diabetes increase risk of incident dementia and mild cognitive impairment?

Study design:
This review article included 19 prospective longitudinal studies including 6184 subjects with diabetes and 38530 subjects without diabetes. All subjects were without dementia or mild cognitive impairment at baseline (=at the beginning of the study).

There was no publication bias.

Results and conclusions:
The investigators found persons with diabetes had a significant increased risk of 46% for Alzheimer's disease [RR = 1.46, 95% CI = 1.20-1.77]. Significant means that there is an association with a 95% confidence.

The investigators found persons with diabetes had a significant increased risk of 148% for vascular dementia [RR = 2.48, 95% CI = 2.08-2.96].

The investigators found persons with diabetes had a significant increased risk of 51% for any dementia [RR = 1.51, 95% CI = 1.31-1.74]. Significant because RR of 1 was not found in the 95% CI of 1.31 to 1.74. RR of 1 means no risk/association.

The investigators found persons with diabetes had a significant increased risk of 21% for mild cognitive impairment [RR = 1.21, 95% CI = 1.02-1.45].

The investigators concluded diabetes is a risk factor for incident dementia (including Alzheimer's disease, vascular dementia and any dementia) and mild cognitive impairment.

Original title:
Diabetes as a risk factor for dementia and mild cognitive impairment: a meta-analysis of longitudinal studies by Cheng G, Huang G, [...], Wang H.

Link:
http://onlinelibrary.wiley.com/doi/10.1111/j.1445-5994.2012.02758.x/epdf

Additional information of El Mondo:
Find more studies/information on elderly and diabetes right here.

Objectives:
The association between elevated serum phosphorus concentration and cardiovascular or all-cause mortality yielded conflicting results. Therefore, this review article (meta-analysis) has been conducted.

Does an elevated serum phosphorus concentration increase cardiovascular and all-cause mortality in the general population?

Study design:
This review article included 6 prospective cohort studies involving 120,269 subjects.

Results and conclusions:
The investigators found when compared the highest with the reference concentration of serum phosphorus, a significant increased risk of 36% for cardiovascular mortality [pooled RR = 1.36, 95% CI = 1.07-1.72]. Significant because RR of 1 was not found in the 95% CI of 1.07 to 1.72. RR of 1 means no risk/association.

The investigators found when compared the highest with the reference concentration of serum phosphorus, a significant increased risk of 33% for all-cause mortality [pooled RR = 1.33, 95% CI = 1.15-1.58]. Significant means that there is an association with a 95% confidence.

The investigators found stratified analyses revealed that elevated serum phosphorus significantly increased all-cause mortality risk with 33% among men [RR 1.33, 95% CI = 1.11-1.60], but not in women [RR = 1.09, 95% CI = 0.89-1.33].

The investigators concluded elevated serum phosphorus concentration is independently associated with excessive risk of cardiovascular and all-cause mortality in the general population without chronic kidney disease. Serum phosphorus on all-cause mortality risk appears to be pronounced in men but exhibits no clear effect on women. However, gender difference of elevated serum phosphorus on mortality risk should be verified by more prospective cohort studies.

Original title:
Serum phosphorus, cardiovascular and all-cause mortality in the general population: A meta-analysis by Bai W, Li J and Liu J.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/27475981

Additional information of El Mondo:
Find more studies/information on elderly and phosphorus right here.

Objectives:
Reported associations between protein intake from different sources and type 2 diabetes (T2D) have been inconsistent.Therefore, this review article has been conducted.

Study design:
This review article included 11 prospective cohort studies with 505,624 participants and 37,918 type 2 diabetes cases (follow-up range: 5-24 years).

Results and conclusions:
The investigators found for the comparison of the highest with lowest categories of total protein intakes a significant higher risk of 9% for type 2 diabetes [RR = 1.09, 95% CI = 1.06 to 1.13]. Significant means that there is an association with a 95% confidence.

The investigators found for the comparison of the highest with lowest categories of animal protein intakes a significant higher risk of 19% for type 2 diabetes [RR = 1.19, 95% CI = 1.11 to 1.28].

The investigators found for the comparison of the highest with lowest categories of plant protein intakes a non-significant reduced risk of 5% for type 2 diabetes [RR = 0.95, 95% CI = 0.89 to 1.02]. Non-significant means it cannot be said with a 95% confidence that a daily higher intake of plant protein really reduced risk of type 2 diabetes with 5%.

The investigators found for the comparison of the highest with lowest categories of plant protein intakes a significant reduced risk of 7% for type 2 diabetes among women [RR = 0.93, 95% CI = 0.85 to 1.00].

The investigators found for the comparison of the highest with lowest categories of plant protein intakes a significant reduced risk of 9% for type 2 diabetes among US populations [RR = 0.91, 95% CI = 0.84 to 0.97].

The investigators concluded that a higher intake of total and animal protein are both associated with an increased risk of of type 2 diabetes. However, a higher intake of plant protein decreases risk of type 2 diabetes among women and US populations.

Original title:
Dietary protein intake and risk of type 2 diabetes: results from the Melbourne Collaborative Cohort Study and a meta-analysis of prospective studies by Shang X, Scott D, […], Sanders KM.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/27629053

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

Objectives:
An increased intake of magnesium might lower blood pressure (BP), yet evidence from clinical trials is inconsistent, perhaps as a result of small sample size or heterogeneity in study design. Therefore, this review article (meta-analysis) has been conducted.

Are there dose-dependent effects of magnesium supplementation on blood pressure?

Study design:
This review article included 20 RCTs included 14 of hypertensive and 6 of normotensive persons totaling 1220 participants.
The doses of magnesium ranged from 10 to 40 mmol/day (median: 15.4 mmol/day or 370 mg per day).

Results and conclusions:
The investigators found magnesium supplementation resulted in only a small overall non-significant reduction in blood pressure. The pooled net estimates of blood pressure change were -0.6 mmHg [95% CI = -2.2 to 1.0] for systolic blood pressure and -0.8 mmHg [95% CI = -1.9 to 0.4] for diastolic blood pressure.

However, the investigators found an apparent dose-dependent effect of magnesium, with significant reductions of 4.3 mmHg systolic blood pressure [95% CI = 6.3 to 2.2, p 0.001) and non-significant reductions of 2.3 mmHg diastolic blood pressure [95% CI = 4.9 to 0.0, p = 0.09) for each 10 mmol/day (240 mg/day) increase in magnesium dose.

The investigators concluded there is a dose-dependent blood pressure reductions, especially systolic blood pressure from magnesium supplementation. However, adequately powered trials with sufficiently high doses of magnesium supplements need to be performed to confirm this relationship.

Original title:
The effect of magnesium supplementation on blood pressure: a meta-analysis of randomized clinical trials by Jeea SH, Miller ER, [...], Klagb MJ.

Link:
http://www.sciencedirect.com/science/article/pii/S0895706102029643

Additional information of El Mondo:
Find more studies/information on magnesium and lowering blood pressure right here.  

Objectives:
Quantification of the association between the intake of fruit and vegetables and risk of esophageal squamous cell carcinoma (ESCC) is controversial even though several studies have explored this association. Therefore, this review article (meta-analysis) has been conducted.

Does a high intake of vegetables and fruit decrease risk of esophageal squamous cell carcinoma?

Study design:
This review article included a total of 32 observational studies involving 10037 cases of esophageal squamous cell carcinoma.

There was no evidence of publication bias.

Results and conclusions:
The investigators found highest vs. lowest vegetable intake, significantly reduced risk of esophageal squamous cell carcinoma with 44% [SRR = 0.56, 95% CI = 0.45-0.69, p-heterogeneity 0.001]. Significant means there is an association with a 95% confidence.

The investigators found highest vs. lowest fruit intake, significantly reduced risk of esophageal squamous cell carcinoma with 47% [SRR = 0.53, 95% CI = 0.44-0.64, p-heterogeneity 0.001].

The investigators found similar results in a linear dose-response analysis and there was evidence of non-linear associations for intakes of fruit [p non-linearity 0.001] and vegetables [p non-linearity = 0.041].

The investigators concluded that intakes of vegetables and fruit reduce risk of esophageal squamous cell carcinoma. Further investigation with prospective designs, validated questionnaires and good control of important confounders is warranted.

Original title:
Intake of fruit and vegetables and risk of esophageal squamous cell carcinoma: A meta-analysis of observational studies by Liu J, Wang J, […], Lv C.

Link:
http://www.ncbi.nlm.nih.gov/pubmed/23319052

Additional information of El Mondo:
Find more information/studies on review, 95% CI and heterogeneity, vegetables and fruits and cancer right here.
 

Objectives:
Micronutrient deficiencies impose a considerable burden of disease on many middle and low income countries. Several strategies have been shown to be effective in improving micronutrient deficiencies. However, the impact of fortified condiments as well as fortified noodles is less well documented. Therefore, this meta-analysis (review article) has been conducted.

What is the impact of micronutrient fortified condiments on hemoglobin, anemia and functional outcomes in children and adults (age: 5 to 50 years)?

Study design:
This review article included 14 RCTs comprising 8845 people with a mean age between 7.3 and 34 years. Mean follow-up was 0.88 years (range: 2.4 months to 2 years).

Only in 2 trials was multi-micronutrient fortification used, e.g. additional fortification with vitamin A, zinc and folate. In the other 12 studies, iron was the net difference in multi-micronutrient exposition between intervention and control groups.

Results and conclusions:
The investigators found in 12 RCTs that micronutrient fortification of condiments significantly increased hemoglobin concentrations by 0.74 g/dL [95% CI = 0.56 to 0.93].

The investigators found different types of iron preparations showed no differences in rise of hemoglobin concentrations (NaFeEDTA: 0.69 g/dL vs. 0.68 g/dL for other preparations).

The investigators found micronutrient fortification also led to a reduced risk of 41% for having anemia [risk ratio 0.59, 95% CI = 0.44 to 0.80].

The investigators found ferritin concentrations significantly increased with fortified condiments.

The investigators concluded the use of micronutrient fortified condiments can be a strategy to reduce anemia in children and adults due to micronutrient deficiencies beyond supplementation programs and fortification of staple food.

Original title:
Micronutrient Fortified Condiments and Noodles to Reduce Anemia in Children and Adults—A Literature Review and Meta-Analysis by Hess S, Tecklenburg L and Eichler K.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4772051/

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

Objectives:
Previous systematic reviews suggest beneficial effects of flavonoids on biomarkers of cardiovascular disease (CVD) risk, but have overlooked the impact of dose response or food complexity. Therefore, this review article has been conducted.

Do taking flavonoid supplements improve flow-mediated dilation (FMD) and blood pressure?

Study design:
This review article included 63 RCTs.

Results and conclusions:
The investigators found meta-analyses of combined flavonoid subclasses showed significant improvements in FMD [chronic: 0.73%, 95% CI = 0.17 to 1.30, 14 RCTs and acute: 2.33%, 95% CI = 1.58 to 3.08, 18 RCTs].

The investigators found meta-analyses of combined flavonoid subclasses showed significant improvements in blood pressures [systolic: -1.46 mmHg, 95% CI = -0.38 to -0.53, 63 RCTs and diastolic: -1.25 mmHg, 95% CI = -1.82 to -0.67, 63 RCTs].

The investigators found similar benefits were observed for the flavan-3-ol, catechol flavonoids (catechins, quercetin, cyanidin etc.), procyanidins, epicatechin and catechin subgroups.

The investigators found dose-response relationships were non-linear for FMD (R2 ≤ 0.30), with greater associations observed when applying polynomial regression analyses (R2 ≤ 0.72). However, there was no indication of a dose response for blood pressure.

The investigators concluded flavonoid subclasses supplements show significant improvements in FMD and blood pressure. However, the flavonoid bioactivity does not follow a classical linear dose-response association and this may have important biological implications.

Original title:
Relative impact of flavonoid composition, dose and structure on vascular function: A systematic review of randomised controlled trials of flavonoid-rich food products by Kay CD, Hooper L, […], Cassidy A.

Link:
http://onlinelibrary.wiley.com/doi/10.1002/mnfr.201200363/abstract;jsessionid=2CCB9E4E779A221E42AA38998C865DA6.d02t03?deniedAccessCustomisedMessage=&userIsAuthenticated=false

Additional information of El Mondo:
Find more information/studies on RCTs, lowering blood pressure and cardiovascular disease right here.

The optimal blood pressure for a healthy adult is120 mmHg systolic pressure and 80 mmHg diastolic pressure.

When blood flow increases through a vessel, the vessel dilates. This phenomenon has been coined flow-mediated dilatation (FMD). Flow-mediated dilation is an accepted technique to quantify endothelial function and has shown to have prognostic value for future cardiovascular disease (CVD). 

Objectives:
Does garlic supplementation reduce cardiovascular disease risk?

Study design:
This review article included original studies and previous review articles (meta-analyses).

Results and conclusions:
The investigators found in 4 meta-analyses and 2 original studies that garlic supplementation significantly reduced blood pressure by 7-16 mmHg (systolic) and 5-9 mmHg (diastolic). Significant means that there is an association with a 95% confidence.

The investigators found in 8 meta-analyses that garlic supplementation significantly reduced total cholesterol by 7.4-29.8 mg/dL.

The most consistent benefits were shown in studies that used aged garlic extract (AGE).

The investigators found a few small studies that used aged garlic extract also showed favourable effects on C-reactive protein (CRP), pulse wave velocity (PWV), and coronary artery calcium (CAC).

Although garlic is generally safe, rare adverse reactions have been documented with limited causality established.

The investigators concluded garlic supplementation has the potential for cardiovascular protection based on risk factor reduction (hypertension and total cholesterol) and surrogate markers (C-reactive protein, pulse wave velocity and coronary artery calcium) of atherosclerosis. Larger studies are warranted to evaluate these effects further.

Original title:
Garlic and Heart Disease by Varshney R and Budoff MJ.

Link:
http://jn.nutrition.org/content/146/2/416S.long

Additional information of El Mondo:
Find more information/studies on garlic consumption and cardiovascular disease right here.

Objectives:
Zinc deficiency is a global nutritional problem, particularly in children and women residing in settings where diets are cereal based and monotonous. It has several negative health consequences. Fortification of staple foods with zinc may be an effective strategy for preventing zinc deficiency and improving zinc-related health outcomes. Therefore, this meta-analysis (review article) has been conducted.

What are the beneficial and adverse effects of fortification of staple foods with zinc on health-related outcomes and biomarkers of zinc status in the general population?

Study design:
This review article included 8 RCTs (709 participants); seven were from middle-income countries of Asia, Africa, Europe and Latin America where zinc deficiency is likely to be a public health problem.
The interventions lasted between one and nine months.

Results and conclusions:
The investigators found in 3 studies with 158 participants that foods fortified with zinc increased the serum or plasma zinc levels with 2.12 µmol/L in comparison to foods without added zinc [MD = 2.12 µmol/L, 95% CI = 1.25 to 3.00 µmol/L; low-quality evidence].

The investigators found in 2 studies with 397 participants that participants consuming foods fortified with zinc versus participants consuming the same food without zinc had similar risk of underweight [average risk ratio = 3.10, 95% CI = 0.52 to 18.38; low-quality evidence].

The investigators found in 2 studies with 397 participants that participants consuming foods fortified with zinc versus participants consuming the same food without zinc had similar risk of stunting [RR = 0.88, 95% CI = 0.36 to 2.13; low-quality evidence].

The investigators found no significant difference in serum or plasma zinc levels in participants consuming foods fortified with zinc plus other micronutrients comparing with participants consuming the same foods with micronutrients but no added zinc [MD = 0.03 µmol/L, 95% CI = -0.67 to 0.72 µmol/L; 4 studies of  low-quality evidence with 250 participants].

The investigators found no adverse effect of fortification of foods with zinc on indicators of iron or copper status.

The investigators concluded fortification of foods with zinc may improve the serum zinc status of populations if zinc is the only micronutrient used for fortification. However, when zinc is added to food in combination with other micronutrients, it may make little or no difference to the serum zinc status. Effects of fortification of foods with zinc on other outcomes including zinc deficiency, children's growth, cognition, work capacity of adults or on haematological indicators are unknown. Given the small number of trials and participants in each trial, further investigation of these outcomes is required.

Original title:
Fortification of staple foods with zinc for improving zinc status and other health outcomes in the general population by Shah D, Sachdev HS, […], Peña-Rosas JP.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/27281654

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

Objectives:
Anemia is a leading cause of maternal deaths and adverse pregnancy outcomes in developing countries. To present knowledge, no previous study has estimated the population-attributable fraction (PAF) of adverse pregnancy outcomes for maternal anemia. Therefore, this meta-analysis (review article) has been conducted.

Is there an association between maternal anemia and pregnancy outcomes in low- and middle-income countries?

Study design:
This review article included 24 prospective cohorts and 5 retrospective cohort studies.

The number of subjects per study ranged from 253 to 399,274 with a total of ∼0.72 million pregnant women with a mean age that ranged from 20 to 30 years.

Results and conclusions:
The investigators found overall, 42.7% [95% CI = 37.0% to 48.4%] of women experienced anemia during pregnancy in low- and middle-income countries.

The investigators found pregnant women with anemia had a significant higher risk of 31% for low birth weight [RR = 1.31, 95% CI = 1.13-1.51].

The investigators found pregnant women with anemia had a significant higher risk of 63% for preterm birth [RR = 1.63, 95% CI = 1.33-2.01].

The investigators found pregnant women with anemia had a significant higher risk of 51% for perinatal mortality [RR = 1.51, 95% CI = 1.30-1.76].

The investigators found pregnant women with anemia had a significant higher risk of 172% for neonatal mortality [RR = 2.72, 95% CI = 1.19-6.25].

The investigators found South Asian, African and low-income countries had a higher pooled anemia prevalence than did other Asian and upper-middle-income countries.

The investigators found in low- and middle-income countries, 12% of low birth weight, 19% of preterm births and 18% of perinatal mortality were attributable to maternal anemia.

The investigators concluded maternal anemia is a risk factor for adverse birth and perinatal health outcomes in low- and middle-income countries. Significantly higher risk of low birth weight and preterm birth were observed in low-income countries and in South Asian countries despite the greater priority and larger investment on maternal and child health programs in recent decades.

Original title:
Maternal anemia and risk of adverse birth and health outcomes in low- and middle-income countries: systematic review and meta-analysis by Rahman MM, Abe SK, […], Shibuya K.

Link:
http://ajcn.nutrition.org/content/103/2/495.long

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