Nutrition and health

Objectives:
An enhanced risk for cardiovascular disease (CVD) still exists even when patients with type 2 diabetes have tight control on blood sugar. Thus, identification of treatment approaches that address CVD risk factors may be useful for patients beyond the blood sugar management. Although emerging evidence suggests that nuts consumption have beneficial effects on cardiometabolic health, the effects of almond intake in patients with type 2 diabetes are still controversial. Therefore, this review article has been conducted. 

Does almond consumption improve risk factors (cholesterol, triglycerides, fasting plasma glucose, insulin, hemoglobin A1c (HbA1c), body mass index, weight, body fat, systolic and diastolic blood pressure and CRP) of cardiovascular disease in patients with type 2 diabetes?

Study design:
This review article included 9 RCTs.

Results and conclusions:
The investigators found there was a causal relationship between almond dietary intake and a  significant reduction in low-density lipoprotein cholesterol (LDL cholesterol or bad cholesterol) [WMD = -5.28 mg/dL, 95% CI = -9.92 to -0.64, p = 0.026] in patients with type 2 diabetes compared with the control group.
This lowering effect of LDL cholesterol was robust in subgroups with almond consumption >50 g/day and baseline LDL cholesterol level 130 mg/dL.

The investigators found, however, the effect of almond on total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL cholesterol or good cholesterol), fasting plasma glucose, insulin, HbA1c, body mass index, weight, body fat, systolic and diastolic blood pressure and CRP was not significant compared with the control group.

The investigators concluded that a dietary intake of at least 50 g/d almond decreases causally LDL cholesterol (bad cholesterol) but has no favourable effect on other cardiometabolic outcomes in patients with type 2 diabetes. Further high-quality studies are needed to firmly establish the clinical efficacy of the almond.

Original title:
Effects of almond on cardiometabolic outcomes in patients with type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials by Moosavian SP, Rahimlou M, […], Jalili C.

Link:
https://pubmed.ncbi.nlm.nih.gov/35443097/

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

Objectives:
While there is growing research interest in the effects of nutrition and exercise on delaying sarcopenia, the results are inconclusive and there is scarce information on regional patterns. Therefore, this review article has been conducted.

Do protein supplements combined with exercise improve extremity strength in healthy older adults with sarcopenia?

Study design:
This review article included 14 RCTs, involving a total of 888 healthy older adults (>60 years).

4 studies in Asian countries provided data on lower-extremity strength, involving 280 participants (138 in protein supplements + exercise group and 142 in exercise group).
Lower-extremity strength was assessed using knee extension (n = 3) or leg extension (n = 1).
The intervention period of all studies was 12 weeks.
The dosage of protein ranged from 3 g/d to 40 g/d.

Results and conclusions:
The investigators found in 4 studies in Asian countries a significant increase in the lower-extremity strength in the protein supplementation + exercise group compared to the exercise group, with a SMD of 0.24 [95% CI = 0.00 to 0.47, p = 0.048, I2 = 0.0%, p = 0.513].

The investigators concluded that protein supplements (3 g/d to 40 g/d during 12 weeks) combined with exercise (knee extension and leg extension) exerts superior benefit on lower-extremity strength in healthy older adults with sarcopenia in Asian countries, when compared to exercise alone or with a placebo. However, no additional benefits from protein supplementation are observed on upper-extremity strength, muscle mass and physical performance regardless of the regions. More well-designed RCTs with information on baseline and total protein intake for longer follow-up periods are warranted to evaluate the effectiveness of protein supplementation and exercise on the prevention and management of sarcopenia in healthy older adults.

Original title:
Effects of protein supplementation and exercise on delaying sarcopenia in healthy older individuals in Asian and non-Asian countries: A systematic review and meta-analysis by Li L, He Y, […], Liu X.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8808080/

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

Upper extremity is part of the body that includes the arm, wrist and hand.

Lower extremity refers to the part of the body from the hip to the toes.

Sarcopenia is a type of muscle loss (muscle atrophy) that occurs with aging and/or immobility. Sarcopenia can affect people in their 30s and beyond.
 

Objectives:
Epidemiological studies indicate that higher intakes of flavonoids are associated with reduced stroke risk. However, which subtypes play significant roles to protect against stroke remain unclear. Therefore, this review article has been conducted.

Does dietary intake of different flavonoid subclasses (flavanones, flavan-3-ols) reduce risk of stroke?

Study design:
This review article included 10 independent prospective cohort studies with 387,076 participants and 9,564 events (persons with stroke).

Results and conclusions:
The investigators found higher intakes of flavanones significantly reduced risk of stroke with 15% [RR = 0.85, 95% CI = 0.78 to 0.93].

The investigators found dose-response analysis showed that 50 mg/day increment of flavanones dietary intake was significantly associated with 11% reduction in stroke risk [RR = 0.89, 95% CI = 0.84 to 0.94].

The investigators found dose-response analysis showed that 200 mg/day increment of flavan-3-ols dietary intake was significantly associated with 14% reduction in stroke risk [RR = 0.86, 95% CI = 0.75 to 0.98].

The investigators found no association with respect to other flavonoid subclasses.

The investigators concluded that both 50 mg/day flavanones and 200 mg/day flavan-3-ols dietary intake reduce stroke risk. The findings of these associations of the present study need to be confirmed in other regions and ethnic origins.

Original title:
A meta-analysis of prospective cohort studies of flavonoid subclasses and stroke risk by Li XQ, Wang C, […], Guo XF.

Link:
https://pubmed.ncbi.nlm.nih.gov/35023220/

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

Objectives:
Is IL-6 is a candidate marker for severe malaria?

Study design:
This review article included 43 studies.

Most of the included studies were prospective observational studies (19, 44.2%) and the remaining study types included cross-sectional studies (16, 37.2%), case-controlled studies (6, 14%) and randomized controlled trials (RCTs) (2, 4.6%).

The studies enrolled patients with P. falciparum (32, 74.4%), P. vivax (4, 9.3%), P. falciparum/P. vivax (3, 6.98%), P. falciparum/P. knowlesi (1, 2.3%), P. falciparum/P. vivax/P. ovale (1, 2.3%), P. falciparum/P. vivax/mixed infection (1, 2.3%) and P. falciparum/P. vivax/P. ovale/P. malariae (1, 2.3%).

Some studies enrolled children (20, 46.5%), adults (16, 37.2%), all age groups (6, 14%) and not specified (1, 2.3%).

Most of the studies (31, 72.1%) used only microscopy for malaria detection although microscopy/PCR (5, 11.6%), microscopy/rapid diagnostic test (RDT; 5, 11.6%) and microscopy/RDT/PCR (2, 4.65%) were also used.

An ELISA was the most common method used for IL-6 measurements (30, 69.8%), followed by a bead-based assay (13, 30.2%).

Thirty-two studies (74.4%) were high quality, whereas 11 studies were moderate qualities.
Heterogeneity of the effect estimate among the included studies was the main limitation of this analysis.

Results and conclusions:
The investigators found results of the meta-analysis showed that patients with severe malaria had higher mean IL-6 levels than those with non-severe malaria [WMD = 96.63 pg/mL, 95% CI = 0.88 to 19.38 pg/mL, p = 0.04, I2 = 99.9%, 13 studies].

The investigators found that the pooled effect estimate was unchanged after the publication bias was adjusted [WMD = 96.60 pg/mL, 95% CI = 4.32 to 188.89 pg/mL, p = 0.04, 13 studies].

The investigators found results of the meta-analysis showed that patients with uncomplicated malaria had higher mean IL-6 levels than the controls [WMD = 42.86 pg/mL, 95% CI = 30.17 to 55.56 pg/mL, p 0.001, I2 = 100%, 17 studies].

The investigators found results of the meta-analysis showed no differences in the mean levels of IL-6 between patients with uncomplicated malaria and those with asymptomatic malaria [WMD = 42.07 pg/mL, 95% CI = -2.23 pg/mL to -86.37 pg/mL, p = 0.063, I2 = 99.1%, 8 studies] or between patients with asymptomatic malaria and healthy controls [WMD = 1.67 pg/mL, 95% CI = -2.73 pg/mL to -6.07 pg/mL, p = 0.45, I2 = 98.1%, 2 studies].

The investigators found subgroup analysis of continents showed no differences in IL-6 levels between patients with severe malaria and non-severe malaria for studies conducted in Africa and Asia.

The investigators found results of the meta-analysis showed that a higher mean level of IL-6 was observed in patients who died compared with the levels of those who survived [WMD = 1,399.19 pg/mL, 95% CI = 384.16 to  2,414.2 pg/mL, p = 0.007, I2 = 93.1%, 4 studies].

The investigators found meta-regression analyses of continents, malarial complications, parasitemia, age, male percentage, malaria diagnostic methods and IL-6 measurement methods showed that these co-variates did not confound the effect estimate [p > 0.05].

The investigators concluded significantly increased levels of IL-6 are observed in patients with severe malaria compared with those in patients with non-severe malaria, which indicates that IL-6 is a candidate marker for severe malaria. In addition, IL-6 might be a candidate marker for malaria infection and therefore could be used to differentiate malaria infection from other febrile diseases. Therefore, it is recommended that future studies should investigate the sensitivity and specificity of increased IL-6 levels to determine the effectiveness of measuring IL-6 levels to detect malaria infection and monitor malaria severity to improve the efficiency of malaria diagnosis and management.

Original title:
Increased interleukin-6 levels associated with malaria infection and disease severity: a systematic review and meta-analysis by Wilairatana P, Mala W, […], Kotepui M.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8993930/

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

Objectives:
Oat supplementation interventions (OSIs) may have a beneficial effect on cardiovascular disease (CVD) risk. However, dietary background can modulate such effect. Therefore, this review article has been conducted.

Does dietary oat supplementation lower levels of blood lipids (cholesterol, triglycerides) and improve anthropometric parameters (glucose level, body mass index, weight, blood pressure, waist circumference) among participants with predominantly mild metabolic disturbances?

Study design:
This review article included 74 RCTs with a total of 4,937 predominantly hypercholesterolemic, obese subjects, with mild metabolic disturbances. Of these, 59 RCTs contributed to the meta-analyses.

The majority of included RCTs (81.1%) had some concerns for risk of bias.

Results and conclusions:
The investigators found oat supplementation (as oat, oat beta-glucan-rich extracts or avenanthramides), compared to control arms without oats, significantly improved levels of:
-total cholesterol (TC) [WMD = -0.42 mmol/L, 95% CI = -0.61 to -0.22];
-LDL cholesterol [WMD = -0.29 mmol/L, 95% CI = -0.37 to -0.20];
-glucose [WMD = -0.25 nmol/L, 95% CI = -0.36 to -0.14];
-body mass index [WMD = -0.13 kg/m², 95% CI = -0.26 to -0.01];
-weight [WMD = -0.94 kg, 95% CI = -1.84 to -0.05] and;
-waist circumference [WMD = -1.06 cm, 95% CI = -1.85 to -0.27].

The investigators found RCTs on inflammation and/or oxidative stress markers were scarce and with inconsistent findings.

The investigators found RCTs comparing an oat supplementation intervention to heterogeneous interventions (e.g., wheat, eggs, rice, etc.), showed lowered levels of glycated haemoglobin, diastolic blood pressure, HDL cholesterol and apolipoprotein B.

The investigators concluded dietary oat supplementation (as oat, oat beta-glucan-rich extracts or avenanthramides) may lower levels of blood lipids and improve anthropometric parameters among obese participants with predominantly mild metabolic disturbances, regardless of dietary background or control. May lower because the majority of included RCTs had some concerns for risk of bias. Therefore, further high-quality trials are warranted to establish the role of oat supplementation intervention on blood pressure, glucose homeostasis and inflammation markers.

Original title:
Effect of oat supplementation interventions on cardiovascular disease risk markers: a systematic review and meta-analysis of randomized controlled trials by Llanaj E, Dejanovic GM, […], Muka T.

Link:
https://pubmed.ncbi.nlm.nih.gov/34977959/

Additional information of El Mondo:
Find more information/studies on oat consumption, overweight and cardiovascular diseases right here.

These products are suitable for persons with cardiovascular diseases.

Objectives:
Is there an association between dietary diversity (DDiv) and growth outcomes (stunting, wasting and underweight) in children aged 5 years?

Study design:
This review article included 70 cross-sectional studies, 4 longitudinal cohort studies, 5 case-control studies and 2 randomized controlled trials.

Of the studies, 45 focused on infants and 36 on children aged 5 years.
The reviewed articles had good quality and low risk of bias (scores >6).

Results and conclusions:
The investigators found in infants, low dietary diversity was significantly associated with stunting, wasting and being underweight [79%, 57% and 68% of the studies, respectively].

The investigators found among children aged 5 years, the association was observed in 75%, 56% and 57% of the studies, respectively, for stunting, wasting and underweight.

The investigators concluded the findings indicate an association between low dietary diversity (DDiv) of infants and children aged 5 years with stunting. However, this association remains uncertain with wasting and being underweight.

Original title:
Association of Dietary Diversity With Growth Outcomes in Infants and Children Aged Under 5 Years: A Systematic Review by Gol RM, Kheirouri S and Alizadeh M.

Link:
https://pubmed.ncbi.nlm.nih.gov/35000681/

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

Objectives:
Evidence associating diet with the incidence of renal cell carcinoma (RCC) is inconclusive. Therefore, this umbrella review article has been conducted.

What is the association between diet and renal cell carcinoma incidence?

Study design:
This umbrella review article included 22 meta-analyses with a total of 502 individual studies and 64 summary hazard ratios (HRs) for renal cell carcinoma incidence: dietary patterns or dietary quality indices (n = 6), foods (n = 13), beverages (n = 4), alcohol (n = 7), macronutrients (n =15) and micronutrients (n =19).

No meta-analyses had high methodological quality.

59% of these 502 individual studies were cohort studies (n = 298), 39% were case-control studies (n = 196) and 2% were pooled studies (n = 8).

Sixty (94%) exposures in the included meta-analyses had more than 1,000 cases or 20,000 participants.

Results and conclusions:
The investigators found no dietary factors showed convincing or highly suggestive evidence of association with renal cell carcinoma incidence in the overall analysis.

The investigators found in the overall analysis that dietary intake of vegetables significantly reduced risk of renal cell carcinoma with 26% [summary HR = 0.74, 95% = 0.63 to 0.86, suggestive evidence].

The investigators found in the overall analysis that dietary intake of vitamin C significantly reduced risk of renal cell carcinoma with 23% [summary HR = 0.77, 95% = 0.66 to 0.90, suggestive evidence].

The investigators found in the overall analysis that moderate drinking significantly reduced risk of renal cell carcinoma with 23% [summary HR = 0.77, 95% = 0.70 to 0.84, convincing evidence] in Europe and North America.

The investigators found in the overall analysis that dietary intake cruciferous vegetables significantly reduced risk of renal cell carcinoma with 22% [summary HR = 0.78, 95% = 0.70 to 0.86, highly suggestive evidence] in North America.

The investigators concluded dietary intake of vegetables and vitamin C could reduce renal cell carcinoma risk. Moderate drinking might be beneficial for Europeans and North Americans and cruciferous vegetables might be beneficial to North Americans, but the results should be interpreted with caution because no meta-analyses had high methodological quality. More researches are needed in the future.

Original title:
The role of diet in renal cell carcinoma incidence: an umbrella review of meta-analyses of observational studies by Liao Z, Fang Z, […], Luo Z.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8812002/

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

An umbrella review article is a scientific article which only includes meta-analyses (also called review articles). The results found in an umbrella review article are more reliable than found in an individual review article.

One swallow does not make a summer. A famous Dutch saying that could not be any more obvious. Just because one single scientific study about a certain topic makes certain claims, it does not necessarily mean it is true. On the other hand, a review article (a collection of scientific studies on a certain topic) of randomized, placebo-controlled double blind clinical trials (RCTs) will answer the following question:
"Do taking dietary supplements make sense?" Yes for a positive conclusion and no for a negative conclusion.

One swallow does not make a summer. A famous Dutch saying that could not be any more obvious. Just because one single scientific study about a certain topic makes certain claims, it does not necessarily mean it is true. On the other hand, a review article (a collection of scientific studies on a certain topic) of (prospective) cohort studies or case-control studies will answer the following question:
"Should I change my diet?".

Objectives:
There is currently a lack of high-quality research on the best dietary recommendations for patients with early glaucoma or at high risk for glaucoma. Therefore, this review article has been conducted.

Does a high dietary vitamin intake reduce risk of glaucoma?

Study design:
This review article included 8 cohort studies, with a total of 262,189 patients.

There was no publication bias.

Results and conclusions:
The investigators found that high-dose dietary intake of vitamins A was significantly associated with a 27% low risk of glaucoma [OR = 0.63, 95% CI = 0.53 to 0.76 , p 001, I2 = 49%].

The investigators found that high-dose dietary intake of vitamins B (a combination of B1, B2, B3, B6 and B12) was significantly associated with a 29% low risk of glaucoma [OR = 0.71, 95% CI = 0.64 to 0.80, p 0.001, I2 = 29%].

The investigators found no association between high-dose dietary intake of vitamins C, D or E and lower risk of glaucoma.

The investigators concluded that high-dose dietary intake of vitamins A and B, but not vitamins C, D or E, is associated with a low prevalence of glaucoma. Overall, middle-aged and elderly people or patients with early glaucoma should consume vitamin-rich foods rich or take additional vitamin supplements.

Original title:
Vitamin intake and glaucoma risk: A systematic review and meta-analysis by Han FF and Fu XX.             

Link:
https://www.sciencedirect.com/science/article/pii/S0181551222000419?via%3Dihub

Additional information of El Mondo:
Find here more information/studies about chronic diseases, vitamin A and B.
 

Objectives:
There is some evidence regarding the positive effects of ginger supplementation on metabolic profile in patients with type 2 diabetes (T2DM). However, they are conflicting and therefore, this review article has been conducted. 

Does ginger supplementation improve metabolic profile (FBS, HbA1c, TC, TG, LDL, HDL, SBP and DBP) in patients with type 2 diabetes?

Study design:
This review article included 10 RCTs.

Results and conclusions:
The investigators found pooled meta-analysis showed a significant reduction in fasting blood sugar (FBS) level following ginger supplementation by polling 8 effect sizes [WMD = -18.81, 95% CI = -28.70 to -8.92, I2 = 77.4%].

The investigators found pooled meta-analysis showed a significant reduction in HbA1c level following ginger supplementation by polling 7 effect sizes [WMD = -0.57, 95% CI = -0.93 to -0.20, I2 = 88.6%].

The investigators found pooled meta-analysis showed a significant reduction in systolic blood pressure (SBP) following ginger supplementation by polling 5 effect sizes [WMD = -4.20, 95% CI = -7.64 to -0.77, I2 = 97%].

The investigators found pooled meta-analysis showed a significant reduction in diastolic blood pressure (DBP) following ginger supplementation by polling 5 effect sizes [WMD = -1.61, 95% CI = -3.04 to -0.18, I2 = 93.2%].

The investigators found pooled meta-analysis showed ginger supplementation had no significant influence on lipid profile involving triglyceride (TG), total cholesterol (TC), LDL cholesterol and HDL cholesterol.

The investigators concluded supplementation with ginger reduces fasting blood sugar, HbA1c, systolic blood pressure and diastolic blood pressure in patients with type 2 diabetes. Further large RCTs are required to shed light on this issue.

Original title:
The effect of ginger supplementation on metabolic profiles in patients with type 2 diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials by Ebrahimzadeh A, Ebrahimzadeh A, […], Milajerdi A.

Link:
https://pubmed.ncbi.nlm.nih.gov/35031435/

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

Objectives:
Does a high serum vitamin D level reduce risk of latent tuberculosis infection?

Study design:
This review article included 2 case-control studies and 3 cohort studies with a total of 1,516 subjects, comprising 117 latent tuberculosis infection (LTBI) patients.
Diagnosis of LTBI in all studies was based upon QFN-GIT, IGRAs and/or TST.
2 case-control and 3 cohort studies were considered as high quality.

Between-studies heterogeneity varied from none to small for the meta-analyses with I2 values ranging from 64.5 to 75.7%. However, sensitivity analysis and visual inspection of funnel plots for checking asymmetry and publication bias weren’t done because only 2 articles were included in association of vitamin D and the risk of LTBI and 3 in association of vitamin D and the incidence of LTBI.

Results and conclusions:
The investigators found in a pooled analysis of 2 case-control studies with 41 LTBI cases and 142 control subjects, that relatively high serum vitamin D level was not significantly associated with a decreased risk of latent tuberculosis infection [OR = 0.51, 95% CI = 0.05 to 5.65, p = 0.58, I2 = 64.5%].
Not significantly because the calculated p-value of 0.58 was larger than the p-value of 0.05.

The investigators found in a pooled analysis of 3 cohort studies involving 1,333 participants, that relatively high serum vitamin D levels did not reduce the incidence of latent tuberculosis infection [RR = 0.56, 95% CI = 0.19 to 1.67, p = 0.300, I2 = 75.7%].

The investigators concluded that serum vitamin D levels are not associated with incidence of latent tuberculosis infection and relatively high serum vitamin D level is not a protective factor for latent tuberculosis infection. Further RCTs are needed to verify whether sufficient vitamin D levels and vitamin D supplementation prevents latent tuberculosis infection.

Original title:
Vitamin D and the risk of latent tuberculosis infection: a systematic review and meta-analysis by Cao Y, Wang X, […], Du J.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8772077/

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

Objectives:
Does a high olive oil consumption reduce cancer risk?

Study design:
This review article included 37 case-control studies with 17,369 cases (persons with cancer) and 28,294 controls (persons without cancer) and 8 cohort studies with 12,461 incident cases among 929,771 subjects (participants).

Significant publication bias was detected via Egger’s test in the analysis on overall cancer risk [p 0.001], breast cancer [p = 0.013] and gastrointestinal cancer risk [p = 0.048].

Results and conclusions:
The investigators found in pooled analysis of case-control and cohort studies that highest olive oil consumption was significantly associated with a 31% lower risk of any cancer [pooled RR = 0.69, 95% CI = 0.62 to 0.77].  
Significantly means that there is an association with a 95% confidence.

The investigators found subgroup analyses showed that the protective effect of high olive oil consumption in terms of cancer risk was also significant in case-control studies [37 study arms, RR = 0.65, 95% CI = 0.57 to 0.74] but not in cohort studies [8 study arms, RR = 0.90, 95% CI = 0.77 to 1.05].
Furthermore, the protective association was also found in a multivariate analysis [32 study arms, RR = 0.72, 95% CI = 0.65 to 0.81], a high study quality analysis [RR = 0.72, 95% CI = 0.64 to 0.81], Mediterranean participants [RR = 0.69, 95% CI = 0.60 to 0.79] and non-Mediterranean participants [RR = 0.49, 95% CI = 0.34 to 0.71].

The investigators found in pooled analysis of case-control and cohort studies that highest olive oil consumption was significantly associated with a 33% lower risk of breast cancer [pooled RR = 0.67, 95% CI = 0.52 to 0.86].  
Significantly because RR of 1 was not found in the 95% CI of 0.52 to 0.86. RR of 1 means no risk/association.

The investigators found subgroup analyses showed that the beneficial effect was reproducible in case-control studies [RR = 0.63, 95% CI = 0.45 to 0.87] but not in cohort studies.
Furthermore, high olive oil consumption was linked to a reduced breast cancer risk in Mediterranean [RR = 0.67, 95% CI = 0.49 to 0.92] and non-Mediterranean populations [RR = 0.25, 95% CI = 0.07 to 0.89].

The investigators found in pooled analysis of case-control and cohort studies that highest olive oil consumption was significantly associated with a 23% lower risk of gastrointestinal cancer [pooled RR = 0.77, 95% CI = 0.66 to 0.89].  
Subgroup analyses showed an inverse relationship between highest olive oil consumption and risk for esophageal cancer [RR = 0.47, 95%CI = 0.24 to 0.93] and pancreatic cancer [RR = 0.58, 95% CI = 0.35 to 0.97].
Furthermore, significant effects were also found in case-control studies [RR = 0.72, 95% CI = 0.61 to 0.85), studies within the Mediterranean area [RR = 0.77, 95% CI = 0.67 to 0.88], multivariate analyses [RR = 0.76, 95% CI = 0.63 to 0.90] and high quality studies [RR = 0.73, 95% CI = 0.62 to 0.86].

The investigators found in pooled analysis of case-control and cohort studies that highest olive oil consumption was significantly associated with a 26% lower risk of upper aerodigestive cancer [pooled RR = 0.74, 95% CI = 0.60 to 0.91].  
Subgroup analyses showed results remained significant for case-control studies [RR = 0.74, 95% CI = 0.60 to 0.91], multivariate analyses [RR = 0.75, 95% CI = 0.66 to 0.86] and studies of high quality [RR = 0.68, 95% CI = 0.52 to 0.89].

The investigators found in pooled analysis of case-control studies that highest olive oil consumption was significantly associated with a 54% lower risk of urinary tract cancer [pooled RR = 0.46, 95% CI = 0.29 to 0.72].  
Subgroup analyses showed results remained significant for studies of high quality [RR = 0.46, 95% CI = 0.32 to 0.66].

The investigators concluded highest versus lowest olive oil consumption is associated with 31% lower cancer risk, especially for breast, overall gastrointestinal, upper aerodigestive and urinary tract cancer. Additional prospective cohort studies on various cancer types, especially in non-Mediterranean regions, as well as large randomized trials, seem desirable in order to provide further insight into the role of olive oil in preventing cancer.

Original title:
Olive oil intake and cancer risk: A systematic review and meta-analysis by Markellos C, Ourailidou ME, […], Psaltopoulout T.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8751986/

Additional information of El Mondo:
Find more information/studies on cancer, olive oil consumption right here.

The conclusions in scientific studies are even more reliable when they are also found in cohort studies, multivariate analyzes (studies where adjustments were made for multiple confounding factors) and high-quality studies.
 

Objectives:
Severe hypertension in pregnancy is a hypertensive crisis that requires urgent and intensive care due to its high maternal and fetal mortality. However, there is still a conflict of opinion on the recommendations of antihypertensive therapy.

What are the optimal blood pressure (BP) levels to prevent severe hypertension in pregnant women with nonsevere hypertension?

Study design:
This review article included 40 RCTs with 6,355 patients.

Results and conclusions:
The investigators found blood pressure lowering treatment significantly lowered risk of severe hypertension with 54% [RR = 0.46, 95% CI = 0.37 to 0.56], preeclampsia with 18% [RR = 0.82, 95% CI = 0.69 to 0.98], severe preeclampsia with 62% [RR = 0.38, 95% CI = 0.17 to 0.84], placental abruption with 48% [RR = 0.52, 95% CI = 0.32 to 0.86] and preterm birth with 19% [37 weeks: RR = 0.81, 95% CI = 0.71 to 0.93], while the risk of small for gestational age infants was significantly increased with 25% [RR = 1.25, 95% CI = 1.02 to 1.54].

The investigators found an achieved systolic blood pressure (SBP) of 130 mmHg significantly reduced the risk of severe hypertension to nearly one-third compared with a systolic blood pressure of ≥140 mmHg, with a significant interaction of the blood pressure levels achieved with BP-lowering therapy.

The investigators found there was no significant interaction between the subtypes of hypertensive disorders of pregnancy and blood pressure lowering treatment, except for placental abruption.

The investigators concluded blood pressure lowering treatment aimed at a systolic blood pressure 130 mmHg and accompanied by the careful monitoring of fetal growth should be recommended to prevent severe hypertension in pregnant women with nonsevere hypertension.

Original title:
Optimal blood pressure target to prevent severe hypertension in pregnancy: A systematic review and meta-analysis by Abe M, Arima H, […], Mukoyama M.

Link:
https://pubmed.ncbi.nlm.nih.gov/35136186/

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

Objectives:
Does a higher intake of dietary antioxidants (like vitamin C and E, β-carotene, zinc, anthocyanins, lutein) reduce risk of Parkinson's disease (PD)?

Study design:
This review article included 6 prospective cohort studies and 2 nested case-control studies (448,737 participants with 4,654 persons with Parkinson's disease) and 6 case-control studies (1,948 persons without Parkinson's disease and 1, 273 persons with Parkinson's disease).

Results and conclusions:
The investigators found comparded to the lowest dietary vitamine E intake, that the highest dietary vitamine E intake significantly reduced risk of Parkinson's disease with 16% [pooled RR = 0.84, 95% CI = 0.71 to 0.99, n = 7 cohort studies].
Significantly means that there is an association with a 95% confidence.

The investigators found compared to the lowest dietary anthocyanins intake, that the highest dietary anthocyanins intake significantly reduced risk of Parkinson's disease with 24% [pooled RR = 0.76, 95% CI = 0.61 to 0.96, n = 2 cohort studies].
Significantly because pooled RR of 1 was not found in the 95% CI of 0.61 to 0.96. RR of 1 means no risk/association.

The investigators found compared to the lowest dietary lutein intake, that the highest dietary lutein intake significantly increased risk of Parkinson's disease with 86% [pooled RR = 1.86, 95% CI = 1.20 to 2.88, n = 3 case-control studies].

The investigators found in dose-response meta-analyses that every increment of dietary vitamin C intake with 50 mg/d significantly reduced risk of Parkinson's disease with 6% [RR = 0.94, 95% CI = 0.88 to 0.99, n = 6].

The investigators found in dose-response meta-analyses that every increment of dietary vitamin E intake with 5 mg/d significantly reduced risk of Parkinson's disease with 16% [RR = 0.84, 95% CI = 0.70 to 0.99, n = 7].

The investigators found in dose-response meta-analyses that every increment of dietary β-carotene intake with 2 mg/d significantly reduced risk of Parkinson's disease with 6% [RR = 0.94, 95% CI = 0.89 to 0.99, n = 6].

The investigators found in dose-response meta-analyses that every increment of dietary zinc intake with 1 mg/d significantly reduced risk of Parkinson's disease with 35% [RR = 0.65, 95% CI = 0.49 to 0.86, n = 1].

The investigators concluded that higher intake of antioxidant-rich foods reduces risk of Parkinson's disease. Future, well-designed prospective studies are needed to validate the present findings.

Original title:
Dietary Antioxidants and Risk of Parkinson's Disease: A Systematic Review and Dose-response Meta-analysis of Observational Studies by Talebi S, Ghoreishy SM, […], Mohammadi H.

Link:
https://pubmed.ncbi.nlm.nih.gov/35030236/

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Objectives:
Does postoperative coffee or caffeine consumption causally reduce risk of postoperative ileus (POI) in patients undergoing elective colorectal surgery?

Study design:
This review article included 4 RCTs with 312 subjects.

Results and conclusions:
The investigators found postoperative coffee or caffeine consumption significantly decreased the time to first bowel movement [MD = -10.36 h, 95% CI = -14.61 to -6.11], shortened the length of hospital stay [MD = -0.95 days, 95% CI = -1.57 to -0.34] and was significantly  associated with a 36%-decreased risk of the use of any laxatives after the procedure [RR = 0.64, 95% CI = 0.44 to 0.92].

The investigators found the time to first flatus, time to tolerance of solid food, risk of any postoperative complication, postoperative reinsertion of a nasogastric (NG) tube and anastomotic leakage showed no statistical differences between groups.

The investigators concluded postoperative coffee or caffeine consumption causally improves bowel movement and decreases the duration of hospital stay in patients undergoing elective colorectal surgery. This method is safe and can prevent or treat postoperative ileus (POI).

Original title:
The effect of coffee/caffeine on postoperative ileus following elective colorectal surgery: a meta-analysis of randomized controlled trials by Yang TW, Wang CT, […], Tsai MC.

Link:
https://pubmed.ncbi.nlm.nih.gov/34993568/

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Postoperative ileus is a prolonged absence of bowel function after surgical procedures, usually abdominal surgery.

Objectives:
What is the safety of dihydroartemisinin-piperaquine (DHA-PQ) compared to artemether-lumefantrine (AL) for the treatment of uncomplicated P. falciparum malaria among children in Africa?

Study design:
This review article included 18 studies involving 10,498 African children with uncomplicated P. falciparum malaria.

A target dose (range) of 4 (2-10) mg/kg bw per day dihydroartemisinin and 18 (16-27) mg/kg bw per day piperaquine given once a day for 3 days for children weighing ≥25 kg.
The target doses and ranges for children weighing 25 kg are 4 (2.5-10) mg/kg bw per day dihydroartemisinin and 24 (20-32) mg/kg bw per day piperaquine once a day for 3 days.

Results and conclusions:
The investigators found, compared to AL, DHA-PQ significantly increased frequency of early vomiting with 126% [RR = 2.26, 95% CI = 1.46 to 3.50, I2 = 0%, participants = 7,796, studies = 10, high quality of evidence].

The investigators found, compared to AL, DHA-PQ significantly increased frequency of cough with 6% [RR = 1.06, 95% CI = 1.01 to 1.11, I2 = 0%, participants = 8,013, studies = 13, high quality of evidence].

The investigators found, compared to AL, DHA-PQ significantly increased frequency of diarrhoea with 16% [RR = 1.16, 95% CI = 1.03 to 1.31, I2 = 8%, participants = 6,841, studies = 11, high quality of evidence].

The investigators concluded that both drugs are well tolerated by children. There are comparable occurrences of adverse events in both treatment arms. But, early vomiting, diarrhoea and cough are common and more frequent in African children who are treated with the DHA-PQ than that of AL (high quality of evidence). All serious adverse events are consistent with malaria symptoms and judged to be unrelated to study medication. More studies comparing AL with DHA-PQ are needed to determine the comparative safety of these drugs.

Original title:
Safety of dihydroartemisinin-piperaquine versus artemether-lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria among children in Africa: a systematic review and meta-analysis of randomized control trials by Assefa DG, Zeleke ED, […], Makonnen E.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8725395/

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

Objectives:
Lutein and zeaxanthin are thought to have beneficial effects on protecting the lens against cataract formation, but findings from epidemiologic studies have been inconsistent. Therefore, this review article has been conducted.

Does dietary lutein and zeaxanthin intake reduce age-related cataract risk?

Study design:
This review article included 6 prospective cohort studies, involving 4416 cases and 41999 participants.

Results and conclusions:
The investigators found for comparing the highest with the lowest categories of dietary lutein and zeaxanthin intake, a significant reduced risk for nuclear cataract of 25% [RR = 0.75, 95% CI = 0.65-0.85], but the reduced risk was not significant for cortical cataract [RR = 0.85, 95% CI = 0.53-1.17] and for posterior subcapsular cataract [RR = 0.77, 95% CI = 0.40-1.13]. Significant means, there is an association with a 95% confidence.

The investigators found in dose-response analysis that every 300 μg/d increment in dietary lutein and zeaxanthin intake was significantly associated with a 3% [RR = 0.97, 95% CI = 0.94-0.99] reduction in the risk of nuclear cataract.

The investigators found in dose-response analysis that every 300 μg/d increment in dietary lutein and zeaxanthin intake was non-significantly associated with a 1% [RR = 0.99, 95% CI = 0.95-1.02] reduction in the risk of cortical cataract. Non-significantly means, there is no association with a 95% confidence.

The investigators found in dose-response analysis that every 300 μg/d increment in dietary lutein and zeaxanthin intake was non-significantly associated with a 3% [RR = 0.97, 95% CI = 0.93-1.01] reduction in the risk of posterior subcapsular cataract. Non-significantly because RR of 1 was found in 95% CI of 0.93 to 1.01. RR of 1 means no risk.

The investigators concluded dietary lutein and zeaxanthin intake (at least 300 μg/d) is associated with a reduced risk of age-related cataract, especially nuclear cataract in a dose-response manner, indicating a beneficial effect of lutein and zeaxanthin in age-related cataract prevention.

Original title:
A dose–response meta-analysis of dietary lutein and zeaxanthin intake in relation to risk of age-related cataract by Ma L, Hao ZX, [...], Pan JP.

Link:
http://link.springer.com/article/10.1007/s00417-013-2492-3

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Objectives:
Does a low salt intake reduce blood pressure?

Study design:
This review article included 34 randomized trials with 3230 participants (the median age was 50 (range 22-73)), of which 22 were in hypertensive individuals and 12 in normotensive individuals. Of the 34 trials, 23 used crossover design and 11 used paralleled comparisons. 22 of the 34 trials were double blind, in 11 the observer was blind to blood pressure and one did not report any blinding procedure.

The study duration varied from 4 weeks to 3 years (median 4 weeks). With the usual salt intake the median 24 hour urinary sodium was 160 mmol (range 125-200 mmol), equivalent to a salt intake of 9.4 g/day (range 7.3-11.7 g/day) and the median blood pressure was 141/86 mmHg.

Despite the fact that only 7 out of 34 trials performed intention to treat analysis, the percentage of participants lost to follow-up after randomization was small (6.7% on average).

Results and conclusions:
The investigators found meta-analysis showed that the mean change in urinary sodium (reduced salt v usual salt) was -75 mmol/24 h (equivalent to a reduction of 4.4 g/day salt), and with this reduction in salt intake, the mean change in blood pressure was -4.18 mmHg [95% CI = -5.18 to -3.18, I2 = 75%] for systolic blood pressure and -2.06 mmHg [95% CI = -2.67 to -1.45, I2 = 68%] for diastolic blood pressure.

The investigators found meta-regression showed that age, ethnic group, blood pressure status (hypertensive or normotensive) and the change in 24 hour urinary sodium were all significantly associated with the fall in systolic blood pressure, explaining 68% of the variance between studies.

The investigators found a 100 mmol reduction in 24 hour urinary sodium (equivalent to a reduction 6 g/day salt) was associated with a fall in systolic blood pressure of 5.8 mmHg [95% CI = -2.5 to -9.2,  p = 0.001] after adjustment for age, ethnic group and blood pressure status.
For diastolic blood pressure, age, ethnic group, blood pressure status and the change in 24 hour urinary sodium explained 41% of the variance between studies.

The investigators found meta-analysis by subgroup showed that in people with hypertension the mean effect was -5.39 mmHg [95% CI = -6.62 to -4.15, I2 = 61%] for systolic blood pressure and -2.82 mmHg [95% CI = -3.54 to -2.11, I2 = 52%] for diastolic blood pressure.
In normotensive people, the figures were -2.42 mmHg [95% CI = -3.56 to -1.29, I2 = 66%] and -1.00 mmHg [95% CI = -1.85 to -0.15, I2 = 66%], respectively.

The investigators found further subgroup analysis showed that the decrease in systolic blood pressure was significant in both white and black people and in men and women.

The investigators found meta-analysis of data on hormones and lipids showed that the mean change was:
0.26 ng/mL/h [95% CI = 0.17 to 0.36, I2 = 70%] for plasma renin activity;
73.20 pmol/L [95% CI = 44.92 to 101.48, I2 = 62%] for aldosterone;
187 pmol/L [95% CI = 39 to 336, I2 = 5%] for noradrenaline (norepinephrine);
37 pmol/L [95% CI = -1 to 74, I2 = 12%] for adrenaline (epinephrine);
0.05 mmol/L [95% CI = -0.02 to 0.11, I2 = 0%] for total cholesterol;
0.05 mmol/L [95% CI = -0.01 to 0.12, I2 = 0%] for low density lipoprotein cholesterol (LDL-cholesterol or bad cholesterol);
-0.02 mmol/L [95% CI = -0.06 to 0.01, I2 = 16%] high density lipoprotein cholesterol (HDL-cholesterol or good cholesterol) and:
0.04 mmol/L [95% CI = -0.02 to 0.09, I2 = 0%] for triglycerides.

The investigators concluded a modest reduction in salt intake of 4.4 g/day for 4 or more weeks causes, from a population viewpoint, important falls in blood pressure in people with both raised and normal blood pressure.
Salt reduction is associated with a small physiological increase in plasma renin activity, aldosterone and noradrenaline and no significant change in lipid concentrations.
The current recommendations to reduce salt intake from 9-12 to 5-6 g/day will have a major effect on blood pressure, but a further reduction to 3 g/day will have a greater effect and should become the long term target for population salt intake.

Original title:
Effect of longer term modest salt reduction on blood pressure: Cochrane systematic review and meta-analysis of randomised trials by He FJ, Li J and MacGregor GA.

Link:
http://www.bmj.com/content/346/bmj.f1325

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A daily diet with a maximum of 3 grams salt per day is a diet with a maximum of 0.15 gram salt per 100 kcal.
A daily diet with a maximum of 0.15 gram salt per 100 kcal is a diet with mainly products/meals with a maximum of 0.15 gram salt per 100 kcal.

Objectives:
Previous trials have shown that zinc supplementation can decrease the risk of diarrhea, pneumonia and malaria in children; however, the effects of zinc supplementation on mortality remain unclear. Therefore, this review article has been conducted.

Does zinc supplementation reduce total mortality and cause-specific mortality in preschool children?

Study design:
This review article included 8 RCTs which included 87,854 children and reported 1,558 events of mortality. The population of the trials ranged from 96 to 42,546 and the follow-up for subjects ranged from 6 to 17.6 months.

Egger and Begg tests showed no evidence of publication bias for total mortality [p value for Egger = 0.207, p value for Begg = 0.902].

Results and conclusions:
The investigators found overall, zinc supplementation had no effect on:
total mortality [RR = 0.76, 95% CI = 0.56-1.04, p = 0.084];
diarrhea-related mortality [RR = 0.80, 95% CI = 0.53-1.20, p = 0.276];
pneumonia-related mortality [RR = 0.52, 95% CI = 0.11-2.39, p = 0.399];
malaria-related mortality [RR = 0.90, 95% CI = 0.77-1.06, p = 0.196] or;  

other causes of mortality [RR = 0.98, 95% CI = 0.67-1.44, p = 0.917]. No effect because RR of 1 was found in the 95% CI of 0.67 to 1.44. RR of 1 means no risk/effect/association.

The investigators found subgroup analysis indicated that zinc supplementation was significantly associated with a reduction in total mortality risk if the participants were boys, aged greater than 12 months and the duration of the follow-up period was less than 12 months. Significant means, there is an association with a 95% confidence

The investigators concluded zinc supplementation reduces total mortality risk if the participants are boys, aged greater than 12 months and the duration of the follow-up period is less than 12 months.

Original title:
Effects of zinc supplementation on the incidence of mortality in preschool children: a meta-analysis of randomized controlled trials by Fu W, Ding LR, [...], Zhou YH.

Link:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3823854/

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

Objectives:
Does iron supplementation during pregnancy improve maternal haematological status and birth weight?

Study design:
This review article included 48 RCTs (17,793 women) and 44 cohort studies (1,851,682 women).

The dose of iron in RCTs ranged from 10 mg to 240 mg daily. Duration of supplementation varied from 7 to 8 weeks up to 30 weeks during pregnancy.

Significant heterogeneity existed for several outcomes that could not be explained substantially by pre-specified subgroups.

Results and conclusions:
The investigators found iron supplementation during pregnancy increased maternal mean haemoglobin concentration by 4.59 g/L [95% CI = 3.72 to 5.46] compared with controls.

The investigators found iron with folic acid was associated with a significant increase in mean haemoglobin concentration of 10.41 g/L [95% CI = 5.36 to 15.46, I2 = 0%, 9 trials] and reduction in risk of anaemia in the third trimester or at delivery of 56% [95% CI = 0.37 to 0.53, I2 = 44%, 5 trials]. Significant means there is an association with a 95% confidence.

The investigators found iron supplementation during pregnancy significantly reduced the risk of anaemia with 50% [95% CI = 0.42 to 0.59] compared with controls.

The investigators found iron supplementation during pregnancy significantly reduced the risk of iron deficiency (of the mother) with 41% [95% CI = 0.46 to 0.79] compared with controls.

The investigators found iron supplementation during pregnancy significantly reduced the risk of iron deficiency anaemia with 60% [95% CI = 0.26 to 0.60] compared with controls.

The investigators found iron supplementation during pregnancy significantly reduced the risk of low birth weight (2500 g) with 19% [95% CI = 0.71 to 0.93] compared with controls.

However, the investigators found iron supplementation during pregnancy non-significantly reduced the risk of preterm birth with 16% [95% CI = 0.68 to 1.03] compared with controls. Non-significant means there is no association with a 95% confidence.

The investigators found in cohort studies that anaemia in the first or second trimester was significantly associated with a higher risk for low birth weight of 29% [adjusted odds ratio 1.29, 95% CI = 1.09 to 1.53] and preterm birth with 21% [adjusted odds ratio = 1.21, 95% CI = 1.13 to 1.30].

The investigators found in exposure-response analysis that for every 10 mg increase in iron dose/day, up to 66 mg/day, the relative risk of maternal anaemia was significantly 0.88 [95% CI = 0.84 to 0.92, p for linear trend 0.001].

The investigators found in exposure-response analysis that birth weight increased by 15.1 g [95% CI = 6.0 to 24.2, p for linear trend = 0.005] and risk of low birth weight significantly decreased by 3% [relative risk = 0.97, 95% CI = 0.95 to 0.98, p for linear trend 0.001] every 10 mg increase in dose/day.

Furthermore, the investigators found for each 1 g/L increase in mean haemoglobin, birth weight increased by 14.0 g [95% CI = 6.8 to 21.8, p for linear trend = 0.002]. However, mean haemoglobin was not associated with the risk of low birth weight and preterm birth.

The investigators found no evidence of a significant effect on duration of gestation, small for gestational age births and birth length and duration of iron use was not significantly associated with the outcomes after adjustment for dose.

The investigators concluded daily prenatal use of iron substantially improved birth weight in a linear dose-response fashion, probably leading to a reduction in risk of low birth weight. An improvement in prenatal mean haemoglobin concentration linearly increased birth weight and a linear decrease in maternal anaemia with higher doses of iron, up to 66 mg/day.

Original title:
Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis by Haider BA, Olofin I, […], Fawzi WW.

Link:
http://www.bmj.com/content/346/bmj.f3443

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Iron deficiency anaemia occurs when there isn't enough iron in the body. Anaemia is a condition where the amount of haemoglobin in the blood is below the normal level.
Iron deficiency anaemia has been defined as haemoglobin 110 g/L and serum ferritin 12 µg/L.

Objectives:
Several reviews and meta-analyses have examined the effects of iodine on mental development. However, none focused on young children, so they were incomplete in summarizing the effects on this important age group. Therefore, this review article has been conducted.

Is there a relationship between iodine and mental development of children 5 years old and under?

Study design:
This review article included 24 studies (14 cohort en 10 intervention studies).
Studies providing supplementation to women before or during pregnancy tended to give injections of iodized oil of 950 mg; only the studies conducted in China and DR Congo gave lower doses (400 and 475 mg, respectively).
The median sample size per group across the 10 intervention studies was 50 with a range of 7 to 624.

Results and conclusions:
The investigators found that the best estimate to date of the effect size of iodine supplementation on mental development in children 5 years old and under was 0.49, which translated into 7.4 IQ points lost due to iodine deficiency.

The investigators found 6.9 to 10.2 IQ points lower in iodine deficient children compared with iodine replete children.

The investigators concluded, regardless of study design, iodine deficiency has a substantial impact on mental development in children 5 years old and under. To further quantify the importance of iodine for mental development in young children, this review points to the need for well-designed randomized controlled trials with adequate sample sizes as well as studies that assess the effectiveness of iodized salt.

Original title:
Iodine and Mental Development of Children 5 Years Old and Under: A Systematic Review and Meta-Analysis by Bougma K, Aboud FE, […], Marquis GS.

Link:
http://www.mdpi.com/2072-6643/5/4/1384/htm

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