Nutrition and health

Objectives:
Previous observational studies regarding the existence of an association between folate intake and the risk of breast cancer have been inconsistent. Therefore, this review article has been conducted.

Does a higher dietary folate intake reduce breast cancer risk?

Study design:
This review article included 14 prospective cohort studies that reported data on 677,858 individuals.
The participant follow-up period ranged 4.7-17.4 years and the number of individuals per study ranged 11,699-88,818.
There was no publication bias.

Results and conclusions:
The investigators found no association between dietary folate intake and breast cancer risk for highest versus lowest category  [RR =  0.97, 95% CI = 0.90-1.05, p  = 0.451, I2 =  57.5%, p = 0.004].

The investigators found dose-response meta-analysis findings showed no association between the risk of breast cancer and a 100 µg/day increase in dietary folate intake [RR = 0.99, 95% CI = 0.98-1.01, p = 0.361, I2 = 66.2%, p 0.001].

The investigators found evidence of a nonlinear relationship between dietary folate intake and the risk of breast cancer.

A daily dietary folate intake of 200-320 µg was associated with a reduced risk of breast cancer. However, daily folate intake levels >400 µg was associated with a increased risk of breast cancer.

The investigators found overall folate intake level was associated with a reduced breast cancer risk of 36% if the patients had a daily alcohol intake >10 g [RR for highest versus lowest category = 0.64, 95% CI = 0.43-0.97].

The investigators concluded there are no effects of increased dietary folate intake on the incidence of breast cancer. But, a daily dietary folate intake of 200-320 µg was associated with a reduced risk of breast cancer. However, daily folate intake levels >400 µg was associated with a increased risk of breast cancer. Future studies should focus on specific populations in order to analyze primary breast cancer prevention.

Original title:
Folate Intake and the Risk of Breast Cancer: A Dose-Response Meta-Analysis of Prospective Studies by Zhang YF, Shi WW, […], Zhou YH.

Link:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4059748/

Additional information of El Mondo:
Find more studies/information on folate intake and breast cancer right here.
 

Objectives:
Does magnesium supplementation reduce risk of cardiovascular disease among diabetic subjects?

Study design:
This review article included RCTs.

Results and conclusions:
The investigators found magnesium supplementation significantly improved fasting plasma glucose with 4.641 mg/dL [WMD = -4.641 mg/dL, 95% CI = -7.602 to -1.680, p = 0.002]. A more beneficial effect of magnesium supplementation was observed in diabetic subjects with hypomagnesaemia.

The investigators found magnesium supplementation significantly improved high-density lipoprotein (HDL or good cholesterol) with 3.197 mg/dL [WMD = 3.197 mg/dL, 95% CI = 1.455 to 4.938, p 0.001]. A more beneficial effect of magnesium supplementation was observed in diabetic subjects with hypomagnesaemia.

The investigators found magnesium supplementation significantly improved low-density lipoprotein (LDL or bad cholesterol) with 10.668 mg/dL [WMD = -10.668 mg/dL, 95% CI = -19.108 to -2.228, p = 0.013]. A more beneficial effect of magnesium supplementation was observed in diabetic subjects with hypomagnesaemia.

The investigators found magnesium supplementation significantly improved plasma triglycerides with 15.323 mg/dL [WMD = -15.323 mg/dL, 95% CI = -28.821 to -1.826, p = 0.026]. A more beneficial effect of magnesium supplementation was observed in diabetic subjects with hypomagnesaemia.

The investigators found magnesium supplementation significantly improved systolic blood pressure with 3.056 mmHg [WMD = 3.056 mmHg, 95% CI = -5.509 to -0.603, p = 0.015]. A more beneficial effect of magnesium supplementation was observed in diabetic subjects with hypomagnesaemia.

The investigators concluded magnesium supplementation has a favourable effect on risk factors of cardiovascular diseases. Although future large RCTs are needed for making robust guidelines for clinical practice.

Original title:
Effect of magnesium supplementation on type 2 diabetes associated cardiovascular risk factors: a systematic review and meta-analysis by Verma H and Garg R.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28150351

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

Objectives:
Iron-deficiency anaemia is common during childhood. Iron administration has been claimed to increase the risk of malaria. Therefore, this meta-analysis (review article) has been conducted.

Does iron administration with or without folic acid, increase malaria risk in children living in areas with hyperendemic or holoendemic malaria transmission? 

Study design:
This review article included 35 RCTs comprising 31,955 children younger than 18 years of age.

Results and conclusions:
The investigators found in 14 trials with 7168 children that overall, iron administration did cause an excess of clinical malaria [risk ratio = 0.93, 95% CI = 0.87 to 1.00; high quality evidence].

The investigators found iron administration probably did not cause an excess of clinical malaria in both populations where anaemia is common and those in which anaemia is uncommon.

The investigators found in 7 trials with 5,586 participants conducted in areas where there are prevention and management services for malaria that iron administration (with or without folic acid) significantly reduced clinical malaria risk with 9% [RR = 0.91, 95% CI = 0.84 to 0.97; low quality evidence].
However, in areas where such services are unavailable, iron administration (with or without folic acid) significantly increased the incidence of malaria [RR = 1.16, 95% CI = 1.02 to 1.31; nine trials, 19,086 participants, low quality evidence].

The investigators found in 3 RCTs with 728 children that iron administration and antimalarial treatment significantly reduced clinical malaria risk with 46% [RR = 0.54, 95% CI = 0.43 to 0.67, I2 = 0%; high quality evidence].
However, there was no difference in the risk of death [RR = 1.05, 95% CI = 0.52 to 2.11].

The investigators found overall, iron administration resulted in fewer anaemic children at follow up and the end average change in haemoglobin from base-line was higher with iron administration.

The investigators concluded there was no increased risk of clinical malaria and parasitaemia, all-cause mortality, or other infectious complications with iron supplementation alone for children living in areas with intense malaria transmission. However, iron supplementation may be associated with an increased risk of malaria in settings with no access to malaria prevention or management services, but is safe when such services are available. In such circumstances, administration of iron with an antimalarial drug confers significant protection from malaria and probably reflects the effect of the antimalarial drugs. Furthermore, iron supplementation significantly improves haemoglobin levels and reduces the prevalence of anaemia in highly malaria-endemic areas. Universal screening for iron deficiency and anaemia can select the population most likely to benefit from iron administration, but such screening programmes are not currently feasible in most areas with intense malaria transmission.

Original title:
Oral iron supplements for children in malaria-endemic areas by Neuberger A, Okebe J, […], Paul M.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4916933/

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

Objectives:
Is a low maternal circulating 25 hydroxyvitamin D (25-OHD) associated with an increased risk of preterm birth or spontaneous preterm birth and can vitamin D supplementation alone during pregnancy reduce risk of preterm birth?

Study design:
This review article included 6 RCTs and 18 observational studies.

Results and conclusions:
The investigators found maternal circulating 25-OHD deficiency significantly increased risk of preterm birth with 25% [pooled OR = 1.25, 95% CI = 1.13-1.38]. However, maternal circulating 25-OHD insufficiency was not associated with an increased risk of preterm birth [pooled OR = 1.09, 95% CI = 0.89-1.35]. Not associated because OR of 1 was found in 95% CI of 0.89 to 1.35. OR of 1 means no risk/association.

The investigators found vitamin D supplementation alone during pregnancy significantly reduced risk of preterm birth with 43% [pooled RR = 0.57, 95% CI = 0.36-0.91]. Significantly because RR of 1 was not found in 95% CI of 0.36 to 0.91. RR of 1 means no risk/association.

The investigators found maternal circulating 25-OHD 50 nmol/L significantly increased risk of spontaneous preterm birth with 45% [pooled OR = 1.45, 95% CI = 1.20-1.75]. 

The investigators concluded a maternal circulating 25-OHD 50 nmol/L increases risk of spontaneous preterm birth and vitamin D supplementation alone during pregnancy reduces risk of preterm birth. However, extrapolation of the results must be done with caution and there is urgent need for larger, better-designed RCT to confirm this effect.

Original title:
Vitamin D and risk of preterm birth: Up-to-date meta-analysis of randomized controlled trials and observational studies by Zhou SS, Tao YH, […], Tao FB.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28150405

Additional information of El Mondo:
Find more information/studies about vitamin D, pregnancy, review article, significant and 95% CI right here.

Objectives:
Increasing evidence suggests that the Mediterranean diet can reduce the risk of cardiovascular disease. Olive oil is the hallmark of this dietary pattern. Therefore, this review article has been conducted.

Does olive oil consumption reduce risk of cardiovascular disease?

Study design:
This review article included case-control, prospective cohort studies and a randomised controlled trial investigating the specific association between olive oil consumption and the risk of cardiovascular disease (101,460 participants) or stroke (38,673 participants). The results of all observational studies were adjusted for total energy intake.

Evidence of heterogeneity was apparent for cardiovascular disease, but not for stroke. Both the Egger test (p = 0.06) and the funnel plot suggested small-study effects.

Results and conclusions:
The investigators found in case-controle studies a non-significant reduced risk of 27% [relative risk = 0.73, 95% CI = 0.44-1.21] for cardiovascular disease for a 25g increase in olive oil consumption.

The investigators found in cohort studies a non-significant reduced risk of 4% [relative risk = 0.96, 95% CI = 0.78-1.18] for cardiovascular disease for a 25g increase in olive oil consumption.

The investigators found in cohort studies olive oil consumption significantly reduced risk of stroke with 26% [relative risk = 0.74, 95% CI = 0.60-0.92].

The investigators found random-effects model showed a significant reduced risk of 18% [RR = 0.82, 95% CI = 0.70, 0.96] for combining all cardiovascular events (CHD and stroke).

The investigators concluded available studies support an inverse association of olive oil consumption with stroke and with stroke and cardiovascular disease combined. This finding is in agreement with the recent successful results of the PREDIMED randomised controlled trial.

Original title:
Olive oil consumption and risk of CHD and/or stroke: a meta-analysis of case-control, cohort and intervention studies by Martínez-González MA, Dominguez LJ and Delgado-Rodríguez M.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/24775425

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

Objectives:
The conclusions from epidemiological studies are controversial between apple and pear consumption and type 2 diabetes mellitus (T2DM) risk. Therefore, this meta-analysis (systematic review) has been conducted.

Study design:
This review article included a total of 5 independent prospective cohort studies with 14,120 T2DM incident cases among 228,315 participants.

Results and conclusions:
The investigators found consumption of apples and pears was associated with 18% reduction in type 2 diabetes mellitus risk [multivariate-adjusted relative risk = 0.82, 95% CI = 0.75-0.88, I2 = 0.00%] when comparing the highest versus lowest category.

The investigators found dose-response analysis showed that one serving per week increment of apple and pear consumption was associated with a 3% [95% CI = 0.96-0.98, p for trend 0.001] reduction in type 2 diabetes mellitus risk.

The investigators concluded a higher consumption of apples and pears; at least one serving per week reduces type 2 diabetes mellitus risk.

Original title:
Apple and pear consumption and type 2 diabetes mellitus risk: a meta-analysis of prospective cohort studies by Guo XF, Yang B, […], Li D.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28186516

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

The standard serving size is a 1/2 cup of sliced fruit. A medium pear produces approximately 1 cup of fruit; so an average medium pear equals two fruit servings.
1 small apple = 1 serving.
 

Objectives:
What is the impact of antioxidants (N-acetylcysteine (NAC), polyunsaturated fatty acids (PUFAs) and vitamins) on incidence of postoperative atrial fibrillation (POAF) and duration of length of hospital stay?

Study design:
This review article included 23 RCTs that reported outcomes of 4278 patients undergoing cardiac surgery.
A total of 10 RCTs with 1,026 patients (513 cases were allocated to the NAC and 513 cases to the control group, with a mean age of 63.2 years and 76.8% being males), 8 RCTs with 2,687 patients (with a mean age of 64.17 years and 77.6% being males), and 5 RCTs with 565 patients (with a mean age of 65.17 years and 73.6% being males) investigated the effect of NAC, PUFA and antioxidant vitamins on POAF, respectively.

There was no publication bias.

Results and conclusions:
The investigators found pooled effects estimates on postoperative atrial fibrillation showed a significant reduction after:
NAC [OR = 0.56, 95% CI = 0.40-0.77, p 0.001, I2 = 15%, p = 0.3];
PUFA [OR = 0.84, 95% CI = 0.71-0.99, p = 0.03] and;
Vitamin C treatment [OR = 0.50, 95% CI = 0.27-0.91, p = 0.02, I2 = 50%].

The investigators found hospital length of stay was not significant reduced after NAC therapy [SMD = 0.082, 95% CI = -0.09 to 0.25, p = 0.3, I2 = 0.0%, p = 0.7], but could be significant decreased with PUFA [SMD = -0.185, 95% CI = -0.35 to -0.018, p = 0.03, I2 = 11%, p = 0.3] and vitamin C [SMD = -0.325, 95% CI = -0.50 to -0.14, p 0.01, I2 = 60.4%, p = 0.056].
Significant because the p-values were less than the p-value of 0.05.

The investigators concluded perioperative antioxidant supplementations with N-acetylcysteine, polyunsaturated fatty acids and vitamin C prevent atrial fibrillation after cardiac surgery. Moreover, polyunsaturated fatty acids and vitamin C are capable to reduce hospital stay, whereas N-acetylcysteine lacks this capacity.

Original title:
Antioxidant supplementations for prevention of atrial fibrillation after cardiac surgery: an updated comprehensive systematic review and meta-analysis of 23 randomized controlled trials by Ali-Hassan-Sayegha S, Mirhosseinia SJ, […], Liakopoulose OJ.

Link:
http://icvts.oxfordjournals.org/content/early/2014/02/19/icvts.ivu020.long

Additional information of El Mondo:
Find more studies on cardiovascular diseases, antioxidants, NAC, PUFA, vitamin C and p-value of 0.05/95% CI right here. 

Objectives:
Does niacine supplementation reduce blood lipids levels in patients with type 2 diabetes mellitus?

Study design:
This review article included randomized controlled trials.

The meta-analysis showed the absence of publication bias and any dose-response relations between niacin and effect size.

There was a significant heterogeneity for the impact of niacin on LDL cholesterol and fasting plasma glucose.

Results and conclusions:
The investigators found niacin supplementation significantly increased HDL cholesterol with 0.27 mmol/L [95% CI = 0.24 to 0.30, p 0.001] in patients with type 2 diabetes mellitus.

The investigators found niacin supplementation significantly reduced LDL cholesterol with 0.250 mmol/L [95% CI = -0.47 to -0.03, p 0.05] in patients with type 2 diabetes mellitus.

The investigators found niacin supplementation significantly reduced triglycerides with 0.39 mmol/L [95% CI = -0.43 to -0.34, p 0.001] in patients with type 2 diabetes mellitus.

The investigators found niacin supplementation significantly increased fasting plasma glucose with 0.085 mmol/L [95% CI = 0.029 to 0.141, p 0.05] compared with controls in patients with long term treatment.

The investigators concluded niacin alone or in combination improves lipid abnormalities in patients with type 2 diabetes mellitus, but requires monitoring of glucose in long term treatment.

Original title:
Effect of niacin on lipids and glucose in patients with type 2 diabetes: A meta-analysis of randomized, controlled clinical trials by Ding Y, Li Y and Wen A.

Link:
http://www.ncbi.nlm.nih.gov/pubmed/25306426

Additional information of El Mondo:
Find more information on niacin (vitamin B3) and diabetes.

Objectives:
Observational studies suggest an association between dietary fiber intake and risk of type 2 diabetes, but the results are inconclusive. Therefore, this review article (meta-analysis) has been conducted.

Does dietary fiber intake reduce risk of type 2 diabetes?

Study design:
This review article included 17 prospective cohort studies of dietary fiber intake and risk of type 2 diabetes involving 19,033 cases and 488,293 participants.

Results and conclusions:
The investigators found total dietary fiber intake significantly reduced risk of type 2 diabetes with 19% [combined RR = 0.81, 95% CI = 0.73-0.90].

The investigators found dietary cereal fiber intake significantly reduced risk of type 2 diabetes with 23% [combined RR = 0.77, 95% CI = 0.69-0.85].

The investigators found dietary fruit fiber intake significantly reduced risk of type 2 diabetes with 6% [combined RR = 0.94, 95% CI = 0.88-0.99].

The investigators found dietary insoluble fiber intake significantly reduced risk of type 2 diabetes with 25% [combined RR = 0.75, 95% CI = 0.63-0.89].

The investigators found a nonlinear relationship of total dietary fiber intake with risk of type 2 diabetes [p for nonlinearity 0.01].

The investigators found dietary fiber intake of 15g per day non-significantly reduced risk of type 2 diabetes with 2% [combined RR = 0.98, 95% CI = 0.90-1.06].

The investigators found dietary fiber intake of 20g per day non-significantly reduced risk of type 2 diabetes with 3% [combined RR = 0.97, 95% CI = 0.87-1.07].

The investigators found dietary fiber intake of 25g per day significantly reduced risk of type 2 diabetes with 11% [combined RR = 0.89, 95% CI = 0.80-0.99].

The investigators found dietary fiber intake of 30g per day significantly reduced risk of type 2 diabetes with 24% [combined RR = 0.76, 95% CI = 0.65-0.88].

The investigators found dietary fiber intake of 35g per day significantly reduced risk of type 2 diabetes with 34% [combined RR = 0.66, 95% CI = 0.53-0.82].

The investigators found that the risk of type 2 diabetes decreased by 6% [combined RR = 0.94, 95% CI = 0.93-0.96] for 2 g/day increment in cereal fiber intake.

The investigators concluded that the intakes of dietary fiber, at least 25g total dietary fiber intake per day reduce risk of type 2 diabetes.

Original title:
Dietary fiber intake and risk of type 2 diabetes: a dose–response analysis of prospective studies by Yao B, Fang H, […], Zhao Y.

Link:
http://link.springer.com/article/10.1007/s10654-013-9876-x

Additional information of El Mondo:
Find more information on fiber and type 2 diabetes right here.

Objectives:
Increased consumption of fruit and vegetables has been shown to be associated with a reduced risk of cognitive impairment and dementia in many epidemiological studies; although sometimes the results are inconsistent. Moreover, the strength of the favorable relation remains uncertain due to the differences in sample selections, methodological approaches, analytical techniques and outcome definitions. Therefore, this meta-analysis (review article) has been conducted.

Does an increased consumption of fruit and vegetables reduce risk of cognitive impairment and dementia?

Study design:
This review article included 5 cohort studies and 4 cross-sectional studies with a total of 31,104 participants and 4,583 incident cases of cognitive impairment and dementia.

There was no potential publication bias in the meta-analysis and the dose-response meta-analysis.

Results and conclusions:
The investigators found an increased consumption of fruit and vegetables was associated with a significant reduction of 20% in the risk of cognitive impairment and dementia [OR = 0.80, 95% CI = 0.71-0.89, I2 = 55.2%, p = 0.005].

The investigators found subgroup analyses showed an inverse association between fruit and vegetable consumption and risk of cognitive impairment and dementia in participants with mean age over 65 years [OR = 0.80, 95% CI = 0.71-0.91] and combined sexes [OR = 0.71, 95% CI = 0.66-0.78]. However, studies from the United States and with full marks of study quality score did not show statistical significances.

The investigators found dose-response meta-analysis showed that an increment of 100g per day of fruit and vegetable consumption was related to a 13% [OR = 0.87, 95% CI = 0.77-0.99, I2 = 39.8%, p = 0.173] reduction in cognitive impairment and dementia risk.

The investigators concluded that an increased consumption of fruit and vegetables, at least 100g per day of fruit and vegetable consumption is associated with a reduced risk of cognitive impairment and dementia.

Original title:
Increased Consumption of Fruit and Vegetables Is Related to a Reduced Risk of Cognitive Impairment and Dementia: Meta-Analysis by Jiang X, Huang J, [...], Zhang Z.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5293796/

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

Objectives:
Is there an association between folate level and the risk of schizophrenia?

Study design:
This review article included 16 high quality studies with a total of 1,183 (52.1%) cases and 1,089 (47.9%) controls.

There was no publication bias based on Egger’s and Begg’s tests [p = 0.48 and 0.30, respectively].

Results and conclusions:
The investigators found folate level in schizophrenia patients was significantly lower than that in healthy controls [SMD = -0.65, 95% CI = -0.86 to -0.45, p 0.00001].

The investigators found in subgroup analysis a decreased folate level in both Asian and European patients (SMD = -0.86, p 0.00001 and SMD = -0.44, p 0.00001, respectively], while there were no significant differences in patients from other areas [p > 0.05].

The investigators found sensitivity analysis confirmed that these results were stable and reliable.

The investigators concluded decreased folate level is a risk factor for schizophrenia, especially in Asian and European patients. More epidemiological and biochemistry studies are required to describe how folate or folate supplementation play roles in the progress of schizophrenia.

Original title:
Folate Deficiency Increased the Risk of Schizophrenia: a Meta-Analysis by Ding Y, Ju M, […], He L.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28124599

Additional information of El Mondo:
Find more information/studies on folate right here.
The folate level of the human body can be increased by dietary folate intake and/or taking folate supplements.

Objectives:
Many studies suggest that high-fat diets are linked to the etiology of non-Hodgkin's lymphoma (NHL). However, the findings are inconsistent and therefore the association between fat and non-Hodgkin's lymphoma remains unclear. Therefore, this review article (meta-analysis) has been conducted.

Does a high fat dietary intake increase non-Hodgkin's lymphoma risk?

Study design:
This review article included two cohort studies and eight case-control studies.

The funnel plot revealed no evidence for publication bias.

Results and conclusions:
The investigators found a significant higher risk of 26% for non-Hodgkin's lymphoma for total fat consumption [RR = 1.26, 95% CI = 1.12-1.42]. Significant because RR of 1 was not found in the 95% CI of 1.12 to 1.42. RR of 1 means no risk/association.

The investigators found subgroup analysis showed a significant higher risk of 41% for diffuse large B-cell lymphoma for total fat consumption [RR = 1.41, 95% CI = 1.08-1.84]. However, there was no significant association between total fat consumption and increase risk of follicular lymphoma [RR = 1.21, 95% CI = 0.97-1.52], small lymphocytic lymphoma/chronic lymphocytic leukemia [RR = 0.91, 95% CI = 0.68-1.23] nor with T cell lymphoma [RR = 1.12, 95% CI = 0.60-2.09].
No significant because RR of 1 was found in the 95% CI of 0.60 to 2.09. RR of 1 means no risk/association.

The investigators concluded that total fat consumption increases non-Hodgkin's lymphoma; especially diffuse large B-cell lymphoma.

Original title:
Dietary Fat Consumption and Non-Hodgkin's Lymphoma Risk: A Meta-analysis by Han TJ, Li JS, [...], Xu HZ.

Link:

https://www.ncbi.nlm.nih.gov/pubmed/28094569

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

Lymphoma is the most common blood cancer. The two main forms of lymphoma are Hodgkin lymphoma and non-Hodgkin lymphoma (NHL). The human body has two main types of lymphocytes that can develop into lymphomas:

1. B lymphocytes (B cells) and;
2. T lymphocytes (T cells).

B-cell lymphomas are much more common than T-cell lymphomas and account for approximately 85 percent of all non-Hodgkin lymphomas. Diffuse large B cell lymphomas (DLBCLs) are the commonest subtype of non-Hodgkin's lymphoma. They constitute about 30 to 40% of adult non-Hodgkin's lymphoma.

A high total fat consumption corresponds to a diet with >35 En% fat and/or >10 En% saturated fat. A diet with >35 En% fat is a diet with a lot of products/meals providing >35 En% fat.
 

Objectives:
Several epidemiological studies investigating the association between dietary vitamin E intake and the risk of lung cancer have demonstrated inconsistent results. Therefore, this review article (meta-analysis) has been conducted.

Does dietary vitamin E intake reduce lung cancer risk?

Study design:
This review article included 9 cohort studies with 4,164 lung cancer cases among 435,532 participants.

The Egger’s test showed no evidence of publication bias [t = 1.24, p = 0.246].

Results and conclusions:
The investigators found for the highest versus lowest categories of dietary vitamin E intake a reduced risk of 16% for lung cancer [pooled RR = 0.84, 95% CI = 0.76-0.93, I2 = 41.1%].

The investigators found in subgroup analysis by geographic location a significant inverse association of dietary vitamin E intake with lung cancer for the European and American populations [pooled RR = 0.85, 95% CI = 0.75-0.95), but not for the Asian population. Significant means that there is an association with a 95% confidence.

The investigators found every 2 mg/d increase in dietary vitamin E intake statistically decreased the risk of lung cancer by 5% [RR = 0.95, 95% CI = 0.91-0.99, p linearity = 0.0237].

The investigators concluded that higher dietary vitamin E intake; at least 2 mg per day exerts a protective effect against lung cancer.

Original title:
Association of dietary vitamin E intake with risk of lung cancer: a dose-response meta-analysis by Zhu YJ, Bo YC, [...], Qiu CG.

Link:
http://apjcn.nhri.org.tw/server/APJCN/26/2/271.pdf

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

Objectives:
Epidemiological studies suggest that soya consumption as a source of phyto-oestrogens and isoflavones may be associated with a reduced risk of colorectal cancer. However, findings have not yet been synthesised for all groups of phyto-oestrogens. Therefore, this review article (meta-analysis) has been conducted.

Does soya consumption reduce colorectal cancer risk?

Study design:
This review article included 16 studies (case-control studies and cohort studies).

Results and conclusions:
The investigators found in case-controle studies a significant reduced risk of 24% [pooled RR = 0.76, 95% CI = 0.69-0. 84] for colorectal cancer when comparing the highest phyto-oestrogens with the lowest intake category. However, the reduced risk for colorectal cancer was not significant in cohort studies [pooled RR = 0.95, 95% CI = 0.85-1.06].

The investigators found in case-controle studies a significant reduced risk of 23% [pooled RR = 0.77, 95% CI = 0.69-0. 85] for colorectal cancer when comparing the highest isoflavones with the lowest intake category. However, the reduced risk for colorectal cancer was not significant in cohort studies [pooled RR = 0.94, 95% CI = 0.84-1.05].

The investigators found in case-controle studies a significant reduced risk of 30% [pooled RR = 0.70, 95% CI = 0.56-0. 89] for colorectal cancer when comparing the highest lignans with the lowest intake category. However, the reduced risk for colorectal cancer was not significant in cohort studies [pooled RR = 1.00, 95% CI = 0.64-1.57].

The investigators found dose-response analysis yielded an 8% reduced risk of colorectal neoplasms for every 20 mg/d increase in isoflavones intake in Asians [pooled RR = 0.92, 95% CI = 0.86-0.97].

The investigators found dose-response analysis showed a non-linear inverse association with colorectal cancer risk for lignans intake, but no association for circulating enterolactone concentrations was observed.

The investigators concluded every 20 mg/d increase in isoflavones dietary intake reduces risk of colorectal neoplasms with 8% in Asians.

Original title:
Phyto-oestrogens and colorectal cancer risk: a systematic review and dose-response meta-analysis of observational studies by Jiang R, Botma A, […], Chang-Claude J.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28091359

Additional information of El Mondo:
Find more information/studies on isoflavones, colorectal cancer and cohort study/review article right here.

Objectives:
The association between serum folate and vitamin B12 levels and the risk of diabetic peripheral neuropathy (DPN) remains unclear. Therefore, this review article (meta-analysis) has been conducted.

Do reduced serum levels of folate and vitamin B12 increase peripheral neuropathy risk among patients with type 2 diabetes?

Study design:
This review article included 16 studies of serum folate levels (1190 patients with diabetic peripheral neuropathy and 1501 patients without diabetic peripheral neuropathy) and 18 studies of serum vitamin B12 levels (1239 patients with diabetic peripheral neuropathy and 1562 patients without diabetic peripheral neuropathy) in patients with type 2 diabetes mellitus (T2DM).

Results and conclusions:
The investigators found reduced serum levels of folate in patients with type 2 diabetes and diabetic peripheral neuropathy compared with patients with type 2 diabetes but without diabetic peripheral neuropathy [WMD = -1.64, 95% CI = -2.46 to -0.81].
A subgroup analysis confirmed this association in the Chinese population, but not in the Caucasian and mixed populations.

The investigators found reduced serum levels of vitamin B12 in patients with type 2 diabetes and diabetic peripheral neuropathy compared with patients with type 2 diabetes but without diabetic peripheral neuropathy [WMD = -70.86, 95% CI = -101.55 to -40.17].
A subgroup analysis confirmed this association in the Chinese population, but not in the Caucasian and mixed populations.

The investigators concluded reduced serum levels of folate and vitamin B12 increase peripheral neuropathy risk among patients with type 2 diabetes. These findings support the need for further controlled studies in defined patient populations and the importance of monitoring serum folate and vitamin B12 levels in patients with type 2 diabetes.

Original title:
Serum folate, vitamin B12 levels and diabetic peripheral neuropathy in type 2 diabetes: A meta-analysis by Wang D, Zhai JX and Liu DW.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28081987

Additional information of El Mondo:
Find more information/studies on diabetes, folate and vitamin B12 right here.

Diabetic peripheral neuropathy is a long-term complication of diabetes. Exposure to high blood glucose levels over an extended period of time causes damage to the peripheral nerves; the nerves that go to the arms, hands, legs and feet. It is one of many complications associated with diabetes, with nearly 60 percent of diabetics having some form of nerve damage.

Objectives:
Some observational studies have shown that elevated serum selenium levels are associated with reduced prostate cancer risk. However, not all published studies support these results. Therefore, this review article (meta-analysis) has been conducted.

Does an elevated serum selenium level reduce prostate cancer risk?

Study design:
This review article included 12 case-control studies, 4 cohort studies and 1 RCT with 6,136 prostate cancer cases among 34,901 participants.

Results and conclusions:
The investigators found elevated serum selenium levels significantly decreased prostate cancer risk with 24% [pooled OR = 0.76, 95% CI = 0.64 to 0.91, I2  =  60.8%, p  =  0.001].  Significant means that there is an association with a 95% confidence.

The investigators found in subgroup analysis, an inverse association between elevated serum selenium levels and prostate cancer risk in case-control studies, current and former smokers, high-grade cancer cases, advanced cancer cases and different populations. However, such correlations were not found among cohort studies, nonsmokers, low-grade cancer cases and early stage cancer cases.

The investigators concluded that elevated serum selenium levels may decrease high-grade prostate cancer among current and former smokers. May decrease because the inverse relationship between elevated serum selenium levels and prostate cancer risk was not significant among cohort studies. Therefore, further cohort studies and randomized control trials based on non-Western populations are required.

Original title:
Serum selenium levels and prostate cancer risk: A MOOSE-compliant meta-analysis by Cui Z, Liu D, […], Liu G.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5293444/

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

Objectives:
Is there an association between individual micronutrients and blood pressure in patients with type 2 diabetes?

Study design:
This review article included 11 RCTs (13 interventions, 723 patients with type 2 diabetes and ages ranging from 50.7 to 66.8 years and 54% of them were males. The duration of diabetes varied from 4.6 to 8.6 years) with 3 to 52 weeks of follow-up were classified according to the type of micronutrient intervention: sodium (n = 1), vitamin C (n = 2), vitamin D (n = 7) and magnesium (n = 1).
Only a meta-analysis of vitamin C and D was able to perform with the available data.

Results and conclusions:
The investigators found vitamin C significantly reduced diastolic blood pressure of patients with type 2 diabetes with 2.88mmHg [WMD = -2.88 mmHg, 95% CI = -5.31 to -0.46, p = 0.020].
However, vitamin C not significantly reduced systolic blood pressure [WMD = -3.93mmHg, 95% CI = -14.78 to 6.92, p = 0.478].
Significant means that there is an association with a 95% confidence.

The investigators found vitamin D significantly reduced diastolic blood pressure of patients with type 2 diabetes with 2.44mmHg [WMD = -2.44 mmHg, 95% CI = -3.49 to -1.39, p  0.001].

The investigators found vitamin D significantly reduced systolic blood pressure of patients with type 2 diabetes with 4.56mmHg [WMD = -4.56 mmHg, 95% CI = -7.65 to -1.47, p = 0.004].

The investigators concluded vitamin D and possibly vitamin C have beneficial effects on blood pressure in patients with type 2 diabetes. Therefore, these interventions might represent a novel approach to the treatment of hypertension in patients with type 2 diabetes.

Original title:
Effects of individual micronutrients on blood pressure in patients with type 2 diabetes: a systematic review and meta-analysis of randomized clinical trials by de Paula TP, Kramer CK, [...], Azevedo MJ.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5233957/

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

Objectives:
Has coenzyme Q10 supplementation lowering effects on inflammatory mediator C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α)?

Study design:
This review article included 17 RCTs.

Results and conclusions:
The investigators found coenzyme Q10 supplementation significantly reduced the levels of circulating CRP with 0.35 mg/L [95% CI = -0.64 to -0.05, p = 0.022].
The results of meta-regression showed that the changes of CRP were independent of baseline CRP, treatment duration, dosage and patients characteristics.

The investigators found coenzyme Q10 supplementation significantly reduced the levels of circulating IL-6 with 1.61 pg/mL [95% CI = -2.64 to -0.58, p = 0.002].
In the meta-regression analyses, a higher baseline IL-6 level was significantly associated with greater effects of coenzyme Q10 on IL-6 levels [p for interaction = 0.006].

The investigators found coenzyme Q10 supplementation significantly reduced the levels of circulating TNF-α with 0.49 pg/mL [95% CI = -0.93 to -0.06, p = 0.027].

The investigators concluded coenzyme Q10 supplementation has lowering effects on CRP, IL-6 and TNF-α. However, these results should be interpreted with caution because of evidence of heterogeneity between studies and limited number of studies.

Original title:
Effects of coenzyme Q10 supplementation on inflammatory markers: A systematic review and meta-analysis of randomized controlled trials by Fan L, Feng Y, […], Chen LH.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28179205

Additional information of El Mondo:
Find here more information/studies about coenzyme Q10.

Objectives:
Creatine is the most widely used supplementation to increase performance in strength; however, the most recent meta-analysis focused specifically on supplementation responses in muscles of the lower limbs without regard to upper limbs. Therefore, this review article (meta-analysis) has been conducted.

Does creatine supplementation increase strength performance of upper limb for exercise with a duration of less than 3 minutes?

Study design:
This review article included 53 studies (563 individuals in the creatine supplementation group and 575 individuals in the control group (placebo group)).

Results and conclusions:
The investigators found for creatine group versus control group no significant effect at T0. However, at T1, the effect size (ES) for bench press and chest press were 0.265 [95% CI = 0.132-0.398, p 0.001] and 0.677 [95% CI = 0.149-1.206, p = 0.012], respectively.

The investigators found for creatine group versus control group overall, pectoral ES was 0.289 [95% CI = 0.160-0.419, p = 0.000] and global upper limb ES was 0.317 [95% CI = 0.185-0.449, p 0.001].

The investigators found meta-analysis of changes between T0 and T1 gave similar results.

The investigators found meta-regression analysis showed no link with characteristics of population or supplementation, demonstrating the efficacy of creatine independently of all listed conditions.

The investigators concluded creatine supplementation is effective in upper limb strength performance for exercise with a duration of less than 3 minutes, independent of population characteristics, training protocols and supplementary doses or duration.

Original title:
Creatine Supplementation and Upper Limb Strength Performance: A Systematic Review and Meta-Analysis by Lanhers C, Pereira B, […], Dutheil F.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/27328852

Additional information of El Mondo:
Find here more information/studies about sport nutrition and creatine.

Objectives:
Different adiposity measures have been associated with increased risk of atrial fibrillation, however, results have previously only been summarized for BMI. Therefore, this review article (meta-analysis) has been conducted.

Is there an association between different adiposity measures and risk of atrial fibrillation?

Study design:
This review article included 25 prospective studies with 83,006 cases among 2,405,381 participants.

Results and conclusions:
The investigators found every 5 unit increment in BMI significantly increased risk of atrial fibrillation with 28% [RR= 1.28, 95% CI = 1.20-1.38, I2 = 97%].

The investigators found every 10 cm increase in waist circumference significantly increased risk of atrial fibrillation with 18% [95% CI = 1.12-1.25, I2 = 73%, n = 5].

The investigators found every 10 cm increase in hip circumference significantly increased risk of atrial fibrillation with 32% [95% CI = 1.16-1.51, I2 = 91%, n = 3].

The investigators found every 0.1 unit increase in waist-to-hip ratio significantly increased risk of atrial fibrillation with 9% [95% CI = 1.02-1.16, I2 = 44%, n = 4].

The investigators found every 5 kg increase in fat mass significantly increased risk of atrial fibrillation with 9% [95% CI = 1.02-1.16, I2 = 94%, n = 4].

The investigators found every 10% increase in fat percentage nonsignificantly increased risk of atrial fibrillation with 10% [95% CI = 0.92-1.33, I2 = 90%, n = 3]. Nonsignificantly because RR of 1 can be found in the 95% CI of 0.92 to 1.33. RR of 1 means no risk.

The investigators found every 5 kg increase in weight significantly increased risk of atrial fibrillation with 10% [95% CI = 1.08-1.13, I2 = 74%, n = 10].

The investigators found every 5% increase in weight gain nonsignificantly increased risk of atrial fibrillation with 8% [95% CI = 0.97-1.19, I2 = 86%, n = 2]. Nonsignificantly means, there is no association at a 95% confidence.

The investigators found the association between BMI and atrial fibrillation was nonlinear [p nonlinearity 0.0001] with a stronger association at higher BMI levels. However, increased risk was observed even at a BMI of 22-24 compared to 20.

The investigators concluded general and abdominal adiposity and higher body fat mass increase risk of atrial fibrillation.

Original title:
Body mass index, abdominal fatness, fat mass and the risk of atrial fibrillation: a systematic review and dose-response meta-analysis of prospective studies by Aune D, Sen A, […], Vatten LJ.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28194602

Additional information of El Mondo:
Find here more information/studies about cardiovascular diseases and overweight.

Objectives:
The associations between dietary zinc and iron intake and risk of depression remain controversial. Therefore, this meta-analysis (systematic review) has been conducted.

Do dietary zink and iron intake decrease risk of depression?

Study design:
This review article included a total of 9 studies for dietary zinc intake and 3 studies for dietary iron intake. 

Results and conclusions:
The investigators found for the highest versus lowest dietary zinc a significant reduced risk of 33% [pooled RR = 0.67, 95% CI = 0.58-0.76] for depression.

The investigators found for the highest versus lowest dietary iron a significant reduced risk of 43% [pooled RR = 0.57, 95% CI = 0.34-0.95] for depression.

The investigators found in subgroup analysis by study design, the inverse association between dietary zinc intake and risk of depression remained significant in cohort studies and cross-sectional studies.

The investigators found the pooled RRs (95% CIs) for depression did not substantially change in the influence analysis and subgroup analysis by adjustment for body mass index (BMI).

The investigators concluded dietary zinc intake reduces risk of depression.

Original title:
Dietary zinc and iron intake and risk of depression: A meta-analysis by Li Z, Li B, [...], Zhang D.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28189077

Additional information of El Mondo:
Find here more information/studies about zinc and review article/95% CI.

Objectives:
Vitamin B12 deficiency in pregnancy is prevalent and has been associated with both lower birth weight (birth weight 2,500 g) and preterm birth (length of gestation 37 weeks). Nevertheless, current evidence is contradictory. Therefore, this meta-analysis (systematic review) has been conducted.

Is there an association between maternal serum or plasma vitamin B12 concentrations in pregnancy and offspring birth weight and length of gestation?

Study design:
This review article included 18 studies.

Results and conclusions:
The investigators found a non-linear association between maternal vitamin B12 levels in pregnancy and birth weight.

The investigators found vitamin B12 deficiency (148 pmol/L) was significantly associated with a 15% higher risk for low birth weight in newborns [adjusted risk ratio = 1.15, 95% CI = 1.01 to 1.31].

The investigators found for each 1-standard-deviation increase in maternal levels of vitamin B12 a significant reduced risk of 11% for preterm birth [adjusted risk ratio = 0.89, 95% CI = 0.82 to 0.97].

The investigators found vitamin B12 deficiency (148 pmol/L) was non-significantly associated with a 21% higher risk for preterm birth [adjusted risk ratio = 1.21, 95% CI = 0.99 to 1.49].

The investigators concluded a maternal vitamin B12 deficiency (148 pmol/L) was associated with a higher risk for low birth weight in newborns. Therefore, this finding supports the need for randomized controlled trials of vitamin B12 supplementation in pregnancy.

Original title:
Associations of Maternal Vitamin B12 Concentration in Pregnancy With the Risks of Preterm Birth and Low Birth Weight: A Systematic Review and Meta-Analysis of Individual Participant Data by Rogne T, Tielemans MJ, [...], Risnes KR.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28108470

Additional information of El Mondo:
Find here more information/studies about vitamin B12 and pregnancy.

Objectives:
Arthritis patients often take fish oil supplements to alleviate symptoms, but limited evidence exists regarding their efficacy. Therefore, this meta-analysis (systematic review) has been conducted.

Do taking marine oil supplements alleviate pain in arthritis patients?

Study design:
This review article included 42 randomized trials; 30 trials reported complete data on pain.

The trials used treatment durations from 2 weeks to 18 months, with doses of EPA from 0.013 to 4.050 g/day and doses of DHA from 0.010 to 2.700 g/day.
Most trials used marine oil from whole fish, but some used cod liver oil, mussel extracts, seal oil and krill oil.

The trials included 2751 patients with a mean age of 53.8 years (range of mean age of 10-68 years) and the mean disease duration was 9.7 years (range 2.3-19.0 years).

Results and conclusions:
The investigators found a favorable effect [SMD = -0.24, 95% CI = -0.42 to -0.07, I2 = 63%] for using marine oil supplements.

The investigators found in 22 trials a significant effect in patients with rheumatoid arthritis [SMD = -0.21, 95% CI = -0.42 to -0.004] for using marine oil supplements.

The investigators also found in 3 trials a significant effect for other or mixed diagnoses [SMD = -0.63, 95% CI = -1.20 to -0.06] for using marine oil supplements, but no significant effect was found in osteoarthritis patients [5 trials: SMD = -0.17, 95% CI = -0.57 to 0.24].

The investigators found a significant, beneficial effect on pain for marine oil with an EPA/DHA ratio >1.5.

The investigators found a significant positive association between SMD and total dose of EPA and DHA [slope β, 0.13 (g/day), 95% CI = 0.04 to 0.22, p = 0.006], indicating less effect at higher dose, but there was no duration-response relationship [p = 0.568].

The investigators concluded using marine oil supplements (with an EPA/DHA ratio >1.5) alleviates pain in rheumatoid arthritis patients.

Original title:
Marine Oil Supplements for Arthritis Pain: A Systematic Review and Meta-Analysis of Randomized Trials by Senftleber NK, Nielsen SM, […], Christensen R.

Link:
http://www.mdpi.com/2072-6643/9/1/42/htm

Additional information of El Mondo:
Find here more information/studies about EPA&DHA and chronic diseases.

Objectives:
The role of vitamin D status in the etiology of allergic diseases is uncertain. Therefore, this meta-analysis (systematic review) has been conducted.

Study design:
This review article included a total of 21 observational studies.

Results and conclusions:
The investigators found children with serum 25(OH)D ≥75 nmol/L had significantly reduced odds of aeroallergen sensitization, but neither vitamin D intake during pregnancy nor vitamin D supplementation in infancy were associated with risk of allergic rhinitis.

The investigators found compared to those with serum 25(OH)D 50 nmol/L, individuals with serum 25(OH)D ≥75 nmol/L had a significant decreased risk of 29% [OR = 0.71, 95% CI = 0.56-0.89, p = 0.04] for allergic rhinitis.
However, this association was mainly observed in adult men; prevalence of allergic rhinitis (AR) was lower in men with serum 25(OH)D ≥75 nmol/L compared to men with serum 25(OH)D 50 nmol/L, while this association was not observed in women.

The investigators concluded serum 25(OH)D ≥75 nmol/L reduced odds of aeroallergen sensitization in children and risk of allergic rhinitis in men.

Original title:
Vitamin D status, aeroallergen sensitization, and allergic rhinitis: A systematic review and meta-analysis by Aryan Z, Rezaei N and Camargo CA Jr.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28102718

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