Nutrition and health

Dietary salt intake increases risk of esophageal cancer

Afbeelding

Objectives:
Evidence has shown that essential nutrients are highly correlated with the occurrence of esophageal cancer (EC). However, findings from observational studies on the associations between dietary carbohydrate, salt consumption and the risk of esophageal cancer remain controversial. Therefore, this review article has been conducted.

Does carbohydrate or salt consumption (dietary salt intake) increase risk of esophageal cancer?

Study design:
This review article included 11 case-control studies and 1 cohort study, examined carbohydrates consumption and 16 case-control studies and 2 cohort studies, examined salt consumption.

Results and conclusions:
The investigators found dietary carbohydrate intake significantly reduced risk of esophageal cancer with 38% [pooled OR = 0.62, 95% CI = 0.50-0.77].

The investigators found dietary salt intake significantly increased risk of esophageal cancer with 97% [OR = 1.97, 95% CI = 1.50-2.61] in case-control studies.

The investigators found dietary salt intake significantly increased risk of esophageal cancer with 4% [RR = 1.04, 95% CI = 1.00-1.08] in cohort studies.

The investigators concluded dietary salt intake increases risk of esophageal cancer.

Original title:
Associations of dietary carbohydrate and salt consumption with esophageal cancer risk: a systematic review and meta-analysis of observational studies by Banda KJ, Chiu HY, [...], Huang HC.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31995192

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

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

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

 

 

High maternal thyroid hormones during pregnancy increase neonatal birth weight

Afbeelding

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

Study design:
This review article included 11 studies.

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

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

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

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

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

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

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

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

Lead increases ALS

Afbeelding

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

Does a high lead exposure increase risk of ALS?

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

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

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

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

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

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Find here more information/studies about chronic diseases.
 

Low-carbohydrate diet reduces cardiovascular disease

Afbeelding

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

Soy protein dietary intake reduces type 2 diabetes

Afbeelding

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Afbeelding

Objectives:
Which factors increase risk of dementia?

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

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

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

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

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

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

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

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

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

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

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

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

Additional information of El Mondo:
Find more information/studies on obesity, diabetes, hypertension and dementia right here.
 

Meat is not a risk factor for asthma in children

Afbeelding

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

Does dietary meat intake increase asthma in children?

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

No publication bias was detected.

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

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

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

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

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

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Find here more information/studies about meat consumption and chronic diseases.
 

Garlic could reduce risk of colorectal cancer

Afbeelding

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

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

There was no notable evidence of publication bias.

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

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

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

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

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

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

Additional information of El Mondo:
Find more information/studies on significantly/cohort studies, garlic consumption and colorectal cancer right here.

 

Exercise lowers the risk for diabetes conferred by insulin resistance

Afbeelding

Objectives:
Although exercise can improve insulin sensitivity, no adequate synthesis exists of exercise intervention studies with regard to their effect on insulin sensitivity. Therefore, this review article (meta-analysis) has beeen conducted.

Does exercise improve insuline sensitivity?

Study design:
This review article included data found across 2509 subjects (115 samples, 78 reports).
The median of mean age was 43 years.
The median of mean preintervention fasting insulin was 8 mU/L.

Results and conclusions:
The investigators found the overall mean effect size for 2-group postintervention comparisons was 0.38 [95% CI = 0.25-0.51, I2 = 0%] and for 2-group pre-post comparisons was 0.43 [95% CI = 0.30-0.56, I2 = 52%].

The investigators found higher mean insulin sensitivity for treatment than control subjects.

The investigators found the postintervention mean of 0.38 was consistent with treatment subjects ending studies with a mean fasting insulin of 6.8 mU/L if control participants’ mean fasting insulin were 7.9 mU/L.
Exploratory moderator analyses did not document different insulin sensitivity effect sizes across intervention characteristics or sample attributes.

The investigators concluded exercise is a valuable primary care and community health strategy for healthy adults to improve insulin sensitivity and lower the risk for diabetes conferred by insulin resistance.

Original title:
Insulin Sensitivity Following Exercise Interventions: Systematic Review and Meta-Analysis of Outcomes Among Healthy Adults by Conn VS, Koopman RJ, […], Hafdahl AR.

Link:
http://journals.sagepub.com/doi/pdf/10.1177/2150131913520328

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Cruciferous vegetable intake protects against cancer of the colon

Objectives:
Evidence shows cruciferous vegetables exhibit chemoprotective properties, commonly attributed to their rich source of isothiocyanates. However, epidemiological data examining the association between cruciferous vegetable intake and colorectal neoplasms have been inconclusive. Therefore, this review article (meta-analysis) has been conducted.

Does cruciferous vegetable intake decrease colon cancer risk?

Study design:
This review article included 33 articles.
Subgroup analysis for individual cruciferae types (n = 8 studies) and GST polymorphism (n = 8 studies) were performed. Pooled adjusted odds ratios (ORs) comparing highest and lowest categories of dietary pattern scores were calculated.

Results and conclusions:
The investigators found when comparing highest with lowest categorie, cruciferous vegetable intake significantly reduced risk of colon cancer with 16% [OR = 0.84, 95% CI = 0.72-0.98, p value heterogeneity 0.001].

The investigators found when comparing highest with lowest categorie, broccoli intake significantly reduced risk of colorectal neoplasms with 20% [OR = 0.80, 95% CI = 0.65-0.99, p value heterogeneity = 0.02].

The investigators found stratification by GST genotype showed that the GSTT1 null genotype confered a reduction in colorectal neoplasms risk of 22% [OR = 0.78, 95% CI = 0.64-0.95, p value heterogeneity = 0.32].

The investigators concluded this meta-analysis provides support to the hypothesis that cruciferous vegetable intake protects against cancer of the colon. This meta-analysis also demonstrates the significance of gene-diet interactions and the importance of assessing individual cruciferous vegetables.

Original title:
Cruciferous vegetables and risk of colorectal neoplasms: a systematic review and meta-analysis by Tse G and Eslick GD.

Link:
http://www.ncbi.nlm.nih.gov/pubmed/24341734

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Recreational physical activity reduces risk of gastric cancer

Afbeelding

Objectives:
Does physical activity reduce gastric cancer risk?

Study design:
This review article included 7 cohort studies (with mean reported follow-up ranging from 6 to 18.8 years) and 9 case control studies reporting 11,111 cases of gastric cancer among 1,606,760 patients.

There was no evidence of publication bias, both quantitatively [Begg and Mazumdar rank correlation test, p = 0.62] and qualitatively, on visual inspection of the funnel plot.

Results and conclusions:
The investigators found the risk of gastric cancer was 21% [OR = 0.79, 95% CI = 0.71-0.87, I2 = 55%]  lower among the most physically active people as compared with the least physically active people, after adjustment for important confounders, including age, obesity, and other risk factors for gastric cancer (smoking, alcohol, dietary patterns and socioeconomic status).
This protective effect was seen for gastric cancers in the cardia [OR = 0.80, 95% CI = 0.63-1.00, 4 studies] and distal stomach [OR = 0.63, 95% CI = 0.52-0.76, 5 studies].

The investigators found increasing physical activity was associated with a reduced risk of gastric cancer in both men [OR = 0.86, 95% CI = 0.75-0.99, 10 studies] and women [OR = 0.72, 95% CI = 0.55-0.94, 3 studies].

The investigators found in 12 studies that increased recreational physical activity showed an 18% reduction in gastric cancer risk [OR = 0.82, 95% CI = 0.72-0.94].

The investigators found the effect size was significantly smaller in high-quality studies [OR = 0.86, 95% CI = 0.75-0.99, 6 studies] as compared with low-quality studies [OR = 0.74, 95% CI = 0.69-0.81, 10 studies]. The results were consistent across sex, study quality, study design and geographic location.

The investigators concluded physical activity - especially recreational physical activity - is associated with reduced risk of gastric cancer. Lifestyle interventions focusing on increasing physical activity may decrease the global burden of gastric cancer, in addition to a myriad of other health benefits with being physically active, which include cardiovascular, metabolic and psychologic wellbeing.

Original title:
Physical Activity Is Associated with Reduced Risk of Gastric Cancer: A Systematic Review and Meta-analysis by Singh S, Varayil JE, […], Iyer PG.

Link:
http://cancerprevention.aacrjournals.org/content/7/1/12.abstract

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1-6 cups/day caffeinated or decaffeinated coffee is associated with reduced type 2 diabetes risk

Objectives:
Previous meta-analyses identified an inverse association of coffee consumption with the risk of type 2 diabetes. However, an updated meta-analysis is needed because new studies comparing the trends of association for caffeinated and decaffeinated coffee have since been published. Therefore, this review article has been conducted.

Does coffee intake reduce type 2 diabetes risk in a dose-response manner?

Study design:
This review article included 28 prospective cohort studies with 1109272 study participants and 45335 cases of type 2 diabetes. The follow-up duration ranged from 10 months to 20 years.

Results and conclusions:
The investigators found for compared with no or rare coffee consumption, a significant reduced risk of type 2 diabetes of:
8% [RR = 0.92, 95% CI = 0.90-0.94] for 1 cup/day;
15% [RR= 0.85, 95% CI = 0.82-0.88] for 2 cups/day;
21% [RR = 0.79, 95% CI = 0.75-0.83] for 3 cups/day;
25% [RR = 0.75, 95% CI = 0.71-0.80] for 4 cups/day;
29% [RR = 0.71, 95% CI = 0.65-0.76] for 5 cups/day and;
33% [RR = 0.67, 95% CI = 0.61-0.74] for 6 cups/day.

The investigators found a significant decreased risk of type 2 diabetes of 9% [RR = 0.91, 95% CI = 0.89-0.94] for an increasement of 1 cup/day caffeinated coffee and 6% [RR = 0.94, 95% CI = 0.91-0.98] for an increasement of 1 cup/day decaffeinated coffee [p for difference = 0.17].

The investigators concluded coffee consumption is inversely associated with the risk of type 2 diabetes in a dose-response manner. Both caffeinated and decaffeinated coffee is associated with reduced diabetes risk.

Original title:
Caffeinated and decaffeinated coffee consumption and risk of type 2 diabetes: a systematic review and a dose-response meta-analysis by Ding M, Bhupathiraju SN, […], Hu FB.

Link:
http://www.ncbi.nlm.nih.gov/pubmed/24459154

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Exercise training helps to prevent and to treat type 2 diabetes in youth

Afbeelding

Objectives:
The prevalence of obesity and diabetes is increasing among children, adolescents and adults. Although estimates of the efficacy of exercise training on fasting insulin and insulin resistance have been provided for adults, similar estimates have not been provided for youth. Therefore, this review article has been conducted.

Study design:
This review article included 24 trials.

Results and conclusions:
The investigators found a small to moderate effect for exercise training on fasting insulin and improving insulin resistance in youth [Hedges’ d effect size = 0.48, 95% CI = 0.22-0.74, p 0.001 and 0.31, 95% CI = 0.06-0.56, p 0.05, respectively].

The investigators concluded there is evidence to support the use of exercise training in the prevention and treatment of type 2 diabetes in youth.

Original title:
Exercise and Insulin Resistance in Youth: A Meta-Analysis by Fedewa MV, Gist NH, […], Dishman RK.

Link:
http://www.pediatricsdigest.mobi/content/133/1/e163.abstract

Additional information of El Mondo:
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100 g/day red meat intake may increase gastric cancer risk

Objectives:
The association of red meat consumption with the risk of stomach cancer has been reported by many studies, with inconclusive results. Therefore, this review article has been conducted.

Does a high red meat consumption increase stomach cancer risk?

Study design:
This review article included a total of 18 studies (cohort and case-control studies) involving 1,228,327 subjects.

Results and conclusions:
The investigators found for the highest versus lowest categories of red meat intake a significant increased risk of 37% for gastric cancer [pooled RR = 1.37, 95% CI = 1.18-1.59, I2 = 67.6%, p 0.001].

The investigators found in population-based case-control studies, a significant increased risk of 58% for gastric cancer [pooled RR = 1.58, 95% CI = 1.22-2.06, I2 = 73.0%, p 0.001].

The investigators found in hospital-based case-control studies, a significant increased risk of 63% for gastric cancer [pooled RR = 1.63, 95% CI = 1.38-1.92, I2 = 19.1%, p = 0.284].

The investigators found, however, no association among cohort studies [RR = 1.00, 95% CI = 0.83-1.20, I2 = 33.9%, p = 0.158].

The investigators found the significant association was also presented in the subgroup analysis by geographic area (Asia, Europe), publication year (≥2000), sample size (1,000, ≥1,000) and quality score (7 stars, ≥7 stars).

The investigators found in dose-response analysis that every 100 g/day increment in red meat intake significant increased gastric cancer risk with 17% [RR = 1.17, 95% CI = 1.05-1.32].

The investigators found in linear regression model that the risk of gastric cancer increased with increasing level of red meat consumption.

The investigators concluded that a increased intake of red meat might be a risk factor for stomach cancer. Might be because the risk was not significant among cohort studies. Therefore, further larger prospective cohort studies are warranted to verify this association.

Original title:
Red meat consumption and stomach cancer risk: a meta-analysis by Song P, Lu M, […], Zhao Q.

Link:
https://link.springer.com/article/10.1007/s00432-014-1637-z

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White meat and fish consumption reduce risk of hepatocellular carcinoma

Afbeelding

Objectives:
The association between meat consumption and the risk of hepatocellular carcinoma (HCC) is still inconclusive. Therefore, this review article has been conducted.

Does meat consumption increase risk of hepatocellular carcinoma?

Study design:
This review article included 7 cohort studies and 10 case-control studies.

Results and conclusions:
The investigators found for the highest vs. lowest consumption levels a non-significant increased risk for hepatocellular carcinoma of 10% [RR = 1.10, 95% CI = 0.85-1.42] for red meat, a non-significant increased risk of 1% [RR = 1.01, 95% CI = 0.79-1.28] for processed meat and a non-significant decreased risk of 3% [RR = 0.97, 95% CI = 0.85-1.11] for total meat. Non-significant means, there is no association with a 95% confidence.

The investigators found for the highest vs. lowest consumption levels a significant decreased risk for hepatocellular carcinoma of 31% [RR = 0.69, 95% CI = 0.58-0.81] for white meat and a significant decreased risk of 22% [RR = 0.78, 95% CI = 0.67-0.90] for fish. The results remained quite stable after stratification by the confounding factors.
Significant means, there is an association with a 95% confidence.

The investigators concluded a high level of white meat or fish consumption reduces the risk of hepatocellular carcinoma, while intake of red meat, processed meat or total meat is not associated with hepatocellular carcinoma risk. These results suggest that dietary intervention may be a promising approach for prevention of hepatocellular carcinoma, which still need to be confirmed by further well-designed prospective studies and experimental research.

Original title:
Systematic review with meta-analysis: meat consumption and the risk of hepatocellular carcinoma by Luo J, Yang Y, [...], Zhu Y.

Link:
http://www.ncbi.nlm.nih.gov/pubmed/24588342

Additional information of El Mondo:
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A review article of cohort studies or case-control studies will answer the following question:
"Should I change my diet?".


 

Red meat consumption increases esophageal cancer risk

Objectives:
Is there an association between meat intake and risk of esophageal cancer?

Study design:
This review article included 7 cohort studies and 28 case-control studies.

Results and conclusions:
The investigators found for the highest versus lowest total meat consumption categories a non-significant increased risk of 19% [95% CI = 0.98-1.46] for esophageal cancer.

The investigators found for the highest versus lowest red meat consumption categories a significant increased risk of 55% [95% CI = 1.22-1.96] for esophageal cancer.

The investigators found for the highest versus lowest processed meat consumption categories a significant increased risk of 33% [95% CI = 1.04-1.69] for esophageal cancer.

The investigators found for the highest versus lowest white meat consumption categories a significant decreased risk of 28% [95% CI = 0.60-0.86] for esophageal cancer.

The investigators found for the highest versus lowest poultry consumption categories a significant decreased risk of 17% [95% CI = 0.72-0.96] for esophageal cancer.

The investigators found for the highest versus lowest fish consumption categories a non-significant decreased risk of 5% [95% CI = 0.76-1.19] for esophageal cancer.

The investigators found when stratified by histological subtype, positive associations among esophageal squamous cell carcinoma and red meat, white meat and poultry and esophageal adenocarcinoma with total meat and processed meat.

The investigators concluded red meat and processed meat consumption increase risk of esophageal cancer, while white meat and poultry decrease risk of esophageal cancer. Fish consumption is not associated with incidence of esophageal cancer.

Original title:
Meat consumption is associated with esophageal cancer risk in a meat- and cancer-histological-type dependent manner by Zhu HC, Yang X, […], Sun XC.

Link:
http://www.ncbi.nlm.nih.gov/pubmed/24395380

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Daily 200-320 micrograms dietary folate intake reduce breast cancer risk

Afbeelding

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/

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Olive oil consumption reduces stroke

Afbeelding

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

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Perioperative antioxidant supplementations with NAC, PUFA and vitamin C prevent atrial fibrillation after cardiac surgery

Afbeelding

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

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Niacin supplementation reduces LDL cholesterol levels in patients with type 2 diabetes mellitus

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

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At least 25g dietary fiber intake per day reduces risk of type 2 diabetes

Afbeelding

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

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