Nutrition and health

Objectives:
The actual effects of L-carnitine administration on leptin serum level is inconsistent. Therefore, this review article (meta-analysis) has been conducted.

Does L-carnitine supplementation reduce leptin serum level?

Study design:
This review article included 7 RCTs with 325 cases (group with L-carnitine administration) and 330 controls (group without L-carnitine administration).

Subgroup analysis to find the sources of heterogeneity showed that L-carnitine dosage [ 2 g: I2 = 00.0%, p = 0.408] and study population [diabetes: I2 = 46.7%, p = 0.153 and non-diabetes: I2 = 15.1%, p = 0.317] were the potential sources of heterogeneity.

Results and conclusions:
The investigators found that L-carnitine supplementation had no significant effect on serum leptin concentrations [WMD = -0.565 ng/mL, 95% CI = -2.417 to 1.287, p = 0.550, I2 = 84.3%, p  0.0001].

The investigators found in subgroup analysis that  ≥ 2 mg L-carnitine supplementation significantly reduced serum leptin concentrations [WMD = -2.742 ng/mL, 95% CI = -3.039 to -2.444, p  0.001].

The investigators found in subgroup analysis that L-carnitine supplementation significantly reduced serum leptin concentrations in diabetic patients [WMD = -2.946 ng/mL, 95% CI = -3.254 to -2.638, p  0.001].

The investigators found in subgroup analysis that L-carnitine supplementation during 12 weeks significantly reduced serum leptin concentrations [WMD = -2.772 ng/mL, 95% CI = -3.073 to -2.471, p  0.001].

The investigators concluded that at least 3 mg L-carnitine per day in the course of 12 weeks reduce serum leptin concentrations, especially in diabetic patients.

Original title:
The effect of L-carnitine supplementation on serum leptin concentrations: a systematic review and meta-analysis of randomized controlled trials by Nazary-Vannani A, Ghaedi E, […], Varkaneh HK.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29453657

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

L-carnitine is a non-essential amino acid, which is also found in foods.

Objectives:
What are the effects of olive oil consumption compared with other plant oils on blood lipids?

Study design:
This review article included 27 RCTs, comprising 1,089 participantes.

Results and conclusions:
The investigators found compared to other plant oils, HDL cholesterol levels (good cholesterol) increased significantly more for olive oil consumption [WMD = 1.37 mg/dL, 95% CI = 0.4 to 2.36].

The investigators found, however, olive oil consumption reduced total cholesterol levels [WMD = 6.27 mg/dL, 95% CI = 2.8 to 10.6], LDL cholesterol levels (bad cholesterol) [WMD = 4.2 mg/dL, 95% CI = 1.4 to 7.01] and triglyceride levels [WMD = 4.31 mg/dL, 95% CI = 0.5 to 8.12] significantly less than other plant oils.

The investigators found that there were no significant effects on Apo lipoprotein A1 and Apo lipoprotein B.

The investigators concluded that olive oil consumption decreases serum total cholesterol, LDL cholesterol and triglyceride levels less but increases HDL cholesterol levels more than other plant oils.

Original title:
Comparison of blood lipid-lowering effects of olive oil and other plant oils: A systematic review and meta-analysis of 27 randomized placebo-controlled clinical trials by Ghobadi S, Hassanzadeh-Rostami Z, […], Faghih S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29420053

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

Objectives:
In 2016, the World Health Organization (WHO) recommended point-of-use fortification of complementary foods with iron-containing micronutrient powders to improve iron status and reduce anaemia in children at risk of anaemia. This recommendation continues to be debated. Therefore, this review article (meta-analysis) has been conducted.

Does point-of-use fortification of foods with iron-containing micronutrient powders reduce anaemia in children at risk of anaemia?

Study design:
This review article included trials.

Results and conclusions:
The investigators found in an arbitrarily selected setting and with adherence as obtained under trial conditions, a small increase in haemoglobin concentration in preschool children with point-of-use fortification of foods with iron-containing micronutrient powders, by only 3.9 g/L, with the upper limit of the 95% CI virtually excluding an effect beyond 5.5 g/L. However, the attenuated effect that is likely to be achieved under real-world conditions is even lower.

The investigators found point-of-use fortification with NaFeEDTA improved geometric mean plasma ferritin concentrations by only 4 μg/L [95% CI = 29.7 to 33.7 μg/L].

The investigators concluded point-of-use fortification of foods with micronutrient powders containing iron gives only a small increase in haemoglobin concentration in preschool children. However, attention should be given to the phenomenon that small group differences in the distribution of continuous outcomes (haemoglobin concentration, ferritin concentrations) can give a false impression of relatively large effects on the prevalence of the dichotomised outcomes (anaemia, iron deficiency).

Original title:
Micronutrient powders to combat anaemia in young children: do they work? by Verhoef H, Teshome E and Prentice AM.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5776757/

Additional information of El Mondo:
Find more information/studies on food fortification/malnutrition, study design/meta-analysis/significant and iron right here.

Objectives:
Does vegetable and/or fruit consumption reduce metabolic syndrome (MetS)?

Study design:
This review article included 20 cross-sectional studies, 1 case-control study and 5 cohort studies.

Results and conclusions:
The investigators found in 16 studies when comparing the highest versus the lowest category of vegetable consumption a significantly reduced risk of 11% [overall multivariable-adjusted RR = 0.89, 95% CI = 0.85-0.93, p 0.001] for metabolic syndrome.

The investigators found in 16 studies when comparing the highest versus the lowest category of fruit consumption a significantly reduced risk of 19% [overall multivariable-adjusted RR = 0.81, 95% CI = 0.75-0.88, p 0.001] for metabolic syndrome.

The investigators found in 8 studies when comparing the highest versus the lowest category of vegetable and fruit consumption a significantly reduced risk of 25% [overall multivariable-adjusted RR = 0.75, 95% CI = 0.63-0.90, p = 0.002] for metabolic syndrome.

The investigators concluded that vegetable and/or fruit consumption is negatively associated with metabolic syndrome. However, more well-designed prospective cohort studies are needed to elaborate the concerned issues further.

Original title:
Associations of vegetable and fruit consumption with metabolic syndrome. A meta-analysis of observational studies by Zhang Y and Zhang DZ.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29506604

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

Objectives:
Approximately 600 million children of preschool and school age are anaemic worldwide. It is estimated that at least half of the cases are due to iron deficiency. Point-of-use fortification of foods with micronutrient powders (MNP) has been proposed as a feasible intervention to prevent and treat anaemia. It refers to the addition of iron alone or in combination with other vitamins and minerals in powder form, to energy-containing foods (excluding beverages) at home or in any other place where meals are to be consumed. MNPs can be added to foods either during or after cooking or immediately before consumption without the explicit purpose of improving the flavour or colour. Therefore, this review article (meta-analysis) has been conducted.

The aim of this review article is to assess the effects of point-of-use fortification of foods with iron-containing MNP alone, or in combination with other vitamins and minerals on nutrition, health and development among children at preschool (24 to 59 months) and school (5 to 12 years) age, compared with no intervention, a placebo or iron-containing supplements.

Study design:
This review article included 13 trials (RCTs and quasi-RCTs) involving 5,810 participants from Latin America, Africa and Asia, of which 6 ongoing/unpublished trials.
All trials compared the provision of MNP for point-of-use fortification with no intervention or placebo. No trials compared the effects of MNP versus iron-containing supplements (as drops, tablets or syrup).
The sample sizes in the included trials ranged from 90 to 2193 participants. 6 trials included participants younger than 59 months of age only, 4 included only children aged 60 months or older and 3 trials included children both younger and older than 59 months of age.

The iron doses varied from 2.5 mg to 30 mg of elemental iron. 4 trials reported giving 10 mg of elemental iron as sodium iron ethylenediaminetetraacetic acid (NaFeEDTA), chelated ferrous sulphate or microencapsulated ferrous fumarate. 3 trials gave 12.5 mg of elemental iron as microencapsulated ferrous fumarate. 3 trials gave 2.5 mg or 2.86 mg of elemental iron as NaFeEDTA. 1 trial gave 30 mg and 1 trial provided 14 mg of elemental iron as microencapsulated ferrous fumarate, while 1 trial gave 28 mg of iron as ferrous glycine phosphate.

Micronutrient powders contained from 2 to 18 vitamins and minerals

Results and conclusions:
The investigators found in comparison with receiving no intervention or a placebo, children receiving iron-containing micronutrient powders for point-of-use fortification of foods had a significantly lower risk of 34% for anaemia prevalence [prevalence ratio = 0.66, 95% CI = 0.49 to 0.88, 10 trials, 2,448 children; moderate-quality evidence].

The investigators found in comparison with receiving no intervention or a placebo, children receiving iron-containing micronutrient powders for point-of-use fortification of foods had a significantly lower risk of 65% for iron deficiency [prevalence ratio = 0.35, 95% CI = 0.27 to 0.47, 5 trials, 1,364 children; moderate-quality evidence].

The investigators found in comparison with receiving no intervention or a placebo, children receiving iron-containing micronutrient powders for point-of-use fortification of foods had higher haemoglobin levels [mean difference MD = 3.37 g/L, 95% CI = 0.94 to 5.80, 11 trials, 2,746 children; low-quality evidence].

The investigators found in comparison with receiving no intervention or a placebo, no effect on diarrhoea among children receiving iron-containing micronutrient powders for point-of-use fortification of foods was observed [risk ratio = 0.97, 95% CI = 0.53 to 1.78, 2 trials, 366 children; low-quality evidence].

The investigators concluded point-of-use fortification of foods with micronutrient powders containing iron (2.5 mg to 30 mg of elemental iron) reduces anaemia and iron deficiency in preschool- and school-age children. However, information on mortality, morbidity, developmental outcomes and adverse effects is still scarce.

Original title:
Point-of-use fortification of foods with micronutrient powders containing iron in children of preschool and school-age by De-Regil LM, Jefferds MED and Peña-Rosas JP.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29168569

Additional information of El Mondo:
Find more information/studies on food fortification/malnutrition, study design/meta-analysis/significant and iron right here.

Objectives:
Is there a dose-response association between serum 25(OH)D (vitamin D level in blood) and risk of dementia and Alzheimer's disease (AD)?

Study design:
This review article included 7 prospective cohort studies and 1 retrospective cohort study involving 1,953 cases of dementia and 1,607 cases of Alzheimer's disease among a total of 28,354 participants.

Results and conclusions:
The investigators found no association between vitamin D insufficiency (10-20 ng/mL) and risk of dementia [pooled HR = 1.09, 95% CI = 0.95 to 1.24].
No association because RR of 1 was found in the 95% CI of 0.95 to 1.24. RR of 1 means no risk/association.

The investigators found no association between vitamin D insufficiency (10-20 ng/mL) and risk of Alzheimer's disease [pooled HR = 1.19, 95% CI = 0.96 to 1.41].

The investigators found vitamin D deficiency (10 ng/mL) significantly increased risk of dementia with 33% [pooled HR = 1.33, 95% CI = 1.08 to 1.58].
Significantly means it can be said with a 95% confidence that vitamin D deficiency really increased the risk of getting dementia with 33%. 

The investigators found vitamin D deficiency (10 ng/mL) non-significantly increased risk of Alzheimer's disease with 31% [pooled HR = 1.31, 95% CI = 0.98 to 1.65].

The investigators found lower risk of dementia was observed at serum 25(OH)D of 25 ng/mL, whereas the risk of Alzheimer's disease decreased continuously along with the increase of serum 25(OH)D up to 35 ng/mL.

The investigators concluded that vitamin D (serum 25(OH)D) levels of 25 to 35 ng/mL decrease risk of dementia and Alzheimer's disease. However, there is no conclusive evidence regarding serum 25(OH)D levels of >35 ng/mL.

Original title:
Vitamin D status and risk of dementia and Alzheimer's disease: A meta-analysis of dose-response by Jayedi A, Rashidy-Pour A and Shab-Bidar S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29447107

Additional information of El Mondo:
Find more information/studies on cohort/case-control study/significant, dementia and vitamin D right here.
 

Objectives:
Individuals with mild cognitive impairment (MCI) are at high risk for developing dementia. Physical exercise is a promising intervention for cognitive decline. Systematic reviews regarding the effects of physical exercise on cognitive and psychological outcomes among MCI patients are limited and a systematic review exploring the effects of exercise modalities on the results has not been conducted. Therefore, this review article has been conducted.

Do individuals with mild cognitive impairment benefit from physical exercise?

Study design:
This review article included 11 studies. The exercise interventions can be classified into 3 types: (a) aerobic exercise, (b) resistance exercise and (c) multi-modal exercise.

Results and conclusions:
The investigators found that physical exercise had beneficial effects for global cognition [SMD = 0.30, 95% CI = 0.10-0.49, p = 0.002].

The investigators found subgroup analysis demonstrated that aerobic exercise programmes were consistently associated with medium effect size [SMD = 0.54-0.58].

The investigators found, however, the effects of physical exercise on domain-specific cognitive function and psychological outcomes in mild cognitive impairment patients remained inconclusive.

The investigators found sensitivity analysis showed that types of control exerted influence on the outcomes.

The investigators concluded that physical exercise, aerobic exercise in particular, benefits global cognition in mild cognitive impairment patients. The evidence of physical exercise on domain-specific cognitive function and psychological outcomes remains unclear, more trials with rigorous study design are necessary to provide the evidence.

Original title:
The effectiveness of physical exercise on cognitive and psychological outcomes in individuals with mild cognitive impairment: A systematic review and meta-analysis by Song D, Yu DSF, […], Lei Y.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29334638

Additional information of El Mondo:
Find here more information/studies on cohort/case-control study/significant, sport nutrition and dementia right here.
 

Objectives:
Plasmodium vivax (P. vivax) is the most geographically widespread species among human malaria parasites. Immunopathological studies have shown that platelets are an important component of the host innate immune response against malaria infections. Therefore, this review article (meta-analysis) has been conducted.

The aim of this review article is to quantify thrombocytopaenia in plasmodium vivax malaria patients and to determine the associated risks of severe thrombocytopaenia in patients with plasmodium vivax malaria compared to patients with plasmodium falciparum malaria.

Study design:
This review article included 58 observational studies (5,536 patients had thrombocytopaenia among a total of 29,664 patients investigated) across 12 endemic countries.  
29 of 58 studies were prospective studies. Of them, the vast majority of participants infected with P. vivax (66%, 19 552/29664) were from a single large study conducted in Indonesia. Half of the studies were conducted in India (50%) and the study period covered the years 1988-2015. Only 25% of the included studies had PCR confirmation of parasite species.

Not all studies included in this review used the same methods for platelet “labelling”.

Results and conclusions:
The investigators found pooled analysis showed that 18.7% [95% CI = 17.0-20.2%] of patients with P. vivax malaria had platelet counts  150 000/mm³. Of these, 10.1% [95% CI = 9.0-10.8%] of the patients infected with P. vivax had either severe thrombocytopaenia (9%) or very severe thrombocytopaenia (13%).
There was an absence of statistical heterogeneity [I2 = 0%], suggesting a high level of homogeneity between studies in each gradient of thrombocytopaenia.

The investigators found a meta-analysis of 11 observational studies showed an equal risk of developing severe/very severe thrombocytopaenia between the patients with P. vivax malaria and those with P. falciparum malaria [OR = 1.98, 95% CI = 0.92-4.25], indicating that thrombocytopaenia is as equally a common manifestation in P. vivax and P. falciparum malaria patients.
In a subgroup of 3 studies, a pooled analysis showed patients with severe P. vivax malaria and those with severe P. falciparum malaria had an equal risk of developing severe/very severe thrombocytopaenia.
Further stratification by age groups showed children with severe P. vivax malaria (60/278) had a higher risk of developing very severe thrombocytopaenia than in those with severe P. falciparum malaria (13/145) [OR = 2.80, 95% CI = 1.48-5.29]. However an equal risk was observed for adult severe cases with P. vivax malaria and those with P. falciparum malaria [45/186 vs 70/207, OR = 1.19, 95% CI = 0.51-2.77, p = 0.22].

The investigators found in a subset of 4 studies a decreased platelet counts in patients with P. vivax malaria compared to the healthy controls [p  0.001 in all four studies].

The investigators found a pooled analysis of 4 studies showed that 15% [95% CI = 9-21%] of P. vivax malaria patients with thrombocytopaenia developed minor bleeding episodes. These bleeding manifestations were epistaxis, haematemesis, petechiae and purpura.

The investigators found a pooled analysis of 2 studies with PCR confirmed parasite species showed an equal risk of mortality with severe thrombocytopaenia in P. vivax malaria patients (10.2%, 5/49) and P. falciparum malaria patients (14%, 8/57) [OR = 1.16, 95% CI = 0.30-4.60, p = 0.87].

The investigators concluded there is some evidence of the clinical relevance of severe thrombocytopaenia in P. vivax malaria patients. However, due to the low number of studies with small sample sizes within the subset of studies that provided clinically relevant information, the confidence in the estimates is limited. Therefore, there is a need for future well designed, large-scale, prospective studies among patients infected with P. vivax from different countries and epidemiological settings with various age and gender groups represented to substantiate these findings.

Original title:
Severe thrombocytopaenia in patients with vivax malaria compared to falciparum malaria: a systematic review and meta-analysis by Naing C and Whittaker MA.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5808388/

Additional information of El Mondo:
Find more information/studies on food fortification/malnutrition and study design/meta-analysis/significant right here.

Objectives:
Does poultry intake reduce risk of stroke?

Study design:
This review article included 7 prospective cohort studies involving 354,718 participants.

Results and conclusions:
The investigators found for the highest versus lowest categories of poultry intake a non-significantly reduced risk of 8% for total stroke [pooled RR = 0.92, 95% CI = 0.82-1.03, I2 = 19.8%, p = 0.28].

The investigators found in subgroup analysis for the highest versus lowest categories of poultry intake, a significantly reduced risk of 14% for total stroke among US people [RR = 0.86, 95% CI = 0.77-0.95, I2 = 0.0%, p = 0.38].

The investigators found in subgroup analysis for the highest versus lowest categories of poultry intake, a significantly reduced risk of 17% for total stroke among women [RR = 0.83, 95% CI = 0.72-0.93, I2 = 0.0%, p = 0.63].

The investigators found in subgroup analysis no association between the highest poultry intake and ischemic stroke risk [RR = 0.91, 95% CI = 0.79-1.02, I2 = 0.0%, p = 0.93].

The investigators found in subgroup analysis no association between the highest poultry intake and hemorrhagic stroke risk [RR = 0.82, 95% CI = 0.59-1.04, I2 = 20.5%, p = 0.28].

The investigators found one serving per week increment in poultry intake was not associated with the risk of stroke [RR = 1.00, 95% CI = 0.96-1.03, I2 = 69.0%, p = 0.004].

The investigators found nonlinear dose-response meta-analysis showed a lower risk of stroke at consumption of 1 serving/week.  

The investigators concluded that 1 serving/week poultry intake reduces risk of stroke, particularly among US people and women.

Original title:
Dietary poultry intake and the risk of stroke: A dose-response meta-analysis of prospective cohort studies by Mohammadi H, Jayedi A, […], Shab-Bidar S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29460808

Additional information of El Mondo:
Find more information/studies on poultry intake and cardiovascular diseases right here.
1 serving poultry corresponds to 100 gram raw poultry.
This meal provides 75 grams of poultry.
Poultry are chickens, turkeys, geese and ducks.

Objectives:
Artemisinin combination therapies (ACTs), the most efficacious antimalarials available, are the recommended first-line treatment for Plasmodium falciparum malaria except in the first trimester of pregnancy. Animal embryotoxicity data and the scarcity of safety data in human pregnancies, have prevented artemisinin derivatives from being recommended for malaria treatment in the first trimester except in lifesaving circumstances. Therefore, this review article (meta-analysis) has been conducted.

The aim of this review article is to compare the risk of miscarriage, stillbirth and major congenital anomaly (primary outcomes) among first-trimester pregnancies treated with artemisinin derivatives versus quinine or no antimalarial treatment.

Study design:
This review article included 5 prospective observational studies involving 30,618 pregnancies; 4 from sub-Saharan Africa (n = 6,666 pregnancies, 6 sites) and 1 from Thailand (n = 23,952).

Results and conclusions:
The investigators found no difference in the risk of miscarriage associated with the use of artemisinins anytime during the first trimester (n = 37/671) compared with quinine [adjusted hazard ratio = 0.73, 95% CI = 0.44 to 1.21, I2 = 0%, p = 0.228, n = 96/945].

The investigators found pregnancies treated with quinine during the first trimester were associated with significantly increased risk of 48% of miscarriage compared with pregnancies not treated with an antimalarial [adjusted hazard ratio = 1.48, 95% CI = 1.18 to 1.86]. However, in the sensitivity analysis the association between miscarriage and first-trimester quinine treatment compared with no antimalarial treatment was no longer significant when data from Thailand were omitted [adjusted hazard ratio = 2.12, 95% CI = 0.76 to 5.94, p = 0.153].
Significant because RR of 1 was not found in the 95% CI of 1.18 to 1.86. RR of 1 means no risk/association.

The investigators found pregnancies treated with artemisinins during the first trimester were not associated with an increased risk of miscarriage compared with pregnancies not treated with an antimalarial [adjusted hazard ratio = 1.16, 95% CI = 0.81 to 1.66].
Not associated because adjusted hazard ratio of 1 was found in the 95% CI of 0.81 to 1.66. Adjusted hazard ratio of 1 means no risk/association.

The investigators found no difference in the risk of stillbirth associated with the use of artemisinins anytime during the first trimester (n = 10/654) compared with quinine [adjusted hazard ratio = 0.29, 95% CI = 0.08 to 1.02, p = 0.053, n = 11/615].

The investigators found neither treatment with an artemisinin nor quinine was associated with an increased risk of stillbirths compared to pregnancies without any antimalarial treatment in the first trimester [adjusted hazard ratio = 0.65, 95% CI = 0.34 to 1.23 and adjusted hazard ratio = 1.35, 95% CI = 0.69 to 2.65, respectively].

The investigators found no difference in the risk of miscarriage and stillbirth combined (pregnancy loss) associated with the use of artemisinins anytime during the first trimester (n = 10/654) compared with quinine [adjusted hazard ratio = 0.58, 95% CI = 0.36 to 1.02, p = 0.099]. 

The investigators found the prevalence of major congenital anomalies was similar for first-trimester artemisinin [1.5%, 95% CI = 0.6% to 3.5%] and quinine exposures [1.2%, 95% CI = 0.6% to 2.4%].

The investigators concluded that first-trimester use of artemisinin derivatives is not associated with an increased risk of miscarriage or stillbirth compared to quinine. The data to date also indicate no difference in the prevalence of major anomalies between treatment groups in early pregnancy, although the numbers of major anomalies were small. Three-day artemisinin combination therapy (ACT) regimens are currently recommended to treat malaria in the second and third trimester. Expanding ACT recommendations to include the first trimester may outweigh the adverse outcomes of partially treated malaria due to poor adherence to 7 days oral quinine regimens in early pregnancy.

Original title:
First-trimester artemisinin derivatives and quinine treatments and the risk of adverse pregnancy outcomes in Africa and Asia: A meta-analysis of observational studies by Dellicour S, Sevene E, […], Stergachis A.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5412992/

Additional information of El Mondo:
Find more information/studies on food fortification/malnutrition, pregnancy and study design/meta-analysis/significant right here.

Objectives:
Dairy product consumption may affect the risk of hip fracture, but previous studies have reported inconsistent findings. Therefore, this review article has been conducted.

Does consumption of dairy products reduce risk of hip fracture?

Study design:
This review article included 10 cohort studies (with a total of 8,613 hip fracture events and 363,557 participants. The length of follow-up ranged from 3 to 22 years) and 8 case-control studies (3,815 hip fracture cases and 6,415 controls/subjects without hip fracture).

Results and conclusions:
The investigators found in cohort studies no association between a high milk consumption and hip fracture risk [pooled RR = 0.91, 95% CI = 0.74-1.12, I2 = 75.0%, p  0.01].
There were no significant changes to the results after using the trim-and-fill method when including 4 missing articles [adjusted random effects summary RR = 1.06, 95% CI = 0.91-1.23].

The investigators found, however, case-control studies indicated that participants in the highest categories of milk consumption had a 29% reduction in the risk of hip fracture [OR = 0.71, 95% CI = 0.55-0.91, I2 = 54%, p = 0.04].
There were no significant changes to the results after using the trim-and-fill method when including 1 missing article [adjusted random effects summary OR = 0.74, 95% CI = 0.57-0.97].

The investigators found in cohort studies no association between a high total dairy consumption and hip fracture risk [pooled RR = 1.02, 95% CI = 0.93-1.12]. No association because RR of 1 was found in the 95% CI of 0.93 to 1.12. RR of 1 means no risk/association.

The investigators found cohort studies indicated that participants in the highest categories of yoghurt consumption had a 25% reduction in the risk of hip fracture [RR = 0.75, 95% CI = 0.66-0.86].
 

The investigators found cohort studies indicated that participants in the highest categories of cheese consumption had a 32% reduction in the risk of hip fracture [RR = 0.68, 95% CI = 0.61-0.77].

The investigators found the summary RR for an increased milk consumption of 200 g/day was 1.00 [95% CI = 0.94-1.07, I2 = 87%, p heterogeneity  0.01] among cohort studies.

The investigators found in cohort studies there was a nonlinear positive association between milk consumption and hip fracture risk [p nonlinearity  0.01], with a rapid increase in risk when milk consumption increased from 0 to 600 g/d. However, there was no further increase in risk with milk consumption between 600 and 1200 g/d.

The investigators found in case-control studies there was a nonlinear association between milk consumption and hip fracture risk [p nonlinearity = 0.28], with a reduction in risk with milk consumption of 200-600 g/d. However, the confidence intervals were wide for all outcomes.

The investigators concluded that a high consumption of yogurt and cheese is associated with a lower risk of hip fracture in cohort studies.

Original title:
Dairy product consumption and risk of hip fracture: a systematic review and meta-analysis by Bian S, Hu J, [...], Ma J.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5778815/

Additional information of El Mondo:
Find here more information/studies on cohort/case-control study/significant, dairy products consumption and elderly right here.
 

Objectives:
New studies indicate that resveratrol can significantly reduce plasma lipids, but the result of randomized clinical trials (RCTs) on resveratrol effect and the serum lipid profile are contradictory. Therefore, this review article (meta-analysis) has been conducted.  

Do resveratrol supplements reduce plasma lipids, like cholesterol levels?

Study design:
This review article included 21 RCTs.

Results and conclusions:
The investigators found resveratrol supplements had no significant effects on both:
-total cholesterol (TC) [WMD = 0.08 mmol/L, 95% CI = -0.23 to 0.08, p = 0.349, I2 = 87.8%];
-low-density lipoprotein (LDL-C or bad cholesterol) [WMD = -0.04 mmol/L, 95% CI = -0.21 to 0.12, p  = 0.620, I2 = 93.4%] and;
-high density lipoprotein (HDL-C or good cholesterol) [WMD = -0.01 mmol/L, 95% CI = -0.04 to 0.02, p = 0.269, I2 = 88.6%].

The investigators found resveratrol supplements had significant effects on
triacylglycerol (TG) [WMD = 0.58 mmol/L, 95% CI = 0.34 to 0.82, p 0.0001, I2 = 99.8%]. But after removing 1 study the significance was eliminated.

The investigators also found that sex, age, BMI, resveratrol dosage and intervention duration could not change the results.

The investigators concluded that resveratrol supplements do not change lipid profile concentration, like cholesterol levels. Confirmation of this conclusion will require more studies exclusively on dyslipidemic patients in which the intake of lipid lowering agents is among the exclusion criteria.

Original title:
Effect of resveratrol on lipid profile: An updated systematic review and meta-analysis on randomized clinical trials by Haghighatdoost F and Hariri M.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29305228

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

Objectives:
There is no agreed standard method to assess the efficacy of antimalarial drugs for uncomplicated falciparum in pregnancy despite an increased risk of adverse outcomes for the mother and the fetus. Therefore, this review article (meta-analysis) has been conducted.

The aim of this review article is to update the currently available efficacy data of artemisinin-based treatments (ABT) and quinine-based treatments (QBT) from both observational and interventional cohort studies in all trimesters with uncomplicated falciparum malaria.  

Study design:
This review article included 48 studies with 7,279 treated Plasmodium falciparum episodes, of which 22 RCTs comparing two or more treatment regimens.
14 studies included women treated with QBT, 40 studies included ABT and 6 studies included both. Altogether, 6244 and 1035 episodes were treated with ABT or QBT, respectively.

First trimester women were included in 12 studies none of which were, however, RCTs of ABT treated.

Results and conclusions:
The investigators found that while polymerase chain reaction (PCR) was used in 24 studies for differentiating recurrence, the assessment and reporting of treatment efficacy was heterogeneous.

The investigators found when the same definition could be applied, PCR-corrected treatment failure of ≥ 10% at any time points was observed in 3/30 ABT and 3/7 QBT arms.

The investigators found in 5 RCTs compared ABT and QBT that the risk of treatment failure was significantly lower in ABT than in QBT [risk ratio = 0.22, 95% CI = 0.07-0.63], although the actual drug combinations and outcome endpoints were different. There was no evidence for asymmetry of the funnel plot suggesting publication bias [p = 0.7].
However, none of these 5 RCTs included pregnant women in the first trimester.

The investigators concluded that efficacy studies in pregnancy are not only limited in number but use varied methodological assessments. In 5 RCTs with comparable methodology, ABT resulted in higher efficacy than QBT in the second and third trimester of pregnancy. Individual patient data meta-analysis can include data from observational cohort studies and could overcome some of the limitations of the current assessment given the paucity of data in this vulnerable group.

Original title:
Systematic literature review and meta-analysis of the efficacy of artemisinin-based and quinine-based treatments for uncomplicated falciparum malaria in pregnancy: methodological challenges by Saito M, Gilder ME, […], Guérin PJ.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5729448/

Additional information of El Mondo:
Find more information/studies on food fortification/malnutrition, pregnancy and study design/meta-analysis/significant right here.

Objectives:
Does the consumption of various types of tomato products reduce prostate cancer risk and is there a potential dose-response relationship?

Study design:
This review article included 30 studies, which summarized data from 24,222 cases (subjects with prostate cancer) among 260,461 participants.

Results and conclusions:
The investigators found that higher total tomato consumption was associated with a reduced risk of 19% for prostate cancer [RR = 0.81, 95% CI = 0.71 to 0.92, p = 0.001].

The investigators found in subgroup analysis that higher tomato foods consumption was associated with a reduced risk of 16% for prostate cancer [RR = 0.84, 95% CI = 0.72 to 0.98, p = 0.030].

The investigators found in subgroup analysis that higher cooked tomatoes and sauces consumption was associated with a reduced risk of 16% for prostate cancer [RR = 0.84, 95% CI = 0.73 to 0.98, p = 0.029]. 

The investigators found in subgroup analysis, however, no association between higher raw tomatoes consumption and prostate cancer risk [RR = 0.96, 95% CI = 0.84 to 1.09, p = 0.487].

The investigators found there was a significant dose-response association for total tomato consumption [p = 0.040], cooked tomatoes and sauces [p  0.001] and raw tomatoes [p = 0.037], but there was not a significant association with tomato foods [p-linear = 0.511, p-nonlinear = 0.289].

The investigators concluded that increased tomato consumption, particularly cooked tomatoes and sauces reduces prostate cancer risk. Furthermore, there are dose-response relationships for total tomato consumption and for cooked tomatoes and sauces. Further studies are required to determine the underlying mechanisms of these associations.

Original title:
Processed and raw tomato consumption and risk of prostate cancer: a systematic review and dose-response meta-analysis by Rowles JL, Ranard KM, […], Erdman JW Jr.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29317772

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Objectives:
Atovaquone/proguanil, registered as Malarone®, is a fixed-dose combination recommended for first-line treatment of uncomplicated Plasmodium falciparum malaria in non-endemic countries and its prevention in travellers. Mutations in the cytochrome bc1 complex are causally associated with atovaquone resistance. Therefore, this review article (meta-analysis) has been conducted.

The aim of this review article is to assess the clinical efficacy of atovaquone/proguanil treatment of uncomplicated malaria and examines the extent to which codon 268 mutation in cytochrome b influences treatment failure and recrudescence based on published information.

Study design:
This review article included 27 P. falciparum studies with 1960 patients, of whom 1695 were treated and followed up to 28 days (86.5%). A total of 1640 patients were successfully treated up to 28 days, 83.7% of the 1960 original patients and 96.8% of the 1695 treated and followed-up patients. Most of the 27 studies were of low methodological quality, being small and having between 18 and 253 participants receiving atovaquone/proguanil.

14 of the 27 studies were RCT designed to test the efficacy of atovaquone/proguanil or used atovaquone/proguanil as a control treatment and participants of these made up only 55% of the total participants.

Results and conclusions:
The investigators found that atovaquone/proguanil treatment efficacy was 89%-98% for P. falciparum malaria (from 27 studies including between 18 and 253 patients in each case) and 20%-26% for Plasmodium vivax malaria (from 1 study including 25 patients).

The investigators found that the in vitro P. falciparum phenotype of atovaquone resistance was an IC50 value >28 nM.

The investigators found in case report analyses that recrudescence in a patient presenting with parasites carrying cytochrome b codon 268 mutation would occur on average at day 29 [95% CI = 22-35], 19 [95% CI = 7-30] days longer than if the mutation is absent.

The investigators concluded that atovaquone/proguanil therapy is comparable in efficacy to ACT used in treating uncomplicated malaria. Late treatment failure is likely to be associated with a codon 268 mutation in cytochrome b, though recent evidence from animal models suggests these mutations may not spread within the population. However, early treatment failure is likely to arise through alternative mechanisms, requiring further investigation.

Original title:
Clinical implications of Plasmodium resistance to atovaquone/proguanil: a systematic review and meta-analysis by Staines HM, Burrow R, […], Krishna S.

Link:
https://academic.oup.com/jac/advance-article/doi/10.1093/jac/dkx431/4693708

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Objectives:
Zinc is an essential trace element for living organisms and their biological processes. Zinc plays a key role in more than 300 enzymes and it is involved in cell communication, proliferation, differentiation and survival. Zinc also plays a role in regulating the immune system with implications in pathologies where zinc deficiency and inflammation are observed. Therefore, this meta-analysis (systematic review) has been conducted.

Do zinc deficiency increase risk of autoimmune disorders?

Study design:
This review article included 62 case-control studies.

The manner of collecting and investigating zinc samples was very heterogeneous.

Results and conclusions:
The investigators found in fixed model that serum zinc concentration of autoimmune disease patients was significantly lower than in controls [mean effect = -1.19, 95% CI = -1.26 to -1.11].

The investigators found in fixed model that plasma zinc concentration of autoimmune disease patients was significantly lower than in controls [mean effect = -3.97, 95% CI = -4.08 to -3.87].

The investigators concluded that a deficiency of zinc in serum and plasma increases risk of autoimmune disorders in humans.

Original title:
Zinc Status and Autoimmunity: A Systematic Review and Meta-Analysis by Sanna A, Firinu D, […], Valera P.

Link:
http://www.mdpi.com/2072-6643/10/1/68/htm

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Find here more information/studies about zinc and chronic diseases.

An autoimmune disease is a condition in which your immune system mistakenly attacks your body. These are the most common autoimmune diseases:  

1. Addison’s disease: Caused by an adrenal hormone insufficiency. Addison’s disease can lead to muscle weakness and fatigue, nausea, weight loss, irritability, low blood pressure, low blood sugar and depression.
2. Celiac disease (gluten allergy): Celiac disease is a reaction to gluten (found in barley, rye and wheat) that causes damage to the lining of the small intestine.
3. Graves’ disease: Caused by extremely overactive thyroid gland. People who have Graves’ disease may have difficulty sleeping, bulging of the eyes, irritability, brittle hair, unexplained weight loss, sensitivity to heat, muscle weakness, light menstrual periods and shakiness of the hands. On the other hand, some people with Graves’ disease may experience no symptoms at all.
4. Hashimoto’s disease: Caused by inflammation of the thyroid gland. Although sometimes no symptoms occur, Hashimoto’s thyroiditis often results in a goiter (enlargement of the thyroid gland, which may be visible as a bulge in the neck), weight gain, fatigue, muscle weakness, depression, cold sensitivity, dry hair and skin, and constipation.
5. Inflammatory bowel disease: This disease refers to a group of inflammatory diseases of the colon and small intestine.
6. Multiple Sclerosis or MS: This disease affects the brain and spinal cord. People who have MS may experience weakness, trouble with balance and coordination, problems speaking and walking, tremors, paralysis and numbness in the extremities.
7. Psoriasis: This is a skin condition that causes redness and irritation as well as thick, flaky, silver-white patches.
8. Pernicious anemia: Caused by the inability to absorb vitamin B12 leading to a decrease in red blood cells.
9. Reactive arthritis: Caused by inflammation of joints, the urethra and eyes.
10. Raynaud’s phenomenon: People with Raynaud’s have a problem with blood flow, resulting in numbness, tingling of the fingers, discoloration, toes and tip of the nose with exposure to cold temperatures.
11. Rheumatoid arthritis: In rheumatoid arthritis, autoimmunity causes the immune system to attack tissues in the joints. It typically affects the small joints in your hands and feet causing painful swelling, stiffness and loss of movement in the joints that can eventually result in bone erosion and joint deformity.
12. Scleroderma: Scleroderma is a connective tissue disease that causes changes in skin, muscles, blood vessels and internal organs.
13. Sjögren’s syndrome: Caused by destruction of the glands that produce tears and saliva causing dry eyes and mouth.
14. Systemic lupus erythematosus: In lupus, antibodies made by the immune system attack the body. Systemic lupus erythematosus can affect skin, kidneys, joints and brain.
15. Type 1 diabetes: In type 1 diabetes, the immune system attacks cells in the pancreas that produce insulin. When your insulin levels are insufficient, your body cannot control your blood glucose level, which can lead to a number of problems, including kidney failure, stroke, vision loss, circulation problems and heart disease.

Objectives:
Anemia is a worldwide public health problem that can be related to many causes, including vitamin A deficiency. Therefore, this review article (meta-analysis) has been conducted.

The aim of this review article is to examine the effect of vitamin A supplementation (VAS) on iron status biomarkers and anemia in humans.

Study design:
This review article included 21 clinical trials and 2 cohort studies, with children, teenagers, pregnant or lactating women.

Results and conclusions:
The investigators found clinical trials showed that vitamin A supplementation significantly reduced risk of anemia by 26% and raised hemoglobin levels, compared to non-treated group, independent of the life stage.

The investigators found clinical trials showed that vitamin A supplementation did not alter the prevalence of iron deficiency among children and teenagers [RR = 0.82, 95% CI = 0.60 to 1.12, p = 0.204].
However, a significant increase in serum ferritin levels was observed in trials conducted among pregnant and lactating women [WMD = 6.61 μg/L, 95% CI = 6.00 to 7.21 μg/L, p 0.001]. Significant because the found p value of 0.001 was lower than p value of 0.05.

The investigators concluded that vitamin A supplementation alone reduces risk of anemia, by improving hemoglobin and ferritin levels in individuals with low serum retinol levels.

Original title:
Effect of vitamin A supplementation on iron status in humans: a systematic review and meta-analysis by da Cunha MS, Campos Hankins NA and Arruda SF.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29336593

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Objectives:
Does exercise training delay the decline in cognitive function among individuals who are at risk of/or have Alzheimer's disease?  

Study design:
This review article included 19 controlled studies with 23 interventions including 1,145 subjects with a mean age of 77.0 ± 7.5.
The studies included an exercise-only intervention and a nondiet, nonexercise control group and reported pre- and post-intervention cognitive function measurements.

Most subjects were at risk of Alzheimer's disease because they had mild cognitive impairment (64%) or a parent diagnosed with Alzheimer's disease (1%) and 35% presented with Alzheimer's disease.

Exercise interventions were performed 3.4 ± 1.4 days per week at moderate intensity (3.7 ± 0.6 metabolic equivalents) for 45.2 ± 17.0 minutes per session for 18.6 ± 10.0 weeks and consisted primarily of aerobic exercise (65%).

Results and conclusions:
The investigators found overall, there was a modest favourable effect of exercise on cognitive function [d+ = 0.47, 95% CI = 0.26 to 0.68].

The investigators found within-group analyses revealed that exercise improved cognitive function [d+w = 0.20, 95% CI = 0.11 to 0.28], whereas cognitive function declined in the control group [d+w = -0.18, 95% CI = -0.36 to 0.00].

The investigators found within-group analyses revealed that aerobic exercise had a moderate favourable effect on cognitive function [d+w = 0.65, 95% CI = 0.35 to 0.95), but other exercise types did not [d+w = 0.19, 95% CI = -0.06 to 0.43].

The investigators concluded that exercise training (3.4 days per week at moderate intensity for 45.2 minutes per session during 18.6 weeks) delays the decline in cognitive function that occurs in individuals who are at risk of/or have Alzheimer's disease, with aerobic exercise having the most favourable effect. Additional randomized controlled clinical trials that include objective measurements of cognitive function are needed to confirm these findings.

Original title:
Can Exercise Improve Cognitive Symptoms of Alzheimer's Disease? A Meta-Analysis by Panza GA, Taylor BA, […], Pescatello LS.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29363108

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Metabolic Equivalents (METs) are commonly used to express the intensity of physical activities.
MET is the ratio of a person's working metabolic rate relative to their resting metabolic rate.
One MET is defined as the energy cost of sitting quietly and is equivalent to a caloric consumption of 1 kcal/kg/hour.

Objectives:
What is the relationship between serum, dietary and urinary potassium and the risk of type 2 diabetes mellitus (T2DM)?  

Study design:
This review article included 8 prospective cohort studies involved 5,053 type 2 diabetes mellitus cases among 119,993 individuals.
The follow-up durations were from 5 to 18.1 years with a baseline age range from 18 to 95 years.
Serum potassium was measured using the ion-selective electrode method. Dietary potassium was estimated from food frequency questionnaire (FFQ). Urinary potassium samples were analyzed by potentiometric methods.
Most of the included studies provided risk estimates adjusted for age, sex, race, BMI and family history of diabetes.

Results and conclusions:
The investigators found in 5 studies involving 28,944 individuals and 3,849 type 2 diabetes mellitus cases, a non-significantly reduced risk of 21% [summary RR = 0.79, 95% CI = 0.60-1.04, I2 = 76.7%] for type 2 diabetes mellitus, when comparing the highest versus lowest serum potassium levels.
However, the sensitivity analysis did show a significant inverse association between serum potassium and type 2 diabetes mellitus risk [RR = 0.63, 95% CI = 0.52-0.73, I2 = 0%].

The investigators found in random dose-response meta-regression analysis a significantly reduced risk of 17% for type 2 diabetes mellitus [RR = 0.83, 95% CI = 0.73-0.95] per 1 mmol/L increase in serum potassium.

The investigators found in 6 studies involving 112,125 individuals and 4,573 type 2 diabetes mellitus cases, a non-significantly reduced risk of 7% [RR = 0.93, 95% CI = 0.81-1.06, I2 = 0.0%, p = 0.52] for type 2 diabetes mellitus, when comparing the highest versus lowest dietary potassium intake.
The sensitivity analysis did not significantly alter the association between dietary potassium and type 2 diabetes mellitus risk.

The investigators found there was no significant dose-response relationship between dietary potassium and type 2 diabetes mellitus risk [RR for every 1000mg increase dietary potassium per day = 1.00, 95% CI = 0.96-1.05].

The investigators found in 3 studies involving 4,376 individuals and 455 type 2 diabetes mellitus cases, a non-significantly reduced risk of 17% [RR = 0.83, 95% CI = 0.39-1.75, I2 = 73.9%, p = 0.02] for type 2 diabetes mellitus, when comparing the highest versus lowest urinary potassium levels.

The investigators found there was no significant dose-response relationship between urinary potassium levels and type 2 diabetes mellitus risk [RR for 10 mmol increase in urinary potassium per 24 hours = 1.00, 95% CI = 0.95-1.05].

The investigators concluded that serum potassium levels are linearly associated with the risk of type 2 diabetes mellitus, with each 1 mmol/L increase in serum potassium lowering the risk by 17%. However, neither dietary potassium nor urinary potassium shows any association with the risk of type 2 diabetes mellitus.

Original title:
Potassium measurements and risk of type 2 diabetes: a dose-response meta-analysis of prospective cohort studies by Peng Y, Zhong GC, […], Yang G.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5725047/

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Objectives:
The World Health Organization recommends participatory learning and action (PLA) in women’s groups to improve maternal and newborn health, particularly in rural settings with low access to health services. There have been calls to understand the pathways through which this community intervention may affect neonatal mortality. Therefore, this review article (meta-analysis) has been conducted.

The aim of this review article is to examine the effect of women’s groups on key antenatal, delivery and postnatal behaviours in order to understand pathways to mortality reduction.

Study design:
This review article included data from 7 cluster-randomised controlled trials that took place between 2001 and 2012 in rural India (2 trials), urban India (1 trial), rural Bangladesh (2 trials), rural Nepal (1 trial) and rural Malawi (1 trial), with the number of participants ranging between 6,125 and 29,901 live births.

There is a high degree of heterogeneity for effects on most behaviours, possibly due to the limited number of trials involving women’s groups and context-specific effects.

Results and conclusions:
The investigators found overall, women’s groups practising participatory learning and action significantly improved behaviours during and after home deliveries, including: 
-the use of safe delivery kits [during: OR = 2.92, 95% CI = 2.02-4.22, I2 = 63.7% and after: 95% CI = 4.4%-86.2%];
-the use of a sterile blade to cut the umbilical cord [during: OR = 1.88, 95% CI = 1.25-2.82, I2 = 67.6% and after 95% CI = 16.1%-87.5%];
-birth attendant washing hands prior to delivery [during: OR = 1.87, 95% CI = 1.19-2.95, I2 = 79% and after: 95% CI = 53.8%-90.4%];
-delayed bathing of the newborn for at least 24 hours [during: OR = 1.47, 95% CI = 1.09-1.99, I2 =  68.0% and after 29.2%-85.6%] and;
-wrapping the newborn within 10 minutes of delivery [during: OR = 1.27, 95% CI = 1.02-1.60, I2 =  0.0% and after: 95% CI = 0%-79.2%]. Significant because RR of 1 was not found in the 95% CI of 1.02 to 1.60. RR of 1 means no risk/association.
Effects were partly dependent on the proportion of pregnant women attending groups.

The investigators found overall, women’s groups practising participatory learning and action non-significantly improved behaviours during and after home deliveries, for:  
-uptake of antenatal care [during: OR = 1.03, 95% CI = 0.77-1.38, I2 = 86.3% and after: 95% CI = 73.8%-92.8%];
-facility delivery [during: OR = 1.02, 95% CI = 0.93-1.12, I2 = 21.4% and after: 95% CI = 0%-65.8%];
-initiating breastfeeding within 1 hour [during OR = 1.08, 95% CI = 0.85-1.39, I2 = 76.6% and after: 95% CI = 50.9%-88.8%] or;
-exclusive breastfeeding for 6 weeks after delivery [during OR = 1.18, 95% CI = 0.93-1.48, I2 = 72.9% and after: 95% CI = 37.8%-88.2%]. Non-significantly because RR of 1 was found in the 95% CI of 0.93 to 1.48. RR of 1 means no risk/association.

The investigators concluded that women’s groups practising participatory learning and action improve key behaviours on the pathway to neonatal mortality, with the strongest evidence for home care behaviours and practices during home deliveries. A lack of consistency in improved behaviours across all trials may reflect differences in local priorities, capabilities and the responsiveness of health services. Future research could address the mechanisms behind how participatory learning and action improves survival, in order to adapt this method to improve maternal and newborn health in different contexts, as well as improve other outcomes across the continuum of care for women, children and adolescents.  

Original title:
Effects of women’s groups practising participatory learning and action on preventive and care-seeking behaviours to reduce neonatal mortality: A meta-analysis of cluster-randomised trials by Seward N, Neuman M, […], Prost A.

Link:
http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002467

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Objectives:
Several studies have been conducted on the relationship between tea intake and the risk of osteoporosis. The results from these studies are, however, inconsistent. Therefore, this review article (meta-analysis) has been conducted.

Does tea intake reduce risk of osteoporosis?

Study design:
This review article included 2 prospective cohort studies, 4 cross-sectional studies and 11 case-control studies with 107,819 cases (people with osteoporosis). In the present study, the main symptom of osteoporosis was hip fracture.
10 studies - case-control and cohort studies were all of high quality - were in relative high quality (over 6 stars) with an average NOS score of 7.23.

The heterogeneity in the present review article mainly came from Asia group, female group, prospective cohort study group and case-control study group.

There was no publication bias of the meta-analysis about tea consumption and osteoporosis.

Results and conclusions:
The investigators found for the highest versus the lowest categories of tea consumption a significantly reduced risk of 38% [total OR = 0.62, 95% CI = 0.46-0.83, I2  =  94%, p   0 .01] for osteoporosis. However, when reducing heterogeneity, the overall OR [95% CI = 0.57-0.74, I2 = 30%] was still significant.
Subgroup analysis showed that tea consumption significantly reduced the risk of osteoporosis in all examined subgroups.

The investigators found stratified by categories of osteoporosis, a significantly reduced risk of 26% [OR  =  0.74, 95% BI = 0.63-0.88] for hip fracture.

The investigators found among women a significantly reduced risk of 27% [OR  =  0.73, 95% CI = 0.54-0.99] for osteoporosis.

The investigators concluded that high tea consumption reduces risk of osteoporosis, particularly hip fracture and particularly among women. However, the exact mechanism of the relationship between tea consumption and osteoporosis still needs further research.

Original title:
Association between tea consumption and osteoporosis: A meta-analysis by Sun K, Wang L, [...], Li X.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5728912/

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Objectives:
Fish oil supplementation has been shown to be associated with a lower risk of metabolic syndrome and benefit a wide range of chronic diseases, such as cardiovascular disease, type 2 diabetes and several types of cancers. However, the evidence of fish oil supplementation on glucose metabolism and insulin sensitivity is still controversial. Therefore, this review article (meta-analysis) has been conducted.

Does fish oil supplementation improve insulin sensitivity in humans?

Study design:
This review article included a total of 17 RCTs with 672 participants. One of the 17 studies was crossover design and others were parallel design.
The doses of active ingredients of fish oil (n-3 fatty acids) ranged from 1 g/d to 4 g/d. Duration of the interventions was ranged from 4 weeks to 24 weeks.
There was no suggestion of small study effect based on visual inspection of the funnel plot. Results of the Egger’s (p = 0.78) and Begg’s (p = 0.43) tests showed that there was no potential publication bias.

Results and conclusions:
The investigators found pooled analysis showed that fish oil supplementation had no effects on insulin sensitivity overall [SMD = 0.17, 95% CI = -0.15 to 0.48, p = 0.292, I2 = 58.1%, p = 0.001].

The investigators found subgroup analysis showed that fish oil supplementation significantly improved insulin sensitivity among people who were experiencing at least one symptom of metabolic disorders [SMD = 0.53, 95% CI = 0.17 to 0.88, p 0.001].

The investigators found subgroup analysis showed a positive effect of fish oil on insulin sensitivity among the short-term intervention group (12 weeks) rather than the long-term intervention group [SMD = 0.31, 95% CI = 0.01-0.61, p = 0.04].

The investigators found subgroup analysis showed that fish oil had no effects on insulin sensitivity among the healthy people or people with T2DM.

The investigators found there were no significant differences between subgroups of methods of insulin sensitivity and doses of omega-3 polyunsaturated fatty acids (n-3 PUFA) of fish oil supplementation.

The investigators found in sensitivity analysis that summary results did not differ significantly when omitting studies one at a time.

The investigators concluded that fish oil supplementation during 12 weeks improves insulin sensitivity among people who were experiencing at least one symptom of metabolic disorders.

Original title:
Fish oil supplementation and insulin sensitivity: a systematic review and meta-analysis by Gao H, Geng T, [...], Zhao Q.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5496233/

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Objectives:
There are some indications of regional differences in the association between fish consumption and clinical outcomes. Therefore, this review article (meta-analysis) has been conducted.  

Are there regional differences in the association between fish consumption and risk of all-cause mortality and cardiovascular (CVD) mortality?

Study design:
This review article included 14 prospective cohort studies (10 publications) with 911,348 participants, of which 75,451 incident deaths.

Results and conclusions:
The investigators found dose-response meta-analysis showed a 20 g/d increment in fish consumption significantly reduced risk of cardiovascular mortality with 4% [relative risk = 0.96, 95% CI = 0.94-0.98, I2 = 0%, n = 8]. However, subgroup analysis resulted in a significant association only in Asian studies and not in Western studies.

The investigators found dose-response meta-analysis showed a 20 g/d increment in fish consumption significantly reduced risk of all-cause mortality with 2% [relative risk = 0.98, 95% CI = 0.97-1.00, I2 = 81.9%, n = 14]. However, subgroup analysis resulted in a significant association only in Asian studies and not in Western studies.

The investigators found analysis of Western studies suggested a nearly U-shaped association, with a nadir at fish consumption of 20 g/d in analysis of both outcomes. Meanwhile, the associations appeared to be linear in Asian studies.

The investigators concluded that fish consumption, particularly 20 g/d reduces boh risk of cardiovascular mortality and all-cause mortality. Furthermore, there is potential evidence of regional differences in the association between fish consumption and mortality. Therefore, it may be helpful to examine the associations by considering types of fish consumed and methods of fish preparation.

Original title:
Fish consumption and risk of all-cause and cardiovascular mortality: a dose-response meta-analysis of prospective observational studies by Jayedi A, Shab-Bidar S, […], Djafarian K.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29317009

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Objectives:
Intermittent preventive treatment (IPT) for malaria is used in infants, children, adults and pregnant women. Dihydroartemisinin-piperaquine (DP) is an effective, well tolerated artemisinin-based combination therapy. The long half-life of piperaquine makes it attractive for IPT. Therefore, this review article (meta-analysis) has been conducted.

The aim of this review article is to assess the efficacy, safety and tolerability of repeated dosing of dihydroartemisinin-piperaquine when used for case management, intermittent preventive treatment, mass drug administration or seasonal malaria chemoprevention?

Study design:
This review article included 1 cohort study in pregnant women (n = 5,288), 1 RCT of repeated treatments in children younger than 5 years (n = 312) and 9 RCTs with IPT/SMC.
Of the 9 RCTs, 5 were in children younger than 5 years (n = 5,481), 1 in schoolchildren (n = 740), 1 in adult men at occupational risk of malaria (n = 961) and 2 in pregnant women (n = 1,846).
In total, there were 14,628 participants; 4,883 in dihydroartemisinin-piperaquine (DP) groups, of whom 4,511 were exposed to DP and 3,935 received at least two courses of DP, including 762 pregnant women and 1,913 children aged less than 5 years. The remaining 9,745 were exposed to placebo or other comparator therapy (including 990 exposed to SP–piperaquine).
The 4,511 participants exposed to dihydroartemisinin-piperaquine (DP) received a total of 18,873 courses, with 18,297 courses taken by the 3,935 participants who received at least two doses, some of whom received as many as 18 monthly doses.

All studies were conducted in areas with no or low parasite resistance to piperaquine or the artemisinins.

Results and conclusions:
The investigators found monthly dihydroartemisinin-piperaquine for intermittent preventive treatment for malaria was associated with an 84% [IRR = 0.16, 95% CI = 0.06-0.26, I2 = 99.4%, p = 0.000] reduction in the incidence of malaria parasitaemia measured by microscopy compared with placebo.

The investigators found monthly dihydroartemisinin-piperaquine for intermittent preventive treatment was associated with fewer serious adverse events than placebo, daily co-trimoxazole or monthly SP.

The investigators found among 56 IPT-DP recipients (26 children, 30 pregnant women) with cardiac parameters, all QTc intervals were within normal limits, with no significant increase in QTc prolongation with increasing courses of DP.

The investigators concluded that monthly dihydroartemisinin-piperaquine appears well tolerated and effective for intermittent preventive treatment for malaria. However, additional data are needed in pregnancy and to further explore the cardiac safety with monthly dosing.

Original title:
Safety, tolerability, and efficacy of repeated doses of dihydroartemisinin-piperaquine for prevention and treatment of malaria: a systematic review and meta-analysis by Gutman J, Kovacs S, [...], ter Kuile FO.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5266794/

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Find more information/studies on food fortification/malnutrition and study design/meta-analysis/significant right here.

Intermittent preventive treatment (IPT) or intermittent preventive therapy is a public health intervention aimed at treating and preventing malaria episodes in infants, children, schoolchildren and pregnant women.

Objectives:
Women have a 50% risk of urinary tract infection (UTI) over their lifetime and 20-30% experience a subsequent urinary tract infection recurrence. Cranberry (Vaccinium spp.) has been advocated for treatment of urinary tract infection; however, its efficacy is controversial. Therefore, this review article (meta-analysis) has been conducted.

Does cranberry reduce the risk of urinary tract infection recurrence in healthy women?

Study design:
This review article included 7 RCTs conducted in healthy nonpregnant women aged ≥18 years with a history of urinary tract infection (n = 1498 participants).
Risk of bias indicated that 2 studies had high loss to follow-up or selective outcome reporting. Overall, the studies were relatively small, with only 2 having >300 participants.

Results and conclusions:
The investigators found that cranberry significantly reduced the risk of urinary tract infection by 26% [pooled risk ratio = 0.74, 95% CI = 0.55-0.98, I2 = 54%].

The investigators concluded that cranberry may be effective in preventing urinary tract infection recurrence in generally healthy women. May be effective because the studies were relatively small, with only 2 having >300 participants. Therefore, larger high-quality studies are needed to confirm these findings.

Original title:
Cranberry Reduces the Risk of Urinary Tract Infection Recurrence in Otherwise Healthy Women: A Systematic Review and Meta-Analysis by Zhuxuan Fu, DeAnn Liska, […], Mei Chung.

Link:
http://jn.nutrition.org/content/147/12/2282.abstract

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