Nutritional advice

At least 28 g/d whole grain intake reduce risk of total, cardiovascular and cancer mortality

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Objectives:
Whole grains are rich source of nutrients and have shown beneficial effects on human health. Therefore, this meta-analysis (review article) has been conducted.

Do taking whole grains reduce mortality risk?

Study design:
This review article included 19 cohort studies with in total 1,041,692 participants and 96,710 deaths.

Results and conclusions:
The investigators found when comparing the highest versus the lowest categories of whole grain, a significantly reduced risk of 16% [RR = 0.84, 95% CI = 0.81-0.88, n = 9] for total mortality.

The investigators found when comparing the highest versus the lowest categories of whole grain, a significantly reduced risk of 17% [RR = 0.83, 95% CI = 0.79-0.86, n = 8] for cardiovascular mortality.

The investigators found when comparing the highest versus the lowest categories of whole grain, a non-significantly reduced risk of 6% [RR = 0.94, 95% CI = 0.87-1.01, n = 14] for cancer mortality.

The investigators found a nonlinear relationship of whole grain intake with risk of total, cardiovascular and cancer mortality.

The investigators found each 28 g/d intake of whole grains was associated with a 9% [pooled RR = 0.91, 95% CI = 0.90-0.93] lower risk for total mortality.

The investigators found each 28 g/d intake of whole grains was associated with a 14% [pooled RR = 0.86, 95% CI = 0.83-0.89] lower risk for cardiovascular mortality.

The investigators found each 28 g/d intake of whole grains was associated with a 3% [pooled RR = 0.97, 95% CI = 0.95-0.99] lower risk for cancer mortality.

The investigators concluded that a higher whole grain intake (at least 28 g/d) reduces risk of total, cardiovascular and cancer mortality. These findings support current dietary guidelines to increase the intake of whole grains. Government officials, scientists and medical staff should take actions to promote whole grains intake.
 
Original title:

Association of whole grain intake with all-cause, cardiovascular, and cancer mortality: a systematic review and dose-response meta-analysis from prospective cohort studies by Zhang B, Zhao Q, [...], Wang X.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29091078

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Artemether-lumefantrine as a first-line agent in the treatment of uncomplicated Plasmodium falciparum malaria in Ethiopia

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Objectives:
As Ethiopia is one of the sub-Saharan countries with a great burden of malaria the effectiveness of first line anti-malarial drugs is the major concern. Therefore, this review article (meta-analysis) has been conducted.

What is the efficacy of artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria in Ethiopia?

Study design:
This review article included 10 prospective single-arm cohort studies involving 1,179 patients with a mean age of 15.8 years.

In the majority (80%) of the studies, subjects were followed for 28 days, while in the remaining (20%) studies; the follow-up period was 42 days.
In each study, anywhere from 66 to 384 patients with P. falciparum mono-infection were included.
Most (70%) of the studies followed patients who were older than six months.
All of the included studies were deemed to be of high quality.

Heterogeneity between the studies was minimal (I2 = 38.8%).

At recruitment, the average parasite count per patient was 12,981/μL of blood and gametocytes were found in 7.7% of patients.

The mean temperature of patients on the day of enrolment was 38.2 ± 0.35 °C.

Results and conclusions:
The investigators found on the third day of treatment, 96.7% and 98.5% of study subjects become fever-free and parasite-free, respectively.

The investigators also found a significant decrease in gametocyte carriage from 7.7% at baseline to 0.4% on the 28th day of treatment.

The investigators found based on the per protocol analysis, the cure rate after use of artemether-lumefantrine was 98.2% (polymerase chain reaction corrected) and 97.01% (polymerase chain reaction uncorrected) after 28 days of follow-up. The reinfection rate within 28 days was 1.1% and the recrudescence rate was 1.9%.

The investigators concluded that the cure rate for uncomplicated P. falciparum malaria using artemether-lumefantrine in Ethiopia is still high enough to recommend the drug as a first-line agent. There should be careful periodic monitoring of the efficacy of this drug, as treatment failure may occur due to resistance, sub-therapeutic levels that may occur due to non-adherence or inadequate absorption.

Original title:
Therapeutic efficacy of artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria in Ethiopia: a systematic review and meta-analysis by Ayalew MB.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5686809/

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Subjects with end-stage renal disease benefit from a diet with <5.5 En% protein

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Objectives:
Recent data pose the question whether conservative management of chronic kidney disease (CKD) by means of a low-protein diet can be a safe and effective means to avoid or defer transition to dialysis therapy without causing protein-energy wasting or cachexia. Therefore, this review article (meta-analysis) has been conducted.

Do subjects with chronic kidney disease benefit from a low-protein diet?

Study design:
This review article included 16 controlled trials of low-protein diet in chronic kidney disease that met the stringent qualification criteria including having 30 or more participants.

Results and conclusions:
The investigators found compared with diets with protein intake of >0.8 g/kg/day, diets with restricted protein intake (0.8 g/kg/day) were associated with higher serum bicarbonate levels, lower phosphorus levels, lower azotemia, lower rates of progression to end-stage renal disease and a trend towards lower rates of all-cause death.

The investigators found compared with diets with protein intake of >0.8 g/kg/day, very-low-protein diets (protein intake 0.4 g/kg/day) were associated with greater preservation of kidney function and reduction in the rate of progression to end-stage renal disease.

The investigators found safety and adherence to a low-protein diet was not inferior to a normal protein diet and there was no difference in the rate of malnutrition or protein-energy wasting.

The investigators concluded a low-protein diet, particularly protein intake 0.4 g/kg/day, appears to enhance the conservative management of non-dialysis-dependent chronic kidney disease and may be considered as a potential option for chronic kidney disease patients who wish to avoid or defer dialysis initiation and to slow down the progression of chronic kidney disease, while the risk of protein-energy wasting and cachexia remains minimal.
 
Original title:
Low-protein diet for conservative management of chronic kidney disease: a systematic review and meta-analysis of controlled trials by Rhee CM, Ahmadi SF, [...], Kalantar-Zadeh K.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29094800

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A protein intake of 0.8 g/kg/day usually corresponds to a diet with 11 En% protein.
A protein intake of 0.4 g/kg/day usually corresponds to a diet with 5.5 En% protein.
A diet with 5.5 En% protein is a diet with a lot of products with 5.5 En% protein. Check here which products contain 5.5 En% protein.
 

Red and processed meat increase risk of stroke

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Objectives:
Previous meta‐analyses on meat intake and risk of stroke did not report the effect of white meat (poultry meat, excluding fish) and did not examine stroke incidence and mortality separately. Therefore, this review article (meta-analysis) has been conducted.

What is the relationship of total (red and processed meat), red (unprocessed or fresh red meat) and processed (processed red meat) meat consumption along with white meat on risk of stroke incidence and mortality disease risk?

Study design:
This review article included 15 prospective cohort studies (254,742 participants with 9,522 stroke incidents and 487,150 participants with 12,999 cases of stroke mortality). The follow-up duration varied from 5.5 to 26 years.

There was no significant publication bias based on the Egger test except that the evaluation of total meat with stroke incidence reached the significance threshold.

The average score for study quality assessed by the Newcastle‐Ottawa Scale was 7.29 (range 7-8) for studies on meat consumption and stroke incidence and 6.87 (range 6-8) for those on stroke mortality.

Results and conclusions:
The investigators found that a high total meat (red and processed meat) consumption resulted in a significantly higher risk of 18% [pooled relative risk = 1.18, 95% CI = 1.09-1.28, I2 = 0%] for total stroke incidence. Significantly means that there is an association with a 95% confidence.

The investigators found that a high red meat consumption resulted in a significantly higher risk of 11% [pooled relative risk = 1.11, 95% CI = 1.03-1.20, I2 = 0%] for total stroke incidence.

The investigators found that a high processed meat consumption resulted in a significantly higher risk of 17% [pooled relative risk = 1.17, 95% CI = 1.08-1.25, I2 = 0%] for total stroke incidence.

The investigators found that a high white meat consumption resulted in a significantly lower risk of 13% [pooled relative risk = 0.87, 95% CI = 0.78-0.97, I2 = 0%] for total stroke incidence.

The investigators found, however, no significant associations between consumption of total [RR = 0.97, 95% CI = 0.85-1.11, I2 = 0%] or red meat [RR = 0.87, 95% CI = 0.64-1.18, I2 = 70.9%] and stroke mortality. No significant associations because RR of 1 was found in the 95% CI of 0.64 to 1.18. RR of 1 means no risk/association.

The investigators found that a high total meat consumption was associated with an increased risk of 41% for hemorrhagic stroke [RR = 1.41, 95% CI = 1.08-1.84, I2 = 0%], but no significant association was found between a high total meat consumption and ischemic stroke [RR = 1.16, 95% CI = 0.94-1.43, I2 = 40.6%].

The investigators found a positive association between total meat consumption and stroke incidence, regardless of sex, number of cases and follow‐up duration.

The investigators found when stratified by adjustment variables, studies that adjusted for family history of myocardial infarction, fruit and vegetable intake and use of aspirin showed a statistically significant relationship between total meat intake and risk of stroke compared with other studies that did not include those as adjustment variables.

The investigators found that a high red meat consumption was associated with an increased risk of 24% for ischemic stroke [RR = 1.24, 95% CI = 1.05-1.46, I2 = 17.7%], but no significant association was found between a high red meat consumption and hemorrhagic stroke [RR = 1.11, 95% CI = 0.89-1.38, I2 = 0%].

The investigators found that a high processed meat consumption was linked to neither ischemic [RR = 1.10, 95% CI = 0.96-1.27, I2 = 11.4%] nor hemorrhagic stroke [RR = 1.19, 95% CI = 0.95-1.49, I2 = 8.10%].

The investigators concluded that higher consumption of red or processed meat is associated with an increase in the risk of stroke, while higher intake of white meat is related to a reduction in stroke incidence. Therefore, recommendations for replacing proportions of red and processed meat to white meat for the prevention of stroke may be considered in clinical practice.

Original title:
Role of Total, Red, Processed, and White Meat Consumption in Stroke Incidence and Mortality: A Systematic Review and Meta-Analysis of Prospective Cohort Studies by Kim K, Hyeon J, […], Park SM.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5634267/

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8.7 g/day viscous soluble fiber during 7 weeks reduces blood pressure

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Objectives:
Dietary fiber intake, especially viscous soluble fiber, has been established as a means to reduce cardiometabolic risk factors. Whether this is true for blood pressure remains controversial. Therefore, this review article (meta-analysis) has been conducted.

Does viscous soluble fiber supplementation reduce cardiovascular disease risk?

Study design:
This review article included 22 (n = 1430) and 21 RCTs (N = 1343) for systolic blood pressure (SBP) and diastolic blood pressure (DBP), respectively.

5 types of viscous fiber supplementation were β-glucan from oats and barley, guar gum, konjac, pectin and psyllium.

Results and conclusions:
The investigators found viscous soluble fiber supplementation significantly reduced systolic blood pressure [MD = -1.59 mmHg, 95% CI = -2.72 to -0.46, I2 = 72%, p 0.01] and diastolic blood pressure [MD = -0.39 mmHg, 95% CI = -0.76 to -0.01, I2 = 67%, p 0.01] at a median dose of 8.7 g/day (1.45-30 g/day) over a median follow-up of 7-weeks.

The investigators found within the five fiber types, systolic blood pressure reductions were observed only for supplementation using psyllium fiber [MD = -2.39 mmHg, 95% CI = -4.62 to -0.17].

The investigators concluded 8.7 g/day viscous soluble fiber supplementation, particularly psyllium fiber during 7 weeks reduces systolic blood pressure (SBP) and diastolic blood pressure (DBP). Therefore, inclusion of viscous fiber to habitual diets may have additional value in reducing cardiovascular risk via improvement in blood pressure.

Original title:
The effect of viscous soluble fiber on blood pressure: A systematic review and meta-analysis of randomized controlled trials by Khan K, Jovanovski E, […], Vuksan V.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29153856

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The prevalence of norovirus in patients with acute gastroenteritis in developing countries is 17%

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Objectives:
While norovirus (NoV) is well known as a leading causal pathogen for acute gastroenteritis in developed countries, structured data on prevalence in developing countries are not available thus far. Therefore, this review article (meta-analysis) has been conducted.

What is the prevalence of norovirus among patients with acute gastroenteritis in developing countries?

Study design:
This review article included evidence from 178 articles with a total of 148,867 patients with acute gastroenteritis.

Results and conclusions:
The investigators found the estimated norovirus prevalence among 148,867 patients with acute gastroenteritis was 17% [95% CI = 15-18%].

The investigators found the estimated norovirus prevalence decreased from 18% [95% CI = 16-20%] for upper middle-income countries to 15% [95% CI = 13-18%] and 6% [95% CI = 3-10%] for lower middle- and low-income countries, respectively.

The investigators found no significant differences in norovirus prevalence by age group (under 5 years, 5 years and over and mixed ages) or severity of symptoms as defined by community, outpatient or inpatient setting.

The investigators found the pooled prevalence of norovirus GII [15%, 95% CI = 13-17%] was significantly higher than that of norovirus GI [1%, 95% CI = 1-1%] in patients with acute gastroenteritis.

The investigators concluded from the evidence considered in this review, the estimated prevalence of norovirus in patients with acute gastroenteritis in developing countries was 17%. This estimate can be used to evaluate the burden of norovirus-associated acute gastroenteritis in developing countries, which is currently unclear due to poor diagnosis and surveillance systems and the estimation may enhance the development of human norovirus vaccines.

Original title:
A systematic review and meta-analysis of the prevalence of norovirus in cases of gastroenteritis in developing countries by Nguyen GT, Phan K, […], Watanabe T.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28984764

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Noroviruses are the most common cause of acute gastroenteritis (infection of the stomach and intestines). Norovirus illness spreads easily and is often called stomach flu or viral gastroenteritis.

Norovirus infection is characterized by nausea, vomiting, watery diarrhea, abdominal pain, and in some cases, loss of taste. A person usually develops symptoms of gastroenteritis 12 to 48 hours after being exposed to norovirus (also called the incubation period).

 

A diet with <10 En% saturated fat reduces cholesterol and blood pressure in children

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Objectives:
Elevated cholesterol has been linked to cardiovascular disease in adults and preclinical markers of atherosclerosis in children, thus reducing saturated (SFA) and trans-fatty acids (TFA) intake from an early age may help to reduce cholesterol and the risk of cardiovascular disease later in life. The World Health Organization (WHO) is currently updating its guidance on SFA and TFA intake in adults and children. Therefore, this review article (meta-analysis) has been conducted.

Does a diet with low saturated fatty acids reduce cholesterol and blood pressure in children and adolescents between 2 to 19 years of age?

Study design:
This review article included 8 RCTs (5 trials had a duration of 1 year and 3 had a duration of ≥ 1year with a total of 2,430 individual children and adolescents between 2 to 19 years of age) and 3 cohort studies.

Minimum duration was 13 days for RCTs and one year for cohort studies.

Saturated fatty acids intake was assessed using 24hr dietary recalls in 4 trials, 3-day diet records in 3 trials and food frequency questionnaires and/or checklists in 2 trials.

No trials were identified meeting the inclusion criteria for trans-fatty acids.

Publication bias was not assessed as the number of trials found was not sufficient to conduct funnel plot analyses for any outcome measure.

Results and conclusions:
The investigators found compared with control diets, there was a highly statistically significant effect of reduced saturated fatty acids intake on total cholesterol [MD = -0.16 mmol/L, 95% CI = -0.25 to -0.07, I2 = 64%], LDL cholesterol [MD = -0.13 mmol/L, 95% CI = -0.22 to -0.03, I2 = 77%] and diastolic blood pressure [MD = -1.45 mmol/L, 95% CI = -2.34 to -0.56].
The effects on cholesterol were greatest among those in which saturated fatty acids was replaced primarily with PUFA or MUFA and when the intervention group achieved a reduction in saturated fatty acids to below 10% of total energy intake.

The investigators found subgroup analysis of the effect of the initial lipid status of the participants showed a significantly different effect of saturated fatty acids reduction on total cholesterol [p = 0.05] between trials involving normolipidaemic/mixed status children [MD -0.21 mmol/L, 95% CI = -0.31 to -0.12] vs hyperlipidaemic children [MD = -0.08 mmol/L, 95% CI = -0.15 to -0.01].

The investigators found subgroup analysis of the effect of the initial lipid status of the participants showed the reduction in LDL cholesterol (bad cholesterol) was greater among the trials conducted in normolipidaemic/mixed status [MD -0.21 mmol/L, 95% CI = -0.30 to -0.13] vs hyperlipidaemic children [MD = -0.02 mmol/L, 95% CI = -0.14 to -0.11].

The investigators found there were no significant associations observed for HDL cholesterol (good cholesterol), triglycerides or apolipoproteins A1 or B.

The investigators found there were no significant associations observed between reduced saturated fatty acids intake and weight, height, body mass index (BMI) or waist circumference.

The investigators found there was no evidence of adverse effects of reducing saturated fatty acids intake in children on micronutrient intakes, cognitive development or sexual maturation in the small number of trials reporting these outcomes.  

The investigators concluded a diet with low saturated fatty acids reduces total cholesterol, LDL cholesterol and diastolic blood pressure in children and adolescents between 2 to 19 years of age without evidence of adverse effects on growth and development. The greatest effect on cholesterol occurred when saturated fatty acids was replaced with PUFA or a mixture of PUFA/MUFA and when saturated fatty acids intake was less than 10% of total energy intake. Therefore, dietary guidelines for children and adolescents should continue to recommend diets low in saturated fat.

Original title:
Health effects of saturated and trans-fatty acid intake in children and adolescents: Systematic review and meta-analysis by Morenga L and Montez JM.

Link:
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0186672

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A diet with saturated fatty acids intake less than 10% of total energy intake is a diet with less than 10 En% saturated fat.
A diet with less than 10 En% saturated fat is a diet that is largely made up of meals/products with less than 10 En% saturated fat. Practically, this means that all meals/products that you eat on a daily basis should on average contain less than 10 En% saturated fat. Check here which products contain less than 10 En% saturated fat.

High intake of cooked carrot might be associated with a low incidence of urothelial cancer

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Objectives:
Previous studies regarding the relationship between carrot intake and risk of urothelial cancer have reported conflicting results. Therefore, this review article (meta-analysis) has been conducted.

Does a high consumption of carrot reduce urothelial cancer risk?

Study design:
This review article included a total of 6 epidemiological studies (4 case-control and 2 cohort studies) with 1,523 urothelial cancer cases.

There was no significant publication bias by Begg's test (p = 0.348) or Egger's test (p = 0.130).

Results and conclusions:
The investigators found overall analysis indicated a significantly reduced risk of 37% for urothelial cancer for high intake of carrot [OR = 0.63, 95% CI = 0.44-0.90, I2 = 79.6%, p 0.001].

The investigators found in the subgroup analysis by study design, a significantly reduced risk of 55% for urothelial cancer in case-control studies [OR = 0.45, 95% CI = 0.25-0.81]. However, this reduced risk was not significant in cohort studies [OR = 0.91, 95% CI = 0.67-1.24].
Not significant because OR of 1 was found in the 95% CI of 0.67 to 1.24. OR of 1 means no risk/association.

The investigators found, when separately analyzed by carrot type, a significantly reduced risk of 31% for cooked carrot [OR = 0.69, 95% CI 0.51-0.94], but the reduced risk was not significant for raw carrot [OR = 0.84, 95% CI = 0.37-1.93].

The investigators found in the stratified analysis by geographical region, a non-significantly reduced risk of 38% [OR = 0.62, 95% CI = 0.37-1.06], a non-significantly reduced risk of 30% [OR = 0.70, 95% CI = 0.29-1.67] and a non-significantly reduced risk of 47% [OR = 0.53, 95% CI = 0.22-1.26] for Europe, Asia and USA, respectively.

The investigators also found a non-significantly reduced risk of 44% [OR = 0.56, 95% CI = 0.27-1.17] and a non-significantly reduced risk of 27% [OR = 0.73, 95% CI = 0.12-4.60] for male and female, respectively.

The investigators concluded that a high intake of carrot might be associated with a low incidence of urothelial cancer. Might be associated because the reduced risk was not significant in cohort studies. Considering the limited included studies and huge heterogeneity, further large well-designed prospective cohort studies are warranted to confirm these findings.

Original title:
Carrot intake and incidence of urothelial cancer: a systematic review and meta-analysis by Luo X, Lu H, [...], Wang S.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5652827/

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50 mg/day dietary vitamin C intake decreases hip fracture risk

Objectives:
Previous studies had inconsistent findings regarding the association between vitamin C intake and the risk of hip fracture. Therefore, this meta-analysis (review article) has been conducted.

Does taking dietary vitamin C reduce risk of hip fracture?

Study design:
This review article included 6 articles, containing 7908 controls and 2899 cases of hip fracture.

Results and conclusions:
The investigators found when comparing the highest versus the lowest categories of vitamin C, that dietary vitamin C was statistically correlated with a lower risk of 27% for hip fracture [overall OR = 0.73, 95% CI = 0.55-0.97, I2 = 69.1%].

The investigators found that every increment of 50 mg/day dietary vitamin C intake significantly reduced risk of hip fracture with 5% [OR = 0.95, 95% CI = 0.91-1.00, p = 0.05].

The investigators concluded that increasing dietary vitamin C (at least 50 mg/day) intake decreases the risk of hip fracture. In order to verify the association of vitamin C intake and hip fracture risk, further well-designed largely randomized controlled trials (RCTs) are needed.

Original title:
Dietary vitamin C intake and the risk of hip fracture: a dose-response meta-analysis by Sun Y, Liu C, […], Lu Q.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29101410

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At least 4 servings/week fish is associated with decreasing memory decline

Objectives:
Fish are a primary source of long-chain omega-3 fatty acids, which may help delay cognitive aging. Therefore, this meta-analysis (review article) has been conducted.

Does a higher fish intake reduce cognitive decline?

Study design:
This review article included 5 cohort studies (23,688 Caucasians aged ≥65 years, 88% female and median follow-up range of 3.9-9.1 years).

Results and conclusions:
The investigators found in multivariate analyses, higher fish intake was associated with slower decline in both global cognition and memory [p-trend ≤ 0.031].

The investigators found consuming ≥4 versus 1 fish serving/week was associated with 0.018 [95% CI = 0.004-0.032] standard units lower rate of memory decline; an effect estimate equivalent to that found for 4 years of age.

The investigators found for global cognition, no comparisons of higher versus low fish intake reached statistical significance.

The investigators found no evidence of effect modification by Alzheimer's.

The investigators concluded that increasing fish intake (at least 4 servings/week) is associated with decreasing memory decline of older persons.

Original title:
Fish intake, genetic predisposition to alzheimer's disease and decline in global cognition and memory in five cohorts of older persons by Samieri C, Morris MC,[…], Grodstein F.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29053784

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A typical serving size of fish can range from 3 to 6 oz., depending on the type of fish and its preparation. The American Heart Association considers 3.5 oz. of cooked fish, or about 3/4 cup, to be a single serving.
 

Malaria infection during pregnancy increases anemia risk in Ethiopia

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Objectives:
Anemia during pregnancy is one of the most common indirect obstetric cause of maternal mortality in developing countries. It is responsible for poor maternal and fetal outcomes. A limited number of studies were conducted on anemia during pregnancy in Ethiopia and they present inconsistent findings. Therefore, this review article (meta-analysis) has been conducted.

What are the findings conducted in several parts of the country and present the national level of anemia among pregnant women in Ethiopia?

Study design:
This review article included 20 cross-sectional studies with a total of 10,281 pregnant women.
The minimum and maximum age of pregnant women included in this review were 14 years and 42 years.

The Begg’s and Egger’s test for publication bias showed no statistical evidence of publication bias.

Results and conclusions:
The investigators found the pooled prevalence of anemia among pregnant women in Ethiopia was [31.66%, 95% CI = 26.20 to 37.11].

The investigators found based on the pooled prevalence of the subgroup analysis result, the lowest prevalence of anemia among pregnant women was observed in Amhara region, [15.89%, 95% CI = 8.82 to 22.96] and the highest prevalence was in Somali region [56.80%, 95% CI = 52.76 to 60.84].

The investigators found based on the pooled prevalence of the subgroup analysis result, Primigravid [RR = 0.61, 95% CI = 0.53 to 0.71] and urban women [RR = 0.73, 95% CI = 0.60 to 0.88, p-heterogeneity = 0.003] were less likely to develop anemia.

The investigators found mothers with short pregnancy interval (2 years) had a higher risk of 114% [RR = 2.14, 95% CI = 1.67 to 2.74, p-heterogeneity = 0.108] to develop anemia.

The investigators found malaria infection during pregnancy significantly increase anemia risk with 94% [RR = 1.94, 95% CI = 1.33 to 2.82].

The investigators concluded almost one-third of pregnant women in Ethiopia have been anemic. Statistically significant association has been observed between anemia during pregnancy and residence, gravidity, pregnancy interval and malaria infection during their pregnancy. Regions with higher anemia prevalence among pregnant women should be given due attention. Further studies should be conducted to better understand the determinant factors in these regions.

Original title:
Prevalence and determinants of anemia among pregnant women in Ethiopia; a systematic review and meta-analysis by Kassa GM, Muche AA, […], Fekadu GA.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5646153/

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Low vitamin D status is related to poorer cognition in healthy adults

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Objectives:
With an aging population and no cure for dementia on the horizon, risk factor modification prior to disease onset is an urgent health priority. Therefore, this meta-analysis (review article) has been conducted.

What is the effect of low vitamin D status or vitamin D supplementation on cognition in midlife and older adults without a diagnosis of dementia?

Study design:
This review article included 26 observational (cross-sectional and longitudinal cohort) studies and 3 intervention studies (n = 19-9,556).

Results and conclusions:
The investigators found in 26 observational studies that low vitamin D status was associated with worse cognitive performance [OR = 1.24, CI = 1.14-1.35] and cognitive decline [OR = 1.26, CI = 1.09-1.23] in midlife and older adults without a diagnosis of dementia; with cross-sectional yielding a stronger effect compared to longitudinal studies.

However, the investigators found in 3 intervention studies that vitamin D supplementation showed no significant benefit on cognition compared with control [SMD = 0.21, CI = -0.05 to 0.46].

The investigators concluded that observational evidence demonstrates low vitamin D is related to poorer cognition in midlife and older adults without a diagnosis of dementia; however, interventional studies are yet to show a clear benefit from vitamin D supplementation. From the evidence to date, there is likely a therapeutic age window relevant to the development of disease and therefore vitamin D therapy. Longitudinal lifespan studies are necessary to depict the optimal timing and duration in which repletion of vitamin D may protect against cognitive decline and dementia in aging, to better inform trials and practice towards a successful therapy.

Original title:
A Systematic Review and Meta-Analysis of The Effect of Low Vitamin D on Cognition by Goodwill AM and Szoeke C.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28758188

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Serum zinc/iron levels are decreased in Alzheimer's disease patients

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Objectives:
Many publications have investigated the association between metal ions and the risk of Alzheimer's disease (AD), but the results were ambiguous. Therefore, this meta-analysis (review article) has been conducted.

What is the association between serum copper/zinc/iron levels and Alzheimer's disease risk?

Study design:
This review article included 44 case-control studies.

Results and conclusions:
The investigators found in 35 case-control studies (2,128 Alzheimer's disease patients and 2,889 healthy controls. The mean age of the patient groups was >54), that serum copper levels were significant higher in Alzheimer's disease patients [MD = 9.13, 95% CI = 6.17 to 12.09, p 0.00001].

The investigators found in 22 case-control studies (1,027 Alzheimer's disease patients and 1,949 healthy controls. The mean age of the patient groups was >54), that serum zinc levels were significant lower in Alzheimer's disease patients [MD = -7.80, 95% CI = -11.61 to -3.99, p 0.0001].

The investigators found in 25 case-control studies (1,379 Alzheimer's disease patients and 1,664 healthy controls. The mean age of the patient groups was >62.74), that serum iron levels were significant lower in Alzheimer's disease patients [MD = -13.01, 95% CI = -20.75 to -5.27, p = 0.001].

The investigators concluded that serum copper levels are significantly increased, while serum zinc/iron levels are significantly decreased in Alzheimer's disease patients.

Original title:
Serum Copper, Zinc, and Iron Levels in Patients with Alzheimer's Disease: A Meta-Analysis of Case-Control Studies by Li DD, Zhang W, [...], Zhao P.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5605551/

Additional information of El Mondo:
Find more information/studies on copper, zinc, iron and dementia right here.
 

Consumption of whole grains, fish, vegetables and fruit decrease risk of cardiovascular diseases

Afbeelding

Objectives:
Despite growing evidence for food-based dietary patterns' potential to reduce cardiovascular disease risk, knowledge about the amounts of food associated with the greatest change in risk of specific cardiovascular outcomes and about the quality of meta-evidence is limited. Therefore, this review article (meta-analysis) has been conducted.

Which food-based dietary patterns reduce risk of cardiovascular diseases, such as coronary heart disease (CHD), stroke and heart failure (HF)?

Study design:
This review article included 123 prospective cohort studies.

Results and conclusions:
The investigators found whole grains significantly reduced risk of coronary heart disease with 5% [RR = 0.95, 95% CI = 0.92-0.98]. Significantly means that there is an association with a 95% confidence.

The investigators found whole grains significantly reduced risk of heart failure with 4% [RR = 0.96, 95% CI = 0.95-0.97]. Significantly because RR of 1 was not found in the 95% CI of 0.95 to 0.97. RR of 1 means no risk/association.

The investigators found vegetables significantly reduced risk of coronary heart disease with 3% [RR = 0.97, 95% CI = 0.96-0.99]. Significantly means it can be said with a 95% confidence that a intake of vegetables really decreased the risk of getting coronary heart disease with 3%.  

The investigators found fruits significantly reduced risk of coronary heart disease with 6% [RR = 0.94, 95% CI = 0.90-0.97].

The investigators found vegetables significantly reduced risk of stroke with 8% [RR = 0.92, 95% CI = 0.86-0.98].

The investigators found fruits significantly reduced risk of stroke with 10% [RR = 0.90, 95% CI = 0.84-0.97].

The investigators found nuts non-significantly reduced risk of coronary heart disease with 33% [RR = 0.67, 95% CI = 0.43-1.05]. Non-significantly means that there is no association with a 95% confidence.

The investigators found fish consumption significantly reduced risk of stroke with 14% [RR = 0.86, 95% CI = 0.75-0.99].

The investigators found fish consumption significantly reduced risk of heart failure with 20% [RR = 0.80, 95% CI = 0.67-0.95].

The investigators found egg significantly increased risk of heart failure with 16% [RR = 1.16, 95% CI = 1.03-1.31].

The investigators found red meat significantly increased risk of coronary heart disease with 15% [RR = 1.15, 95% CI = 1.08-1.23].

The investigators found red meat significantly increased risk of stroke with 12% [RR = 1.12, 95% CI = 1.06-1.17].

The investigators found red meat significantly increased risk of heart failure with 8% [RR = 1.08, 95% CI = 1.02-1.14].

The investigators found processed meat significantly increased risk of coronary heart disease with 27% [RR = 1.27, 95% CI = 1.09-1.49].

The investigators found processed meat significantly increased risk of stroke with 17% [RR = 1.17, 95% CI = 1.02-1.34].

The investigators found processed meat significantly increased risk of heart failure with 12% [RR = 1.12, 95% CI = 1.05-1.19].

The investigators found sugar-sweetened beverages significantly increased risk of coronary heart disease with 17% [RR = 1.17, 95% CI = 1.11-1.23].

The investigators found sugar-sweetened beverages significantly increased risk of heart failure with 7% [RR = 1.07, 95% CI = 1.02-1.12].

The investigators found sugar-sweetened beverages significantly increased risk of stroke with 8% [RR = 1.08, 95% CI = 1.05-1.12].

The investigators found there were clear indications for non-linear dose-response relationships between whole grains, fruit, nuts, dairy and red meat and coronary heart disease.

The investigators concluded there is a relationship between food-based dietary patterns and risk of cardiovascular diseases, with an increased risk for consumption of eggs, red meat, processed meat and sugar-sweetened beverages and a decreased risk for consumption of whole grains, vegetables, fruit and fish.

Original title:
Food groups and risk of coronary heart disease, stroke and heart failure: A systematic review and dose-response meta-analysis of prospective studies by Bechthold A, Boeing H, […], Schwingshackl L.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29039970

Additional information of El Mondo:
Find more information/studies on food groups and cardiovascular diseases right here. 

Mortality effects of vitamin A supplementation in children <5 years do not vary by dosing frequency, total dose, or duration

Objectives:
Although vitamin A supplementation reduces child mortality, it remains unclear whether dosing frequency, total dose, or duration modifies effectiveness. Therefore, this review article has been conducted.

Do mortality effects of vitamin A supplementation in children 5 years vary by dosing frequency, total dose, or duration?

Study design:
This review article included 17 RCTs with 1,180,718 children. Mean age was 31.5 months at baseline.
Supplementation frequency ranged every 3 months-every 2 years, supplementation duration 4-60 months [mean = 15.4, SD = 12.8] and total dose 134,361-2,200,000 IU [mean = 667,132 IU, SD = 540,795].

Results and conclusions:
The investigators found compared with control, vitamin A supplementation significantly reduced mortality with 22% [95% CI = 10-32, p = 0.002]. Significantly means that there is an association with a 95% confidence.
This protective effect was not modified by increasing supplementation frequency [dose/year: RR = 1.02, 95% CI = 0.98-1.06, p = 0.22], total dose [per 200,000 IU: RR = 1.02, 95% CI = 0.97-1.06, p = 0.31], nor supplementation duration [per year: RR = 1.06, 95% CI = 0.97-1.15, p = 0.14].

The investigators found multivariate meta-regression showed similar results.

The investigators found sensitivity analyses excluding 1 controversial trial did not alter findings.

The investigators concluded that mortality effects of vitamin A supplementation in children 5 years do not vary by dosing frequency, total dose, or duration.

Original title:
Mortality Benefits of Vitamin A Are Not Affected by Varying Frequency, Total Dose, or Duration of Supplementation by Kranz S, Pimpin L, […], Mozaffarian D.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28513263

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

Breastfeeding during 6-9 months reduces risk of endometrial cancer

Objectives:
Does breastfeeding reduce risk of endometrial cancer?

Study design:
This review article included individual-level data from 3 cohort and 14 case-control studies, with a total of  8,981 women with endometrial cancer and 17,241 women in a control group.

Results and conclusions:
The investigators found ever breastfeeding was associated with an 11% reduction in risk of endometrial cancer [pooled OR = 0.89, 95% CI = 0.81-0.98].
The association with ever breastfeeding was not explained by greater parity and did not vary notably by body mass index or histologic subtype (grouped as endometrioid and mucinous compared with serous and clear cell).

The investigators found longer average duration of breastfeeding per child was associated with lower risk of endometrial cancer, although there appeared to be some leveling of this effect beyond 6-9 months.

The investigators concluded that reducing endometrial cancer risk can be added to the list of maternal benefits associated with breastfeeding. Ongoing promotion, support and facilitation of this safe and beneficial behavior might therefore contribute to the prevention of this increasingly common cancer.

Original title:
Breastfeeding and Endometrial Cancer Risk: An Analysis From the Epidemiology of Endometrial Cancer Consortium by Jordan SJ, Na R, […], Webb PM.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28486362

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

N-3 PUFA supplementation improves immune function and reduces the level of inflammation in gastrointestinal cancer patients postoperatively

Afbeelding

Objectives:
Surgical resection remains the primary treatment for gastrointestinal (GI) malignancy including early-stage cancer. Omega-3 polyunsaturated fatty acids (n-3 PUFAs) have been reported to have beneficial clinical and immune-modulating effects in the prognosis of gastrointestinal cancer patients undergoing surgery. Therefore, this review article (meta-analysis) has been conducted.

What is the impact of n-3 PUFA supplementation on postoperative inflammation status and immune function of gastrointestinal cancer patients?

Study design:
This review article included a total of 9 RCTs with 623 participants.

The homogeneous test detected no statistical heterogeneity between studies.

There was no evidence of publication bias following assessment by funnel plot, Egger’s test [p > 0.05] and Begg’s test [p > 0.05].

Results and conclusions:
The investigators found the n-3 PUFAs regime significantly resulted in lower levels of C-reactive protein [p 0.05], interleukin-6 [p 0.01] and higher levels of albumin, CD3+ T cells, CD4+ T cells and CD4+/CD8+ ratio [p 0.05] compared with the isocaloric nutrition regime.

The investigators found, however, no significant difference in the level of tumor necrosis factor-α between the n-3 PUFAs regime and the isocaloric nutrition regime [p = 0.17].

The investigators found that the level of CD8 + T cells significantly decreased compared with the isocaloric nutrition regime [p 0.0001].

The investigators concluded that n-3 PUFAs are effective in improving the nutritional status and immune function of gastrointestinal cancer patients undergoing surgery as they effectively enhance immunity and attenuate the inflammatory response. Although further larger trials are needed, these fatty acids should be widely used in the clinic.

Original title:
Effects of omega-3 fatty acids on patients undergoing surgery for gastrointestinal malignancy: a systematic review and meta-analysis by Yu J, Liu L, [...], Yang F.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5391568/

Additional information of El Mondo:
Find more information/studies on n-3 PUFA consumption and cancer right here.
 

Coenzyme Q10 supplements result in lower mortality and improved exercise capacity of patients with heart failure

Objectives:
The therapeutic efficacy of coenzyme Q10 on patients with cardiac failure remains controversial. Therefore, this review article (meta-analysis) has been conducted.

Do patients with heart failure benefit from coenzyme Q10 supplements?

Study design:
This review article included a total of 14 RCTs with 1064 patients in coenzyme Q10 (treatment) group and 1085 patients in placebo (control) group.

Egger’s test results showed no significant evidence of publication bias in either endpoint.

Results and conclusions:
The investigators found compared with placebo, coenzyme Q10 supplementation significantly decreased mortality risk with 31% [RR = 0.69, 95% CI = 0.50 to 0.95, p = 0.02, I2 = 0%].

The investigators found a greater improvement in exercise capacity was established in patients who used coenzyme Q10 than in those who used placebo [SMD = 0.62, 95% CI = 0.02 to 0.30, p = 0.04, I2 = 54%].

The investigators found patients who used coenzyme Q10 and placebo associated with similar left heart ejection fraction [SMD = 0.14, 95% CI = -0.08 to 0.37, p = 0.22, I2 = 54%].

The investigators found no significant difference between coenzyme Q10 and placebo for NYHA classification [SMD = -0.70, 95% CI = -1.92 to 0.51, p = 0.26, I2 = 89%].

The investigators concluded in patients with heart failure, the administration of coenzyme Q10 results in lower mortality and improved exercise capacity compared with the effects of placebo treatment.

Original title:
Efficacy of coenzyme Q10 in patients with cardiac failure: a meta-analysis of clinical trials by Lei L and Liu Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5525208/

Additional information of El Mondo:
Find more information/studies on coenzyme Q10 and cardiovascular diseases right here. 

Plant-based dietary patterns decrease cancer risk

Afbeelding

Objectives:
The aim of this review article (meta-analysis) is to compare empirically derived dietary patterns in relation to cancer risk.

Study design:
This review article included observational studies, which evaluated the association with cancer risk between a posteriori derived dietary patterns.

Results and conclusions:
The investigators found a significantly 64% increased risk of cancer for the adoption of high-meat compared to plant-based dietary patterns [RR = 1.64, 95% CI = 1.02-2.63].

The investigators found a significantly 12% lower risk of cancer for individuals adopting a plant-based dietary pattern over a mixed one [RR = 0.88, 95% BI = 0.82-0.95].

The investigators concluded that plant-based dietary patterns decrease cancer risk; meanwhile meat-based dietary patterns increase cancer risk.

Original title:
Differences in the association between empirically derived dietary patterns and cancer: a meta-analysis by Bella F, Godos J, […], Sciacca S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/27894200

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

Prevalence of stunted and wasted children at the same time is highest in the 12- to 24-month age group, especially among boys and in fragile and conflict-affected states

Afbeelding

Objectives:
Children can be stunted and wasted at the same time. Having both deficits greatly elevates risk of mortality.

The aim of this review article is to estimate the prevalence and burden of children aged 6-59 months concurrently wasted and stunted.

Study design:
This review article included data from demographic and health survey and Multi-indicator Cluster Surveys datasets from 84 countries.

Results and conclusions:
The investigators found pooled prevalence of concurrence in the 84 countries was 3.0% [95% CI = 2.97-3.06], ranging from 0% to 8.0%.

The investigators found 9 countries reported a concurrence prevalence greater than 5%. The estimated burden was 5,963,940 children.

The investigators found prevalence of concurrence was highest in the 12- to 24-month age group [4.2%, 95% CI = 4.1-4.3] and was significantly higher among boys [3.54%, 95% CI = 3.47-3.61], compared to girls [2.46%, 95% CI = 2.41-2.52].

The investigators found fragile and conflict-affected states reported significantly higher concurrence [3.6%, 95% CI = 3.5-3.6], than those defined as stable [2.24%, 95% CI = 2.18-2.30].

The investigators concluded prevalence of concurrence (stunted and wasted children at the same time) is highest in the 12- to 24-month age group, especially among boys and in fragile and conflict-affected states. Given the high risk of mortality associated with concurrence, the findings indicate a need to report on this condition as well as investigate whether these children are being reached through existing programmes.

Original title:
Children concurrently wasted and stunted: A meta-analysis of prevalence data of children 6-59 months from 84 countries by Khara T, Mwangome M, […], Dolan C.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28944990

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

Pomegranate supplementation has no favourable effect on improvements in glucose and insulin metabolism

Afbeelding

Objectives:
The potential glucose-lowering effects of pomegranate have been reported in animal and observational studies, but intervention studies in humans have generated mixed results. Therefore, this review article (meta-analysis) has been conducted.

What are the effects of pomegranate supplementation on measures of glucose control, insulin levels and insulin sensitivity in humans?

Study design:
This review article included 16 RCTs with 538 subjects. 14 trials adopted parallel study designs and the 2 remaining trials used crossover designs.
The total number of subjects included in each study ranged from 14 to 74 subjects.
The mean age of participants in each trial ranged from 30 to 70 years, with differing age ranges in most studies.
11 studies used pomegranate juice as a supplement (the dosage ranged from 120 to 500 ml/day).
2 studies used pomegranate seed oil as treatments (the dosage ranged from 400 to 2000 mg/day).
3 studies utilized pomegranate extract as the intervention (the dosage ranged from 710 to 1420 mg/day).  
The duration of the pomegranate intervention varied from 1 to 12 weeks (median: 5.5 weeks).

Overall, significant heterogeneity was detected for FBI and HOMA-IR, but subgroup analysis could not identify factors significantly influencing these parameters.
No significant publication bias was found.

Results and conclusions:
The investigators found that pomegranate did not significantly affect the measures of:
-FBG (fasting blood glucose) [WMD = -0.6 mg/dL, 95% CI = -2.79 to 1.58, p = 0.59, I2 = 0%];
-FBI (fasting blood insulin) [WMD = 0.29 μIU/mL, 95% CI = -1.16 to 1.75, p = 0.70, I2 = 60.4%];
-HOMA-IR (homeostatic model assessment of insulin resistance) [WMD = -0.04, 95% CI = -0.53 to 0.46, p = 0.88, I2 = 59.8%] or;
-HbA1c (glycated haemoglobin) [WMD = -0.11%, 95% CI = -0.39 to 0.18, p = 0.46, I2 = 0%].
These results were robust in sensitivity analysis.

The investigators found meta-regression analysis showed that the factor (dose of pomegranate juice supplementation) was not associated with the treatment effects on FBG level [coefficient = -0.006, 95% CI = -0.023 to 0.011, p = 0.46].

The investigators found no significant difference in the FBG-lowering effect between trials that were conducted in subjects with cardiovascular disease risk [WMD = 0.30 mg/dL, 95% CI = -2.36 to 2.97, p = 0.82] and those that were conducted in healthy individuals [WMD = -2.53 mg/dL, 95% CI = -6.36 to 1.30, p = 0.19].

The investigators found no statistically significant differences in the pooled effects of pomegranate on FBG in the subgroups stratified by study designs, intervention durations, types of intervention, baseline BMI and baseline FBG levels (FBG levels at the beginning of the studie).

The investigators concluded pomegranate supplements have no favourable effect on improvements in glucose and insulin metabolism. The current evidence suggests that daily pomegranate supplementation is not recommended as a potential therapeutic strategy in glycemic management. Further large-scale RCTs with longer duration are required to confirm these results.

Original title:
Lack of efficacy of pomegranate supplementation for glucose management, insulin levels and sensitivity: evidence from a systematic review and meta-analysis by Huang H, Liao D, […], Zhu Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5629805/

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

Higher sodium increases metabolic syndrome

Afbeelding

Objectives:
The prevalence of metabolic syndrome (MetS) has been greatly increased, worldwide. In recent years, investigators have proposed that sodium might contribute to the development of metabolic syndrome; however, the published data were conflicting. Therefore, this review article (meta-analysis) has been conducted.

Does sodium contribute to the development of metabolic syndrome?

Study design:
This review article included 17 observational studies with 66,274 participants.

Results and conclusions:
The investigators found that subjects with metabolic syndrome had significantly higher levels of sodium compared to healthy controls [Hedges' g = 0.21, 95% CI = 0.12-0.29, I2 = 68.6%]. Subgroup analyses revealed that the difference was significant when the sodium status was assessed using urinary sodium levels.

The investigators found that random effects meta-regression analysis also revealed that body sodium level increases with the number of metabolic syndrome components.

The investigators found that participants with highest dietary/urinary or serum sodium levels had a significantly 37% higher chance of developing metabolic syndrome when compared with participants with the lowest sodium levels [OR = 1.37, 95% CI = 1.31-1.42, I2 = 86.9%].

The investigators concluded that higher sodium input into the body is directly associated with the likelihood of metabolic syndrome. Prospective cohort studies and well-designed randomized clinical trials considering the effect of sodium restricted diets on the risk of metabolic syndrome as an outcome are necessary to represent the causal association.

Original title:
Sodium status and the metabolic syndrome: A systematic review and meta-analysis of observational studies by Soltani S, Kolahdouz Mohammadi R, […], Salehi-Abargouei A.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28846446

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

Find out whether you are overweight or not right here.

Those with metabolic syndrome are advised to select the following food items.

Sodium is part of table salt or sodium choride.

High-sodium or high-salt products are products with more than 0.3 gram salt per 100 kcal. These products are rich in salt.
A high-salt diet is a diet with many products with more than 0.3 gram salt per 100 kcal.

EPA and DHA supplements reduce risk of cardiovascular diseases

Afbeelding

Objectives:
Over 200 clinical trials have examined the effect of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) supplements on risk factors associated with cardiovascular disease. However, an updated analysis of the evidence is lacking. Therefore, this review article (meta-analysis) has been conducted.

Do EPA and DHA supplements reduce risk of cardiovascular diseases?

Study design:
This review article included 171 RCTs with acceptable quality (Jadad score ≥3).

Results and conclusions:
The investigators found compared to placebo-control, EPA and DHA supplements produced significant reductions of triglycerides of 0.368 mmol/L [95% CI = -0.427 to -0.309].
The triglyceride-lowering effect was dose-dependent.

The investigators found compared to placebo-control, EPA and DHA supplements produced significant reductions of systolic blood pressure of 2.195 mmHg [95% CI = -3.172 to -1.217].

The investigators found compared to placebo-control, EPA and DHA supplements produced significant reductions of diastolic blood pressure of 1.08 mmHg [95% CI = -1.716 to -0.444].

The investigators found compared to placebo-control, EPA and DHA supplements produced significant reductions of heart rate of 1.37 bpm [95% CI = -2.41 to -0.325].

The investigators found compared to placebo-control, EPA and DHA supplements produced significant reductions of C-reactive protein of 0.343 mg/L [95% CI = -0.454 to -0.232].

The investigators found compared to placebo-control, EPA and DHA supplements produced a significant increase of LDL cholesterol (bad cholesterol) [mean difference = 0.150 mmol/L, 95% CI = 0.058 to 0.243].

The investigators found compared to placebo-control, EPA and DHA supplements produced a significant increase of HDL cholesterol (good cholesterol) [mean difference = 0.039 mmol/L, 95% CI = 0.024-0.054].

The investigators concluded EPA and DHA supplements have lipid-lowering, hypotensive, anti-arrhythmic and anti-inflammatory effects.

Original title:
Eicosapentaenoic acid and docosahexaenoic acid containing supplements modulate risk factors for cardiovascular disease: a meta-analysis of randomised placebo-control human clinical trials by AbuMweis S, Jew S, […], Agraib L.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28675488

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

Pneumococcal Conjugate Vaccine PCV10 and PCV13 reduce the hospitalization rates for pneumonia, particularly in children aged <24months

Afbeelding

Objectives:
What is the impact of Pneumococcal Conjugate Vaccine with 10 pneumococcal serotypes PCV10 and PCV13 in reducing the incidence of Community-Acquired Pneumonia (CAP) hospitalizations in children aged 5years?

Study design:
This review article included 12 articles.

High heterogeneity was detected among studies evaluating the hospitalization rate for clinically and radiologically confirmed pneumonia.

Results and conclusions:
The investigators found in children aged 24 months a significantly reduction of 17% [95% CI = 11-22%, p 0.001] in the hospitalization rates for clinically confirmed pneumonia after the introduction of the novel PCVs.

The investigators found in children aged 24 months, a significantly reduction of 31% [95% CI = 26-35%, p 0.001] in the hospitalization rates for radiologically confirmed pneumonia after the introduction of the novel PCVs

The investigators found in children aged 24-59 months a significantly reduction of 9% [95% CI = 5-14%, p 0.001] in the hospitalization rates for clinically confirmed pneumonia after the introduction of the novel PCVs.

The investigators found in children aged 24-59 months, a significantly reduction of 24% [95% CI = 12-33%, p 0.001] in the hospitalization rates for radiologically confirmed pneumonia after the introduction of the novel PCVs

The investigators concluded there is a significant impact of PCV10 and PCV13 in reducing the hospitalizations for pneumonia, particularly in children aged 24months and for radiologically confirmed disease. Further appropriately designed studies, comparing the impact of PCV10 and PCV13, are needed in order to obtain solid data on which to establish future immunization strategies.

Original title:
The impact of 10-valent and 13-valent pneumococcal conjugate vaccines on hospitalization for pneumonia in children: A systematic review and meta-analysis by Alicino C, Paganino C, […], Ansaldi F.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28911902

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

No more than 1.62 g/kg/day dietary protein supplementation augments resistance exercise training induced gains in muscle mass and strength in healthy adults

Afbeelding

Objectives:
Does dietary protein supplementation augment resistance exercise training (RET)-induced gains in muscle mass and strength?

Study design:
This review article included 49 RCTs with RET ≥6 weeks in duration, involving 1,863 participants.

Results and conclusions:
The investigators found that during periods of prolonged RET, dietary protein supplementation significantly increased changes in:
-strength-one-repetition-maximum [2.49 kg, 95% CI = 0.64 to 4.33];
-FFM (fat free mass) [0.30 kg, 95 BI = 0.09 to 0.52];
-muscle size-muscle fibre cross-sectional area [CSA = 310 µm2, 95% CI = 51 to 570] and
-mid-femur [CSA = 7.2 mm2, 95% CI = 0.20 to 14.30]

The investigators found that the impact of protein supplementation on gains in fat free mass (FFM) was reduced with increasing age [-0.01 kg, 95% CI = -0.02 to -0.00, p = 0.002] and was more effective in resistance-trained individuals [0.75 kg, 95% CI = 0.09 to 1.40, p = 0.03].

The investigators found that protein supplementation beyond total protein intakes of 1.62 g/kg/day resulted in no further RET-induced gains in fat free mass.

The investigators concluded dietary protein supplementation (1.62 g/kg/day) enhances changes in muscle strength and size during prolonged resistance exercise training in healthy adults.

Original title:
A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults by Morton RW, Murphy KT, […], Phillips SM.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28698222

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