Nutrition and health

Objectives:
Does higher protein intake increase bone mineral density?

Study design:
This review article included 6 RCTs and 20 prospective cohort studies.
There were no adverse effects of higher protein intakes.
Studies were heterogeneous and confounding could not be excluded.

Results and conclusions:
The investigators found moderate evidence suggested that higher protein intake may have a protective effect on lumbar spine bone mineral density compared with lower protein intake [net percentage change = 0.52%, 95% CI = 0.06%-0.97%, I2 = 0%, n = 5] but had no effect on total hip, femoral neck, or total body bone mineral density or bone biomarkers.

The investigators concluded that higher protein intake may have a protective effect on lumbar spine bone mineral density. May have because studies were heterogeneous and confounding could not be excluded. Therefore, high-quality, long-term studies are needed to clarify dietary protein's role in bone health.

Original title:
Dietary protein and bone health: a systematic review and meta-analysis from the National Osteoporosis Foundation by Shams-White MM, Chung M, […], Weaver CM.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28404575

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

A higher protein diet is a diet with 20-35 En% protein. The easiest way to meet a diet with 20-35 En% protein is to choose food items/meals with also 20-35 En% protein. Check here which products contain 20-35 En% protein.
 

Objectives:
Adequate nutrition is critical for optimal growth and development. However, young children may be at risk of nutrient deficiencies when transitioning to weaning foods for a variety of reasons. Supplementation with fortified milk may provide potentially lacking essential nutrients, but effects on growth and nutritional status are yet to be established. Therefore, this meta-analysis (review article) has been conducted.

Have fortified milk beneficial effects on growth and nutritional outcomes in young children?

Study design:
This review article included 15 RCTs with healthy children aged 6-47 months. Fortification varied from iron, zinc, vitamins, essential fatty acids, to pre- and/or probiotics.
Frequently reported outcomes were weight, height and iron status.
Studies varied in geographical location, sample size and duration.

Results and conclusions:
The investigators found that fortified milk had minimal effects on weight gain [mean difference = 0.17 kg, 95% CI = 0.02 to 0.31 kg] compared with control milk.

The investigators found a significant reduced risk of 68% [OR = 0.32, 95% CI = 0.15 to 0.66] for anaemia in fortified milk group compared with control group.

The investigators found no significant effects on height gain, changes in body composition or haemoglobin concentration.

The investigators concluded that fortified milk is an effective source of complementary nutrition to supplement children in need when consumed in appropriate amounts in addition to a normal diet. Due to compositional differences, further research on fortified milk is warranted before making global recommendations on benefits for growth and nutritional outcomes in young children.

Original title:
Effect of fortified milk on growth and nutritional status in young children: a systematic review and meta-analysis by Matsuyama M, Harb T, […], Hill RJ.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/27938461

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

Objectives:
The association between vitamin D deficiency and early spontaneous pregnancy loss (SPL) is unclear. Therefore, this review article (meta-analysis) has been conducted.

Does a vitamin D deficiency increase risk of early spontaneous pregnancy loss?

Study design:
This review article included 5 studies (case-control and cohort studies), including 10,630 pregnant women.

Results and conclusions:
The investigators found no significant association between a low 25(OH)D level (vitamin D level in blood) and an increased risk of early spontaneous pregnancy loss.

However, the investigators found in subgroup analysis, an extremely low 25(OH)D level (20 ng/mL) was significantly associated with an 124% increased risk of early spontaneous pregnancy loss in the first trimester [relative risk = 2.24, 95% CI = 1.15-4.37, I2 = 0.0%, p = 0.355].

The investigators concluded that severe vitamin D deficiency (20 ng/mL) could be detrimental to early embryonic development and increases risk of early spontaneous pregnancy loss.

Original title:
Meta-analysis of the effect of the maternal vitamin D level on the risk of spontaneous pregnancy loss by Zhang H, Huang Z, [...], Wei Y.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28500757

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

Objectives:
Does resistance training reduce blood pressure in prehypertensive and hypertensive subjects?

Study design:
This review article included 5 RCTs provided data on 201 individuals.

Results and conclusions:
The investigators found when compared to group control, resistance training alone significantly reduced systolic blood pressure with 8.2 mmHg in prehypertensive and hypertensive subjects [95% CI = -10.9 to -5.5, I2 = 22.5%, p for heterogeneity = 0.271 and effect size = -0.97].

The investigators found when compared to group control, resistance training alone significantly reduced diastolic blood pressure with 4.1 mmHg in prehypertensive and hypertensive subjects [95% CI = -6.3 to -1.9, I2 = 46.5%, p for heterogeneity = 0.113 and effect size = -0.60].

The investigators concluded resistance training alone reduces systolic and diastolic blood pressure in prehypertensive and hypertensive subjects. These findings support the recommendation of resistance training as a tool for management of systemic hypertension.

Original title:
Resistance training alone reduces systolic and diastolic blood pressure in prehypertensive and hypertensive individuals: meta-analysis by de Sousa EC, Abrahin O, […], Vieira RP.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28769100

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

Objectives:
In the 2007 World Cancer Research Fund/American Institute for Cancer Research Second Expert Report, the expert panel judged that there was strong evidence that alcoholic drinks and body fatness increased esophageal cancer risk, whereas fruits and vegetables probably decreased its risk. The judgments were mainly based on case-control studies. As part of the Continuous Update Project (CUP), this review article (meta-analysis) has been conducted.

What is the relationship between nutrition and esophageal cancer risk?

Study design:
This review article included a total of 57 cohort studies, used in previous 13 meta-analyses.

Results and conclusions:
The investigators found a significant reduced risk of 11% for esophageal adenocarcinoma for every increment of 100g/day vegetable intake [RR = 0.89, 95% CI = 0.80-0.99, n = 3].

The investigators found a significant increased risk of 47% for esophageal adenocarcinoma for every 5 unit increment in BMI [RR = 1.47, 95% CI = 1.34-1.61, n = 9].

The investigators found a significant reduced risk of 16% for esophageal squamous cell carcinoma for every increment of 100g/day fruit intake [RR = 0.84, 95% CI = 0.75-0.94, n = 3].

The investigators found a significant reduced risk of 36% for esophageal squamous cell carcinoma for every 5 unit increment in BMI [RR = 0.64, 95% CI = 0.56-0.73, n = 8].

The investigators found a significant increased risk of 59% for esophageal squamous cell carcinoma for every increment of 50g/day processed meat intake [RR = 1.59, 95% CI = 1.11-2.28, n = 3].

The investigators found a significant increased risk of 37% for esophageal squamous cell carcinoma for every increment of 100g/day processed and red meat intake [RR = 1.37, 95% CI = 1.04-1.82, n = 3].

The investigators found a significant increased risk of 25% for esophageal squamous cell carcinoma for every increment of 10g/day alcohol intake [RR = 1.25, 95% CI = 1.12-1.41, n = 6].

The investigators concluded evidence from cohort studies shows a protective role of vegetables and body weight control in esophageal adenocarcinomas development. For squamous cell carcinomas, higher intakes of red and processed meats and alcohol increase the risk, whereas fruits intake has a protective role.

Original title:
An update of the WCRF/AICR systematic literature review and meta-analysis on dietary and anthropometric factors and esophageal cancer risk by Vingeliene S, Chan DSM, […], Norat T.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28666313

Additional information of El Mondo:
Find more information/studies on vegetable, fruit, alcohol and meat consumption, significant/cohort/95% CI and cancer right here.
 

Objectives:
Are there differences in serum ceruloplasmin levels between patients with preeclampsia and healthy controls?

Study design:
This review article included 15 studies, with a total number of 1927 women.

Results and conclusions:
The investigators found that maternal serum ceruloplasmin concentration was significantly higher in preeclamptic than in the healthy pregnant women [MD = 12.57 mg/dL, 95% CI = 8.81 to 16.33].

The investigators found that ceruloplasmin levels were significantly higher both in mild [MD = 13.8 mg/dL, 95% CI = 2.64 to 23.53] and severe [MD = 21.84 mg/dL, 95% CI = 0.97 to 42.71] preeclampsia, when compared to the control group.

The investigators found that the severity of the disease did not significantly affect the levels of protein [MD = -9.34 mg/dL, 95% CI = -20.93 to 2.26].

The investigators concluded that serum ceruloplasmin may be a useful screening and follow-up tool for the evaluation of pregnant women with an indicative history of developing preeclampsia. Future studies are needed to evaluate the levels of this specific protein throughout the pregnancy course and provide data on its sensitivity and specificity by introducing cut-off values.

Original title:
Serum ceruloplasmin levels in preeclampsia: a meta-analysis by Bellos I, Papantoniou N and Pergialiotis V.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28605950

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

Ceruloplasmin carries 65% to 90% of the copper found in blood.

Objectives:
Promising experimental studies suggest that quercetin has potential anti-inflammatory effects. However, the results of current clinical trials on quercetin's effects on the C-reactive protein (CRP), a sensitive inflammatory biomarker, are ambiguous. Therefore, this review article (meta-analysis) has been conducted.

Does quercetin supplementation reduce CRP levels?

Study design:
This review article included 7 RCTs with 10 treatment arms.

Results and conclusions:
The investigators found a significant reduction of circulating CRP levels [WMD = -0.33 mg/L, 95% CI = -0.50 to -0.15, p 0.001] following quercetin supplementation.

The investigators found in subgroup analysis, a significant reducing effect in trials with ≥500 mg/day dosage [WMD = -0.34 mg/L, 95% CI = -0.52 to -0.16, p ≤ 0.001] and in those with CRP 3 mg/L [WMD = -0.34 mg/L, 95% CI = -0.51 to -0.18, p ≤ 0.001].

The investigators found in meta-regression, no association between changes in CRP concentrations, dose of supplementation and CRP baseline values.

The investigators concluded quercetin supplementation reduces circulating C-reactive protein levels; especially at doses above 500 mg/day and in patients with CRP 3 mg/L.
 
Original title:
Effects of supplementation with quercetin on plasma C-reactive protein concentrations: a systematic review and meta-analysis of randomized controlled trials by Mohammadi-Sartang M, Mazloom Z, […], Firoozi D.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28537580

Additional information of El Mondo:
Find more information/studies on chronic disease and flavonoids right here. Quercetin is a flavonoid.

Objectives:
The relationship between intake of fish and n-3 fatty acids and endometrial cancer risk has not been consistent across epidemiological studies. Therefore, this review article (meta-analysis) has been conducted.

Do fish consumption and dietary EPA and DHA intake reduce endometrial cancer risk?

Study design:
This review article included 4 prospective cohort studies, 1 case-cohort study and 11 case-control studies (including 8 population-based case-control studies and 3 hospital-based case-control studies).
The prospective cohort studies had a mean follow-up of 6.5 to 9.1 years.
The highest category of fish ranged from >1-2 servings/week to >15.4 servings/week,
The highest category of DHA ranged from 143 to 227 mg/d.
The highest category of EPA ranged from 74.7 to 127 mg/d.

When fish intake was reported in unit of g/d, it was converted to serving/week by assuming 1 serving = 100g.
Overall, all 16 studies were classified as high-quality studies.
There was no publication bias.

Results and conclusions:
The investigators found a non-significant association between the highest vs. lowest category of fish consumption and endometrial cancer risk [RR = 1.04, 95% CI = 0.84-1.30, I2 = 80.4%].
According to the subgroup analyses, the null association persisted in strata according to study design, location, type of controls, number of cases, publication year and adjustments of energy intake, reproductive factors and smoking.

The investigators found in subgroup analyses for every one additional serving/week of fish intake, a significant reduced risk of 10% for endometrial cancer in studies conducted in Europe [RR = 0.90, 95% CI = 0.84-0.97]. Significant means that there is an association with a 95% confidence.

The investigators found in subgroup analyses for every one additional serving/week of fish intake, a significant increased risk of 15% for endometrial cancer in studies conducted in Asia [RR = 1.15, 95% CI = 1.10-1.21]. Significant because RR of 1 was not found in the 95% CI of 1.10 to 1.21. RR of 1 means no risk/association.

The investigators found in studies adjusting for smoking for every one additional serving/week of fish intake, a significant reduced risk of 5% for endometrial cancer [RR = 0.95, 95% CI = 0.91-1.00].

The investigators found in studies without an adjustment of smoking for every one additional serving/week of fish intake, a significant increased risk of 14% for endometrial cancer [RR = 1.14, 95% CI = 1.09-1.19].

The investigators found a non-significant inverse association between the highest category of DHA intake and endometrial cancer risk [RR = 0.85, 95% CI = 0.64-1.11, I2 = 59.6%]. However, the dose-response analysis suggested a significant non-linear relationship between DHA intake and endometrial cancer risk [p = 0.04 and p for heterogeneity = 0.39], with a decreased risk being detected for an intake of DHA no more than 175 mg/d.

The investigators concluded that there is a significant inverse association between every one additional serving/week of fish intake and endometrial cancer risk in studies conducted in Europe and studies adjusted for smoking. Furthermore, there is a significant non-linear relationship between DHA intake and risk of endometrial cancer, with a decreased risk being detected for an intake of DHA no more than 175 mg/d. Further well-designed studies are warranted to better characterize the relationship between fish, n-3 PUFA and endometrial cancer development.

Original title:
Dietary n-3 polyunsaturated fatty acids, fish consumption, and endometrial cancer risk: a meta-analysis of epidemiological studies by Hou R, Yao SS, […], Jiang L.

Link:
http://www.impactjournals.com/oncotarget/index.php?journal=oncotarget&page=article&op=view&path[]=18295&path[]=58664

Additional information of El Mondo:
Find more information/studies on fish consumption, significant/cohort/95% CI and cancer right here.
These fish contain 175 mg DHA.
 

Objectives:
The associations between n-3 polyunsaturated fatty acids (PUFAs) and metabolic syndrome (MetS) risk have demonstrated inconsistent results. Therefore, this review article (meta-analysis) has been conducted.

Do higher circulating n-3 PUFA levels associate with a lower metabolic syndrome risk?

Study design:
This review article included a total of 7 case-control studies and 20 cross-sectional studies.
There was no publication bias.
Results and conclusions:
The investigators found a higher plasma/serum n-3 PUFAs was associated with a lower metabolic syndrome risk of 37% [pooled OR = 0.63, 95% CI = 0.49-0.81, I2 = 72.4%].

The investigators found the plasma/serum n-3 PUFAs in controls was significantly higher than cases [WMD = 0.24, 95% CI = 0.04-0.43], especially docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA).

The investigators found, however, no significant association between dietary intake of n-3 PUFAs or fish and metabolic syndrome risk.

The investigators found in sensitivity analysis by omitting one study at a time and re-calculated the remaining data, that exclusion of anyone study did not substantially influence the pooled effects.

The investigators concluded a higher circulating n-3 PUFAs is associated with a lower metabolic syndrome risk. The circulating n-3 PUFAs can be regarded as biomarkers indicating metabolic syndrome risk, especially DPA and DHA. The evidence of this review article will have important public implications in preventing metabolic syndrome through supplemental long-chain n-3 PUFAs of marine-origin. Furthermore, added RCTs and epidemiological studies with large sample-size are warranted to confirm these findings.

Original title:
n-3 Polyunsaturated Fatty Acids and Metabolic Syndrome Risk: A Meta-Analysis by Guo XF, Li X, […], Li D.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5537818/

Additional information of El Mondo:
Find more information/studies on overweight and n-3 PUFA right here.  
Docosapentaenoic acid (DPA) is a dietary omega-3 fatty acid mainly found in fish, fish oil, seal oil and red meat.

Find out whether you are overweight or not right here.

Objectives:
Have flaxseed supplementation positive effects on body composition?

Study design:
This review article included a total of 45 RCTs.

Results and conclusions:
The investigators found a significant reduction in body weight [WMD = -0.99 kg, 95% CI = -1.67 to -0.31, p = 0.004], BMI [WMD = -0.30 kg m², 95% CI = -0.53 to -0.08, p = 0.008] and waist circumference [WMD = -0.80 cm, 95% CI = -1.40 to -0.20, p = 0.008] following flaxseed supplementation.

The investigators found subgroup analyses showed that using whole flaxseed in doses ≥30 g/d, longer-term interventions (≥12 weeks) and studies including participants with higher BMI (≥ 27 kg/m²) had positive effects on body composition.

The investigators concluded whole flaxseed supplementation in doses ≥30 g/d during ≥12 weeks has positive effects on body composition in overweight and obese participants (=participants with BMI ≥ 25 kg/m²).

Original title:
The effect of flaxseed supplementation on body weight and body composition: a systematic review and meta-analysis of 45 randomized placebo-controlled trials by Mohammadi-Sartang M, Mazloom Z, […], Totosy de Zepetnek JO.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28635182

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

Find out whether you are overweight or not right here.

Objectives:
Although several epidemiological studies have investigated the association between dietary calcium intake and the risk of esophageal cancer, the results are inconsistent. Therefore, this review article (meta-analysis) has been conducted.

Does dietary calcium intake reduce risk of esophageal cancer?

Study design:
This review article included 3 cohort studies and 14 case-control studies, including 3,396 cases (subjects with esophageal cancer) and 346,815 controls (subjects without esophageal cancer).

Egger’s test showed no evidence of significant publication bias.

The sample size was large enough to evaluate the effect of calcium intake on esophageal cancer.

A dose-response effect analysis could not be performed due to the incomplete data of dietary calcium intake.

The average of highest dietary calcium intake in Asian populations was 621 mg/day.

Results and conclusions:
The investigators found for highest vs. lowest dietary calcium intake a significant reduced risk of 20% for esophageal cancer [pooled OR = 0.80, 95% CI = 0.71-0.91, I2 = 33.6%].
This significant reduced risk was also found in studies conducted in Asia [OR = 0.67, 95% CI = 0.52-0.86, I2 = 0.0%], studies published after 2000 [OR = 0.64, 95% CI = 0.53-0.77, I2 = 0.0%), studies adjusted for dietary energy intake [OR = 0.83, 95% CI = 0.70-0.98, I2 = 3.6%], studies of esophageal squamous cell carcinoma [OR = 0.76, 95% CI = 0.60-0.96, I2 = 28.3%], cohort studies [OR = 0.67, 95% CI = 0.54-0.84, I2 = 23.6%] and studies with high quality score [OR = 0.76, 95% CI = 0.66-0.87, I2 = 12.7%].

The investigators found in sensitivity analysis (conducted by leaving one study out in turn and pooling the ORs of the remaining studies) the summary ORs did not substantially change, which indicated that the results were statistically robust.

The investigators concluded that a higher intake (621 mg/day) of dietary calcium has protective effect against esophageal cancer - especially esophageal squamous cell cancer - in Asian populations. To further solidify the association of dietary calcium intake with the risk of esophageal cancer, well-designed studies - especially prospective cohort studies with validated FFQ and adjusted for dietary energy intake - should be conducted.

Original title:
Protective Effect of Dietary Calcium Intake on Esophageal Cancer Risk: A Meta-Analysis of Observational Studies by Li Q, Cui, L, […], Wang L.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5452240/

Additional information of El Mondo:
Find more information/studies on calcium, significant/cohort/95% CI and cancer right here.
 

Objectives:
Previous studies have demonstrated that asthma might be associated with an increase in cardiovascular disease (CVD) and death. However, this relationship differs by gender. Therefore, this review article (meta-analysis) has been conducted.

Is asthma associate with an increase risk in cardiovascular disease and death among men and women?

Study design:
This review article included 4 retrospective cohort studies and 6 prospective cohort studies. The length of follow-up ranged from 4.5 to 27 years. The sample sizes of the cohorts ranged from 1,233 to 151,620 (a total of 406,426).

There was no evidence of publication bias [Begg’s, p = 1.000 and Egger’s linear regression, p = 0.150].

Results and conclusions:
The investigators found overall, subjects with asthma experienced a significant increased risk of 33% for cardiovascular disease events [RR = 1.33, 95% CI = 1.15-1.53, p 0.0001, I2 = 88%, p 0.00001]. These findings remained consistent after sensitivity analysis by omitting one study each time.

The investigators found in subgroup analyses that women with asthma had a significantly higher risk of cardiovascular disease as compared to the reference group [RR = 1.55, 95% CI = 1.20-2.00, p = 0.0007, I2 = 84%], whereas no significant association was found in men [RR = 1.20, I2 = 83%, 95% CI = 0.92-1.56, p = 0.17]. However, the combined RR value was 1.36, 95% CI = 1.15-1.62, p = 0.0003]. These findings remained consistent after sensitivity analysis by omitting one study each time.
To further explore the interaction between gender and asthma on cardiovascular disease risk, the “test for subgroup differences” were examined and gave a p = 0.17, which suggested that the influence of gender on the association between asthma and cardiovascular disease risk was not statistically significant. Therefore, it cannot confirm or refute a significant difference in the incidence of cardiovascular disease between male and female asthmatic patients.

The investigators found asthma was associated with an increased risk of 36% of all-cause mortality in a random effects model as compared to reference subjects without asthma [RR = 1.36, 95% CI = 1.01-1.83, p = 0.05, I2 = 62%, p = 0.05]. These findings remained consistent after sensitivity analysis by omitting one study each time.

The investigators concluded there is an association between asthma and an increased risk of cardiovascular disease and all-cause mortality and women with asthma have a higher risk of cardiovascular disease than men with asthma. These findings indicate a need for early detection and intervention during general outpatient visits in asthmatics who may have potential cardiovascular disease complications or mortality.

Original title:
Asthma and risk of cardiovascular disease or all-cause mortality: a meta-analysis by Xu M, Xu J and Yang X.

Link:
http://www.annsaudimed.net/index.php/vol37/vol37iss2/1109.html

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

Objectives:
The clinical benefits of perioperative antioxidant vitamin therapy in cardiac patients remain controversial. Therefore, this review article (meta-analysis) has been conducted.

Do patients undergoing cardiac surgery benefit from perioperative antioxidant vitamin therapy?

Study design:
This review article included 12 RCTs with 1584 cardiac patients.

Results and conclusions:
The investigators found compared with placebo or no antioxidant vitamin therapy that administration of antioxidant vitamin therapy resulted in a significant reduction:
-in postoperative atrial fibrillation (POAF) [RR = 0.55, 95% CI = 0.42 to 0.73, p  0.0001];
-duration of hospital stay [MD = -0.68, 95% CI = -0.98 to -0.39, p  0.00001];
-intensive care unit length of stay [MD = -0.21, 95% CI = -0.30 to -0.12, p  0.00001] and;      
-intubation time [MD = -2.41, 95% CI = -3.83 to -0.98, p = 0.001].

The investigators also found a trend towards a decrease in postoperative complications [RR = 0.72, 95% CI = 0.48-1.08, p = 0.11] and duration of postoperative atrial fibrillation [MD = -1.950, 95% CI = -3.28 to 0.29, p = 0.10].

The investigators concluded that perioperative antioxidant vitamin therapy in patients undergoing cardiac surgery reduces the incidence of postoperative atrial fibrillation, duration of hospital stay, intensive care unit length of stay and intubation time.

Original title:
The clinical benefits of perioperative antioxidant vitamin therapy in patients undergoing cardiac surgery: a meta-analysis by Geng J, Qian J, […], Shen Z.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28645181

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

Objectives:
Studies implicate choline and betaine metabolite trimethylamine N-oxide (TMAO) in cardiovascular disease (CVD). Therefore, this review article (meta-analysis) has been conducted.

Is there an association between choline and betaine dietary intake and cardiovascular disease?

Study design:
This review article included a total of 6 prospective cohort studies comprising 18,076 incident cardiovascular disease events, 5,343 cardiovascular disease deaths among 184,010 participants.

There was no evidence for heterogeneity among studies.
Only 2 studies provided data on phosphatidylcholine and cardiovascular disease mortality.

Results and conclusions:
The investigators found in random effects meta-analysis, incident cardiovascular disease was not associated with choline [RR = 1.00, 95% CI = 0.98-1.02] or betaine [RR = 0.99, 95% CI = 0.98-1.01] dietary intake.
Results did not vary by study outcome (incident coronary heart disease, stroke, total cardiovascular disease).

The investigators found random effects meta-analysis did not support an association between choline and cardiovascular disease mortality [RR = 1.09, 95% CI = 0.89-1.35], but one study supported a positive association and there was significant heterogeneity [I2 = 84%, p 0.001].

The investigators concluded that there is no association between dietary choline/betaine intake with incident cardiovascular disease, but further research into choline and cardiovascular disease mortality are needed.

Original title:
Dietary Choline and Betaine and Risk of CVD: A Systematic Review and Meta-Analysis of Prospective Studies by Meyer KA and Shea JW.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28686188

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

Objectives:
Iron deficiency is a prevalent nutritional disease and fatigue is a common complaint in the general and patient population, however, the association between iron deficiency without anaemia (IDNA) and fatigue is unclear. Therefore, this review article (meta-analysis) has been conducted.

Does improving iron status decrease fatigue in patients with iron deficiency without anaemia?

Study design:
This review article included a total of 6 RCTs and 6 cross-sectional studies.

Results and conclusions:
The investigators found in the meta-analysis of 6 RCTs, a significant therapeutic effect of iron supplements in fatigue patients with iron deficiency without anaemia [pooled effect size = 0.33, 95% CI = 0.17 to 0.48, I2 = 0.0%, p 0.0001]. A sensitivity analysis found that the overall results (i.e. significant association) were robust.

The investigators found in the meta-analysis of 6 cross-sectional studies, a non-significant therapeutic effect of iron supplements in fatigue patients with iron deficiency without anaemia [pooled effect size = 0.10, 95% CI = -0.11 to 0.31, I2 = 57.4%, p = 0.362]. A sensitivity analysis found that the overall results (i.e. no significant association) were not robust, however, removal of one study made the outcomes significant.

The investigators concluded improving iron status decreases fatigue in patients with iron deficiency without anaemia. However, further research is necessary to identify diagnostic criteria for selecting fatigue patients who might benefit from iron therapy and to assess the prevalence of patients with iron deficiency without anaemia in the general population.

Original title:
Iron deficiency without anaemia is a potential cause of fatigue: meta-analyses of randomised controlled trials and cross-sectional studies by Yokoi K and Konomi A.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28625177

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

Objectives:
Have flaxseed supplementation positive effects on body composition?

Study design:
This review article included a total of 45 RCTs.

Results and conclusions:
The investigators found a significant reduction in body weight [WMD = -0.99 kg, 95% CI = -1.67 to -0.31, p = 0.004], BMI [WMD = -0.30 kg m², 95% CI = -0.53 to -0.08, p = 0.008] and waist circumference [WMD = -0.80 cm, 95% CI = -1.40 to -0.20, p = 0.008] following flaxseed supplementation.

The investigators found subgroup analyses showed that using whole flaxseed in doses ≥30 g/d, longer-term interventions (≥12 weeks) and studies including participants with higher BMI (≥ 27 kg/m²) had positive effects on body composition.

The investigators concluded whole flaxseed supplementation in doses ≥30 g/d during ≥12 weeks has positive effects on body composition in overweight and obese participants (=participants with BMI ≥ 25 kg/m²).

Original title:
The effect of flaxseed supplementation on body weight and body composition: a systematic review and meta-analysis of 45 randomized placebo-controlled trials by Mohammadi-Sartang M, Mazloom Z, […], Totosy de Zepetnek JO.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28635182

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

Find out whether you are overweight or not right here.

Objectives:
Current studies evaluating the association of tea consumption and bone mineral density (BMD) have yielded inconsistent findings. Therefore, this meta-analysis (review article) has been conducted.

Does tea consumption increase bone mineral density?

Study design:
This review article included 4 cohort, 1 case-control and 8 cross-sectional studies including a total of 12,635 cases (6,059 in the tea consumption group and 6,576 individuals in non-tea consumption group).

Results and conclusions:
The investigators found tea consumption significantly reduced the occurrence of low bone mass with 34% [OR  =  0.66, 95% CI  =  0.47-0.94, p =  0.02].

The investigators found tea consumption significantly yielded higher mineral densities in several bones, including:
-the lumbar spine [standardized mean difference (SMD) = 0.19, 95% CI = 0.08-0.31, p  =  0.001];
-hip [SMD = 0.19, 95% CI = 0.05-0.34, p  =  0.01];
-femoral neck [mean difference (MD) = 0.01, 95% CI = 0.00-0.02, p  =  0.04];
-Ward triangle [MD = 0.02, 95% CI = 0.01-0.04, p  =  0.001] and;
-greater trochanter [MD = 0.03, 95% CI = 0.02-0.04, p  0.00001]
than the non-tea consumption group.

The investigators concluded that tea consumption increases bone mineral density, especially in the lumbar spine, hip, femoral neck, Ward triangle and greater trochanter, which can prevent bone loss.

Original title:
Updated association of tea consumption and bone mineral density: A meta-analysis by Zhang ZF, Yang JL, [...], Liu ZX.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5371490/

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

Objectives:
It has been unclear whether supplemental probiotics therapy improves clinical outcomes in type 2 diabetic patients. Therefore, this meta-analysis (systematic review) has been conducted.

Do probiotics supplements improve clinical outcomes in type 2 diabetic patients?

Study design:
This review article included 12 RCTs involving 684 type 2 diabetic patients.

Results and conclusions:
The investigators found a significant decreased glucose level in the probiotics group [pooled standardized mean difference = -0.18 mg/dL, 95% CI = -0.35 to -0.01, p = 0.04, I2 = 64%, p = 0.004] compared to the control group.

The investigators found a significant reduction in HbA1c in the probiotics group [pooled standardized mean difference = -0.38%, 95% CI = -0.62 to -0.14, p = 0.002, I2 = 0%, p = 0.72] compared to the control group.

The investigators found a significant reduction in fasting insulin level in the probiotics group [pooled standardized mean difference = -0.38, 95% CI = -0.59 to -0.18, p = 0.003, I2 = 0%, p = 0.81] compared to the control group.

The investigators found a significant reduced HOMA-IR level in the probiotics group [pooled standardized mean difference = -0.99, 95% CI = -1.52 to -0.4, p = 0.0002, I2 = 86%, p 0.00001] compared to the control group.

The investigators found a significant reduced CRP level in the probiotics group [pooled standardized mean difference = -1.34 mg/L, 95% CI = -1.76 to -0.92, p 0.00001, I2 = 90%, p 0.00001] compared to the control group.

The investigators found a non-significant reduction in both triglyceride levels [SMD = -0.23, 95% CI = -0.48 to 0.02, p = 0.07, I2 = 52%, p = 0.03] and cholesterol levels [total cholesterol: SMD = -0.18, 95% CI = -0.42 to 0.06, p = 0.14, I2 = 47%, p = 0.05 and LDL-cholesterol: SMD = -0.03, 95% CI = -0.20 to 0.14, p = 0.73, I2 = 3%, p = 0.41] in the probiotics group compared to the control group.

The investigators concluded that probiotics supplementation is associated with significant improvement in HbA1c and fasting insulin in type 2 diabetes patients. These results may provide evidence for encouraging use of probiotics in patients with type 2 diabetes mellitus. However, more randomized placebo-controlled trials with larger sample sizes are warranted to confirm these findings.

Original title:
Effect of Probiotics on Glucose and Lipid Metabolism in Type 2 Diabetes Mellitus: A Meta-Analysis of 12 Randomized Controlled Trials by Yao K, Zeng L, [...], Zou X.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5491138/

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

Objectives:
Controversy exists on the association between alcohol consumption and risk of heart failure (HF). Therefore, this review article (meta-analysis) has been conducted.

Is there an association between alcohol consumption and risk of heart failure?

Study design:
This review article included a total of 13 prospective cohort studies, with 13,738 heart failure cases among 355,804 participants.

Results and conclusions:
The investigators found light alcohol drinking (0.1-7 drinks/week) significantly reduced risk of heart failure with 14% [RR = 0.86, 95% CI = 0.81-0.90]. However, there was no statistically significant association between moderate (7.1-14 drinks/week), high (14.1-28 drinks/week), or heavy (>28 drinks/week) alcohol consumption and heart failure risk.

The investigators found former drinking significantly increased risk of heart failure with 22% [RR = 1.22, 95% CI = 1.11-1.33] compared with never or occasional drinking.

The investigators concluded that light alcohol drinking (0.1-7 drinks/week) is associated with a lower risk of heart failure, while former drinking is associated with a higher risk of heart failure.

Original title:
Alcohol consumption and risk of heart failure: Meta-analysis of 13 prospective studies by Susanna C. Larsson, […], Alicja Wolk

Link:
http://www.sciencedirect.com/science/article/pii/S0261561417301681

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

Objectives:
Dietary intake is potentially associated with the onset of Crohn’s disease (CD), but evidence from epidemiological studies has remained unclear. Therefore, this review article (meta-analysis) has been conducted.

Is there a positive association between fat, carbohydrate or protein intake and the risk of Crohn’s disease?

Study design:
This review article included 4 case-control studies with a total of 311 Crohn’s disease cases and 660 controls and 5 prospective cohort studies with a total of 238,887 participants and 482 Crohn’s disease cases.

The Egger’s test detected no obvious publication bias in fiber (p = 0.708), while there were not enough studies to conduct the analyses for carbohydrate, fat and protein.

Results and conclusions:
The investigators found no evidence of a non-linear relationship between total carbohydrate intake and Crohn’s disease risk [p for non-linearity = 0.376].

The investigators found no association between 10 g increment/day of total carbohydrate intake and Crohn’s disease risk [RR = 0.991, 95% CI = 0.978-1.004, I2 = 0.0%, p = 0.439]. No association because RR of 1 was found in the 95% CI of 0.978 to 1.004. RR of 1 means no risk/association.

The investigators found no evidence of a non-linear relationship between total fat intake and Crohn’s disease risk [p for non-linearity = 0.281].

The investigators found no association between 10 g increment/day of total fat intake and Crohn’s disease risk [RR = 1.018, 95% CI = 0.969-1.069, I2 = 44.6%, p = 0.125].

The investigators found no evidence of a non-linear relationship between total protein intake and Crohn’s disease risk [p for non-linearity = 0.163].

The investigators found no association between 10 g increment/day of total protein intake and Crohn’s disease risk [RR = 1.029, 95% CI = 0.955-1.109, I2 = 54.7%, p = 0.085].

The investigators found a non-linear relationship between fiber dietary intake and Crohn’s disease risk [p for non-linearity = 0.019].

The investigators found a significant reduced risk of 14.7% for Crohn’s disease for per 10 g increment/day of fiber [RR = 0.853, 95% CI = 0.762-0.955]. However, the protective role of fiber dietary intake in the development of Crohn’s disease was gone after adjustment for the risk factor smoking [RR for per 10 g increment/day = 0.890, 95% CI = 0.776-1.020].

The investigators found a non-linear relationship between sucrose intake and Crohn’s disease risk [p for non-linearity = 0.023].

The investigators found a significant increased risk of 8.8% for Crohn’s disease for per 10 g increment/day of sucrose [RR = 1.088, 95% CI = 1.020-1.160, I2 = 0.0%, p = 0.39]. Significant means it can be said with a 95% confidence that each 10 g increment/day of sucrose really increased the risk of Crohn’s disease. 

The investigators concluded there is a lack of association between total carbohydrate, fat or protein intake and the risk of Crohn’s disease, while high fiber dietary intake might decrease the risk but the association was influenced by study design and smoking adjustment. High sucrose intake might increase the risk of Crohn’s disease. However, large-scale prospective designed studies are needed to confirm these findings.

Original title:
Macronutrient Intake and Risk of Crohn’s Disease: Systematic Review and Dose–Response Meta-Analysis of Epidemiological Studies by Zeng L, Hu S, [...], Tan Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5452230/

Additional information of El Mondo:
Find more information/studies on fat, protein, carbohydrate and fiber right here.

 

Onderzoeksvraag:
Is er een verband tussen het eten van koolhydraten, eiwitten of vetten en de ziekte van Crohn?

Studieopzet:
Dit overzichtsartikel bevatte 4 patiënt-controle studies met in totaal 311 mensen met de ziekte van Crohn en 660 mensen zonder de ziekte van Crohn en 5 prospectieve cohort studies met in totaal 238887 deelnemers, waarvan 482 mensen met de ziekte van Crohn.

De gemiddelde score van de studies was 7.78.

Er was geen publicatie bias in de vezelsstudies. Echter, er was niet genoeg gegevens om vast te kunnen stellen of in de eiwit-, vet- en koolhydratenstudies ook publicatie bias aanwezig was of niet.

Resultaten en conclusies:
De onderzoekers vonden geen bewijs voor een non-lineair verband tussen het eten van koolhydraten en de ziekte van Crohn.

De onderzoekers vonden voor elke verhoging met 10 gram koolhydraten per dag via voeding, een niet significant verlaagde risico van 0.9% voor de ziekte van Crohn [gepoolde RR = 0.991, 95% BI = 0.978-1.004, I2 = 0.0%, p = 0.439]. Niet significant want RR van 1 zat in de 95% BI van 0.978 tot 1.004. RR van 1 betekent geen risico/verband.

De onderzoekers vonden een non-lineair verband tussen het eten van tafelsuiker en de ziekte van Crohn.

De onderzoekers vonden voor elke verhoging met 10 gram tafelsuiker (saccharose of sucrose) per dag via voeding, een significant verhoogde risico van 8.8% voor de ziekte van Crohn [gepoolde RR = 1.088, 95% BI = 1.020-1.160, I2 = 0.0%, p = 0.395]. Significant want RR van 1 zat niet in de 95% BI van 1.020 tot 1.160.

De onderzoekers vonden een non-lineair verband tussen het eten van vezels en de ziekte van Crohn.

De onderzoekers vonden voor elke verhoging met 10 gram vezels per dag via voeding, een significant verlaagde risico van 14.7% voor de ziekte van Crohn [gepoolde RR = 0.853, 95% BI = 0.762-0.955, I2 = 0.0%, p = 0.730]. Echter, dit verlaagde risico was niet meer significant na het corrigeren voor de confounder sigarettenrook [RR voor elke verhoging met 10 gram vezels per dag via voeding = 0.890, 95% BI = 0.776-1.020].

De onderzoekers vonden geen bewijs voor een non-lineair verband tussen het eten van vet en de ziekte van Crohn.

De onderzoekers vonden voor elke verhoging met 10 gram vet per dag via voeding, een niet significant verhoogde risico van 1.8% voor de ziekte van Crohn [gepoolde RR = 1.018, 95% BI = 0.969-1.069, I2 = 44.6%, p = 0.125]. Niet significant wil zeggen, er is geen verband bij een 95% betrouwbaarheid.

De onderzoekers vonden geen bewijs voor een non-lineair verband tussen het eten van eiwit en de ziekte van Crohn.

De onderzoekers vonden voor elke verhoging met 10 gram eiwit per dag via voeding, een niet significant verhoogde risico van 2.9% voor de ziekte van Crohn [gepoolde RR = 1.029, 95% BI = 0.955-1.109, I2 = 54.7%, p = 0.085].

De onderzoekers concludeerden dat er geen verband bestond tussen het eten van koolhydraten, eiwitten of vetten en de ziekte van Crohn. Echter, het eten van tafelsuiker verhoogt mogelijk de kans op het krijgen van de ziekte van Crohn. Mogelijk omdat er niet genoeg gegevens aanwezig waren om uit te sluiten dat er geen publicatie bias aanwezig was.

Oorspronkelijke titel:
Macronutrient Intake and Risk of Crohn’s Disease: Systematic Review and Dose–Response Meta-Analysis of Epidemiological Studies by Zeng L, Hu S, [...], Tan Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5452230/

Extra informatie van El Mondo:
Vind hier meer studies over koolhydraten, vetten en eiwitten.
De conclusie in een overzichtsartikel is pas betrouwbaar wanneer er geen sprake is van publicatie bias (treedt op wanneer wetenschappelijke studies wegens ongewenste resultaat (bijvoorbeeld verhoogde risico) niet gepubliceerd worden).
 

Objectives:
Although pre-exercise consumption of a low-glycemic-index (LGI) carbohydrate meal is generally recommended, the findings regarding subsequent exercise performance are inconsistent. Therefore, this review article (meta-analysis) has been conducted.

Does a pre-exercise low-glycemic-index carbohydrate meal lead to greater endurance performance than a pre-exercise high-glycemic-index (HGI) meal?

Study design:
This review article included 15 trials (randomized controlled or crossover trials).
All included studies were of low research quality.

Results and conclusions:
The investigators found the synthesized effect size [d  = 0.42, z  = 3.40, p  = 0.001] indicated that the endurance performance following a low-glycemic-index carbohydrate meal was superior to that following a high-glycemic-index meal.

The investigators found subgroup analyses demonstrated that the treatment effect did not vary across outcome measures (exercise to exhaustion, time trial and work output) or athletic status (trained or recreational participants).

The investigators concluded weak evidence supports the claim that endurance performance following pre-exercise consumption of a low-glycemic-index (LGI) carbohydrate meal is superior to that following pre-exercise consumption of a high-glycemic-index (HGI) meal. Further high-quality research in this area is warranted.

Original title:
Effect of pre-exercise carbohydrate diets with high vs low glycemic index on exercise performance: a meta-analysis by Heung-Sang Wong S, Sun FH, […], Ya-Jun Huang W.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28383695

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

A low-glycemic-index (LGI) carbohydrate diet is a diet with a lot of products with GI lower than 55. Products with GI lower than 55 are called low-glycemic-index carbohydrate products. These products are low-glycemic-index carbohydrate products.
 

Objectives:
Epidemiological studies evaluating the associations between serum copper and ratios of copper/zinc (Cu/Zn) and the preeclampsia (PE) risk in Asian population have produced inconsistent results. Therefore, this review article (meta-analysis) has been conducted.

Do a higher serum copper and ratios of Cu/Zn increase the preeclampsia risk in Asian population?

Study design:
This review article included relevant studies up to November 2016.
Pooled standardized mean difference (SMD) was calculated with random effects model.

Results and conclusions:
The investigators found that preeclampsia patients significantly had a higher serum copper level [SMD = 1.05, 95% CI = 0.34 to 1.77, I2 = 96.9%, p 0.0001] compared with healthy pregnancy controls.

The investigators found in subgroup analyses, a higher serum copper level in preeclampsia patients was observed in case-control studies [SMD = 1.39, 95% CI = 0.44 to 2.34]. However, no significant difference was found between preeclampsia patients and healthy pregnancy controls for ratios of Cu/Zn [SMD = 0.26, 95% CI = -0.77 to 1.29, I2 = 95.8%, p 0.0001].

The investigators concluded that a higher serum copper level is associated with an increased risk of preeclampsia in Asian population. However, further studies are needed to confirm these results.

Original title:
High serum copper level is associated with an increased risk of preeclampsia in Asians: A meta-analysis by Song X, Li B, [...], Zhang D.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28385285

Additional information of El Mondo:
Find more information/studies on copper, zinc, pregnancy and review article/significant/95% CI right here.

Objectives:
The design of infant immunization schedules requires an understanding of the factors that determine the immune response to each vaccine antigen. Therefore, this meta-analysis (review article) has been conducted.

Is there an association between maternal antibody concentrations and infant vaccine responses?

Study design:
This review article included a total of 7,630 infants of which 3,906 (51.2%) were boys from 32 studies in 17 countries.
Mean (SD) age at baseline was 9.0 (2.3) weeks. Preexisting maternal antibody inhibited infant antibody responses to priming doses for 20 of 21 antigens.
Antigen-specific antibody concentration measured 1 month after priming vaccine doses, before booster vaccination and 1 month after booster vaccine doses.

Results and conclusions:
The investigators found that the largest effects were observed for inactivated polio vaccine, where 2-fold higher maternal antibody concentrations resulted in 20% to 28% lower postvaccination antibody concentration [type 1, geometric mean ratio [GMR] = 0.80, 95% CI = 0.78-0.83 and type 2, GMR = 0.72, 95% CI = 0.69-0.74 and type 3, GMR = 0.78, 95% CI = 0.75-0.82].

The investigators found for acellular pertussis antigens, 2-fold higher maternal antibody was associated with 11% lower postvaccination antibody for pertussis toxoid [GMR = 0.89, 95% CI = 0.87-0.90] and filamentous hemagglutinin [GMR = 0.89, 95% CI = 0.88-0.90] and 22% lower pertactin antibody [GMR = 0.78, 95% CI = 0.77-0.80].

The investigators found for tetanus and diphtheria, the estimates were 13% [GMR = 0.87, 95% CI = 0.86-0.88] and 24% [GMR = 0.76, 95% CI = 0.74-0.77], respectively.

The investigators found the influence of maternal antibody was still evident in reduced responses to booster doses of acellular pertussis, inactivated polio and diphtheria vaccines at 12 to 24 months of age.

The investigators found children who were older when first immunized had higher antibody responses to priming doses for 18 of 21 antigens, after adjusting for the effect of maternal antibody concentrations. The largest effect was seen for polyribosylribitol phosphate antibody, where responses were 71% higher per month [GMR = 1.71, 95% CI = 1.52-1.92].

The investigators concluded that maternal antibody concentrations and infant age at first vaccination both influence infant vaccine responses. These effects are seen for almost all vaccines contained in global immunization programs and influence immune response for some vaccines even at the age of 24 months. These data highlight the potential for maternal immunization strategies to influence established infant programs.

Original title:
The Influence of Maternally Derived Antibody and Infant Age at Vaccination on Infant Vaccine Responses: An Individual Participant Meta-analysis by Voysey M, Kelly DF, […], Pollard AJ.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28505244

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

Objectives:
Do overweight and obese adults benefit from n-3 PUFA supplements?

Study design:
This review article included a total of 11 RCTs involving 617 participants.

Results and conclusions:
The investigators found a statistically non-significant difference in weight loss between n-3 PUFA supplements and placebo [WMD = 0.00, 95% CI = -0.42 to 0.43, p = 0.99].

The investigators found n-3 PUFA supplements was superior to placebo in reducing serum triglyceride levels [Std MD = -0.59, 95% CI = -0.93 to -0.25, p = 0.0007].

The investigators found a significant reduction in waist circumference for n-3 PUFA group [WMD = -0.53, 95% CI = -0.90 to -0.16, p = 0.005].

The investigators found no significant differences in body mass index, total serum levels of cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol and fasting glucose levels between n-3 PUFA supplements and placebo.

The investigators concluded that n-3 PUFA supplements reduce waist circumference and triglyceride levels in overweight and obese adults. However, large-scale, well-designed RCTs are needed to further address this issue.

Original title:
Efficacy of Omega-3 Polyunsaturated Fatty Acids Supplementation in Managing Overweight and Obesity: A Meta-Analysis of Randomized Clinical Trials by Zhang YY, Liu W, […], Tian HM.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28112774

Additional information of El Mondo:
Find more information/studies on overweight, n-3 PUFA and cholesterol right here.  

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