Nutrition and health

Objectives:
There has been accumulating evidence that several micronutrients may play a protective role in the risk of solid cancers. However, their role in hematological malignancies remains to be elucidated. Therefore, this review article has been conducted.

Is there a relationship between vitamin intake and risk of non-Hodgkin lymphoma?

Study design:
This review article included a total of 12 cohort studies.

Results and conclusions:
The investigators found null associations regarding
-supplemented vitamin A [pooled RR = 0.92, 95% CI = 0.80-1.07];
-supplemented vitamin C [pooled RR = 1.00, 95% CI = 0.90-1.12];
-total vitamin D [pooled RR = 1.05, 95% CI = 0.91-1.20];
-supplemented vitamin E [pooled RR = 0.98, 95% CI = 0.88-1.10] and;
-dietary lycopene intake [pooled RR = 1.00, 95% CI = 0.86-1.16] and risk of non-Hodgkin lymphoma.

The investigators found no summary estimates were provided for other hematological malignancies due to the limited number of studies.

The investigators concluded there is no association between vitamin A, C, D, E and lycopene and risk of non-Hodgkin lymphoma.

Original title:
Micronutrient Intake and Risk of Hematological Malignancies in Adults: A Systematic Review and Meta-analysis of Cohort Studies by Psaltopoulou T, Ntanasis-Stathopoulos I, […], Sergentanis TN.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30288994

Additional information of El Mondo:
Find more information/studies on vitamin A, C, D, E and lycopene right here.

Objectives:
Valuating the effect of kangaroo mother care (KMC) on breastfeeding success shows conflicting results. Therefore, this review article has been conducted.

Does kangaroo mother care increase breastfeeding?  

Study design:
This review article included 20 RCTs with 1,432 neonates in the kangaroo mother care (KMC) group and 1,410 neonates in the conventional care (CNC) group (control group).

Majority of studies had high risk of bias.

Results and conclusions:
The investigators found breastfeeding success rate was higher in the kangaroo mother care group within different time slots. However, this difference was not statistically significant [RR = 1.11, 95 CI = 0.93-1.34 and RR =1.13, 95% CI = 0.92-1.34 based on the time slot and birth weight, respectively].

The investigators found the between-groups difference in the mean scores of Infant Breast-Feeding Assessment Tool (IBFAT) was statistically significant [p 0.05].

The investigators found breastfeeding was initiated very sooner in the kangaroo mother care group, suggesting a statistically significant between-groups difference [-0.72, 95% CI = -0.92 to -0.53, p 0.05].

The investigators concluded there is a superiority of kangaroo mother care over conventional care in terms of breastfeeding success. Assessing the complications and costs of kangaroo mother care implementation recommended.

Original title:
Effect of Kangaroo Mother Care on successful breastfeeding: A systematic review and Meta-Analysis of randomised controlled trials by Ghojazadeh M, Hajebrahimi S, […], Azami-Aghdash S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30251612

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

Objectives:
Is there a relationship between step count and changes in blood pressure (BP) in healthy adults?

Study design:
This review article included 14 trials involving healthy adults and an intervention in the form of brisk walking with a pedometer.

Net changes in blood pressure and step count in each trial were calculated and pooled. In addition, the pooled net changes of two categories (trials that achieved walking 10,000 steps a day and those that did not) were compared.

Results and conclusions:
The investigators found that pooled net changes in blood pressure improved significantly [systolic blood pressure = -3.1 mmHg and diastolic blood pressure = -1.6 mmHg].

The investigators found, however, when the trials were categorized depending on whether they achieved walking 10,000 steps a day, the pooled net change in systolic blood pressure and diastolic blood pressure did not differ significantly between both groups of subjects.

The investigators found the meta-regression analyses indicated that net change in systolic blood pressure was significantly associated with an increased step count (e.g., systolic blood pressure is expected to decrease approximately 4 mmHg if increased step count by 2000 steps a day).
However, net change in systolic blood pressure was not associated with the step count in an intervention group following the intervention.

The investigators concluded that there is no evidence that walking 10,000 steps a day lowers the blood pressure to any marked degree in healthy adults. In order to reduce systolic blood pressure by walking with a pedometer, one should be mindful of increasing one's step count to 20,000 steps per day.

Original title:
The required step count for a reduction in blood pressure: a systematic review and meta-analysis by Igarashi Y, Akazawa N and Maeda S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30127487

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Find more information/studies on review article/RCTs, lowering blood pressure, sport nutrition right here.

Objectives:
There were inconsistent results with respect to the correlation between consumption of wine and the development of colorectal cancer (CRC). Therefore, this review article has been conducted.

Does consumption of wine increase colorectal cancer risk?

Study design:
This review article included a total of 8 case-control studies and 9 cohort studies, involving 12,110 colorectal cancer cases.

Results and conclusions:
The investigators found that wine drinking was not associated with any greater risk for colorectal cancer [SRR = 0.99, 95% CI = 0.89-1.10, p-heterogeneity 0.001] compared with nondrinkers.

The investigators found subgroup analyses (to get more information) indicated that null associations were observed in men and women for colon and rectal cancer.

The investigators found subgroup analyses showed neither light to moderate [2 drinks/day: SRR = 0.93, 95% CI = 0.80-1.08, I2 = 69.2%] nor heavy [≥2 drinks/day: SRR = 1.00, 95% CI = 0.86-1.16, I2 = 39.9%] consumption of wine was associated statistically with colorectal cancer risk.

The investigators concluded that wine consumption is not associated with the risk of colorectal cancer. Furthermore, null associations are found in men and women for colon and rectal cancer.

Original title:
Wine consumption and colorectal cancer risk: a meta-analysis of observational studies by Xu W, Fan H, [...], Ge Z.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30247171

Additional information of El Mondo:
Find more information/studies on review article/significant/heterogeneity, colorectal cancer and wine consumption right here.

Objectives:
Does dietary carrot intake reduce breast cancer risk?

Study design:
This review article included a total of 10 articles involving 13,747 cases (women with breast cancer).

A significant heterogeneity was observed among studies.

Results and conclusions:
The investigators found for the highest compared with the lowest dietary carrot intake a significantly reduced risk of 21% for breast cancer [OR = 0.79, 95% CI = 0.68 to 0.90]. Omission of any single study (=sensitivity analysis) had little effect on the combined risk estimate.

The investigators found in the subgroup analyses separated by study design, the inverse associations were more pronounced in the case-control studies than in the cohort studies, while the associations did not significantly differ by geographical region, study quality, exposure assessment.

The investigators concluded that high intake of dietary carrot reduces breast cancer risk.

Original title:
Association between dietary carrot intake and breast cancer: A meta-analysis by Chen H, Shao F, […], Miao Q.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30212943

Additional information of El Mondo:
Find more information/studies on review article/significant/heterogeneity, breast cancer and carrot consumption right here.

Objectives:
What is the incidence of bacterial meningitis among children aged 1-59 months in South Asia, focusing on vaccine-preventable aetiologies?  

Study design:
This review article included 48 articles cumulatively reporting 20,707 cases of bacterial meningitis from 1987 to 2013.

Results and conclusions:
The investigators found meta-analyses showed mean annual incidence of bacterial meningitis was 105 [95% CI = 53-173, I2 > 78%, p  0.0001] cases per 100,000 children.

The investigators found on average, Haemophilus influenzae type b (Hib) accounted for 13% [95% CI = 8-19%] of cases, pneumococcus for 10% [95% CI = 6-15%] and meningococcus for 1% [95% CI = 0-2%].
Among studies reporting only confirmed cases, these three bacteria caused a median of 78% cases [IQR = 50-87%].

The investigators found Haemophilus influenzae type b (Hib) meningitis incidence declined by 72-83% at sentinel hospitals in Pakistan and Bangladesh, respectively, within two years of implementing nationwide vaccination.

The investigators found on average, pneumococcal conjugate vaccine 10 (PCV10) covered 49% [95% CI = 39-58%], 13-valent pneumococcal protein-conjugate vaccine (PCV13) covered 51% [95% CI = 40-61%] and 3-valent pneumococcal polysaccharide vaccine (PPSV23) covered 74% [95% CI = 67-80%] of pneumococcal meningitis serotypes.

The investigators found lower PCV10 and PCV13 serotype coverage in Bangladesh was associated with higher prevalence of serotype 2, compared to India and Pakistan.

The investigators concluded South Asia has relatively high incidence of bacterial meningitis among children aged 1-59 months, with vaccine-preventable bacteria causing a substantial proportion. These estimates are likely underestimates due to multiple epidemiological and microbiological factors. Further research on vaccine impact and distribution of pneumococcal serotypes will inform vaccine policymaking and implementation.

Original title:
Incidence and aetiology of bacterial meningitis among children aged 1-59 months in South Asia: systematic review and meta-analysis by Ali M, Chang BA1, […], Morris SK.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30145101

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

Objectives:
Several studies have been published about the effect of garlic on lipid profile and blood glucose in diabetic patients. Which, the results mostly contradict with each other. Therefore, this review article has been conducted.

Does garlic improve lipid profile and blood glucose in diabetic patients?

Study design:
This review article included 33 articles with a total of 1,273 individuals, with a mean of 39 samples per study.

Results and conclusions:
The investigators found the concentration of serum total cholesterol significantly decreased wih 16.87 mg/dL [95% CI = -21.01 to -12.73, p = 0.001] in the garlic group when compared with the placebo group.

The investigators found the concentration of serum LDL cholesterol (bad cholesterol) significantly decreased with 9.65 mg/dL [95% CI = -15.07 to -4.23, p = 0.001] in the garlic group when compared with the placebo group.

The investigators found the concentration of serum triglycerides significantly decreased with 12.44 mg/dL [95% CI = -18.19 to -6.69, p = 0.001] in the garlic group when compared with the placebo group.

The investigators found the concentration of serum HDL cholesterol (good cholesterol) significantly increased with 3.19 mg/dL [95% CI = 1.85 to 4.53, p = 0.001] in the garlic group when compared with the placebo group.

The investigators found the concentration of serum fasting blood sugar significantly decreased with 10.90 mg/dL [95% CI = -16.40 to -5.40, p = 0.001] in the garlic group when compared with the placebo group.

The investigators found the concentration of serum HbA1c significantly decreased with 0.60 mg/dL [95% CI = -0.98 to -0.22, p = 0.001] in the garlic group when compared with the placebo group.

The investigators concluded that garlic improves lipid profile as well as glucose parameters and can be therapeutically effective in patients suffering from cardiovascular diseases and diabetes.

Original title:
The effect of garlic on lipid profile and glucose parameters in diabetic patients: A systematic review and meta-analysis by Shabani E, Sayemiri K and Mohammadpour M.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30049636

Additional information of El Mondo:
Find more information/studies on diabetes, cholesterol, meta-analyses/heterogeneity and garlic right here.

 

Objectives:
Meta-analyses on the effect of vitamin D intake on status in children are lacking, especially those focused on vitamin D-fortified foods. Therefore, this review article has been conducted.

What is the effect of vitamin D interventions (fortified foods, supplements, bolus injections) on vitamin D status in children 2-18 y of age?

Study design:
This review article included 26 RCTs (5,403 children) with interventions (n = 9 fortified foods, n = 15 supplements, n = 2 bolus injections) from 100-4,000 IU vitamin D/d over 4 wk to 2 y.

Results and conclusions:
The investigators found the serum 25-hydroxyvitamin D weighted mean difference for all 26 trials [WMD = 23.5 nmol/L, 95% CI = 20.7 to 26.3 nmol/L, I2 = 99.9%] resulted in a mean increase of 1.0 nmol/L [95% CI = 0.3 to 1.7 nmol/]) for each increase of 100 IU vitamin D/d [per 1 µg/d: 0.4 nmol/L, 95% CI = 0.1 to 0.7 nmol/L].

The investigators found the response per 100 IU vitamin D/d was greater in trials with a mean baseline serum 25-hydroxyvitamin D 30 nmol/L, with the use of fortified foods and with baseline (=at the beginning of the study) vitamin D intakes 100 IU/d.

The investigators concluded the serum 25-hydroxyvitamin D response to vitamin D intake differs on the basis of baseline status, intakes and delivery mode, but not age, sex or latitude in children 2-18 y of age.

Original title:
Effect of Vitamin D Supplementation, Food Fortification, or Bolus Injection on Vitamin D Status in Children Aged 2-18 Years: A Meta-Analysis by Brett NR, Gharibeh N and Weiler HA.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30032221

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

It is not possible to get 100 IU vitamin D through food items. It is only possible through supplementation.

Objectives:
What are the effects of ginger intake on weight loss, glycemic control and lipid profiles among overweight (BMI>25) and obese (BMI>30) subjects?

Study design:
This review article included 14 RCTs with in total of 473 subjects.

Results and conclusions:
The investigators found that supplementation with ginger significantly decreased among overweight (BMI>25) and obese (BMI>30) subjects:
-body weight (BW) [SMD -0.66, 95% CI = -1.31 to -0.01, p = 0.04];
-waist-to-hip ratio (WHR) [SMD = -0.49, 95% CI = -0.82 to -0.17, p = 0.003];
-hip ratio (HR) [SMD = -0.42, 95% CI = -0.77 to -0.08, p = 0.01];
-fasting glucose [SMD = -0.68, 95% CI = -1.23 to -0.05, p = 0.03] and;
-insulin resistance index (HOMA-IR) [SMD= -1.67, 95% CI = -2.86 to -0.48, p = 0.006].

The investigators found that supplementation with ginger significantly increased HDL-cholesterol (good cholesterol) levels [SMD = 0.40, 95% CI = 0.10 to 0.70, p = 0.009] among overweight (BMI>25) and obese (BMI>30) subjects.

The investigators found, however, that supplementation with ginger had no detrimental effect on:
-body mass index (BMI) [SMD = -0.65, 95% CI = -1.36 to 0.06, p = 0.074];
-insulin [SMD = -0.54, 95% CI = -1.43 to 0.35, p = 0.23];
-triglycerides [SMD = -0.27, 95% CI = -0.71 to 0.18, p = 0.24];
-total cholesterol [SMD = -0.20, 95% CI = -0.58 to 0.18, p = 0.30] and;
-LDL-cholesterol [SMD = -0.13, 95% CI = -0.51 to 0.24, p = 0.48].

The investigators concluded that ginger intake reduces body weight, waist-to-hip ratio, hip ratio, fasting glucose and insulin resistance index and increases HDL-cholesterol (good cholesterol), but has no affect on insulin, BMI, triglycerides, total- and LDL-cholesterol (bad cholesterol) levels among overweight and obese subjects.

Original title:
The effects of ginger intake on weight loss and metabolic profiles among overweight and obese subjects: A systematic review and meta-analysis of randomized controlled trials by Maharlouei N, Tabrizi R, […], Asemi Z.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29393665

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

Persons with overweight are advised to choose products/meals with maximum 30 En% fat, maximum 7 En% saturated fat, maximum 0.2 grams salt per 100 kcal and minimum 1.5 grams fiber per 100 kcal. Check here which products/meals are suitable for persons with overweight.
 

Objectives:
Oxidative stress has been found to be implicated in the development of Alzheimer's disease (AD). Therefore, this review article has been conducted.

Is there an association between selenium level in the brain and Alzheimer’s disease? 

Study design:
This review article included 14 studies with 40 observations on selenium concentrations in Alzheimer’s disease and control brains (persons without Alzheimer’s disease).

The effect size as standardized mean difference (SMD) was generated using review manager 5.3.

The funnel plot with Egger's [p = 0.88] and Begg's tests [p = 0.24] detected no significant publication bias.

Results and conclusions:
The investigators found random-effects meta-analysis indicated a decrease [SMD = - 0.42] in brain tissue selenium levels in patients with Alzheimer’s disease as compared to non-Alzheimer’s disease controls.
The results of sensitivity analysis indicated that no single study/observation had significantly influenced the overall outcome.

The investigators found the subgroup meta-analysis demonstrated that the selenium levels were decreased in the temporal, hippocampal and cortex regions of the brains in patients with Alzheimer’s disease.
The results of sensitivity analysis indicated that no single study/observation had significantly influenced the overall outcome.

The investigators concluded there is consolidated evidence for a significant decrease of selenium status in Alzheimer’s disease brains compared to controls (persons without Alzheimer’s disease). In line with the evidence supporting selenium's antioxidant role and the involvement of oxidative stress in Alzheimer’s disease development, these findings support new therapeutic strategies aimed at brain tissue selenium homeostasis in Alzheimer’s disease.

Original title:
Brain Selenium in Alzheimer's Disease (BRAIN SEAD Study): a Systematic Review and Meta-Analysis by Varikasuvu SR, Prasad VS, [...], Manne M.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30171594

Additional information of El Mondo:
Find more information/studies on selenium and Alzheimer’s disease right here.
 

Objectives:
Is hepatitis B vaccination in adults causally associated with autoimmune diseases?

Study design:
This review article included 14 controlled studies with documented incidence of autoimmune diseases occurring after hepatitis B vaccinations in adults from January 1990 to March 2017.

Results and conclusions:
The investigators found overall no association between hepatitis B vaccination and the onset of autoimmune diseases [overall odds ratio = 1.06, 95% CI = 0.93-1.21, with non-significant heterogeneity].

Only one study showed a significant excess risk between hepatitis B immunisation and autoimmune disease.

The investigators concluded despite multiple case reports, there is no reliable scientific evidence of autoimmune diseases being caused by hepatitis B vaccinations.

Original title:
Autoimmune diseases after hepatitis B immunization in adults: Literature review and meta-analysis, with reference to 'autoimmune/autoinflammatory syndrome induced by adjuvants' (ASIA) by Elwood JM and Ameratunga R.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30100071

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Find more information/studies on food fortification/malnutrition right here.

Objectives:
Inflammation is associated with an increased risk of a range of chronic diseases. A diet high in fruit and vegetables may help to reduce inflammation, as fruit and vegetables are rich sources of antioxidants and other biologically active substances, which may improve immune function. Therefore, this meta-analysis (systematic review) has been conducted.

Does fruit or vegetables intake reduce inflammation and improve immune function?

Study design:
This review article included 71 clinical trials and 12 were observational studies (n = 10 cross-sectional studies and n = 2 cohort studies).

Results and conclusions:
The investigators found among observational studies (n = 10 studies) an inverse association between intakes of fruit or vegetables and inflammatory biomarkers.

The investigators found the majority of the intervention studies (n = 48 studies) reported beneficial effects of fruit or vegetable intake on ≥1 biomarker of systemic or airway inflammation.

The investigators found a meta-analysis of included studies showed that fruit or vegetable intake significantly decreased circulating levels of C-reactive protein and tumor necrosis factor-α [p 0.05] and significantly increased the γδ-T cell population [p 0.05].

The investigators concluded that higher intakes of fruit and vegetables lead to both a reduction in proinflammatory mediators and an enhanced immune cell profile.

Original title:
Effects of fruit and vegetable consumption on inflammatory biomarkers and immune cell populations: a systematic literature review and meta-analysis by Hosseini B, Berthon BS, […], Wood LG.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29931038

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

The level of C-reactive protein (CRP), which can be measured in your blood, increases when there's inflammation in your body.

Tumour necrosis factor-alpha (TNF-alpha) is recognized as an important mediator in many cytokine-dependent inflammatory events.

 

Objectives:
Do dietary flavonoid intake reduce colorectal cancer risk?

Study design:
This review article included 5 prospective cohort and 7 case-control studies with a tolal of 17,481 cases (persons with colorectal cancer) and 740,859 controls (persons without colorectal cancer).

All studies were adjusted for a wide range of potential confounders of colorectal cancer, such as age, gender, BMI, physical activity, family history of colorectal cancer, education, energy intake, alcohol, fiber intake, red and processed meat intake, tobacco, aspirin and non-steroidal anti-inflammatory drug.

There was no publication bias.

Results and conclusions:
The investigators found that there was no significant association between colorectal cancer risk and total flavonoid intake, with a pooled OR from the combination of the included studies of 0.73 [95% CI = 0.48-1.10] for the highest category of intake vs. the lowest category. Similarly, no association between the intake of flavanones or flavan-3-ols and the risk of colorectal cancer was observed.

The investigators found in subgroup analysis of both cohort and case-control studies that when compared with the lowest, the highest intake of dietary flavonols significanty reduced risk of colorectal cancer with 30% [OR = 0.70, 95% CI = 0.54-0.90]. Nevertheless, substantial heterogeneities existed across the studies.
However, this reduced risk was not significant in cohort studies [pooled RR = 1.00, 95% CI = 0.92-1.08].

The investigators found in subgroup analysis of both cohort and case-control studies that when compared with the lowest, the highest intake of dietary flavones significanty reduced risk of colorectal cancer with 21% [OR = 0.79, 95% CI = 0.83-0.99]. Nevertheless, substantial heterogeneities existed across the studies.
However, this reduced risk was not significant in cohort studies [pooled RR = 1.02, 95% CI = 0.94-1.11].

The investigators found in subgroup analysis of both cohort and case-control studies that when compared with the lowest, the highest intake of dietary anthocyanidins significanty reduced risk of colorectal cancer with 22% [OR = 0.78, 95% CI = 0.64-0.95]. Nevertheless, substantial heterogeneities existed across the studies. 
However, this reduced risk was not significant in cohort studies [pooled RR = 1.00, 95% CI = 0.91-1.10].

The investigators found dose-response meta-analysis indicated that an increment of dietary flavones intake of 1 mg per day significantly reduced risk of colorectal cancer with 9% [pooled OR = 0.91, 95% CI = 0.84-0.99].

The investigators found dose-response meta-analysis indicated that an increment of dietary flavonols intake of 10 mg per day significantly reduced risk of colorectal cancer with 14% [pooled OR = 0.86, 95% CI = 0.76-0.97].

The investigators found that high intake of flavonols significantly decreased risk of colon cancer with 20% [OR = 0.80, 95% CI = 0.68-0.94].
Significantly means that there is an association with a 95% confidence.

The investigators found that high intake of flavones significantly decreased risk of rectal cancer with 18% [OR = 0.82, 95% CI = 0.70-0.97].
Significantly because OR of 1 was not found in the 95% CI of 0.70 to 0.97. OR of 1 means no risk/association.

The investigators concluded that high intake of dietary flavonols, flavones and anthocyanidins may decrease the risk of colorectal cancer. May decrease because substantial heterogeneities existed across the studies and the reduced risk was not significant in cohort studies.

Original title:
Dietary Flavonoids and the Risk of Colorectal Cancer: An Updated Meta-Analysis of Epidemiological Studies by Chang H, Lin Lei L, […], Guohua Zhao G.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6073812/

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Find more information/studies on review article/significant/publication bias, colorectal cancer and flavonoids right here.

The results of a review article are only reliable when they are also found in cohort studies. Thus, the significantly reduced risk must be found in both patient-control studies (more sensitive to errors) and cohort studies (less susceptible to errors).

Objectives:
Despite the World Health Organization recommendation of exclusive breastfeeding (EBF) for the first six months of life, the rate remains low both in developed and developing countries. In Ethiopia, findings regarding the prevalence of exclusive breastfeeding have been highly variable. Antenatal care and institutional delivery are the most important factors contributing to the practice of exclusive breastfeeding. However, their effect has not been investigated in Ethiopia. Therefore, this review article has been conducted.

Do antenatal care and institutional delivery increase exclusive breastfeeding?

Study design:
This review article included 32 studies (published between 2007 to 2017) with a total of 23,543 breastfeeding women. 29 (71.8%) of the studies are cross-sectional study design. The sample size of the studies ranged from 119 to 5, 227.

Results and conclusions:
The investigators found the result of 32 included studies indicated that the pooled prevalence of exclusive breastfeeding in Ethiopia was 59.3% [95% CI = 53.8 to 64.8%].

The investigators found subgroup analysis indicated that the highest prevalence was observed in Afar region (65.6%), followed by SNNP (63.8%) and then by Oromia (61.8%).

The investigators found mothers who attended antenatal visits were 2.1 times more likely to practice exclusive breastfeeding compared to their counterparts [OR = 2.1, 95% CI = 1.5 to 2.8).

The investigators found, moreover, mothers who gave birth at a health institution were 2.2 times more likely to practice exclusive breastfeeding compared to mothers who gave birth at home [OR = 2.2, 95% CI = 1.3 to 3.5].

The investigators concluded exclusive breastfeeding in Ethiopia is significantly lower than the global recommendations. Mothers who attended antenatal visits and who gave birth at health institutions have better exclusive breastfeeding practices. Based on these findings, it is strongly recommended that the utilization of antenatal care and institutional delivery should be improved through health extension workers.

Original title:
Exclusive breastfeeding practice in Ethiopia and its association with antenatal care and institutional delivery: a systematic review and meta-analysis by Alebel A, Tesma C, […], Kibret GD.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6048887/

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

Objectives:
Chloroquine remains the mainstay of treatment for Plasmodium vivax malaria despite increasing reports of treatment failure. Therefore, this review article has been conducted.

The aim of this review article is to investigate the effect of chloroquine dose and the addition of primaquine on the risk of recurrent vivax malaria across different settings.

Study design:
This review article included 37 Plasmodium vivax clinical trials (from 17 countries) with a total of 5,240 patients (2,990 patients were treated with chloroquine alone, of whom 1041 (34.8%) received a dose below the target 25 mg/kg.
The trials were published between Jan 1, 2000 and March 22, 2017.

Results and conclusions:
The investigators found the risk of recurrence of Plasmodium vivax malaria was 32.4% [95% CI = 29.8-35.1] by day 42.

The investigators found after controlling for confounders, a 5 mg/kg higher chloroquine dose significantly reduced the rate of recurrence overall with 18% [adjusted hazard ratio = 0.82, 95% CI 0.69-0.97, p = 0.021] and in children younger than 5 years with 41% [adjusted hazard ratio = 0.59, 95% CI = 0.41-0.86, p = 0.0058].

The investigators found adding primaquine to chloroquine dose significantly reduced the risk of recurrence to 4.9% [95% CI = 3.1-7.7] by day 42, which is lower than with chloroquine alone (adjusted hazard ratio = 0.10, 95% CI = 0.05-0.17, p 0.0001].

The investigators concluded increasing the recommended dose to 30 mg/kg in children younger than 5 years reduces substantially the risk of early recurrence when primaquine is not given. Radical cure with primaquine is highly effective in preventing early recurrence and also improves blood schizontocidal efficacy against chloroquine-resistant Plasmodium vivax malaria.

Original title:
The effect of chloroquine dose and primaquine on Plasmodium vivax recurrence: a WorldWide Antimalarial Resistance Network systematic review and individual patient pooled meta-analysis by Commons RJ, Simpson JA, […], Price RN.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30033231

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

Objectives:
Intervention studies suggest that incorporating walnuts into the diet may improve blood lipids without promoting weight gain. Therefore, this review article has been conducted.

Does a diet with walnuts improve blood lipids profile (such as cholesterol and triglycerides) without promoting weight gain?

Study design:
This review article included 26 clinical trials with a total of 1,059 participants.
Weighted mean differences (WMDs) were used.

Results and conclusions:
The investigators found compared with control group, a walnut-enriched diet significantly reduced total blood cholestrerol level with 6.99 mg/dL [95% CI = -9.39 to -4.58 mg/dL, p 0.001; 3.25% greater reduction].

The investigators found compared with control group, a walnut-enriched diet significantly reduced low-density lipoprotein (LDL) cholesterol level with 5.51 mg/dL [95% CI = -7.72 to -3.29 mg/dL, p 0.001; 3.73% greater reduction].

The investigators found compared with control group, a walnut-enriched diet significantly reduced triglyceride concentrations with 4.69 mg/dL [WMD = -4.69 mg/dL, 95% CI = -8.93 to -0.45 mg/dL, p = 0.03; 5.52% greater reduction].  

The investigators found more pronounced reductions in blood lipids were observed when walnut interventions were compared with American and Western diets [WMD for total blood cholestrerol level = -12.30, 95% CI = -23.17 to -1.43] and for LDL blood cholestrerol level = -8.28, 95% CI = -13.04 to -3.51, p 0.001].

The investigators found apolipoprotein B was also reduced significantly more on walnut-enriched diet compared with control group [WMD = -3.74 mg/dL, 95% CI = -6.51 to -0.97 mg/dL, p = 0.008].

The investigators found a trend towards a reduction was observed for apolipoprotein A [WMD = -2.91, 95% CI = -5.98 to 0.08, p = 0.057].

The investigators found, however, walnut-enriched diet did not lead to significant differences in weight change compared with control diet [WMD = -0.12 kg, 95% CI = -2.12 to 1.88, p = 0.90], systolic blood pressure [WMD = -0.72 mmHg, 95% CI = -2.75 to 1.30, p = 0.48] or diastolic blood pressure [WMD = -0.10 mmHg, 95% CI = -1.49 to 1.30, p = 0.88].

The investigators concluded that walnut-enriched diet improves total and LDL cholesterol levels (bad cholesterol), apolipoprotein B levels and triglyceride levels without adversely affecting body weight or blood pressure.

Original title:
Effects of walnut consumption on blood lipids and other cardiovascular risk factors: an updated meta-analysis and systematic review of controlled trials by Guasch-Ferré M, Li J, […], Tobias DK.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29931130

Additional information of El Mondo:
Find more information/studies on review article/significantly, nut consumption and cholesterol right here.

Persons with atherosclerosis often have an elevated total cholesterol level, an elevated LDL cholesterol level, an elevated triglyceride level and an elevated apolipoprotein B level.

Persons with atherosclerosis are advised to choose products/meals with maximum 30 En% fat, maximum 7 En% saturated fat, maximum 0.2 gram salt per 100 kcal and minimum 1.5 grams fiber per 100 kcal. Check here which products/meals are suitable for persons with atherosclerosis.
 

Objectives:
Hepatitis B virus (HBV) infection remains an important public health problem in China and adults need to be vaccinated. Therefore, this review article has been conducted.

The aim of this review article is to assess the appropriate immunization of adults in China.

Study design:
This review article included 27 RCTs with a total of 18,308 participants.

The seroprotection was defined as anti-HBs≥ 10 mIU/mL.

Results and conclusions:
The investigators found 20 micrograms (20 μg) of HBV vaccine resulted in a better response than 10 micrograms [RR = 1.05, 95% CI = 1.02 to 1.08].  

The investigators found the 0-, 1- and 6-month schedule was more effective than the 0-, 1-, and 2 - or 3-month schedule [RR = 0.98, 95% CI = 0.96 to 1.00].

The investigators found no significant differences between:
-10 μg and 5 μg (yeast-derived hepatitis B vaccines) YDV [RR = 1.05, 95% CI = 0.88 to 1.01].
-10 μg and 5 μg recombinant Chinese hamster ovary cell (CHO) hepatitis B vaccine [RR = 1.01, 95% CI = 0.98 to 1.04].
-domestic and imported hepatitis B vaccines [RR = 1.02, 95% CI = 0.99 to 1.05].  
-0-, 1- and 6-month and 0-, 1- and 12-month schedules [RR = 1.02, 95% CI = 0.89 to 1.08].

The investigators concluded that 20 μg of HBV vaccine should be given for adults in China, and the 0-, 1- and 12-month immunization program schedule is also worth choosing when it is not possible to complete the 0-, 1- and 6-month schedule.

Original title:
Suitable hepatitis B vaccine for adult immunization in China: a systematic review and meta-analysis by Wu Z, Bao H, [...], Hu Y.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30089437

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

Objectives:
Controversial results have been reported concerning the influence of calcium intake on prostate cancer risk. Therefore, this review article has been conducted.

Does calcium intake increase prostate cancer risk?

Study design:
This review article included 11 cohort studies and 1 case control study.

The average age of majority was between 50-70 years and also about 83%of articles had been performed in the USA.

Begg’s test showed the effect of publication bias was significant for relationship between calcium intake and total prostate cancer [p = 0.02] and the relationship between total calcium and localized prostate cancer [p = 0.03].

Results and conclusions:
The investigators found that total calcium intake significantly increased the total prostate cancer risk with 15% [overall RR = 1.15, 95% CI = 1.04-1.27, I2 = 59.7%, p = 0.006].
Sensitivity analysis by removing one study at the same time indicated that the overall RR was robust.

The investigators found in studies with follow-up more than 10 years a significantly increased risk of 22% [RR = 1.22, 95% CI = 1.07-1.38] for total prostate for total calcium intake.

The investigators found in 9 studies a significantly increased risk of 9% [RR = 1.09, 95% CI = 1.01-1.18] for total prostate cancer for 750 mg calcium intake per day.

The investigators found in 8 cohort studies, no association between total calcium intake and localized prostate cancer [RR = 1.05, 95% CI = 0.96-1.14].

The investigators found in 7 cohort studies, no association between total calcium intake and advance prostate cancer [RR = 1.15, 95% CI = 0.89-1.50].

The investigators concluded that calcium intake of 750 mg per day could be considered as a risk factor for total prostate cancer. Could be because there was publication bias.

Original title:
Total Calcium (Dietary and Supplementary) Intake and Prostate Cancer: a Systematic Review and Meta-Analysis by Rahmati S, Azami M, […], Sayehmiri K.

Link:
http://journal.waocp.org/?sid=Entrez:PubMed&id=pmid:29936714&key=2018.19.6.1449

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

Objectives:
Adults and young children in countries experiencing the nutrition transition are known to be affected simultaneously by undernutrition and overnutrition. Adolescence is a critical period for growth and development. Yet, it is unknown to what extent this double burden of malnutrition affects adolescents in low- and middle-income countries (LMICs) and the macrolevel contextual factors associated with the double burden of malnutrition. Therefore, this review article has been conducted.

The aim of this review article is to quantify the magnitude of the double burden of malnutrition among adolescents and to examine the potential sources of heterogeneity in prevalence estimates across low- and middle-income countries.

Study design:
This review article included individual-participant data from the Global School-Based Student Health and Health Behavior in School-Aged Children surveys conducted in 57 low- and middle-income countries between 2003 and 2013, comprising 129,276 adolescents aged 12-15 years.

Results and conclusions:
The investigators found the prevalence of stunting was 10.2% [95% CI = 8.3% to 12.2%] and of thinness was 5.5% [95% CI = 4.3% to 6.9%].

The investigators found the prevalence of overweight or obesity was 21.4% [95% CI = 18.6% to 24.2%].

The investigators found between 38.4% and 58.7% of the variance in adolescent malnutrition was explained by macrolevel contextual factors.

The investigators found the prevalence of concurrent stunting and overweight or obesity was 2.0% [95% CI = 1.7% to 2.5%].

The investigators concluded that the double burden of malnutrition among adolescents in low- and middle-income countries is common. Context-sensitive implementation and scale-up of interventions and policies for the double burden of malnutrition are needed to achieve the Sustainable Development Goal to end malnutrition in all of its forms by 2030.

Original title:
The double burden of malnutrition among adolescents: analysis of data from the Global School-Based Student Health and Health Behavior in School-Aged Children surveys in 57 low- and middle-income countries by Caleyachetty R, Thomas GN, […], Uauy R.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29947727

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

Objectives:
The association of high sodium intake with risk of stroke has been accepted. But considering the proposed J/U-shaped association between sodium intake and risk of all-cause mortality, the shape of the dose-response relationship has not been determined yet. Therefore, this review article has been conducted.

Is there a dose-response association of dietary sodium and sodium-to-potassium ratio with risk of stroke in adults aged 18 years or older?

Study design:
This review article included 14 prospective cohort studies, 1 case-cohort study and 1 case-control study with a total of 261,732 participants, of which 10,150 cases of stroke.

Results and conclusions:
The investigators found a significantly increased risk of 6% [pooled RR = 1.06, 95% CI = 1.02 to 1.10, I2 = 60%, n = 14 studies] for stroke for a 1 gr/d increment in dietary sodium intake.

The investigators found a significantly increased risk of 22% [pooled RR = 1.22, 95% CI = 1.04 to 1.41, I2 = 60%, n = 5 studies] for stroke for a one-unit increment in dietary sodium-to-potassium ratio (mmol/mmol).

The investigators found the risk of stroke increased linearly with increasing dietary sodium intake and also along with the increase in dietary sodium-to-potassium ratio.

The investigators found no evidence of a J/U-shaped association in the analyses of total stroke, stroke incidence and stroke mortality.

The investigators found high sodium intake was associated with a somewhat worse prognosis among Asian countries as compared to westerns.

The investigators concluded that higher dietary sodium intake and higher dietary sodium-to-potassium ratio are associated with a higher risk of stroke in adults aged 18 years or older. Reducing dietary sodium-to-potassium ratio can be considered as a supplementary approach in parallel with the decrease in sodium intake in order to decrease stroke risk.

Original title:
Dietary sodium, sodium-to-potassium ratio, and risk of stroke: A systematic review and nonlinear dose-response meta-analysis by Jayedi A, Ghomashi F, […], Shab-Bidar S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29907351

Additional information of El Mondo:
Find more information/studies on review article/significantly, sodium, potassium and cardiovascular diseases prevention right here.

Sodium is a component of salt. Thus, a high sodium intake means a high salt intake.
A high salt diet means, practically, a diet with a lot of products with minimum 0.3 gram salt per 100 kcal.

A low salt diet means, practically, a diet with a lot of products with maximum 0.2 gram salt per 100 kcal. These products meet a low salt diet.

Objectives:
Whether a vegetarian diet is appropriate for pregnancy remains unclear. Therefore, this review article has been conducted.

What is the association between vegetarian diet during pregnancy and various maternal-fetal outcomes?

Study design:
This review article included 19 observational studies.

Results and conclusions:
The investigators found in pooled analysis no association between vegetarian pregnancy and low birth weight (LBW) [RR = 1.27, 95% CI = 0.98-1.65, p = 0.07, I2 = 0%].

The investigators found, however, in subgroup analysis that Asian (India/Nepal) vegetarian mothers exhibited a significantly increased risk of 33% to deliver a baby with low birth weight [RR = 1.33, 95% CI = 1.01-1.76, p = 0.04, I2 = 0%]. But, the WMD of neonatal birth weight in 5 studies suggested no difference between vegetarians and omnivores.

Given the high heterogeneity of the included studies, lack of high-quality evidence and limited studies included for each category, the investigators failed to reach conclusive results regarding the risks of hypospadias, intrauterine growth retardation, maternal anemia and gestational diabetes mellitus.

The investigators concluded that Asian vegetarian mothers have an increased risk to deliver babies with low birth weight than those of omnivores. Large-scale prospective studies focusing on pre- and/or early gestational nutrition will help clarify the correlation between vegetarian diet and various pregnancy outcomes.

Original title:
Is a vegetarian diet safe to follow during pregnancy? A systematic review and meta-analysis of observational studies by Tan C, Zhao Y and Wang S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29621406

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

 

Objectives:
Total dietary fat intake might influence the risk of fracture; however, conflicting findings have been reported to date. Therefore, this review article has been conducted.

Is there an association between dietary fat intake and risk of fracture?

Study design:
This review article included 6 observational studies.

Results and conclusions:
The investigators found no significant association between total dietary fat intake and risk of fracture [pooled effect size = 1.31, 95% CI = 0.95-1.79, p = 0.09].

The investigators found dietary saturated fat intake significantly increased risk of fracture with 79% [pooled effect size = 1.79, 95% CI = 1.05-3.03, p = 0.03].

The investigators found dietary monounsaturated fatty acids (MUFAs) intake derived from animal sources significantly increased risk of fracture with 129% [pooled effect size = 2.29, 95% CI = 1.50-3.50, p 0.0001].

The investigators concluded that both dietary saturated fat and monounsaturated fatty acids (MUFAs) intake derived from animal sources increase risk of fracture.

Original title:
Dietary fat, saturated fatty acid, and monounsaturated fatty acid intakes and risk of bone fracture: a systematic review and meta-analysis of observational studies by Mozaffari H, Djafarian K, […], Shab-Bidar S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29947872

Additional information of El Mondo:
Find more information/studies on fat consumption and elderly.

A diet high in saturated fat is a diet that is largely made up of meals/products with more than 10 En% saturated fat. Practically, this means that all meals/products that you eat on a daily basis should on average contain more than 10 En% saturated fat. Check here which products contains more than 10 En% saturated fat.
More than 10 En% saturated fat means that the total amounts of saturated fat make up for more than 10% of the total kcal of the diet.
 

Objectives:
Although glucosamine and chondroitin sulfate have showed beneficial effects on joint tissues in osteoarthritis (OA), their therapeutic use in the clinical setting is still debatable. Therefore, this meta-analysis (systematic review) has been conducted.

Do glucosamine and chondroitin sulfate supplements relieve pain of knee osteoarthritis?

Study design:
This review article included RCTs.

The pain of knee osteoarthritis was measured using the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) and/or the Visual Analog Scale (VAS).

Results and conclusions:
The investigators found that glucosamine supplements significantly reduced pain of knee osteoarthritis (expressed as Visual Analog Scale (VAS) [WMD = - 7.41 mm, 95% CI = - 14.31 to - 0.51, p = 0.04].
Significant means that there is an association with a 95% confidence.

The investigators found that chondroitin supplements significantly reduced pain of knee osteoarthritis (expressed as Visual Analog Scale (VAS) [WMD = - 8.35 mm, 95% CI = - 11.84 to - 4.85, p  0.00001].
Significant because the found p-value of 0.00001 is less than 0.05.

The investigators found that the combination of glucosamine and chondroitin supplements non-significantly reduced pain of knee osteoarthritis (expressed as Visual Analog Scale (VAS) [WMD = - 0.28 mm, 95% CI = - 8.87 to 8.32, p = 0.95].
Non-significantly because the found p-value of 0.95 is greater than 0.05.

The investigators found that none of the glucosamine, chondroitin supplements or their combination had a significant positive effect on the total WOMAC index and its subscores.

The investigators concluded that oral supplementation with glucosamine or chondroitin sulfate reduces pain in knee osteoarthritis. However, there is no additional effect using both therapeutic agents in combination for the management of symptomatic knee osteoarthritis.

Original title:
Effect of glucosamine and chondroitin sulfate in symptomatic knee osteoarthritis: a systematic review and meta-analysis of randomized placebo-controlled trials by Simental-Mendía M, Sánchez-García A, […], Simental-Mendía LE.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29947998

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

 

Objectives:
The fixed dose combination of artemether-lumefantrine (AL) is the most widely used treatment for uncomplicated Plasmodium falciparum malaria. However, lower cure rates and lumefantrine exposures have been reported in children below 5 years of age and pregnant women during their second and third trimester.

The aim of this study is to investigate the pharmacokinetic and pharmacodynamic properties of lumefantrine and the pharmacokinetic properties of its metabolite, desbutyl-lumefantrine, in order to inform optimal dosing regimens in children below 5 years of age and pregnant women during their second and third trimester.

Study design:
This review article included 26 relevant clinical studies published between 1 January 1990 and 31 December 2012, with 4,122 patients in whom lumefantrine concentrations were measured.

The developed lumefantrine population pharmacokinetic model was used for dose optimisation through in silico simulations.

Results and conclusions:
The investigators found venous plasma lumefantrine concentrations 7 days after starting standard artemether-lumefantrine (AL) treatment were 24.2% and 13.4% lower in children weighing 15 kg and 15-25 kg, respectively.

The investigators found venous plasma lumefantrine concentrations 7 days after starting standard artemether-lumefantrine (AL) treatment were 20.2% lower in pregnant women compared with non-pregnant adults.

The investigators found lumefantrine exposure decreased with increasing pre-treatment parasitaemia and the dose limitation on absorption of lumefantrine was substantial.

The investigators found simulations using the lumefantrine pharmacokinetic model suggested that, a dose increase for pregnant women in their second and third trimester (100 mg artemether and 600 mg lumefantrine twice daily for 3 days, i.e., 1 extra tablet per dose) did not result in equivalent lumefantrine concentrations at day 7 compared to a non-pregnant adult population receiving the standard dose.
However, the intensified dosing regimen (standard dose at 0, 8, 16, 24, 32, 40, 48, 56 and 64 hours) resulted in similar lumefantrine concentrations at day 7 compared to a non-pregnant adult population receiving the standard treatment (twice daily for 3 days).
An extended dosing regimen (standard dose twice daily for a total 5 days) displayed the highest probability of target attainment, with >75% of the simulated lumefantrine concentrations at day 7 above the mean lumefantrine concentration at day 7 in a non-pregnant adult population receiving standard treatment.

The investigators found simulations using the lumefantrine pharmacokinetic model suggested that, a dose increase for children weighing between 5 kg and 25 kg (lumefantrine doses: 120 mg for children 5-6 kg, 180 mg for children 7-8 kg, 240 mg for children 9-13 kg, and 360 mg for children 14-23 kg, twice daily for 3 days) did not result in equivalent lumefantrine concentrations at day 7 compared to children weighing between 5 kg and 25 kg receiving the standard dose (twice daily for 3 days).

The investigators concluded that in young children and pregnant women beyond the first trimester, lengthening the dose regimen (twice daily for 5 days) and, to a lesser extent, intensifying the frequency of dosing (3 times daily for 3 days) would be more efficacious than using higher individual doses in the current standard treatment regimen (twice daily for 3 days). However, these findings should be evaluated in prospective clinical studies to determine whether they would improve cure rates, demonstrate adequate safety and thereby prolong the useful therapeutic life of this valuable antimalarial treatment.

Original title:
Artemether-lumefantrine dosing for malaria treatment in young children and pregnant women: A pharmacokinetic-pharmacodynamic meta-analysis by Kloprogge F, Workman L, […], Tarning J.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5997317/

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

Objectives:
The purpose of this review article is to review previously published meta-analyses on the effectiveness of dietary fiber on type 2 diabetes.

Study design:
This umbrella review article included 16 meta-analyses.

Results and conclusions:
The investigators found in the meta-analyses when comparing highest versus lowest dietary fiber intake, a statistically significant reduced risk of 15 to 19% [RR = 0.81-0.85] for type 2 diabetes. However, statistically significant heterogeneity was observed in all of these meta-analyses.

The investigators found in the meta-analyses when comparing highest versus lowest dietary cereal fibers, a statistically significant reduced risk of 13 to 33% [RR = 0.67-0.87] for type 2 diabetes. However, statistically significant heterogeneity was observed in all of these meta-analyses.

The investigators found in the meta-analyses of supplementation studies using β-glucan or psyllium fibers on type 2 diabetic participants, statistically significant reductions were identified in both fasting blood glucose concentrations and glycosylated hemoglobin percentages.

The investigators concluded that those consuming the highest amounts of dietary fiber, especially cereal fiber, may benefit from a reduction in the incidence of developing type 2 diabetes. May benefit because statistically significant heterogeneity was observed in all of these meta-analyses.
There also appears to be a small reduction in fasting blood glucose concentration, as well as a small reduction in glycosylated hemoglobin percentage for individuals with type 2 diabetes who add β-glucan or psyllium to their daily dietary intake.

Original title:
Dietary Fiber Intake and Type 2 Diabetes Mellitus: An Umbrella Review of Meta-analyses by McRae MP.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/29628808

Additional information of El Mondo:
Find more information/studies on diabetes, meta-analyses/heterogeneity and dietary fiber right here.