Nutrition and health

Objectives:
Malaria parasites have developed resistance to most of the known antimalarial drugs in clinical practice, with reports of artemisinin resistance emerging in South East Asia (SEA). Therefore, this review article (meta-analysis) has been conducted.

The aim of this review article is find the status of artemisinin resistance and efficacy of different modalities of the current artemisinin-based combination therapies (ACTs).

Study design:
This review article included 82 studies for qualitative and quantitative analysis.

Results and conclusions:
The investigators found artemisinin resistance was only reported in South East Asia. K13 mutation C580Y was the most abundant mutation associated with resistance having an abundance of 63.1% among all K13 mutations reported.

The investigators found although the overall network meta-analysis had shown good performance of dihydroartemisinin piperaquine in the early years, a subgroup analysis of the recent years revealed a poor performance of the drug in relation to recrudescence, clinical failure and parasitological failure especially in the artemisinin resistant regions.

The investigators concluded with report of high resistance and treatment failure against the leading artemisinin combination therapy in South East Asia, it is imperative that a new drug or a formulation is developed before further spread of resistance.

Original title:
Efficacy and resistance of different artemisinin-based combination therapies: a systematic review and network meta-analysis by Mathenge PG, Low SK, […], Hirayama K.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31015034

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

Objectives:
The associations between dietary fat intake and cognitive function are inconsistent and inconclusive. Therefore, this review article has been conducted.

Is there a relationship between different types of fat intake and cognitive impairment?

Study design:
This review article included 9 prospective cohort studies covering a total of 23,402 participants.

Results and conclusions:
The investigators found compared with the lowest category of consumption, the highest category of saturated fat consumption significantly increased risk of cognitive impairment with 40% [RR = 1.40, 95% CI = 1.02-1.91].

The investigators found compared with the lowest category of consumption, the highest category of saturated fat consumption significantly increased risk of Alzheimer disease with 87% [RR = 1.87, 95% CI = 1.09-3.20].

The investigators found total and unsaturated fat dietary intakes were not statistically associated with cognitive outcomes with significant between-study heterogeneity.

The investigators concluded there is an increased risk between saturated fat consumption and both cognitive impairment and Alzheimer disease. Given the substantial heterogeneity in the sample size and methodology used across studies, the evidence presented here should be interpreted with caution.

Original title:
Dietary Fat Intake and Cognitive Function among Older Populations: A Systematic Review and Meta-Analysis by Cao GY, Li M, […], Xu B.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31062836

Additional information of El Mondo:
Find more information/studies on saturated fat intake, dementia and elderly right here.

A diet with a high saturated fat intake is a diet with >10 En% saturated fat.
>10 En% saturated fat means that the total amounts of saturated fat make up for >10% of the total kcal of the diet.
The easiest way to follow this diet is to choose only meals/products that also contain 10 En% saturated fat.
Check here which products contain >10 En% saturated fat.

A diet with a low saturated fat intake is a diet with 7 En% saturated fat.

Objectives:
Dietary polyphenols, including flavonoids, have been the focus of major recent attentions due to their wide content in a variety of foods commonly consumed and the findings from numerous studies showing evidence of an association with positive outcomes on human health. Therefore, this review article has been conducted.

Does dietary intake of flavonoids (e.g., anthocyanins, isoflavones, flavones, flavonols, flavanones, flavan-3-ols) reduce hypertension?

Study design:
This review article included 15 cross-sectional investigations and 7 prospective cohort studies (1 study reported on 3 prospective cohort studies).
5 prospective cohort studies, comprising 200,256 individuals and 45,732 cases of hypertension were included in the quantitative analysis.

All studies included covariates that may have significantly influenced the endpoint outcome (hypertension), such as age, sex (when not analyzed separately), BMI, education, physical activity and smoking status. However, not all studies adjusted for key dietary factors that might influence risk of hypertension, such as sodium and potassium intake.

There was no publication bias.

Results and conclusions:
The investigators found analysis by extreme quantiles of intake of flavonoid showed a non-significant association with decreased risk of hypertension [risk ratio = 0.96, 95% CI = 0.89 to 1.03, I2 = 74%, p = 0.01].
Non-significant because RR of 1 was found in the 95% CI of 0.89 to 1.03. RR of 1 means no risk/association.

The investigators found taking into consideration individual flavonoid subclasses, dietary intake of anthocyanins was associated with 8% reduction in risk of hypertension, when comparing highest vs. lowest exposure [risk ratio = 0.92, 95% CI = 0.88 to 0.97].
Significant because RR of 1 was not found in the 95% CI of 0.88 to 0.97. RR of 1 means no risk/association.

The investigators concluded dietary intakes of anthocyanins reduce risk of hypertension. However, further studies are needed to elucidate the retrieved association between polyphenol consumption and decreased risk of hypertension and to clarify whether individual subclasses, rather than the total content of polyphenols, may exert beneficial effects on blood pressure.

Original title:
Dietary Polyphenol Intake, Blood Pressure, and Hypertension: A Systematic Review and Meta-Analysis of Observational Studies by Godos J, Vitale M, […], Grosso G.

Link:
https://www.mdpi.com/2076-3921/8/6/152/htm

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

Objectives:
Does dietary intake of n-3 PUFAs (such as DHA, EPA, DPA and ALA) or fish consumption improve lung function?

Study design:
This review article included 9 cohort studies from the Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium (n = 37,077 black and white participants).

In each cohort and each ancestry, separately, associations of dietary n-3 PUFA/fish intake with lung function were estimated in linear regression models.
Fixed-effects meta-analysis was used to generate summarized effect estimates across the cohorts and ancestries.

The lung function was measured by the forced expiratory volume in 1 second (FEV1) and the forced vital capacity (FVC).

Results and conclusions:
The investigators found dietary DPA, DHA, EPA and fish intake significantly improved forced expiratory volume in one second (FEV1) and forced vital capacity (FVC).
However, dietary α-linolenic acid (ALA) had little to no association with these lung function parameters.

The investigators found associations were similar for black and white participants and consistent in direction and magnitude across most cohort studies.

The investigators found for all participants, 1 standard deviation (SD) higher dietary intake of DPA (∼30 mg/d), DHA (∼200 mg/d) and EPA (∼150 mg/d) were associated with 12-16 mL higher FEV1 and 10-15 mL higher FVC.
The effect estimates for fish consumption were in the same direction but smaller in magnitude.

The investigators found ∼200 mg/d DHA and ∼150 mg/d EPA were associated with 28-32 mL higher FEV1 and 24-25 mL higher FVC in current smokers.

The investigators found ∼200 mg/d DHA and ∼150 mg/d EPA were associated with 17-21 mL higher FEV1 and 7-12 mL higher FVC in former smokers.

The investigators found ∼200 mg/d DHA and ∼150 mg/d EPA had little to no association with FEV1 and FVC in never smokers.

The investigators concluded that dietary ∼200 mg/d DHA, ∼30 mg/d DPA and ∼150 mg/d EPA and fish intake are associated with higher lung function, especially among current and former smokers.

Original title:
Positive Associations of Dietary Marine Omega-3 Polyunsaturated Fatty Acids with Lung Function: A Meta-analysis (P18-087-19) by Patchen B, Xu J, […], Cassano P.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6579416/  

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Find more information/studies on fish consumption, review article/significantly and chronic disease right here.

DHA, DPA and EPA are found in fish.

 

Objectives:
Whether exercise can improve cardiovascular health in kidney transplant recipients (KTRs) is unclear. Therefore, this review article (meta-analysis) has been conducted.

Does exercise improve cardiovascular health in kidney transplant recipients?

Study design:
This review article included 12 RCTs (trials) in the review and 11 RCTs for further qualitative analysis.
Most trials provided a 30-60 minutes exercise session for 2-4 times per week.
In terms of the total intervention period, most trials ranged from 10 weeks to 6 months.

Results and conclusions:
The investigators found in 5 trials with a total of 199 participants that exercise had no effects on either systolic [MD = 1.67, 95% CI = -2.17 to 5.51, p = 0.39] or diastolic blood pressure [MD = 0.65, 95% CI = -4.02 to 5.32, p = 0.78].

The investigators found in 3 trials with a total of 261 participants that exercise had no significant benefits in overall lipid profile [MD = 0.03, 95% CI = -0.09 to 0.15, p = 0.62].
In subgroup analysis, total cholesterol [p = 0.15], LDL cholesterol [p = 0.83] and triglyceride [p = 0.82] were not ameliorated by exercise.

The investigators found in 2 trials with 22 subjects in the exercise group and 28 controls that a 12 months of resistance training or regimens of aerobic or resistance training for 12 weeks was not associated with an improvement in kidney function [MD = 2.60, 95% CI = -12.88 to 13.09, p = 0.74].

The investigators found that aerobic training, resistance training or the combination during 12 weeks to 12 months was not associated with an improvement on body weight [MD = -2.02, 95% CI = -8.24 to 4.20, p = 0.52, n = 3] or BMI [MD = 0.12, 95% CI = -1.52 to 1.77, p = 0.88, n = 4].

The investigators found in 2 trials with a total of 64 participants that a 12-week exercise showed a consistent improvement in small arterial stiffness [MD = -1.14, 95% CI = -2.19 to -0.08, p = 0.03].

The investigators found in 5 trials with a total of 202 participants that aerobic training, resistance training or combined method over the course of 12 weeks to 12 months had a significant improvement in exercise capacity (VO₂ peak) [MD = 2.25, 95% CI = 0.54 to 3.69, p = 0.01]. 

The investigators found exercise improved quality of life in different aspects, with significant enhancement in social functioning [MD = 16.76, 95% CI = 2.16 to 31.37, p = 0.02] and overall QOL scores [MD = 12.87, 95% CI = 6.80 to 18.94, p 0.01].

The investigators concluded exercise intervention in kidney transplant recipients improves arterial stiffness and it also improves exercise tolerance and quality of life. Additional long-term RCTs examining a greater number of patients are needed to understand the effects of exercise on cardiovascular health in kidney transplant recipients.

Original title:
Effects of exercise training on cardiovascular risk factors in kidney transplant recipients: a systematic review and meta-analysis by Chen G, Liu Gao L and Li X.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6534232/

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

Objectives:
Recent evidence has encouraged low- and middle-income countries to consider transitioning from long-standing iron and folic acid supplementation (IFA) to multiple micronutrient supplementation (MMS) during pregnancy; however, global guidance is limited. Therefore, this review article (meta-analysis) has been conducted.

The aim of this review article is to evaluate the incremental cost-effectiveness of transitioning from long-standing iron and folic acid supplementation (IFA) to multiple micronutrient supplementation (MMS).

Study design:
This review article included data of 2 meta-analyses published in 2017 (Cochrane and The Lancet).

Impacts on health outcomes were aggregated using disability-adjusted life years (DALYs). Costs included the supplements and their distribution through antenatal care. The incremental cost-effective ratio (ICER) for transitioning from IFA to MMS was calculated for each country under each meta-analysis scenario and Monte Carlo simulations were applied to generate a measure of certainty around the results.

Results and conclusions:
The investigators found the effectiveness of transitioning from long-standing iron and folic acid supplementation (IFA) to multiple micronutrient supplementation (MMS)
under the Cochrane scenario was smaller and less certain compared with The Lancet scenario.

The investigators found, however, even under the Cochrane scenario, MMS would avert 4,391, 5,769 and 8,578 more DALYs than IFA per 100,000 pregnancies in Pakistan, India and Bangladesh, respectively (62.6%, 76.8% and 82.6% certainty).

The investigators found the ICER of transitioning from IFA to MMS was 41.54, 31.62 and 21.26 US dollars (USD 2016) per DALY averted, respectively.

The investigators concluded despite discrepancies in the overall effect of multiple micronutrient supplementation (MMS) depending on the meta-analysis used, multiple micronutrient supplementation is cost-effective and generates positive health outcomes for both infants and pregnant women. Whilst the effectiveness of multiple micronutrient supplementation is sensitive to the prevalence of certain health outcomes under the conservative scenario (Cochrane), multiple micronutrient supplementation nevertheless averts more DALYs than long-standing iron and folic acid supplementation (IFA) with high certainty and should re-enter public health discussion in Pakistan, India and Bangladesh.

Original title:
Multiple Micronutrient Supplements Are More Cost-effective Than Iron and Folic Acid: Modeling Results from 3 High-Burden Asian Countries by Kashi B, M Godin C, [...[, De-Regil LM.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31131412

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

Objectives:
The role of fruit and vegetables (FVs) consumption in decreasing gallstone disease risk remains contradictory.Therefore, this review article has been conducted.

Does fruit or vegetables consumption reduce risk of gallstone disease?

Study design:
This review article included 1 cross-sectional study, 1 case-control studie and 9 cohort studies, covering approximately 33,983 patients with gallstone disease and 1,53,3752 participants.

Results and conclusions:
The investigators found in a pooled analysis, vegetables consumption was significantly related to a decreased gallstone disease risk of 17% [RR  =  0.83, 95% CI = 0.74-0.94, I2  =  91.1%]. This reduced gallstone disease risk was solid in most subgroup analysis.

The investigators found in a pooled analysis, fruits consumption was significantly related to a decreased gallstone disease risk of 12% [RR  =  0.88, 95% CI = 0.83-0.92, I2  =  0.01%].  
This reduced gallstone disease risk was solid in most subgroup analysis.

The investigators found nonlinear dose-response analysis indicated that gallstone risk was reduced by 4% [RR  =  0.96, 95% CI = 0.93-0.98, p =0.001] for every 200 g per day increment in vegetables consumption.

The investigators found nonlinear dose-response analysis indicated that gallstone risk was reduced by 3% [RR  =  0.97, 95% CI = 0.96-0.98, p =0.001] for every 200 g per day increment in fruits consumption.

The investigators concluded that vegetables and fruits consumption, particularly 200g fruits or 200g vegetables per day is correlated with a reduced risk of gallstone disease.

Original title:
Fruits and vegetables consumption and the risk of gallstone diasease: A systematic review and meta-analysis by Zhang JW, Xiong JP, [...], Zhao HT.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31305451

Additional information of El Mondo:
Find here more information/studies about chronic disease and vegetables and fruits consumption.

Objectives:
Preventing cardiovascular disease (CVD) is the top priority in public health. Hyperlipidemia and hypertension are key contributors to cardiovascular disease which can be easily modified with dietary and lifestyle interventions. Therefore, this review article has been conducted.

Does cashew consumption reduce blood lipids levels (i.e., triglyceride, total cholesterol, HDL cholesterol (good cholesterol) and LDL cholesterol (bad cholesterol) and blood pressure?

Study design:
This review article included 5 RCTs with 246 participants receiving cashew nut (intervention group) and 235 receiving placebo (placebo group).

There was no publication bias.

Results and conclusions:
The investigators found overall analysis showed a statistically significant reducing effect of cashew nut consumption on triglyceride levels [WMD = -14.39, 95% CI = -27.30 to -1.49, I2 = 82%].
Significant means that there is an association with a 95% confidence.

The investigators found overall analysis showed a statistically significant reducing effect of cashew nut consumption on systolic blood pressure [WMD = -1 mm/Hg, 95% CI = -5.12 to -3.01, I2 = 0%].

The investigators found overall analysis showed a statistically significant reducing effect of cashew nut consumption on diastolic blood pressure [WMD = -4.06 mm/Hg, 95% CI = -1.65 to -0.35, I2 = 0%].

The investigators found, however, no statistically significant changes of other cardiovascular risk markers including total cholesterol [WMD = -1.89, 95% CI = -9.17 to 5.39, p = 0.61], LDL cholesterol [WMD = -5.49, 95% CI = -16.76 to 5.78, p = 0.34] and HDL cholesterol [WMD = -0.67, 95% CI = -2.54 to 1.19, p = 0.48] were observed after cashew nut consumption.
No statistically significant because the calculated p-values of e.g. 0.61 or 0.34 were larger than the p-value of 0.05.

The investigators concluded that cashew consumption improves triglyceride levels as well as systolic and diastolic blood pressure with no significant effects on other cardiometabolic factors (i.e., total cholesterol, HDL cholesterol (good cholesterol) and LDL cholesterol (bad cholesterol)). Further studies are warranted with different calories and dietary compositions.

Original title:
The Effect of Cashew Nut on Cardiovascular Risk Factors and Blood Pressure: A Systematic Review and Meta-analysis (P06-117-19) by Mahboobi S.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6573847/

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

Objectives:
Does calcium supplement with or without other drugs reduce risk of preeclampsia and gestational hypertension?

Study design:
This review article included 27 RCTs, with 28,492 pregnant women.

Results and conclusions:
The investigators found calcium supplement significantly reduced risk of preeclampsia with 49% [RR = 0.51, 95% CI = 0.40 to 0.64].

The investigators found calcium supplement significantly reduced risk of gestational hypertension with 30% [RR = 0.70, 95% CI = 0.60 to 0.82].

The investigators found sub-analyses revealed high-dose (1.2-2 g/day), moderate-dose (0.6-1.2 g/day) and low-dose (0.6 g/day) of calcium supplement significantly reduced risk of preeclampsia.

The investigators found sub-analyses revealed high-dose (1.2-2 g/day) and moderate-dose (0.6-1.2 g/day) of calcium supplement significantly reduced risk of gestational hypertension.

The investigators concluded high-dose (1.2-2 g/day) and moderate-dose (0.6-1.2 g/day) of calcium supplement reduced both risk of preeclampsia and gestational hypertension. However, further studies with direct comparison of different dose of calcium supplementation are needed to explore the ideal dose of calcium supplementation to prevent preeclampsia and gestational hypertension.

Original title:
The association between calcium supplement and preeclampsia and gestational hypertension: a systematic review and meta-analysis of randomized trials by Sun X, Li H, [...], Zhang X.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30935246

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

 

Objectives:
Has L-carnitine supplementation positive effects on inflammatory mediators including C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6)?

Study design:
This review article included 13 RCTs.

Results and conclusions:
The investigators found L-carnitine supplementation was significantly associated with lower levels of CRP in comparison to controls [WMD = -1.23 mg/L, 95% CI = -1.73 to -0.72 mg/dL, p  0.0001].
This reduced effect was greatest during an intervention of more than 12 weeks.

The investigators found L-carnitine supplementation was also significantly associated with lower levels of IL-6 in comparison to controls [WMD = -0.85 pg/dL, 95% CI = -1.38 to -0.32 pg/dL, p = 0.002].
This reduced effect was greatest during an intervention of more than 12 weeks.

The investigators found L-carnitine supplementation was also significantly associated with lower levels of TNF-α in comparison to controls [WMD = -0.37 pg/dL, 95% CI = -0.68 to -0.06 pg/dL, p = 0.018].
This reduced effect was greatest during an intervention of more than 12 weeks.

The investigators concluded that L-carnitine supplementation reduces levels of inflammatory mediators, especially in studies with a duration of more than 12 weeks. Further studies with different doses and intervention durations and separately in men and women are necessary.

Original title:
The effect of L-carnitine on inflammatory mediators: a systematic review and meta-analysis of randomized clinical trials by Haghighatdoost F, Jabbari M and Hariri M.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30915521 

Additional information of El Mondo:
Find here more information/studies about chronic disease and L-carnitine.

Objectives:
Does maternal vitamin D deficiency during pregnancy increase risk of low birth weight?

Study design:
This review article included a total of 16 studies.

Results and conclusions:
The investigators found when compared with normal serum levels of vitamin D, maternal vitamin D deficiency had an increased risk of 139% of low birth weight [OR = 2.39, 95% CI = 1.25-4.57, p = 0.008] and same results were found in the comparison of the mean [total mean birth weight decreased by 0.08 kg, 95% CI = -0.10 to -0.06, p 0.001].

The investigators concluded there is a consistent association between vitamin D deficiency during pregnancy and an increased risk of low birth weight and preventing maternal vitamin D deficiency may be an important public health strategy to help decrease the risk of low birth weight.

Original title:
Maternal vitamin D deficiency during pregnancy and low birth weight: a systematic review and meta-analysis by Fang K, He Y, […], Liu K.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31122092

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

Objectives:
Although many studies have shown that low zinc status is associated with diabetes, the putative effects of zinc supplementation on glycemic control are inconclusive. Therefore, this review article (meta-analysis) has been conducted.

Does zinc supplementation reduce risk of diabetes mellitus?

Study design:
This review article included 32 RCTs, involving a total of 1,700 participants in 14 countries.

Results and conclusions:
The investigators found overall, compared with their respective control groups, the subjects in the zinc supplementation group had a statistically significant reduction in concentrations of :
-fasting glucose [WMD = -14.15 mg/dL, 95% CI = -17.36 to -10.93 mg/dL];
-2-h postprandial glucose [WMD = -36.85 mg/dL, 95% CI = -62.05 to -11.65 mg/dL];
-fasting insulin [WMD = -1.82 mU/L, 95% CI = -3.10 to -0.54 mU/L];
-homeostasis model assessment for insulin resistance [WMD = -0.73, 95% CI = -1.22 to -0.24]:
-glycated hemoglobin [WMD = -0.55%, 95% CI = -0.84 to -0.27%] and;
-high-sensitivity C-reactive protein [WMD = -1.31 mg/L, 95% CI = -2.05 to -0.56 mg/L].

The investigators found, moreover, subgroup analyses revealed that the effects of zinc supplementation on fasting glucose were significantly influenced by diabetic status and the formulation of the zinc supplement.

The investigators concluded several key glycemic indicators are significantly reduced by zinc supplementation, particularly the fasting glucose in subjects with diabetes and in subjects who received an inorganic zinc supplement. Together, these findings support the notion that zinc supplementation may have clinical potential as an adjunct therapy for preventing or managing diabetes.

Original title:
Zinc supplementation improves glycemic control for diabetes prevention and management: a systematic review and meta-analysis of randomized controlled trials by Wang X, Wu W, [...], Wang F.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31161192

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

Objectives:
Iron has been shown to promote breast carcinogenesis in animal models through generation of oxidative stress and interaction with estrogen. Heme iron, which is found exclusively in animal-sourced foods, is suggested to have a more detrimental effect. Epidemiological evidence of the association between iron and breast cancer risk remains inconclusive and has not been comprehensively summarized. Therefore, this review article has been conducted.

Does dietary iron consumption increase breast cancer risk?

Study design:
This review article included 15 case-control studies and 12 prospective cohort studies.

Of the 17 studies assessing iron intake, 7 were cohort studies with study size ranging from 4,646 to 193,742 participants, follow-up ranging from 5.5 to 20 years and number of breast cancer cases ranging from 188 to 9,305. The remaining 10 studies were case-control studies, of which 4 were hospital-based, 3 were population-based and 3 were nested within existing cohorts, with case numbers ranging from 220 to 3,452.

Of the 11 studies assessing body iron status, 5 were cohort studies with study size ranging from 1,795 to 164,355 participants, follow-up ranging from 7.1 to 17.6 years and number of cases ranging from 80 to 3,238. The remaining 6 studies used a nested case-control or case-cohort design, with follow-up (where reported) ranging from 4 to 15.7 years and case numbers ranging from 107 to 795.

Overall, NOS scores ranged from 4 to 9 (mean = 7.0).

No publication bias was found.

Results and conclusions:
The investigators found compared to lowest category, highest dietary heme iron intake significantly increased risk of breast cancer with 12% [pooled RR = 1.12, 95% CI = 1.04-1.22, I2 = 39%, p heterogeneity = 0.15].

The investigators found each 1 mg/day increase in dietary heme iron intake, was associated with a statistically significant 8% increase in breast cancer risk [pooled RR = 1.08, 95% CI = 1.002–1.17].

The investigators found compared to lowest levels, highest serum iron levels significantly increased risk of breast cancer with 22% [pooled RR = 1.22, 95% CI = 1.01-1.47, I2 = 61%, p heterogeneity = 0.04].

The investigators found serum iron levels exhibited a J-shaped dose-response relationship with breast cancer risk, with strong evidence of a nonlinear effect [p nonlinearity  0.001].

Specifically, a steady increase in risk was noted for serum iron levels above ~ 100 μg/dL, with the association becoming statistically significant at just beyond ~ 125 μg/dL.

The investigators concluded that higher dietary heme iron intake and higher serum iron levels increase breast cancer risk. Further research is needed to better elucidate the association between iron intake/status and risk of breast cancer.

Original title:
Iron intake, body iron status, and risk of breast cancer: a systematic review and meta-analysis by Chang VC, Cotterchio M and Khoo E.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6555759/

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

Objectives:
Dietary proteins, including those obtained from animal and plant sources, have inconsistently been correlated with type 2 diabetes mellitus (T2DM) risk. Therefore, this review article (meta-analysis) has been conducted.

Does dietary protein intake increase risk of type 2 diabetes mellitus?

Study design:
This review article included 21 cohort studies with a total of 487,956 individuals and 38,350 T2DM cases (persons with type 2 diabetes mellitus).

Results and conclusions:
The investigators found high total dietary protein intake was associated with an increased risk of 10% for type 2 diabetes mellitus [RR = 1.10, p = 0.006] whereas moderate total dietary protein intake was not significantly associated with type 2 diabetes mellitus risk [RR = 1.00,  p = 0.917].  
Not significantly because the calculated p-value of 0.917 was larger than the p-value of 0.05.

The investigators found, moreover, an increased risk of 13% [RR = 1.13, p = 0.013] for type 2 diabetes mellitus was observed with high  dietary animal protein intake whereas moderate animal protein intake had little or no effect on type 2 diabetes mellitus risk [RR = 1.06, p = 0.058].

The investigators found, high dietary intake of plant protein did not affect type 2 diabetes mellitus risk [RR = 0.93, p = 0.074], whereas moderate intake was associated with a reduced risk of 6% for type 2 diabetes mellitus [RR = 0.94, p  0.001].

The investigators concluded high dietary total protein and dietary animal protein intakes are associated with an increased risk of type 2 diabetes mellitus, whereas moderate plant protein intake is associated with a decreased risk of type 2 diabetes mellitus.

Original title:
Dietary protein intake and subsequent risk of type 2 diabetes: a dose-response meta-analysis of prospective cohort studies by Ye J, Yu Q, [...], Wang Y.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30929078

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

A diet with high protein intake is a diet with a minimum of 35 En% protein (En% = energy percentage). These products from the supermarket contain at least 35 En% protein.
35 En% protein means that the amounts of protein contribute 35% to the total calories (kcal) of the diet.
If the diet contains 2000 kcal, 175 grams of protein contribute 35% to this 2000 kcal.
1 gram of protein gives 4 kcal. Thus, 175 grams of protein provide 700 kcal and 700 kcal is 35% of 2000 kcal.

A diet with moderate protein consumption is a diet with 20-25 En% protein. The easiest way to follow a diet with moderate protein consumption is to choose only products/meals that also contain 20-25 En% protein. These products from the supermarket contain 20-25 En% protein.

 

Objectives:
Anemia is one of the most common hematologic problems occurs among patients with tuberculosis (TB). Many studies have been carried out estimating the prevalence of anemia among tuberculosis patients in different countries reported various results. Therefore, this review article has been conducted.

Does tuberculosis increase risk of anemia?

Study design:
This review article included 41 studies.

Results and conclusions:
The investigators found the prevalence of anemia among all tuberculosis patients was 61.53% [95% CI = 53.44-69.63].  

The investigators found the prevalence of anemia among male tuberculosis patients was 66.95% [95% CI = 51.75-82.14].

The investigators found the prevalence of anemia among female tuberculosis patients was 72.67 [95% CI = 60.79-84.54].

The investigators found the prevalence of mild anemia among all tuberculosis patients was 35.67% [95% CI = 27.59-43.46].  

The investigators found the prevalence of moderate anemia among all tuberculosis patients was 31.19% [95% CI = 25.15-37.24].  

The investigators found the prevalence of severe anemia among all tuberculosis patients was 11.61% [95% CI = 7.88-15.34].

The investigators found the prevalence of chronic disease anemia among all tuberculosis patients was 49.82% [95% CI = 15.58-84.07].

The investigators found the prevalence of iron deficiency anemia among all tuberculosis patients was 20.17% [95% CI = 6.68-33.65].

The investigators concluded the prevalence of anemia among tuberculosis patients is high especially among women. More than 43% of these patients suffer from moderate and severe anemia and about half of them has chronic disease anemia.

Original title:
Prevalence of anemia among patients with tuberculosis: A systematic review and meta-analysis by Barzegari S, Afshari M2, […], Moosazadeh M.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31151500

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

Objectives:
Is there an association between poultry and egg consumption and brain cancer risk?

Study design:
This review article included a total of 10 articles (6 articles for poultry consumption and 5 articles for egg consumption).

Results and conclusions:
The investigators found no association between poultry consumption and reduced risk of brain cancer [summarized relative risk = 0.901, 95% CI = 0.703-1.154, I2 = 60.7%, p = 0.018].
No association because RR of 1 was found in the 95% CI of 0.703 to 1.154. RR of 1 means no risk/association.

The investigators found in 4 studies no association between poultry consumption and reduced risk of brain cancer glioma [summarized relative risk = 0.873, 95% CI = 0.737-1.034, I2 = 0.0%, p = 0.838].

The investigators found no association between egg consumption and reduced risk of brain cancer [summarized relative risk = 0.998, 95% CI = 0.552-1.805, I2 = 82.6%, p = 0.001].

The investigators found no association between egg consumption and increased risk of brain cancer glioma [summarized relative risk = 1.472, 95% CI = 0.935-2.316].

The investigators concluded that poultry and egg consumption are not associated with the risk of brain cancer. Due to the limited quality of evidence currently available, more studies related to poultry and egg consumption for brain cancer is necessary.

Original title:
A meta-analysis of the association between poultry and egg consumption and the risk of brain cancer by Luo H, Sun P, [...], Guo Y.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30782302

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

Objectives:
Intermittent preventive treatment (IPT) with sulphadoxine-pyrimethamine (SP) is recommended for preventing maternal and fetal effects of malaria in pregnancy. Increasing parasite resistance to sulphadoxine-pyrimethamine has necessitated the search for an alternative medication. Therefore, this review article has been conducted.

What is the magnitude of effects of dihydroartemisinin‐piperaquine (DP) and sulphadoxine‐pyrimethamine (SP) in preventing malaria during pregnancy?

Study design:
This review article included 3 RCTs involving 3,719 participants.
The trials commenced in 2011, 2012 and 2014 in Malawi, Kenya and Uganda, respectively. The included studies involved pregnant women who were given DP (as routine IPT, a three‐dose regimen, monthly regimen or as IST) and compared with those given SP.

Results and conclusions:
The investigators found compared with intermittent preventive treatment with sulphadoxine-pyrimethamine (IPT-SP), moderate certainty evidence indicated that women who received intermittent preventive treatment with a three‐dose regimen of dihydroartemisinin-piperaquine (IPT-DP) had a significantly lower risk of 83% [OR = 0.17, 95% CI = 0.10-0.29, 1171 participants] of clinical malaria during pregnancy.

The investigators found high certainty evidence showed intermittent screening and treatment with dihydroartemisinin-piperaquine did not reduce placental malaria [OR = 1.29, 95% CI = 1.10-1.50, 2 studies, 2,903 participants] or maternal parasitemia at delivery [OR = 1.39, 95% CI = 1.14-1.69, 2 studies, 2,903 participants].  

The investigators found compared with intermittent preventive treatment with sulphadoxine-pyrimethamine (IPT-SP), moderate certainty evidence indicated that women who received intermittent preventive treatment with a monthly regimen of dihydroartemisinin-piperaquine (IPT-DP) had a significantly lower risk of 99% [OR 0.01, 95% CI = 0.00-0.19, 1 study, 206 participants] of clinical malaria during pregnancy.

The investigators found effect of dihydroartemisinin-piperaquine on low birth weight and adverse birth outcomes was minimal.

The investigators concluded the efficacy of DP as a potential agent for IPT for malaria in pregnancy reported in this review is limited by few studies and moderate certainty of the evidence. Although also limited by few studies, there is moderate to high certainty of evidence that the use of DP for intermittent screening and treatment (IST) of malaria is not superior to IPT‐SP. The findings from the studies included in this review indicate that further high‐quality research with large numbers of participants, in settings endemic for malaria infection, is needed to provide reliable evidence for policy and practice recommendations.

Original title:
A systematic review and meta-analysis of dihydroartemisinin-piperaquine versus sulphadoxine-pyrimethamine for malaria prevention in pregnancy by Olaleye A, Okusanya BO, […], Meremikwu M.

Link:
https://obgyn.onlinelibrary.wiley.com/doi/full/10.1002/ijgo.12835

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

Objectives:
The role of chromium as a weight loss agent remains questionable and although previous meta-analyses findings have reported small reductions in body weight in individuals with overweight/obesity following chromium supplementation, there have been significant limitations with these findings. Therefore, this review article has been conducted.

Do individuals with overweight/obesity benefit from chromium supplementation?

Study design:
This review article included 21 RCTs with a total of 1,316 participants.

Results and conclusions:
The investigators found pooled analysis showed significant reductions in anthropometric indices associated with body composition for:
-weight loss [WMD = -0.75 kg, 95% CI = -1.04 to -0.45, p  0.001];
-body mass index (BMI) [WMD = -0.40, 95% CI = -0.66 to -0.13, p = 0.003] and;
-body fat percentage [WMD = -0.68%, 95% CI = -1.32 to -0.03, p = 0.04] in individuals with overweight/obesity following chromium supplementation. No changes were detected in controls.

The investigators found subgroup analysis showed significant improvements in weight loss and body fat percentage, particularly for study durations ≤12 weeks and doses ≤400 μg/d chromium.

The investigators concluded ≤400 μg/d chromium supplementation during ≤12 weeks is associated with some improvements in body composition in subjects with obesity/overweight. The effect size was medium and the clinical relevance of chromium as a weight loss aid remains uncertain. Therefore, further investigation from larger and well-designed randomized controlled studies, especially in patients with diabetes, is warranted.

Original title:
A meta-analysis of the effect of chromium supplementation on anthropometric indices of subjects with overweight or obesity by Tsang C, Taghizadeh M, […], Jafarnejad S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31115179

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

Objectives:
Does coenzyme Q10 (CoQ10) supplementation improve biomarkers of inflammation and oxidative stress among patients with coronary artery disease (CAD)?

Study design:
This review article included 13 RCTs.

Given the presence of heterogeneity, random-effects model or fixed-effect model were used to pool standardized mean differences (SMDs) as summary effect sizes.

Results and conclusions:
The investigators found pooled findings for biomarkers of inflammation and oxidative stress demonstrated that coenzyme Q10 supplementation significantly increased superoxide dismutase (SOD) [SMD = 2.63, 95% CI = 1.17 to 4.09, p  0.001, I2 = 94.5%] and catalase (CAT) levels [SMD = 1.00, 95% CI = 0.57 to 1.43, p  0.001, I2 = 24.5%] among patients with coronary artery disease.

The investigators found pooled findings for biomarkers of inflammation and oxidative stress demonstrated that coenzyme Q10 supplementation significantly reduced malondialdehyde (MDA) [SMD = -4.29, 95% CI = -6.72 to -1.86, p = 0.001, I2 = 97.6%] and diene levels [SMD = -2.40, 95% CI = -3.11 to -1.68, p  0.001, I2 = 72.6%] among patients with coronary artery disease.

The investigators found among patients with coronary artery disease no significant effect of coenzyme Q10 supplementation on:
-C-reactive protein (CRP) [SMD = -0.62, 95% CI = -1.31 to 0.08, p = 0.08, I2 = 87.9%];
-tumor necrosis factor alpha (TNF-α) [SMD = 0.22, 95% CI = -1.07 to 1.51, p = 0.73, I2 = 89.7%];
-interleukin-6 (IL-6) [SMD = -1.63, 95% CI = -3.43 to 0.17, p = 0.07, I2 = 95.2%] and;
-glutathione peroxidase (GPx) levels [SMD = 0.14, 95% CI = -0.77 to 1.04, p = 0.76, I2 = 78.7%].
No significant because the calculated p-values were larger than the p-value of 0.05.

The investigators concluded coenzyme Q10 supplementation increases superoxide dismutase and catalase and decreases malondialdehyde and diene levels, but has no affect on C-reactive protein, tumor necrosis factor alpha, interleukin-6 and glutathione peroxidase levels among patients with coronary artery disease.

Original title:
The effects of coenzyme Q10 supplementation on biomarkers of inflammation and oxidative stress in among coronary artery disease: a systematic review and meta-analysis of randomized controlled trials by Jorat MV, Tabrizi R, […], Asemi Z.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30758695

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

Malondialdehyde and diene are biomarkers of oxidative stress. Oxidative stress can arise when human cells cannot adequately destroy the excess of free radicals formed.

Free radicals can be rendered harmless by antioxidants such as vitamins C and E and by antioxidative enzymes such as superoxide dismutase and catalase.

Objectives:
Breastfeeding initiation within the first half hour after birth is one of the World Health Organization recommendations. However, in most hospitals, mother-infant contact and breastfeeding initiation are delayed due to routine mother and infant care. Therefore, this review article has been conducted.

Does mother-infant skin to skin contact (SSC) immediately after birth increase the success rate and duration of first breastfeeding?

Study design:
This review article included a total of 9 RCTs with 597 participants were assigned to the intervention group and 553 participants were assigned to the comparison group.

Results and conclusions:
The investigators found quantitative analysis based on mean differences or odds ratio showed that mother-infant skin to skin contact had a significantly positive effect on success in first breastfeeding [MD =1.90, 95% CI = 0.958 to 2.856, p = 0.00; OR = 2.771, 95% CI = 1.587 to 4.838, p = 0.00] and first breastfeeding duration [MD = 26.627, 95% CI = 1.070 to 52.184, p = 0.041].

The investigators concluded mother-infant skin to skin contact immediately after birth has beneficial effects on breastfeeding and can increase the success rate and duration of the first lactation. Therefore, these findings can be used by healthcare providers in evidence-based decision-making about ways to increase breastfeeding rates.

Original title:
The effect of mother-infant skin to skin contact on success and duration of first breastfeeding: A systematic review and meta-analysis by Karimi FZ, Sadeghi R, […], Khadivzadeh T.

Link:
https://www.sciencedirect.com/science/article/pii/S1028455918302766?via%3Dihub

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

Objectives:
Plasma creatinine has been described as a prognostic biomarker for Amyotrophic Lateral Sclerosis (ALS), but with conflicting results in the literature. Therefore, this review article (meta-analysis) has been conducted.

Does a high plasma creatinine concentration reduce risk of ALS?

Study design:
This review article included 14 distinct cohorts (19 studies).

The overall quality of the studies was low mainly due to potential attrition bias and several studies did not report analyzable results raising concern regarding a potential reporting bias.

Results and conclusions:
The investigators found for baseline plasma creatinine, mortality risk was 28% lower when creatinine was higher than 88.4 µmol/L [HR = 0.72, 95% CI = 0.58 to 0.88, p = 0.0003] and was 25% lower if creatinine was above versus below the median [HR = 0.75, 95% CI = 0.63 to 0.89, p = 0.0008].

The investigators found a significant positive correlation between plasma creatinine at baseline and functional score and between creatinine decline and functional score decline [p  0.0001 for both].

The investigators found, however, a negative correlation between plasma creatinine and functional score decline [p = 0.033].

The investigators concluded plasma creatinine seems to be a promising prognostic biomarker for ALS. However, new studies with sound methodology and standardized criteria for the evaluation of ALS progression should be conducted to validate plasma creatinine as a clinical biomarker for ALS prognosis.

Original title:
Plasma creatinine and amyotrophic lateral sclerosis prognosis: a systematic review and meta-analysis by Lanznaster D, Bejan-Angoulvant T, […], Blasco H.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30961401

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

Objectives:
Previous studies had demonstrated some associations between coffee and tea consumption and brain cancer risk resulted in an inconsistent relationship. Therefore, this review article has been conducted.

Does coffee or tea consumption reduce brain cancer risk?

Study design:
This review article included 8 cohort studies and 3 case-control studies, involving 2,583 cases (persons with brain cancer) among 1,684,262 participants.

Based on Egger’s test and funnel plot, there existed no publication bias.

Results and conclusions:
The investigators found highest category of coffee consumption significantly reduced risk of brain cancer with 21.5% [RR = 0.785, 95% CI = 0.580-0.984, I2 = 65.6%, p for heterogeneity = 0.001], when compared with the lowest category.

The investigators found in supgroup analysis highest category of coffee consumption significantly reduced risk of glioma with 24% [RR = 0.760, 95% CI = 0.548-0.972], when compared with the lowest category.

The investigators found in cohort studies highest category of coffee consumption significantly reduced risk of brain cancer with 14.2% [RR = 0.858, 95% CI = 0.700-0.992], when compared with the lowest category. However, this reduced risk was not significant in case-control studies.

The investigators found highest category of coffee consumption significantly reduced risk of brain cancer with 88.3% in Asian populations [RR = 0.217, 95% CI = 0.042-0.896], when compared with the lowest category. However, this reduced risk was not significant in other populations.

The investigators found sensitivity analysis showed pooled RR of coffee consumption ranged from 0.738 [95% CI = 0.542-0.961) to 0.905 [95% CI = 0.754-1.088].

The investigators found highest category of tea consumption significantly reduced risk of brain cancer with 20.2% in American populations [RR = 0.798, 95% CI = 0.646-0.986], when compared with the lowest category.

The investigators found sensitivity analysis showed pooled RR of tea consumption ranged from 0.863 [95% CI = 0.699-1.067] to 0.947 [95% CI = 0.763-1.176].

The investigators found highest category of coffee plus tea consumption significantly reduced risk of brain cancer with 31.6% [RR = 0.684, 95% CI = 0.481-0.975], when compared with the lowest category.

The investigators concluded higher consumption of coffee reduces risk of brain cancer in Asian populations and higher consumption of tea reduces risk of brain cancer in American population. However, future studies with detailed information about sex, lifestyle and some other related factors are warranted to further explore the association between coffee or tea consumption and risk of brain cancer.

Original title:
Association between tea and coffee consumption and brain cancer risk: an updated meta-analysis by Song Y, Wang Z, [....], Guo J.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419842/

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

Objectives:
Micronutrient malnutrition is highly prevalent in low- and middle-income countries (LMICs) and disproportionately affects women and children. Although the effectiveness of large-scale food fortification (LSFF) of staple foods to prevent micronutrient deficiencies in high-income settings has been demonstrated, its effectiveness in LMICs is less well characterized. Therefore, this review article has been conducted.

Does large-scale food fortification (LSFF) of staple foods prevent micronutrient deficiencies in low- and middle-income countries (LMICs)?

Study design:
This review article included 50 studies.

4 studies for vitamin A fortification with a mean intervention duration of 14 months (12 to 24 months). Geographic locations included Indonesia, South Africa, Guatemala and Nicaragua and food vehicles included sugar, maize flour and oil.

11 studies for iodine fortification. Study populations consisted mostly of school-age children and adolescents (aged 5-18 years) in Asian and African locations. Iodine fortificants were varied and included potassium iodate, sodium iodide and multiple fortificants. Intervention duration ranged from 10 months to 14 years, with a mean of 5.7 years.

19 studies for iron fortification. The study populations consisted of women and children of varying age groups, including 2 studies pertaining specifically to pregnant women and 1 looking at the effects of fortification on anaemic children.
The food vehicles were varied and included maize flour, wheat flour, rice, soy sauce, fish sauce and milk.
Several fortificants were used, including sodium iron ethylenediaminetetraacetate (NaFeEDTA), ferrous sulfate, ferrous fumarate, ferrous bisglycinate, electrolytic iron and ferric orthophosphate.
The studies were geographically diverse, with the majority coming from Asia and South America. One was a multicountry study, reporting on anemia prevalence in 12 different countries.
Intervention duration ranged from 18 months to 16 years, with a mean of 5.3 years.

17 studies for folic acid fortification. The vast majority of studies took place in Central and South America and food vehicles included wheat and maize flour.
Intervention duration ranged from 12 months to 11 years, with a mean of 4.2 years.

The range of each age group was children (1-4 years), school-age children (5-9 years), adolescents (10-19 years) and women of reproductive age (WRA).

Results and conclusions:
The investigators found in pooled analysis that vitamin A fortification was associated with a significant increase in serum retinol [SMD = 0.31, 95% CI = 0.18 to 0.45].
The effect was significant for each of the age groups assessed and particularly for older [children SMD = 0.50, 95% CI = 0.16 to 0.85].
Single studies examining the effect of vitamin A fortification in children aged 1 y and women of reproductive age also signaled improvements in serum retinol (vitamin A level in blood).  

The investigators found that serum retinol levels of children aged 0-9 years significantly improved by 0.28 μg/dL [95% CI = 0.14 to 0.43 μg/dL] following large-scale food fortification with vitamin A for an average of 14 months.
Today, the global prevalence of vitamin A deficiency (VAD; defined as a serum retinol concentration 0.70 μmol/L) for children aged 5 y is 33.3%, equating to 190 million children. When considering the impact of these findings on a population curve, this global deficiency would shift to 32.82%, indicating an approximate reduction in vitamin A deficiency for 2.7 million children [95% CI = 1.3 to 4.1 million children] in just over 1 year.

The investigators found large-scale food fortification with iodine was associated with a significant increase in urinary iodine [SMD = 1.02, 95% CI = 0.63 to 1.42].
Subgroup analysis revealed a statistically significant impact for school-age children [SMD = 1.12, 95% CI = 0.57 to 1.67]. Accordingly, the prevalence of iodine deficiency was reduced for this age group as well [RR = 0.25, 95% CI = 0.21 to 0.29].

The investigators found large-scale food fortification with iodine significantly reduced goiter prevalence (grade 1-2) among school-age children with 74% [OR = 0.26, 95% CI = 0.16 to 0.43], a finding that was indicative of the long-term impact of salt iodization programs.

The investigators found large-scale food fortification with iron was associated with a small, but significant, increase in the hemoglobin concentration for combined populations (preschool children, school-age children and WRA only). However, when disaggregating by age and status (pregnant and anaemic populations at baseline) the effect remained significant for pregnant women only [SMD = 0.12, 95% CI = 0.01 to 0.23].

The investigators found large-scale food fortification with iron was associated with a 34% decline in anemia prevalence for combined age groups [RR = 0.66, 95% CI = 0.59 to 0.74], with the greatest impact noted for women of reproductive age [RR = 0.66, 95% CI = 0.58, 0.76], followed by school-age children (1-4 years) [RR = 0.68, 95% CI = 0.52, 0.90].

The investigators found in 3 studies looked at the impact of iron fortification in pregnant women specifically that, although anemia prevalence was significantly reduced [RR = 0.73, 95% CI = 0.64 to 0.84], the decline was less than it was for nonpregnant women.

The investigators found large-scale food fortification with iron significantly increased serum ferritin increased by 0.39 μg/L [95% CI = 0.34 to 0.44 μg/L], indicating a significant improvement in iron stores for combined age groups following iron fortification.
Variability around the point estimates for serum ferritin was largest for the youngest children [SMD = 0.47, 95% CI = 0.35 to 0.59].

The investigators found large-scale food fortification with iron significantly decreased prevalence of iron deficiency by 58% among all population subsets [RR = 0.42, 95% CI = 0.32 to 0.56].  

The investigators found large-scale food fortification with folic acid significantly reduced prevalence of total neural tube defects with 41% [OR = 0.59, 95% CI = 0.49 to 0.70] and neural tube defect subtype, including spina bifida with 34% [OR = 0.66, 95% CI = 0.53 to 0.82], anencephaly with 51% [RR = 0.49, 95% CI = 0.40 to 0.60] and cephalocele with 36% [OR = 0.64, 95% CI = 0.47 to 0.88].

The investigators found among women of reproductive age, folic acid fortification of flour was associated with a significant decline of 80% in the prevalence of folate deficiency [RR = 0.20, 95% CI = 0.15 to 0.25], as well as improvements in serum/plasma folate levels [SMD = 1.25, 95% CI = 0.50 to 1.99].

The investigators concluded that large-scale food fortification has a positive impact on some functional health outcomes, including goiter, anemia and neural tube defects prevalence. Large-scale food fortification also increases relevant micronutrient biomarker concentrations, and improves iron stores and reduces iron deficiency prevalence in both women and children.

Original title:
Improved micronutrient status and health outcomes in low- and middle-income countries following large-scale fortification: evidence from a systematic review and meta-analysis by Keats EC, Neufeld LM, […], Bhutta ZA.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6537942/

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

Objectives:
The role of gut microbiota in the management of diabetes has been shown. Several current trials are investigating the effect of probiotics and prebiotics, which are widely used to modulate intestinal microbiota, on inflammatory factors and biomarkers of oxidative stress in diabetic patient. However, their findings are controversial. Therefore, this review article (meta-analysis) has been conducted.

Do probiotic and synbiotic supplementation improve biomarkers of inflammation and oxidative stress in diabetic patients?

Study design:
This review article included 16 RCTs (n = 1,060).

Randomized controlled trials (RCTs) reported the effect of probiotics or synbiotics on circulating (serum and plasma) inflammatory marker (hs-CRP) and oxidative stress indicators (malondialdehyde [MDA], glutathione [GSH], nitric oxide [NO] and total antioxidant capacity [TAC]) among patients with diabetes.

The methodological quality varied across these trials.

Results and conclusions:
The investigators found probiotic and synbiotic supplementation significantly decreased hs-CRP level [SMD = -0.38, 95% CI = -0.51 to -0.24, p = 0.000] and the oxidative stress indicator malondialdehyde [SMD = -0.61, 95% CI = -0.89 to -0.32, p = 0.000] in diabetic patients compared to those in subjects receiving placebos.

The investigators found, in addition, probiotic and synbiotic supplementation significantly increased total antioxidant capacity [SMD = 0.31, 95% CI = 0.09 to 0.52, p = 0.006], nitric oxide [SMD = 0.62, 95% CI = 0.25 to 0.99, p = 0.001] and glutathione [SMD = 0.41, 95% CI = 0.26, 0.55, p = 0.000] levels.

The investigators concluded that probiotic and synbiotic supplementation improve biomarkers of inflammation and oxidative stress in diabetic patients. Further studies are needed to develop clinical practice guidelines for the management of inflammation and oxidative stress in these patients.

Original title:
The effect of probiotic and synbiotic supplementation on biomarkers of inflammation and oxidative stress in diabetic patients: A systematic review and meta-analysis of randomized controlled trials by Zheng HJ, Guo J, [...], Wang Y.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30794924

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

Oxidative stress is an imbalance between free radicals and antioxidants in your body. Antioxidants can reduce oxidative stress.
 

Objectives:
Does kiwifruit improve metabolic health in participants with cardiovascular risk factors, including hypercholesterolemia, hypertension, diabetes type 2 and smokers?

Study design:
This review article included 5 RCTs involving 489 participants.

Results and conclusions:
The investigators found no significant effect of kiwifruit on:
-systolic blood pressure (SBP) [MD = -1.72 mmHg, 95% CI = -4.27 to 0.84];
-diastolic blood pressure (DBP) [MD = -2.35 mmHg, 95% CI = -5.10 to 0.41];
-total cholesterol (TC) [MD = -0.14 mmol/L, 95% CI = -0.71 to 0.43];
-triglyceride (TG) [MD = -0.23 mmol/L, 95% CI = -0.66 to 0.20];
-low-density lipoprotein cholesterol (bad cholesterol or LDL) [MD = -0.41 mmol/L, 95% CI = -0.99 to 0.18];
-high-density lipoprotein cholesterol (good cholesterol or HDL) [MD = 0.15 mmol/L, 95% CI = -0.18 to 0.48];
-fasting plasma glucose (FPG) [MD = -0.08 mmol/L, 95% CI = -0.37 to 0.21];
-homeostasis model assessment of insulin resistance (HOMA-IR) [MD = -0.29, 95% CI = -0.61 to 0.02] and;
-body weight (BW) [MD = 1.08 kg, 95% CI = -4.22 to 2.05].

The investigators found subgroup analysis limiting to studies of whole kiwifruit and duration of intervention of at least 8 weeks again revealed no such effect of kiwifruit on total cholesterol, triglyceride, LDL cholesterol and HDL cholesterol.

The investigators concluded kiwifruit has no effect on metabolic health, as measured by systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides, LDL cholesterol and HDL cholesterol, fasting plasma glucose, homeostasis model assessment of insulin resistance (HOMA-IR) and body weight in participants with cardiovascular risk factors including hypercholesterolemia, hypertension, diabetes type 2 and smokers. Due to limited evidence and high heterogeneity of the study results, the potential of kiwifruit as a nonpharmaceutical alternative for metabolic health should be further evaluated in well-defined, well-controlled trials with larger sample size and standardized preparation.

Original title:
Effect of kiwifruit on metabolic health in patients with cardiovascular risk factors: a systematic review and meta-analysis by Suksomboon N, Poolsup N and Lin W.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6350646/

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