Nutritional advice

Objectives:
Taurine plays a pivotal role in regulating glucose and lipid metabolism, blood pressure homeostasis and obesity largely due to its cytoprotective, antioxidant and anti-inflammatory actions. Despite promising data from animal studies in this scenario, the efficacy of taurine supplementation in human studies has been inconsistent. Therefore, this review article has been conducted.

Does taurine supplementation lower blood pressure and improve the lipid profile in patients with liver dysregulation?

Study design:
This review article included 12 RCTs.
Most studies were conducted in patients with liver or metabolic dysregulation (diabetes, hepatitis, fatty liver, obesity, cystic fibrosis, chronic alcoholism and cardiac surgery).
The taurine dosage varied from 0.5 to 6 g/d for 15 days to 6 months.

Results and conclusions:
The investigators found that taurine administration (supplementation) had a significant effect of on systolic blood pressure [WMD = -4.67 mm Hg, 95% CI = -9.10 to -0.25], diastolic blood pressure [WMD = -2.90 mm Hg, 95% CI = -4.29 to -1.52], total cholesterol levels [WMD = -10.87 mg/dL, 95% CI = -16.96 to -4.79] and triglycerides levels [WMD = -13.05 mg/dL, 95% CI = -25.88 to -0.22]. 

The investigators found, however, that taurine administration had no effect on fasting blood glucose [WMD = 0.06 mg/dL], HDL cholesterol [WMD = 0.90 mg/dL], LDL cholesterol [WMD = -6.17 mg/dL], as well as on body mass index [WMD = -0.46 kg/m²] and body weight [WMD = -0.47 kg] as the anthropometric measures.

The investigators concluded that, in patients with liver dysregulation, taurine supplements (0.5 to 6 g/d for 15 days to 6 months) reduce blood pressure and improve the lipid profile by reducing total cholesterol and triglyceride levels.

Original title:
The effects of taurine supplementation on obesity, blood pressure and lipid profile: A meta-analysis of randomized controlled trials by Guan L and Miao P.

Link:
https://pubmed.ncbi.nlm.nih.gov/32871172/

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The main sources of taurine are animal foods, such as meat, fish and dairy products.

Objectives:
Is there a difference between high-load (≥70 of 1RM) and low-load (70 of 1RM) resistance training (RT) on femoral neck and lumbar spine bone mineral density (BMD) in middle-aged and older people?

Study design:
This review article included 6 RCTs.

Results and conclusions:
The investigators found the meta-analysis revealed no difference in femoral neck bone mineral density [MD = 0.00 g/cm², 95% CI = -0.01 to 0.01, p = 0.63, I2 = 47%, p = 0.07] and lumbar spine bone mineral density [MD = 0.01 g/cm², 95% CI = -0.00 to 0.02, p = 0.12, I2 = 59%, p = 0.02] between high-load (≥70 of 1RM) resistance training group and low-load (70 of 1RM) resistance training group. 

The investigators found subgroup analysis revealed a significant effect of high-load resistance training on femoral neck bone mineral density when participants presented normal bone mineral density values [MD = 0.01 g/cm², 95% CI = 0.00 to 0.02, p = 0.04] and on interventions lasting up to 6 months [MD = 0.01 g/cm², 95% CI = 0.00 to 0.02, p = 0.03].

The investigators concluded both high-load (≥70 of 1RM) and low-load (70 of 1RM) resistance training (RT) have similar effects on femoral neck and lumbar spine bone mineral density (BMD) in middle-aged and older people.

Original title:
High and Low-Load Resistance Training Produce Similar Effects on Bone Mineral Density of Middle-Aged and Older People: A Systematic Review With Meta-Analysis of Randomized Clinical Trials by Souza D, Barbalho M, […], Gentil P.

Link:
https://www.sciencedirect.com/science/article/abs/pii/S0531556520303211?via%3Dihub

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Objectives:
Many studies have investigated the association between dietary iron intake and death due to cardiovascular disease (CVD), but the results were inconsistent. Therefore, this review article has been conducted.

Does dietary iron intake increase risk of death due to cardiovascular disease (cardiovascular disease mortality)?

Study design:
This review article included 19 prospective cohort studies including 720,427 participants (46,045 deaths due to cardiovascular disease).

Results and conclusions:
The investigators found when comparing the highest versus lowest level, the highest level of dietary heme iron intake significantly increased risk of death due to cardiovascular disease with 19% [pooled RR = 1.19, 95% CI = 1.01-1.39].

The investigators found every 1-mg/day increase in dietary heme iron intake significantly increased risk of death due to cardiovascular disease with 25% [pooled RR = 1.25, 95% CI = 1.17-1.33].

The investigators found every 1-mg/day increase in dietary heme iron intake significantly increased risk of death due to stroke with 17% [pooled RR = 1.17, 95% CI = 1.04-1.32].

The investigators found the association between dietary iron intake and cardiovascular disease mortality was linear [p nonlinearity > 0.05].

The investigators concluded higher dietary intake of heme iron (at least 1-mg/day) is associated with a greater risk of cardiovascular disease mortality. Therefore, reducing consumption of heme iron may help to prevent premature death due to cardiovascular disease.

Original title:
Dietary iron intake and risk of death due to cardiovascular diseases: A systematic review and dose-response meta-analysis of prospective cohort studies by Han M, Guan L, […], Lu J.

Link:
https://pubmed.ncbi.nlm.nih.gov/32674239/

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Food items of heme iron are:

• Beef or chicken liver
• Beef
• Canned light tuna
• Canned sardines
• Organ meats
• Oysters, clams, mussels
• Poultry

Objectives:
Micro-nutrients are closely related to pulmonary tuberculosis (PTB). Most patients with PTB suffer from micro-nutrients deficiency. Therefore, this review article has been conducted.

Do patients with tuberculosis benefit from micro-nutrients support during an anti-tuberculosis treatment?

Study design:
This review article included a total of 13 RCTs with a total of 2,847 participants.
The duration of the experimental group with micro-nutrients support was more than 2 weeks.

Results and conclusions:
The investigators found micro-nutrients support significantly improved sputum smears [OR = 0.16, 95% CI = 0.03 to 0.77].

The investigators found micro-nutrients support significantly improved culture negative conversion rates [MD = -2.36, 95% CI = -4.72 to -0.01].

The investigators found micro-nutrients support significantly increased lymphocytes [MD = 0.20, 95% CI = 0.06 to 0.35].

The investigators found micro-nutrients support significantly decreased leukocytes, neutrophils, CRP and ESR.

The investigators found, however, micro-nutrients support had no impact on body weight, MUAC, haemoglobin, albumin or monocytes [p > 0.05].

The investigators concluded micro-nutrients support reduces chronic inflammation and improves sputum smears or culture conversions to contribute to anti-tuberculosis treatment.

Original title:
The effect of micro-nutrients on malnutrition, immunity and therapeutic effect in patients with pulmonary tuberculosis: A systematic review and meta-analysis of randomised controlled trials by Cai H, Chen L, […], Wang X.

Link:
https://pubmed.ncbi.nlm.nih.gov/33049436/

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Objectives:
Previous studies lack consistent conclusions as to whether astaxanthin is actually linked to various health benefits as claimed. Therefore, this review article has been conducted.

Is there a causal relationship between astaxanthin consumption and improvements in risk factors for diabetes or cardiovascular disease?

Study design:
This review article included 14 RCTs.

Results and conclusions:
The investigators found that astaxanthin consumption was not associated with FBS, HbA1c, TC, LDL-C, TG, BMI, BW, DBP and SBP.

The investigators found that astaxanthin consumption was associated with an increase in HDL cholesterol levels [WMD = 1.473 mg/dL, 95% CI = 0.319 to 2.627, p = 0.012].

The investigators found that astaxanthin consumption during ≥12 weeks was associated with a decrease in CRP levels [WMD = -0.528 mg/L, 95% CI = -0.990 to -0.066].

The investigators found that >12 mg/day astaxanthin consumption was associated with a decrease in CRP levels [WMD = -0.389 mg/dL, 95% CI = -0.596 to -0.183].

The investigators concluded that astaxanthin consumption is causally associated with an increase in HDL cholesterol levels (good cholesterol) and a decrease in CRP levels for >12 mg/day astaxanthin consumption during ≥12 weeks. Significant associations are not observed for other outcomes.

Original title:
The effects of astaxanthin supplementation on obesity, blood pressure, CRP, glycemic biomarkers, and lipid profile: A meta-analysis of randomized controlled trials by Xia W, Tang N, [...], Zhu Y.

Link:
https://pubmed.ncbi.nlm.nih.gov/32755613/

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Objectives:
Is there a causal relationship between dairy products or calcium supplements and the reduction in fat mass and BMI among overweight or obese adults?

Study design:
This review article included 10 and 14 RCTs with ≥ 12 weeks interventions of calcium supplements and dairy products among overweight (BMI>25) or obese (BMI>30) adults aged ≥18.

Results and conclusions:
The investigators found that dairy products significantly reduced fat mass among overweight or obese adults [SMD = -0.40, 95% CI = -0.77 to -0.02].
This reduction was also significant in the analysis of RCTs with low risk of bias scores.

The investigators found that dairy products significantly reduced BMI among overweight or obese adults [SMD = -0.46 kg/m², 95% CI = -0.67 to -0.26].
This reduction was also significant in the analysis of RCTs with low risk of bias scores.

The investigators found that calcium supplements significantly reduced fat mass among overweight or obese adults [SMD = -0.15, 95% CI = -0.28 to -0.02].
However, this reduction was not significant in the analysis of RCTs with low risk of bias scores.

The investigators concluded there is a causal relationship between dairy products without distinction of fat percentage and the reduction in fat mass and BMI among overweight or obese adults.

Original title:
Meta-analysis of randomized controlled trials on calcium supplements and dairy products for changes in body weight and obesity indices by Hong JY, Lee JS, [...], Kim MK.

Link:
https://pubmed.ncbi.nlm.nih.gov/33292017/

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Objetivos:
¿Reduce el consumo de frutas y verduras el riesgo de cáncer del conducto biliar?

Diseño del estudio:
Este artículo de revisión incluyó 14 estudios.

No hubo sesgo de publicación entre los estudios [p Begg = 0.53, p Egger = 0.84 para hortalizas y p Begg = 0.95, p Egger = 0.64 para frutas].

Resultados y conclusiones:
Los investigadores encontraron para el consumo más alto en comparación con más bajo, un riesgo significativamente reducido del 52% para el cáncer del conducto biliar [RR resumido = 0.48, 95% IC = 0.22 a 0.74, I2 = 86.8%, p 0.001, n = 10] para el consumo de verduras.

Los investigadores encontraron para el consumo más alto en comparación con más bajo, un riesgo significativamente reducido del 53% para el cáncer del conducto biliar [RR resumido = 0.47, 95% IC = 0.32 a 0.61, I2 = 63.3%, p = 0.001, n = 13] para el consumo de fruta.

Los investigadores encontraron por cada incremento de 100 gramos/día de consumo de verduras, un riesgo significativamente reducido del 69% para el cáncer del conducto biliar [RR = 0.31, 95% IC = 0.20 a 0.47, I2 = 63.3, n = 8].

Los investigadores concluyeron que el consumo de frutas y verduras reduce el riesgo de cáncer del conducto biliar. Se necesitan más estudios prospectivos bien diseñados para confirmar estos hallazgos.

Título original:
Vegetable, Fruit Consumption and Risk of Biliary Cancer: Evidence from a Meta-Analysis by Huai J and Xiaohua Ye X.

Enlace:
https://pubmed.ncbi.nlm.nih.gov/32731775/

Información adicional de El Mondo:
Encontrar aquí más información/estudios sobre significativamente/estudios de cohorte, el consumo de frutas y verduras y el cáncer.

Objectives:
Data on the association of nut intake with risk of cancer and its mortality are conflicting. Although previous meta-analyses summarized available findings in this regard, some limitations may distort their findings. Moreover, none of these meta-analyses examined the dose-response associations of total nut intake with the risk of specific cancers as well as associations between specific types of nuts and cancer mortality. Therefore, this review article (meta-analysis) has been conducted.

Do higher nut dietary intakes reduce risk of cancer incidence and mortality?

Study design:
This review article included in total 43 articles (observational studies) on cancer risk and 9 articles (observational studies) on cancer mortality.

Results and conclusions:
The investigators found when comparing the highest with lowest intakes of total nuts, the highest intakes of total nuts (tree nuts and peanuts), significantly reduced risk of cancer with 16% [summary effect size = 0.86, 95% CI = 0.81 to 0.92, p 0.001, I2 = 58.1%, p 0.01].

The investigators found when comparing the highest with lowest intakes of tree nuts, the highest intakes of tree nuts significantly reduced risk of cancer with 13% [pooled effect size = 0.87, 95% CI = 0.78 to 0.96, p 0.01, I2 = 15.8%, p = 0.28].

The investigators found based on the dose-response analysis, a 5-g/d increase in total nut intake was associated with 3%, 6% and 25% lower risks of overall, pancreatic and colon cancers, respectively.  

The investigators found in terms of cancer mortality, 13%, 18% and 8% risk reductions with higher intakes of total nuts, tree nuts and peanuts, respectively.

The investigators found, in addition, a 5-g/d increase in total nut intake was associated with a 4% lower risk of cancer mortality.

The investigators concluded there is a protective association between total nut and tree nut intake and the risk of cancer and its mortality.

Original title:
Association of Total Nut, Tree Nut, Peanut, and Peanut Butter Consumption with Cancer Incidence and Mortality: A Comprehensive Systematic Review and Dose-Response Meta-Analysis of Observational Studies by Naghshi S, Sadeghian M, […], Sadeghi O.

Link:
https://pubmed.ncbi.nlm.nih.gov/33307550/

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Tree nuts in this review article are walnuts, pistachios, macadamia nuts, pecans, cashews, almonds, hazelnuts and Brazil nuts.

Objectives:
Type 1 diabetes mellitus (T1DM) causes the irreversible destruction of pancreatic beta cells. The Bacillus Calmette-Guerin (BCG) vaccine can modulate the immune response and decelerate disease progression. Therefore, this review article has been conducted.

Do patients with type 1 diabetes mellitus benefit from the Bacillus Calmette-Guerin (BCG) vaccine?

Study design:
This review article included 4 RCTs. The sample sizes ranged from 6 to 94, with a total of 198 subjects. The mean age of the examinees ranged from 10.1 to 36.0 years and the follow-up duration ranged from 1 to 8 years.

Results and conclusions:
The investigators found the pooled meta-analysis demonstrated no significant difference in HbA1c levels [MD = -0.12, 95% CI = -0.53 to 0.30, I2 = 56%] or fasting C-peptide levels [MD = -0.15, 95% CI = -0.35 to 0.06, I2 = 0%] in the BCG intervention group as compared with that in the placebo group.
The results remained unchanged after removing each study in the sensitivity analysis.

The investigators concluded there is no robust evidence to support the use of the Bacillus Calmette-Guerin (BCG) vaccine for the treatment of type 1 diabetes mellitus although the HbA1c levels tend to improve. Additional RCTs to assess the long-term effects of the Bacillus Calmette-Guerin (BCG) vaccine on glycemic control are warranted.

Original title:
Therapeutic Effects of BCG Vaccination on Type 1 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials by Chang YC, Lin CJ, […], Hsu HY.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7139880/

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Objectives:
Dyslipidemia is a common metabolic disease worldwide and also an important predisposing factor for cardiovascular diseases (CVDs). Coffee is loved by people all over the world; however, the association between coffee consumption and blood lipids has yielded inconsistent results. Therefore, this review article has been conducted.

Is there a causal relationship between coffee consumption and dyslipidemia?

Study design:
This review article included 12 RCTs.

Results and conclusions:
The investigators found pooled results showed that coffee consumption significantly increased total cholesterol (TC) levels [WMD = 0.21 mmol/L, 95% CI = 0.04 to 0.39, p = 0.017].  
Significant means that there is an association with a 95% confidence.

The investigators found pooled results showed that coffee consumption significantly increased triglyceride (TG) levels [WMD = 0.12 mmol/L, 95% CI = 0.03 to 0.20, p = 0.006].  
Significant because the calculated p-value of 0.006 was less than the p-value of 0.05.

The investigators found pooled results showed that coffee consumption significantly increased LDL cholesterol (bad cholesterol) levels [WMD = 0.14 mmol/L, 95% CI = 0.05 to 0.24, p = 0.003].  

The investigators found pooled results showed that coffee consumption had no significant effect on HDL cholesterol (good cholesterol) levels [WMD = -0.01 mmol/L, 95% CI = -0.06 to 0.04, p = 0.707].
No significant means that there is no association with a 95% confidence.

The investigators found dose-response analysis results revealed significant positive nonlinear associations between coffee consumption and the increase in total cholesterol, LDL cholesterol and triglyceride levels.

The investigators concluded that coffee consumption is associated with an elevated risk for dyslipidemia and cardiovascular diseases. So a reasonable habit of coffee consumption (3 cups/d) is essential for the prevention of dyslipidemia.  

Original title:
Effect of coffee consumption on dyslipidemia: A meta-analysis of randomized controlled trials by Du Y, Lv Y, […], Luo Q.

Link:
https://pubmed.ncbi.nlm.nih.gov/33239163/

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Dyslipidemia is elevation of plasma cholesterol, triglycerides (TGs), or both, or a low HDL cholesterol (good cholesterol) level that contributes to the development of atherosclerosis. Atherosclerosis is the main underlying cause of cardiovascular disease (CVD).

Objectives:
A dietary protein intake (DPI) of between 0.6 and 0.8 g protein per kilogram body weight per day (g/kg/day) is frequently recommended for adults with moderate-to-advanced chronic kidney disease (CKD). However, evidence on whether patients with diabetic kidney disease (DKD) actually benefit from a DPI of ≤ 0.8 g/kg/day and from a low-protein diet (LPD) at CKD stages 1-3 has not been consistent. Therefore, this review article has been conducted.

Do patients with diabetic kidney disease benefit from a dietary protein intake of 0.8 g protein per kilogram body weight per day (g/kg/day)?

Study design:
This review article included 9 RCTs with a total of 506 participants and follow-up periods varying from 4.5 to 60 months.

Results and conclusions:
The investigators found that patients with diabetic kidney disease who consumed 0.8 g protein/kg/day had a significantly reduced decline in glomerular filtration rate (GFR) [MD = 22.31 mL/min/1.73 m², 95% CI = 17.19 to 27.42, p 0.01] and a significant decrease in proteinuria [SMD = -2.26 units, 95% CI = -2.99 to -1.52, p 0.001] versus those on the control diet.

The investigators found the benefits of a low-protein diet to patients with diabetic kidney disease at chronic kidney disease stages 1-3 were a markedly decreased proteinuria [SMD - 0.96 units, 95% CI = -1.81 to -0.11, p = 0.03] and slight but significant decreases in glycated hemoglobin [-0.42%] and cholesterol levels [-0.22 mmol/L].

The investigators concluded that a dietary protein intake of 0.8 g/kg/day is strongly associated with a slow decline in glomerular filtration rate (GFR) and decreases proteinuria in the patients with diabetic kidney disease. Patients with chronic kidney disease (CKD) stages chronic kidney disease 1-3 benefit from a low-protein diet in terms of a marked decrease of proteinuria and slight but significant improvements in lipid and glucose control.  

Original title:
Diabetic Kidney Disease Benefits from Intensive Low-Protein Diet: Updated Systematic Review and Meta-analysis by Li Q, Wen F, [...], Wang W.

Link:
https://pubmed.ncbi.nlm.nih.gov/33150563/

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For example: you are a patient with diabetic kidney disease, you weigh 70 kg and you want to eat 2200 kcal every day. How should you meet a dietary protein intake of 0.8 g protein per kilogram body weight per day (g/kg/day) in daily life?
Every day you should take maximal 0.8 g protein x 70 kg = 56 g protein. 56 g protein give 56x4 kcal = 224 kcal. 224 kcal is around 10% of 2200 kcal. Thus, you should eat products whose protein content contributes maximum 10% to the total kcal of the product in question, meaning you should eat products with 10 En% protein. These products in the supermarket contain maximum 10 En% protein.

Thus, a dietary protein intake of 0.8 g protein per kilogram body weight per day (g/kg/day) for a person weighing 70 kg on a diet of 2200 kcal, means he/she should eat products with maximum 10 En% protein in daily life.
 

Objectives:
Do omega-3 fatty acid supplements (EPA and DHA) improve sarcopenia-related performances among the elderly?

Study design:
This review article included 10 RCTs with 552 participants.
The number of study participants ranged from 24 to 126 and the durations of the interventions spanned 10 to 24 weeks.
The doses ranged from 0.16 to 2.6 g/day of EPA and from 0 to 1.8 g/day of DHA.
The mean ages of the participants across the RCTs ranged from 63 to 75 years old.

Results and conclusions:
The investigators found in subgroup analyses that omega-3 fatty acid supplements (EPA and DHA) at more than 2 g/day significantly increased muscle mass among the elderly [SMD = 0.67 kg, 95% CI = 0.16 to 1.18, p 0.05].

The investigators found in subgroup analyses that omega-3 fatty acid supplements (EPA and DHA) during more than 6 months significantly improved walking speed among the elderly [SMD = 1.78 m/sec, 95% CI = 1.38 to 2.17, p 0.05].

The investigators concluded that taking at least 2 grams of omega-3 supplements (EPA and DHA) per day increases muscle mass among the elderly, while taking omega-3 supplements for at least 6 months increases walking speed among the elderly.

Original title:
Effects of Omega-3 Fatty Acids on Muscle Mass, Muscle Strength and Muscle Performance among the Elderly: A Meta-Analysis by Huang YH, Chiu WC, […], Wang YH.

Link:
https://www.mdpi.com/2072-6643/12/12/3739/htm

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EPA and DHA are present in fish.
 

Objectives:
Does pistachio supplementation reduce obesity risk?

Study design:
This review article included 11 randomized controlled trials (RCTs) with 1,593 subjects.

The assigned pistachio intake was below 50 g/d in 3 studies.
Intervention times were shorter than 12 weeks in 4 studies.
There was no significant publication bias.

Results and conclusions:
The investigators found compared to the control diet group, the pistachio supplementation regimen significantly decreased BMI [-0.18 kg/m², 95% CI = -0.26 to -0.11 kg/m², p 0.001, I2 = 29.8%, p = 0.180].

The investigators found compared to the control diet group, the pistachio supplementation regimen did not significantly change waist circumference [net change = 0.76 cm, 95% CI = -0.11 to 1.63 cm, p = 0.087, I2 = 7.0%, p = 0.340].

The investigators found compared to the control diet group, the pistachio supplementation regimen had no effect on body weight [net change = 0.22 kg, 95% CI = -0.50 to 0.07 kg, p = 0.141, I2 = 0.0%, p = 0.962].

The investigators concluded compared to a controlled dietary intake, an adequate amount of pistachio supplementation lowers BMI without increasing body weight, which supports the view that pistachio consumption is beneficial for human health.

Original title:
The relationship between pistachio (Pistacia vera L) intake and adiposity: A systematic review and meta-analysis of randomized controlled trials by Xia K, Yang T, […], Chen XZ.

Link:
https://journals.lww.com/md-journal/Fulltext/2020/08210/The_relationship_between_pistachio__Pistacia_vera.7.aspx

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Objectives:
Does calcium combined with vitamin D supplementation reduce risk of osteoporosis in postmenopausal women?

Study design:
This review article included 10 RCTs.

Results and conclusions:
The investigators found calcium combined with vitamin D supplementation significantly increased total bone mineral density [SMD = 0.537, 95% CI = 0.227 to 0.847] in postmenopausal women.

The investigators found calcium combined with vitamin D supplementation significantly increased lumbar spine bone mineral density [SMD = 0.233, 95% CI = 0.073 to 0.392, p 0.001] in postmenopausal women.

The investigators found calcium combined with vitamin D supplementation significantly increased arms bone mineral density [SMD = 0.464, 95% CI = 0.186 to 0.741] in postmenopausal women.

The investigators found calcium combined with vitamin D supplementation significantly increased femoral neck bone mineral density [SMD = 0.187, 95% CI = 0.010 to 0.364] in postmenopausal women.

The investigators found calcium combined with vitamin D supplementation significantly reduced risk of hip fracture with 13.6% [RR = 0.864, 95% CI = 0.763 to 0.979] in postmenopausal women.

The investigators found in subgroup analysis that calcium combined with 400 IU/d (10 mcg/d) vitamin D supplementation significantly increased femoral neck bone mineral density [SMD = 0.335, 95% CI = 0.113 to 0.558] in postmenopausal women.

The investigators found in subgroup analysis that dairy products fortified with calcium and vitamin D significantly increased total bone mineral density [SMD = 0.784, 95% CI = 0.322 to 1.247] in postmenopausal women.

The investigators found in subgroup analysis that dairy products fortified with calcium and vitamin D significantly increased lumbar spine bone mineral density [SMD = 0.320, 95% CI = 0.146 to 0.494] in postmenopausal women.

The investigators concluded that dairy products fortified with calcium and vitamin D have a favourable effect on bone mineral density. Furthermore, calcium combined with vitamin D supplementation could prevent osteoporosis hip fracture in postmenopausal women.

Original title:
Effects of combined calcium and vitamin D supplementation on osteoporosis in postmenopausal women: a systematic review and meta-analysis of randomized controlled trials by Liu C, Kuang X […], Li D.

Link:
https://pubmed.ncbi.nlm.nih.gov/33237064/

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Objectives:
Epidemiological studies showing the correlation between folate (folic acid) and the breast cancer risk have revealed inconsistent results. Therefore, this review article (meta-analysis) has been conducted.

Do higher folate dietary intakes or plasma folate levels reduce risk of breast cancer?

Study design:
This review article included 39 studies on folate dietary intake (19 were prospective cohort studies, which included 37,917 cases (persons with breast cancer) and 20 were case-control studies, which included 13,074 cases and 17,497 controls (persons without breast cancer)) and 12 studies on plasma folate level (10 were case-control studies, consisting of 7,850 cases and 8,898 controls and 2 cohort studies, consisting of 815 incident cases).

Results and conclusions:
The investigators found when compared to the lowest folate dietary intake, the highest folate dietary intake significantly reduced risk of breast cancer with 15% [combined OR = 0.85, 95% CI = 0.79 to 0.92, I2 = 75.2%, p 0.001].
This reduced risk was not significant for cohort studies [OR = 0.97, 95% CI = 0.91 to 1.03, I2 = 53.3%, p = 0.316].

The investigators found for every 100-μg/day increase in folate dieatary intake, a significantly reduced risk of 2% for breast cancer [combined OR = 0.98, 95% CI = 0.97 to 0.99, I2 = 72.8%, p = 0.002].
This reduced risk was also significantly in cohort studies [summary OR = 0.99, 95% CI = 0.98 to 1.00]. 
Significant means that there is an association with a 95% confidence.

The investigators found stratification by menopausal status showed that a higher folate dietary intake significantly reduced risk of breast cancer in premenopausal women with 20% [OR = 0.80, 95% CI = 0.66 to 0.97, p = 0.022] but not in postmenopausal women [OR = 0.94, 95% CI = 0.83 to 1.06, p = 0.320].
Significant because OR of 1 was not found in the 95% CI of 0.66 to 0.97. OR of 1 means no risk.

The investigators found the highest versus lowest plasma folate levels had no correlation with the risk of breast cancer [combined OR = 0.98, 95% CI = 0.82 to 1.17, I2 = 63.0%, p = 0.822].

The investigators concluded there is a negative correlation between folate dieatary intake, at least 100-μg/day and the risk of breast cancer. However, plasma folate levels have no correlation with the risk of breast cancer. Therefore, whether folate dietary intake has practical clinical significance requires further study and the use of additional folate supplements should be carefully considered.

Original title:
Association of folate intake and plasma folate level with the risk of breast cancer: a dose-response meta-analysis of observational studies by Ren X, Xu P, [...], Dai Z.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7695428/

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The plasma folate level can be increased by taking folate-rich foods and/or folate supplements.

Objectives:
Does fish consumption reduce risk of coronary heart disease (CHD), stroke and all-cause mortality in patients with type 2 diabetes (T2D)?

Study design:
This review article included 9 prospective cohort studies with 57,394 diabetic patients.

Results and conclusions:
The investigators found for the highest compared with the lowest category of fish consumption, a significantly reduced risk of 14% [relative risk = 0.86, 95% CI = 0.76 to 0.96, I2 = 50%, n = 8] for all-cause mortality in patients with type 2 diabetes.

The investigators found for the highest compared with the lowest category of fish consumption, a significantly reduced risk of 39% [relative risk = 0.61, 95% CI = 0.29 to 0.93, I2 = 68%, n = 3] for coronary heart disease in patients with type 2 diabetes.

The investigators found there was a monotonic inverse association, with a nadir at fish consumption of approximately 2-3 servings/week, in both analyses.

The investigators concluded 2-3 servings/week of fish consumption reduce risk of all-cause mortality and coronary heart disease in patients with type 2 diabetes.

Original title:
Fish consumption and the risk of cardiovascular disease and mortality in patients with type 2 diabetes: a dose-response meta-analysis of prospective cohort studies by Jayedi A, Soltani S, […], Shab-Bidar S.

Link:
https://pubmed.ncbi.nlm.nih.gov/32410513/

Additional information of El Mondo:
Find more information/studies on fish consumption, cardiovascular disease and diabetes right here.
 

Objectives:
Africa still bears the largest burden of malaria as the majority of infections in the continent are caused by P. falciparum. Artemether-lumefantrine (AL, Coartem®) is the most widely used artemisinin-based combination therapy (ACT), for treating uncomplicated falciparum malaria globally. However, the development of resistance to antimalarial drugs is a major challenge for malaria control. Therefore, this review article has been conducted.

What is the efficacy of Artemether-lumefantrine ((AL, Coartem®) for the treatment of uncomplicated falciparum malaria in Africa?

Study design:
This review article included 39 articles that reported the treatment outcome of 8,320 patients.
The number of participants in each included study varied from 33 to 595.
Majority of the included articles 31 (79.5%) measured the efficacy of AL in terms of ACPR at day 28, while in the remaining studies at 7 (17.9%) and 1 (2.7%), the follow-up period was 42 and 63 days, respectively.
Most 31 (79.5%) of the studies included patients who were older than 6 months, while in the remaining studies at 7 (17.9%) included all age groups and 1 (2.6%) include only pregnant women.

Among the total 8,320 study subjects, males were dominant (>50%). At enrollment, the mean age, weight, body temperature and the hemoglobin level were ranged from 1.9 to 31.9 years, 8.7 to 40.3 kilograms, 38.1 to 39°C and 8.7 to 12.5 g/dL, respectively.

At enrollment, gametocytes were found in 2.1% to 13.9% of the study participants.
Similarly, the average parasite count (the geometric parasite density, GMPD) per patient was between 7,898 and 65,299 in a microliter of blood.
Parasite density (parasite/μL of whole blood) was estimated using the following formula; “number of parasites counted”/“WBC counted” multiplied with “total WBC count/μL”.

Results and conclusions:
The investigators found after 28 days of follow-up, the pooled PCR uncorrected and corrected APCR was at 87% [95% CI = 85 to 90%] and 97.0% [95% CI = 96 to 98%], respectively.

The investigators found, moreover, the proportion of early treatment failure (ETF) was almost 0%, while most of the included articles reported 8% late treatment failures.

The investigators found the reinfection and recrudescence rate was less than 10% and 2.6%, respectively, within 28 days.

The investigators found rapid fever and parasite clearance in which greater than 93% and 94% patients were parasite and fever free at day three following AL treatment.

The investigators concluded Coartem® remains effective and thus could continue to be the drug of choice for the treatment of uncomplicated falciparum malaria for all age groups in Africa. However, the risk of new emerging resistance for this combination warrants regular monitoring of its efficacy across the continent.

Original title:
Therapeutic Efficacy of Artemether-Lumefantrine (Coartem®) for the Treatment of Uncomplicated Falciparum Malaria in Africa: A Systematic Review by Derbie A, Mekonnen D, […], Abebe T.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7599419/

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

Objectives:
The association between vitamin C intake and breast cancer is unclear. Therefore, this review article (meta-analysis) has been conducted.

Does a higher vitamin C intake reduce risk of breast cancer incidence, mortality and recurrence?

Study design:
This review article included 24 cohort studies and 30 case-control studies.

Results and conclusions:
The investigators found pooled results suggested that the highest versus lowest vitamin C intake was significantly associated with a 14% lower risk of breast cancer incidence [relative risk = 0.86, 95% = 0.81 to 0.92, I2 = 78.7%, p 0.00].
Sensitivity analysis indicated that the overall results remained consistent even after excluding studies individually.

The investigators found the use of random-effects model indicated that a 100-mg/day increment in vitamin C intake had no significant effect on breast cancer risk.

The investigators found stratification by study design showed a 26% lower risk of breast cancer incidence for vitamin C intake in case-control studies [RR = 0.74, 95% CI = 0.65 to 0.84, p 0.001]. However, a non-significant inverse association was found in cohort studies [RR = 0.96, 95% CI = 0.89 to 1.04, p = 0.295].

The investigators found when the studies were stratified by the source of vitamin C, a 11% lower risk of breast cancer incidence with dietary intake [RR = 0.89, 95% CI = 0.82 to 0.96, p = 0.004] but not with supplements [RR = 1.02, 95% CI = 0.94 to 1.10, p = 0.678].

The investigators found that the highest versus lowest vitamin C intake was significantly associated with a 22% lower risk of breast cancer mortality [HR = 0.78, 95% CI = 0.69 to 0.88, I2 = 2.6%].

The investigators found that the highest versus lowest vitamin C intake was significantly associated with a 19% lower risk of breast cancer recurrence [HR = 0.81, 95% CI = 0.67 to 0.99, p = 0.043, I2 = 0.0%].

The investigators concluded that higher vitamin C dietary intake is significantly associated with a reduced risk of breast cancer incidence, mortality and recurrence.

Original title:
Association of vitamin C intake with breast cancer risk and mortality: a meta-analysis of observational studies by Zhang D, Xu P, [...], Dai Z.

Link:
https://www.aging-us.com/article/103769/text

Additional information of El Mondo:
Find more information/studies on significant/cohot studies, vitamin C consumption and cancer right here.
 

Objectives:
Dietary sodium intake has received considerable attention as a potential risk factor of cardiovascular disease. However, evidence on the dose-response association between dietary sodium intake and cardiovascular disease risk is unclear. Therefore, this review article has been conducted.

Is there a dose-response association between dietary sodium intake and cardiovascular disease (CVD) risk?

Study design:
This review article included 36 cohort studies with a total of 616,905 participants.
The duration of follow-up ranged from 2.7 years to 29 years.

For dietary sodium intake assessment, 18 of the studies were based on twenty-four urinary excretion, 7 used food frequency questionnaires, 8 used 24 h dietary recall, 2 used dietary records; 1 used a self-administered questionnaire and 1 used single spot urine sodium excretion.
The daily dietary sodium intake ranged from 1.0 to 7.5 g.

The mean score (± standard deviation) for the quality of the included studies was 8.0 ± 1.0 according to the Newcastle-Ottawa Scale.

Results and conclusions:
The investigators found compared with individuals with low sodium intake, individuals with high sodium intake had an 19%-higher adjusted risk of cardiovascular disease [rate ratio = 1.19, 95% CI = 1.08 to 1.30].

The investigators found in dose-response meta-analysis that the risk of cardiovascular disease significantly increased by 6% when 1 g dose of sodium was ingested [rate ratio = 1.06, 95% CI = 1.01 to 1.11].

The investigators concluded that high sodium intake is an important risk factor of cardiovascular disease (CVD) and in dose-response meta-analysis, every 1 g of dietary sodium intake increases the risk of cardiovascular disease by 6%.

Original title:
Dietary Sodium Intake and Risk of Cardiovascular Disease: A Systematic Review and Dose-Response Meta-Analysis by Wang YJ, Yeh TL, [...], Chien KL.

Link:
https://www.mdpi.com/2072-6643/12/10/2934/htm

Additional information of El Mondo:
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1 gram salt (sodium chloride) = 0.4 gram sodium.

Objectives:
Soy products contain several compounds with anti-inflammatory properties like genistein and daidzein which reported to act through different pathways. However, there are inconsistent results and lack of any comprehensive review regarding randomized controlled trials which assess the effect of soy products on inflammatory markers. Therefore, this review article has been conducted.

Does soy product supplementation reduce levels of inflammatory markers, like CRP, IL-6?

Study design:
This review article included 51 RCTs.

Results and conclusions:
The investigators found soy product supplementation significantly reduced CRP levels [MD = -0.27 mg/L, 95% CI = -0.51 to -0.02, p = 0.028] but it did not affect IL-6 [MD = 0.0 pg/mL, 95% CI = -0.06 to 0.06, p = 0.970] and TNF-α [MD = -0.04 pg/mL, 95% CI = -0.11 to 0.03, p = 0.252].

The investigators found subgroup analysis showed that soy supplementation had a significant impact on decreasing IL-6 and TNF-α levels when studies had a long-term intervention (≥12 weeks) and used low dose isoflavone (100 mg/day).

The investigators concluded there is a significant reduction in CRP levels after soy product supplementation.

Original title:
The effects of soy supplementation on inflammatory biomarkers: A systematic review and meta-analysis of randomized controlled trials by Asbaghi O, Yaghubi E, […], Ghaedi E.

Link:
https://pubmed.ncbi.nlm.nih.gov/32979840/

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

Objectives:
There is some inconclusive evidence for the role of fish consumption in susceptibility to multiple sclerosis (MS). Therefore, this review article has been conducted.

Does fish consumption reduce multiple sclerosis (MS)?

Study design:
This review article included 6 observational studies.

Results and conclusions:
The investigators found that the consumption of fish (at least 0.5 servings of fish per week) significantly decreased the risk of multiple sclerosis with 23% [OR = 0.77, 95% CI = 0.64 to 0.92, p-value = 0.004, I2 = 54.7%] compared with controls.

The investigators concluded that dietary intake of at least 0.5 servings of fish per week during adolescence and after reduce the risk of multiple sclerosis; however, further studies are required to prove this preventive effect.

Original title:
Dietary fish intake and the risk of multiple sclerosis: a systematic review and meta-analysis of observational studies by Rezaeizadeh H, Mohammadpour Z, […], Homayon IA.

Link:
https://pubmed.ncbi.nlm.nih.gov/32787642/

Additional information of El Mondo:
Find here more information/studies about fish consumption.

Objectives:
A lower conversion vaccination rate and a more rapid decline in antibody titers over time in dialysis patients raise concerns about the effectiveness of pneumococcal vaccination (PV) in this population, which has not been systematically reviewed. Therefore, this review article has been conducted.

Does pneumococcal vaccine alone or in combination with influenza vaccine reduce all-cause mortality risk in dialysis patients?

Study design:
This review article included 5 cohort studies and 1 quasi-randomized controlled trial enrolling 394,299 dialysis patients.

Results and conclusions:
The investigators found compared with unvaccinated individuals, those receiving pneumococcal vaccination had a 27%-lower risk of all-cause mortality [adjusted relative risk = 0.73, 95% CI = 0.67 to 0.79, I2 = 31.1%, grade low certainty] and a 20%-lower risk of cardiovascular events [adjusted relative risk = 0.80, 95% CI = 0.69 to 0.93, I2 = 47.2%, grade low certainty] without serious adverse effect reported.

The investigators found compared with no vaccination, lower all-cause mortality was observed in those receiving pneumococcal vaccination combined with influenza vaccination [adjusted relative risk = 0.71, 95% CI = 0.67 to 0.75, I2 = 63.3%], pneumococcal vaccination alone [adjusted relative risk = 0.86, 95% CI = 0.78 to 0.94, I2 = 0%] and influenza vaccination alone [adjusted relative risk = 0.76, 95% CI = 0.73 to 0.79, I2 = 0%].

The investigators found there were no difference between pneumococcal vaccinated patients vs non-vaccinated patients with respect to pneumonia.

The investigators found immune response to pneumococcal conjugate vaccine-13 was weaker in polysaccharide pneumococcal vaccine-23-pre-vaccinated compared with vaccine-naive patients.

The investigators concluded the use of pneumococcal vaccine especially combined with influenza vaccination is associated with lower risks of all-cause mortality in dialysis patients but may be affected by residual confounding/healthy vaccinee bias.

Original title:
Effectiveness and safety of pneumococcal vaccines used alone or combined with influenza vaccination in dialysis patients: A systematic review and meta-analysis by Mo Y, Zeng J, […], Su G.

Link:
https://www.sciencedirect.com/science/article/pii/S0264410X20312627?via%3Dihub

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

Objectives:
Heated debates have been on-going about tea consumption and the incidence of cancer, especially in head and neck cancer types. Therefore, this review article (meta-analysis) has been conducted.

Does habitual tea consumption reduce risk of nasopharyngeal cancer?

Study design:
This review article included 6 articles.

Results and conclusions:
The investigators found that habitual tea consumption significantly reduced risk of nasopharyngeal cancer with 13.5% [OR = 0.865, 95% CI = 0.806 to 0.929].

The investigators concluded that habitual tea consumption is associated with prevention of nasopharyngeal cancer development. Additional studies are needed to further understand the molecular role of bioactive compound and potential health benefit of tea consumption in nasopharyngeal cancer prevention.

Original title:
The Association between Tea Consumption and Nasopharyngeal Cancer: A Systematic Review and Meta-Analysis by Okekpa SI, Basria R, […], Musa MY.

Link:
https://pubmed.ncbi.nlm.nih.gov/32856842/

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

Objectives:
Probiotics are being used increasingly in pregnant women, whereas the efficiency on pregnancy outcomes is yet lacking. Therefore, this review article has been conducted.

Have probiotic supplements during pregnancy positive effects on pregnancy outcomes, such as eczema, gestational age?

Study design:
This review article included 18 RCTs with a total of 4,356 pregnant women.

Results and conclusions:
The investigators found probiotic supplementation during pregnancy significantly decreased risk of atopic eczema with 32% [RR = 0.68, 95% CI = 0.58 to 0.81, p 0.001, without significant heterogeneity].

The investigators found probiotic supplementation during pregnancy significantly decreased risk of eczema with 21% [RR = 0.79, 95% CI = 0.68 to 0.91, p = 0.002, without significant heterogeneity].

The investigators found probiotic supplementation during pregnancy was associated with a prolonged gestational age [WMD = 0.09, 95 % CI = 0.04 to 0.15, p = 0.001 with insignificant heterogeneity].
However, probiotic supplementation during pregnancy had no significant effect on birth weight [p = 0.851].

The investigators found probiotic supplementation during pregnancy significantly decreased risk of death with 66% [RR = 0.34, 95% CI = 0.13 to 0.91, p = 0.031, without evidence of heterogeneity].

The investigators found probiotic supplementation during pregnancy significantly decreased risk of necrotising enterocolitis (NEC) with 62% [RR = 0.38, 95% CI = 0.18 to 0.11, p = 0.012, without evidence of heterogeneity].

The investigators concluded probiotic supplementation in pregnant women is beneficial for atopic eczema, eczema, gestational age, death and necrotising enterocolitis.

Original title:
Effect of probiotic supplementation in pregnant women: a meta-analysis of randomised controlled trials by Kuang L and Jiang Y.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31856928

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Necrotizing enterocolitis (NEC) is a devastating disease that affects mostly the intestine of premature infants. The wall of the intestine is invaded by bacteria, which cause local infection and inflammation that can ultimately destroy the wall of the bowel (intestine). Such bowel wall destruction can lead to perforation of the intestine and spillage of stool into the infant’s abdomen, which can result in an overwhelming infection and death.
 

Objectives:
Malnutrition on the background of HIV (Human Immunodeficiency Virus) infection is a complex medical condition that carries significant morbidity and mortality for affected children, with greater mortality from SAM (Severe Acute Malnutrition) among HIV-positive children than their HIV-negative peers. HIV-induced immune impairment heightened risk of opportunistic infection and can worsen nutritional status of children. HIV infection often leads to nutritional deficiencies through decreased food intake, mal-absorption and increased utilization and excretion of nutrients, which in turn can hasten death. Therefore, this review article has been conducted.

What is the magnitude of underweight, wasting and stunting among HIV positive children in East Africa?

Study design:
This review article included 14 cross-sectional studies and 8 cohort studies with 22,074 patients. The total number of participants in the included studies ranged from 96 to 5,951.

There was no publication bias.

Results and conclusions:
The investigators found pooled prevalence of underweight, wasting and stunting among HIV positive children in East Africa was 41.63% [95% CI = 35.69 to 47.57, I2 = 98.7%, p 0.001], 24.65% [95%CI = 18.34 to 30.95, I2 = 99.2%, p 0.001] and 49.68% [95% CI = 42.59 to 56.77, I2 = 99.0%, p 0.001], respectively.

The investigators found the prevalence of underweight among HIV positive children was 49.67% in Ethiopia followed by 42.00 in Rwanda. It was high among cohort studies [44.87%].

The investigators found based on the year of publication, the prevalence of underweight among HIV positive children was 40.88% from studies conducted from January 2008-December 2014, while it was 43.68% from studies conducted from 2015-2019.

The investigators found prevalence of wasting among HIV positive children was 29.7% in Tanzania followed by 24.94% in Ethiopia.

The investigators found, based on the study design, the prevalence of wasting among HIV positive children was high in cohort studies [31.15%].
The prevalence of stunting among HIV positive children was 51.63% in Ethiopia, followed by 48.21% in Uganda.

The investigators concluded there is a high prevalence of undernutrition among HIV positive children in East Africa. Despite the country level variations of child undernutrition in East Africa, still it is high in all aspects compared to the studies from other parts of Africa. It is recommended that further systematic review and meta-analysis need to be conducted on magnitude of malnutrition among HIV positive children in Sub-Saharan Africa as a whole.

Original title:
Magnitude of underweight, wasting and stunting among HIV positive children in East Africa: A systematic review and meta-analysis by Abate BB, Aragie TG and Tesfaw G.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7498078/

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