Nutritional advice

Objectives:
A low insulin-like growth factor 1 (IGF-1) level is known to be associated with many disorders. Several studies have shown that soy consumption may influence IGF-1, but the findings remain inconclusive. Therefore, this review article (meta-analysis) has been conducted.

Does soy consumption increase insulin-like growth factor 1 (IGF-1) level?

Study design:
This review article included 8 clinical trials.

Results and conclusions:
The investigators found, overall, a significant increment in plasma IGF-1 was observed following soy intervention [WMD = 13.5 ng/mL, 95% CI = 5.2 to 21.8, I2 = 97%].

The investigators found, subgroup analyses demonstrated a significantly greater increase in IGF-1, when soy was administered at a dosage of ≤40 g/day [WMD = 11.7 ng/mL, 95% CI = 10.9 to 12.6, I2 = 98%] and when the intervention duration was 12 weeks [WMD = 26.6 ng/mL, 95% CI = 9.1 to 44.1, I2 = 0.0%].

The investigators found, in addition, soy intervention resulted in a greater increase in IGF-1 among non-healthy subjects [WMD = 36 ng/mL, 95% CI = 32.7 to 39.4, I2 = 84%] than healthy subjects [WMD = 9.8 ng/mL, 95% CI = 8.9 to 10.7, I2 = 90%].

The investigators concluded ≤40 grams of soy consumption per day during 12 weeks increase the IGF-1 level.

Original title:
The Effect of Soy Intervention on Insulin-Like Growth Factor 1 Levels: A Meta-Analysis of Clinical Trials by Jiawei Zeng J, Feng Y, […], Chen X.

Link:
https://pubmed.ncbi.nlm.nih.gov/32072706/

Additional information of El Mondo:
Find more information/studies on subgroup analysis/significant and soja consumption right here.

Objectives:
Is intralesional injection of mumps-measles-rubella (MMR) vaccine associated with a higher complete response in cutaneous warts?

Study design:
This review article included 5 RCTs with a total of 425 subjects.

Funnel plot analysis for complete response was asymmetrical, indicating the risk of publication bias.
There were statistically significant small-study effects for intralesional MMR on complete response upon analysis using Harbord's test (p = 0.047).
Grading of Recommendations Assessment, Development and Evaluation (GRADE) assessment showed that intralesional MMR injection has high level of certainty (quality of evidence) for complete response in warts with an absolute increase of 505 per 1000.

Results and conclusions:
The investigators found intralesional injection of mumps-measles-rubella (MMR) vaccine was associated with an increased complete response [OR = 9.43, 95% CI = 5.78 to 15.37, p 0.001, I2 = 5%, p = 0.38].

The investigators found subgroup analysis on patients receiving injection of mumps-measles-rubella (MMR) vaccine for every 2 weeks for a maximum of five injections revealed an OR of 11.70 [95% CI = 6.40, 21.38, p 0.001, I2 = 20%, p = 0.29].

The investigators found patients receiving intralesional mumps-measles-rubella (MMR) vaccine were associated with a lower partial response [OR = 0.54, 95% CI = 0.33 to 0.88, p = 0.01, I2 = 0%, p = 0.66].

The investigators found intralesional mumps-measles-rubella (MMR) vaccine was associated with a reduced no-response [OR = 0.16, 95% CI = 0.06 to 0.43, p 0.001, I2 = 69%, p = 0.01].

The investigators concluded intralesional MMR injection is associated with a higher complete response and lower no-response with a high level of certainty.

Original title:
Intralesional Measles-Mumps-Rubella Is Associated With a Higher Complete Response in Cutaneous Warts: A Systematic Review and Meta-Analysis of Randomized Controlled Trial Including GRADE Qualification by Vania R, Raymond Pranata R and Tan ST.

Link:
https://pubmed.ncbi.nlm.nih.gov/31985307/

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Find more information/studies food fortification right here.

Objectives:
An increased risk of gastric cancer for pickled vegetable and salted fish intake has been suggested, yet the lack of a dose-response association warrants a quantitative analysis. Therefore, this review article (meta-analysis) has been conducted.

Do pickled vegetable and salted fish intakes increase risk of gastric cancer?

Study design:
This review article included 21 cohort studies with a total of 195,624 participants for the analysis of pickled vegetable intake and 16 cohort studies with a total of

196,384 participants for the analysis of salted fish intake.

Results and conclusions:
The investigators found in a dose-response meta-analysis of 6 studies, a significantly increased risk of 15% [combined RR = 1.15, 95% CI = 1.07 to 1.23, p for heterogeneity = 0.14] for gastric cancer incidence for a 40 g/day increment in pickled vegetable intake.

The investigators found in the categorical meta-analysis of 6 studies, a marginally significant increase in the risk of gastric cancer incidence, comparing the highest to the lowest intake of salted fish [RR = 1.17, 95% CI = 0.99 to 1.38, p for heterogeneity = 0.26].

The investigators concluded intake of 40 g/day of pickled vegetable increases risk of gastric cancer incidence.

Original title:
Pickled Vegetable and Salted Fish Intake and the Risk of Gastric Cancer: Two Prospective Cohort Studies and a Meta-Analysis by Yoo JY, Cho HJ, […], Park SK.

Link:
https://www.mdpi.com/2072-6694/12/4/996/htm

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Find more information/studies on vegetables and cancer right here

Objectives:
Is there a causal relationship between tomato consumption and lowering effects on cholesterol, triglycerides or fasting blood sugar levels?
 
Study design:
This review article included 6 RCTs.

Results and conclusions:
The investigators found tomato consumption significantly reduced total plasma cholesterol levels [WMD = -4.39 mg/dL, 95% CI = -7.09 to -1.68, I2 = 48%, p = 0.05].

The investigators found tomato consumption significantly reduced plasma triglyceride (TG) levels [WMD = -3.94 mg/dL, 95% CI = -7.67 to -0.21, I2 = 90%, p = 0.001].
A higher reduction effect was found on younger participants.

The investigators found tomato consumption significantly reduced plasma LDL cholesterol (bad cholesterol) levels [WMD = -2.09 mg/dL, 95% CI = -3.73 to -0.81, I2 = 78%, p = 0.001].
A higher reduction effect was found on younger participants.

The investigators found tomato consumption significantly increased plasma HDL cholesterol (good cholesterol) levels [WMD = 2.25 mg/dL, 95% CI = 0.41 to 4.10, I2 = 97%, p = 0.001].

The investigators found tomato consumption had no significant effect on plasma fasting blood sugar levels [WMD = 0.59 mg/dL, 95% CI = -0.28 to 1.46, I2 = 95%, p = 0.001].

The investigators concluded that tomato consumption increases plasma HDL cholesterol (good cholesterol) levels and decreases plasma total cholesterol, LDL cholesterol (bad cholesterol) and triglyceride levels.

Original title:
Effect of Tomato Consumption on Fasting Blood Glucose and Lipid Profiles: A Systematic Review and Meta-Analysis of Randomized Controlled Trials by Li H, Chen, A, [...],Yin X.

Link:
https://pubmed.ncbi.nlm.nih.gov/32243013/

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Find more information/studies on tomato consumption and lowering of cholesterol levels right here.

Patients with heart disease often have high LDL cholesterol, low HDL cholesterol and high triglycerides levels.

Objectives:
Undernutrition is associated with an elevated risk of mortality among children in low- and middle-income countries. Small-quantity lipid-based nutrient supplements (LNS) have been evaluated as a method to prevent undernutrition and improve infant development, but the effects on mortality are unknown. Therefore, this review article has been conducted.

Do lipid-based nutrient supplements reduce risk of undernutrition among children 6-24 months old?

Study design:
This review article included 18 RCTs conducted in 11 countries that enrolled 41,280 children and reported 586 deaths.

Results and conclusions:
The investigators found in 13 RCTs that lipid-based nutrient supplements significantly reduced risk of all-cause mortality with 27% [RR = 0.73, 95% CI = 0.59 to 0.89, I2 = 23.2%] among children 6-24 months old.
Estimates were similar when trials with maternal lipid-based nutrient supplements intervention arms were added or when alternative formulations of lipid-based nutrient supplements were excluded.

The investigators found the results appeared stronger in trials in which lipid-based nutrient supplements were compared with passive control arms.

The investigators found excluding these contrasts and only comparing multicomponent arms with lipid-based nutrient supplements groups and comparison groups that contained all the same components without lipid-based nutrient supplements attenuated the effect estimate [RR = 0.82, 95% CI = 0.61 to 1.10].

The investigators concluded lipid-based nutrient supplements provided for the prevention of undernutrition may reduce risk of all-cause mortality among children 6-24 months old, but more trials with appropriate comparison groups allowing isolation of the effect of lipid-based nutrient supplements alone are needed.
 
Original title:
Lipid-based Nutrient Supplements and All-Cause Mortality in Children 6-24 Months of Age: A Meta-Analysis of Randomized Controlled Trials by Stewart CP, Wessells KR, […], Dewey KG.

Link:
https://academic.oup.com/ajcn/article/111/1/207/5613093

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

Objectives:
Do dietary calcium intakes or calcium supplements increase risk of cardiovascular disease?
 
Study design:
This review article included 26 prospective cohort studies and 16 RCTs.

Results and conclusions:
The investigators found in cohort studies that dietary calcium intakes ranging from 200 to 1500 mg/d did not affect the risk of cardiovascular disease [relative risk = 0.96, 95% CI = 0.87 to 1.05].

The investigators found in cohort studies that dietary calcium intakes ranging from 200 to 1500 mg/d did not affect the risk of coronary heart disease [relative risk = 0.98, 95% CI = 0.88 to 1.08].

The investigators found in cohort studies that dietary calcium intakes ranging from 200 to 1500 mg/d did not affect the risk of stroke [relative risk = 0.94, 95% CI = 0.85 to 1.04].

The investigators found in RCTs that calcium supplements significantly increased risk of coronary heart disease with 20% [relative risk = 1.20, 95% CI = 1.08 to 1.33, I2 = 0.0%].

The investigators found in RCTs that calcium supplements significantly increased risk of myocardial infarction with 21% [relative risk = 1.21, 95% CI = 1.08 to 1.35, I2 = 0.0%].

The investigators concluded that 200-1500 mg/d calcium intake from dietary sources do not increase the risk of cardiovascular disease, including coronary heart disease and stroke, while calcium supplements increase coronary heart disease risk, especially myocardial infarction.

Original title:
The Evidence and Controversy Between Dietary Calcium Intake and Calcium Supplementation and the Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis of Cohort Studies and Randomized Controlled Trials by Yang C, Shi X, […], Sun G.

Link:
https://pubmed.ncbi.nlm.nih.gov/31625814/

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

Objectives:
Does rotavirus vaccination reduce risk of rotavirus associated diarrhea in sub-Saharan Africa?

Study design:
This review article included 17 studies with a total of 176,698 participants and all were children less than 5 years of age.

There was no evidence of publication bias.

Results and conclusions:
The investigators found the pooled proportion for pre-vaccination period was 42% [95% CI = 38% to 46%, I2 = 99.00%] and reduced to 21% [95% CI = 17% to 25%, I2 = 99.05%] during post-vaccination period.

The investigators found rotavirus diarrhea significantly reduced in children 12 months as compared to children 12-24 months old.

The investigators found seasonal peaks of rotavirus diarrhea were between June-September.

The investigators concluded the proportions of rotavirus-positive cases reduce from 42% during the pre-vaccination period to 21% post-vaccination period. Thus, there is evidence that the introduction of the rotavirus vaccine in sub-Saharan Africa, has significantly reduced the burden of rotavirus associated diarrhea by half. Therefore, there is a need to encourage the remaining countries to introduce the vaccine to their routine national immunization programs.

Original title:
Evidence of rotavirus vaccine impact in sub-Saharan Africa: Systematic review and meta-analysis by Godfrey O, Zhang W, […], Li D.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7185587/

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

Objectives:
Epidemiologic studies focusing on the association between 1-carbon metabolism-related vitamins (ie, folate, vitamin B6, vitamin B2, vitamin B12) and breast cancer risk have reported inconsistent findings. Therefore, this review article (meta-analysis) has been conducted.

Does higher dietary intake of folate (folic acid), vitamin B2, B6 or B12 reduce breast cancer risk?

Study design:
This review article included 27 studies (case-control and cohort studies) with a total of 49,707 cases (persons with breast cancer) among 1,274,060 individuals.

Results and conclusions:
The investigators found for the highest folate dietary intake compared with the lowest, a significantly reduced risk of 7% [pooled relative risk = 0.93, 95% CI = 0.88 to 0.99, p = 0.018] for breast cancer.

The investigators found for the highest vitamin B6 dietary intake compared with the lowest, a significantly reduced risk of 6% [pooled relative risk = 0.94, 95% CI = 0.89 to 1.00, p = 0.037] for breast cancer.

The investigators found for the highest vitamin B2 dietary intake compared with the lowest, a significantly reduced risk of 10% [pooled relative risk = 0.90, 95% CI = 0.82 to 0.99, p = 0.026] for breast cancer.

The investigators found no significant association between vitamin B12 and breast cancer risk [RR = 0.99, 95% CI = 0.94 to 1.04, p = 0.604].

The investigators found folate and vitamin B6 dietary intake significantly decreased the risk of estrogen receptor-negative (ER-)/progesterone receptor-negative (PR-) breast cancer but not ER+/PR+ breast cancer.

The investigators found an increment of 100 μg/d folate dietary intake corresponded to a 7% [RR = 0.93, 95% CI = 0.89 to 0.98, p = 9.007] deceased risk of ER-/PR- breast cancer.

The investigators concluded both higher folate, vitamin B2 and B6 dietary intake decreases risk of breast cancer, especially ER-/PR- breast cancer.

Original title:
Association Between One-carbon Metabolism-related Vitamins and Risk of Breast Cancer: A Systematic Review and Meta-analysis of Prospective Studies by Zeng J, Gu Y, […], Chang H.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32241696

Additional information of El Mondo:
Find more information/studies on folate, vitamin B2 and B6 intake and breast cancer right here.

If breast cancer cells have estrogen receptors, the cancer is called ER-positive breast cancer. If breast cancer cells have progesterone receptors, the cancer is called PR-positive breast cancer. If the cells do not have either of these 2 receptors, the cancer is called ER/PR-negative.

Objectives:
Older people (≥60 years old) are particularly vulnerable to influenza virus infection and vaccine is effective in reducing the disease burden in this population. However, it remains obscure whether their antibody response is lower than those of younger adults (18-60 years old). Therefore, this review article has been conducted.

Have older people (≥60 years old) a lower antibody response to influenza virus infection than younger adults (18-60 years old)?

Study design:
This review article included 6 RCTs with a  total of 7,976 participants.

Results and conclusions:
The investigators found for the seroprotection rate (SPR) the pooled risk ratio (RR) was 0.92 [95% CI = 0.90 to 0.94, I2 = 66%, p 0.0001] for A/H1N1 and 0.94 (95% CI = 0.90 to 0.98, I2 = 91%, P = .002) for B/Victoria and the antibody responses of A/H3N2 and B/Yamagata were similar in the two age groups.

The investigators found for the seroconversion rate (SCR), the pooled RR was 0.85 [95% CI = 0.76 to 0.94, I2 = 93%, p = 0.003], 0.77 [95% CI = 0.66 to 0.91, I2 = 94%, p = 0.002] and 0.83 (95% CI: 0.71-0.96, I2 = 94%, p = 0.02] for A/H1N1, B/Victoria and B/Yamagata, respectively and the antibody responses of A/H3N2 were similar in the two groups.

The investigators found some variations in the antibody responses across virus types and subtypes after influenza vaccination.

The investigators concluded the seroprotection rate (SPR) and the seroconversion rate (SCR) of older adults (≥60 years old) are lower than those in younger adults (18-60 years old) for A/H1N1 and B/Victoria, while the two age groups have similar antibody responses for A/H3N2. But, the antibody responses to vaccines are not associated with real-world vaccine effectiveness (VE), indicating that antibody response might not fully reflect the vaccine effectiveness of A/H3N2.

Original title:
Immunogenicity of influenza vaccine in elderly people: a systematic review and meta-analysis of randomized controlled trials, and its association with real-world effectiveness by Meng Z, Zhang J, [...], Yang X.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32347787

Additional information of El Mondo:
Find more information/studies on vaccination ight here.

Objectives:
Multiple sclerosis (MS) is a demyelinating and disabling inflammatory disease of the central nervous system. Multiple sclerosis is triggered by complex environmental factors which mostly affect genetically the susceptible young people. Emerging data has suggested that changes of homocysteine (Hcy), vitamin B12 and folate serum levels may be associated with multiple sclerosis. However, previous findings are not always consistent. Therefore, this review aricle has been conducted.

Does a low serum homocysteine, vitamin B12 or folate level increase risk of multiple sclerosis?

Study design:
This review article included 21 original studies with 1,738 multiple sclerosis patients and 1,424 controls (patients without multiple sclerosis). There were 17 studies for measuring homocysteine, 16 studies for measuring vitamin B12 and 13 studies for measuring folate in patients with multiple sclerosis, respectively.

Results and conclusions:
The investigators found patients with multiple sclerosis (MS) had higher serum levels of homocysteine [SMD = 0.64, 95% CI = 0.33 to 0.95, p 0.0001] compared with control groups.

The investigators found no significant differences of SMD for vitamin B12 [SMD = -0.08, 95% CI = -0.35 to 0.20, p = 0.58] or folate [SMD = 0.07, 95% CI = -0.14 to 0.28, p = 0.52] between MS and controls.

The investigators found subgroup analysis demonstrated that there was statistically significant difference for homocysteine between relapsing-remitting MS (RRMS) patients and controls with a SMD of 0.67 [95% CI = 0.21 to 1.13, p = 0.004].

However, no significant difference of homocysteine serum levels between secondary progressive MS patients or primary progressive MS patients and controls.

The investigators found no significant difference of homocysteine levels in females [SMD = 0.22, 95% CI = -0.16 to 0.60, p = 0.25] or males [SMD = 0.56, 95% CI = -0.13 to 1.26, p = 0.11] between MS patients and controls.

The investigators concluded higher serum levels of homocysteine increase risk of multiple sclerosis (MS), especially for relapsing-remitting MS (RRMS) patients. Functional studies are required to assess the effects of homocysteine on patients with MS at the molecular level.

Original title:
Serum levels of Homocysteine, Vitamin B12 and Folate in Patients with Multiple Sclerosis: an Updated Meta-Analysis by Li X, Yuan J, [...], Hu W.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7085269/

Additional information of El Mondo:
Find here more information/studies about lowering serum levels of homocysteine.

Objectives:
Is there a causal relationship between daily egg consumption and positive effects on blood pressure?
 
Study design:
This review article included 15 RCTs with a total of 748 participants and mean age range from 23.3 to 67.1 years old.

All included studies used whole egg as an intervention which varied from one egg/day to three eggs/day and duration of supplementation ranged from 3 to 12 weeks.

No evidence of publication bias was seen in the meta-analyse (review article) of systolic blood pressure [Begg’s p = 0.235, Eggers’s p = 0.433] and diastolic blood pressure [Begg’s p = 0.254, Eggers’s p = 0.267].

No heterogeneity was found among included studies.

Results and conclusions:
The investigators found, overall, egg consumption had no significant effect on systolic blood pressure [WMD = 0.046 mmHg, 95% CI = - 0.792 to 0.884, p = 0.914, I2 = 0.0%, p = 0.453] and diastolic blood pressure [WMD = -0.603 mmHg, 95% CI = -1.521 to 0.315, p = 0.198, I2 = 38.1%, p = 0.067].
Subgroup analyses had no effect on pooled results.
Sensitivity analysis indicated that excluding each trial did not significantly change the overall observed effects of egg consumption.

The investigators found nonlinear dose-response meta-analysis did not reveal a significant effect of egg consumption [p-nonlinearity = 0.76] and study duration on diastolic blood pressure [p-nonlinearity = 0.63].

The investigators found subgroup analyses based on study design, sex, population health status, obesity and hypertension status, diet adherence, study duration and amount of egg consumption did not affect the overall effects of egg consumption on systolic blood pressure and diastolic blood pressure values.

The investigators concluded that 1-3 eggs/day during 3 to 12 weeks have no effect on blood pressure. However, high-quality RCTs with longer durations are needed to further confirm the effects of egg consumption on blood pressure.

Original title:
Effect of Egg Consumption on Blood Pressure: a Systematic Review and Meta-analysis of Randomized Clinical Trials by Kolahdouz-Mohammadi R, Malekahmadi M, […], Soltani S.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7189334/

Additional information of El Mondo:
Find more information/studies on causal relationship/significantly, egg consumption and lowering of blood pressure right here.

Objectives:
Physical exercise may offer multiple benefits to patients with chronic kidney disease (CKD). However, it was not traditionally recommended because of the possibility of impairing renal function and increasing proteinuria. Therefore, this review aricle has been conducted.

Does low-intensity physical exercise offer benefits to patients with chronic kidney disease?

Study design:
This review article included 21 RCTs with a intervention of at least 12 weeks and 927 patients.

The frequency of low-intensity physical exercise in 14 studies was 3 times per week during 30 minutes.

Results and conclusions:
The investigators found no differences in glomerular filtration rate or proteinuria between the intervention group (group with low-intensity physical exercise) and the control group (group without low-intensity physical exercise) [SMD = -0.3, p = 0.81 and SMD = 26.6, p = 0.82].

The investigators found positive effects on peak oxygen consumption [SMD = 2.5, p 0.001], functional capacity [SMD = 56.6, p 0.001], upper limb strength [SMD = 6.8, p 0.001] and haemoglobin [SMD = 0.3, p = 0.003] for the intervention group.

The investigators found an improvement on the quality of life, using the KDQOL-36 survey [SMD = 3.56, p = 0.02] and the SF-36 survey [SMD = 6.66, p = 0.02] for the intervention group.

The investigators concluded low-intensity physical exercise routinely has no negative impact on renal function. On the contrary, it improves aerobic and functional capacity, impacting positively on the quality of life.

Original title:
Impact of physical exercise in patients with chronic kidney disease: Sistematic review and meta-analysis by Villanego F, Naranjo J, […], Mazuecos A.

Link:
https://reader.elsevier.com/reader/sd/pii/S0211699520300266?token=62CEB2BCF50CE23B396565B5DC989F795AEEB75C666C74AA410FD2172DB39F90DBBB5D72BF3B4347C0C8AD2FEF8B0110

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

Low-intensity physical exercises are a casual walk, a stretch session, a beginners' yoga class or tai chi.

Objectives:
Has probiotic supplementation positive effects on the outcomes of preterm infants in India?

Study design:
This review article included 9 RCTs (n = 1,514).

Results and conclusions:
The investigators found in 9 RCTs that probiotics supplementation significantly reduced risk of necrotizing enterocolitis (NEC) ≥ Stage II with 64% [risk ratio = 0.36, 95% CI = 0.20 to 0.66, p = 0.0009].  

The investigators found in 7 RCTs that probiotics supplementation significantly reduced risk of late onset sepsis with 44% [risk ratio = 0.56, 95% CI = 0.45 to 0.71, p  0.00001].

The investigators found in 8 RCTs that probiotics supplementation significantly reduced risk of mortality with 38% [risk ratio = 0.62, 95% CI = 0.41 to 0.95, p = 0.03].

The investigators found that probiotics supplementation significantly reduced the time to full feeds [mean difference = -4.09 d, 95% CI = -4.52 to -3.65, p  0.00001, 5 RCTs] and duration of hospital stay [MD = -2.00 d, 95% CI = -2.46 to -1.53, p  0.00001, 6 RCTs].  

The investigators concluded probiotic supplementation has positive effects on the outcomes of preterm infants in India.

Original title:
Probiotics for Preterm Infants in India - Systematic Review and Meta-Analysis of Randomized Controlled Trials by Balasubramanian H, Ananthan A, […], Patole S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32185693

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Find more information/studies on probiotic, pregnancy and food fortification right here.

Objectives:
Does high magnesium dietary intake reduce risk of type 2 diabetes and stroke?

Study design:
This review article included 53 prospective cohort studies with a total of 1,912,634 participants and 76,678 cases (persons with type 2 diabetes or stroke).

Participants were predominately middle aged at baseline (at the beginning of the studies), with a mean magnesium intake of 370 mg/day for the highest category and 232 mg/day for the lowest category.

The mean duration of all eligible studies was 10.7 years.

Results and conclusions:
The investigators found, when comparing the highest category of magnesium dietary intake (370 mg/day) to the lowest (232 mg/day), a significantly reduced risk of 22% [RR = 0.78, 95% CI = 0.75 to 0.81, p 0.001, I2 = 35.6%, p = 0.021] for type 2 diabetes.

The investigators found, when comparing the highest category of magnesium dietary intake (370 mg/day) to the lowest (232 mg/day), a significantly reduced risk of 11% [RR = 0.89, 95% CI = 0.83 to 0.94, p 0.001, I2 = 0%, p = 0.529] for total stroke.

The investigators found, when comparing the highest category of magnesium dietary intake (370 mg/day) to the lowest (232 mg/day), a significantly reduced risk of 12% [RR = 0.88, 95% CI = 0.81 to 0.95, p = 0.001, I2 = 16.9%, p = 0.265] for ischaemic stroke.

The investigators found in studies adjusted for cereal fiber dietary intake, a significantly reduced risk of 21% [RR = 0.79, 95% CI = 0.73 to 0.85, p 0.001] for type 2 diabetes.

The investigators found in studies adjusted for calcium dietary intake, a significantly reduced risk of 11% [RR = 0.89, 95% CI = 0.80 to 0.99, p = 0.040] for total stroke.

The investigators found in stratified analyses by characteristics of the population and study design, a significantly reduced risk of 9% [RR = 0.91, 95% CI = 0.83 to 0.99] for total stroke among female.

The investigators found in stratified analyses by characteristics of the population and study design, a significantly reduced risk of 11% [RR = 0.89, 95% CI = 0.79 to 1.00] for ischaemic stroke among female.

The investigators found in stratified analyses by characteristics of the population and study design, a significantly reduced risk of 11% [RR = 0.89, 95% CI = 0.82 to 0.96] for total stroke among individuals with BMI ≥25 kg/m².

The investigators found in stratified analyses by characteristics of the population and study design, a significantly reduced risk of 12% [RR = 0.88, 95% CI = 0.81 to 0.96] for ischaemic stroke among individuals with BMI ≥25 kg/m².

The investigators found in stratified analyses by characteristics of the population and study design, a significantly reduced risk of 11% [RR = 0.89, 95% CI = 0.83 to 0.95] for total stroke among studies wtith ≥12-year follow-up.

The investigators found in stratified analyses by characteristics of the population and study design, a significantly reduced risk of 12% [RR = 0.88, 95% CI = 0.81 to 0.95] for ischaemic stroke among studies wtith ≥12-year follow-up.

The investigators found for every 100 mg/day increment of magnesium dietary intake, a significantly reduced risk of 6% [RR = 0.94, 95% CI = 0.93 to 0.95] for type 2 diabetes.

The investigators found for every 100 mg/day increment of magnesium dietary intake, a significantly reduced risk of 2% [RR = 0.98, 95% CI = 0.97 to 0.99] for total stroke.

The investigators found for every 100 mg/day increment of magnesium dietary intake, a significantly reduced risk of 2% [RR = 0.98, 95% CI = 0.97 to 0.99] for ischaemic stroke.

The investigators concluded magnesium dietary intake has a substantial inverse association with type 2 diabetes and (total/ ischaemic) stroke. Furthermore, female, participants with obesity (BMI ≥ 25 kg/m²) and with a longer follow-up period (≥12 years) obtain greater benefit from magnesium intake with a lower risk of total and ischaemic stroke incidence. Overall, these findings support the guidelines to address the role of magnesium dietary intake in early prevention strategies to combat type 2 diabetes and stroke. However, additional RCTs are needed in the future to validate the causality.

Original title:
Association of magnesium intake with type 2 diabetes and total stroke: an updated systematic review and meta-analysis by Zhao B, Zeng L, [...], Zhang W.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7103847/

Additional information of El Mondo:
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Objectives:
Does Alzheimer disease increase risk of stroke?

Study design:
This review article included 8 studies, representing 121,719 individuals (Alzheimer disease = 73,044 and non-Alzheimer disease = 48,675).

Results and conclusions:
The investigators found patients with Alzheimer disease had a significantly increased risk of 42% [relative risk = 1.42, 95% CI = 1.23 to 1.64] for hemorrhagic stroke.

The investigators concluded Alzheimer disease increases risk of hemorrhagic stroke.

Original title:
Risk of hemorrhagic and ischemic stroke in patients with Alzheimer disease: A synthesis of the literature by Waziry R, Chibnik LB, […], Hofman A.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31949087

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

Objectives:
The impact of light-intensity physical activity (LPA) in preventing cancer mortality has been questioned. Therefore, this review article has been conducted.

Does light-intensity physical activity reduce cancer mortality?

Study design:
This review article included 5 prospective cohort studies, in which the definition of light-intensity physical activity based on accelerometer readings was mainly set within 100 to 2,100 counts/min.

Results and conclusions:
The investigators found 30 min/day of light-intensity physical activity significantly reduced cancer mortality with 14% [summary HR = 0.86, 95% CI = 0.79 to 0.95, I2 1%] and the association between light-intensity physical activity and risk reduction in cancer mortality was linearly shaped [p nonlinearity = 0.72].

The investigators found light-intensity physical activity exhibited a comparable magnitude of risk reduction in cancer mortality of moderate-to-vigorous physical activity regardless of equal time-length [0.87 per 30 min/day vs. 0.94 per 30 min/day, p interaction = 0.46] or equal amount [0.74 vs. 0.94 per 150 metabolic equivalents-min/day, p interaction = 0.11].

The investigators found, furthermore, replacing sedentary time by light-intensity physical activity of 30 min/day significantly decreased the risk of cancer mortality by 9%.

The investigators concluded 30 min/day of light-intensity physical activity reduce cancer mortality.

Original title:
Objectively-Measured Light-Intensity Physical Activity and Risk of Cancer Mortality: A Meta-analysis of Prospective Cohort Studies by Qiu S, Cai X, […], Schumann U.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32303534

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Find here more information/studies about sport nutrition and cancer.

Light intensity physical activity is an activity that is classified as 3 METS.

Objectives:
Cholera has harmful effects on the foetus but safety data of the oral cholera vaccine in pregnant women is controversial. Therefore, this review article has been conducted.

Has cholera vaccination during pregnancy harmful effects on the foetus?

Study design:
This review article included 5 studies with 5,584 pregnant women (2,920 exposed and 2,664 not exposed).

Results and conclusions:
The investigators found no significant increase in adverse pregnancy outcome [RR = 1.03, 95% CI = 0.79 to 1.34] or miscarriage [RR = 1.15, 95% CI = 0.84 to 1.57] or stillbirth [RR = 1.11, 95% CI = 0.69 to 1.80] following cholera vaccine administration during pregnancy compared to control group (group without cholera vaccine administration).
Significant because RR of 1 was found in the 95% CI of 0.69 to 1.80. RR of 1 means no risk/association.

The investigators found no association with an increased risk of preterm delivery [RR = 0.61, 95% CI = 0.35 to 1.06], low birth weight [RR = 0.84, 95% CI = 0.56 to 1.26], accidental abortion [RR = 1.02, 95% CI = 0.77 to 1.35] and malformation [RR = 0.70, 95% CI = 0.22 to 2.25] following cholera vaccine administration during pregnancy compared to control group.

The investigators concluded there is no evidence of an association among oral cholera vaccination and adverse pregnancy outcomes. However, these findings do not rigorously exclude the possibility that the vaccine protocol may result in some degree of harm.

Original title:
Pregnancy Outcomes after a Mass Vaccination Campaign with an Oral Cholera Vaccine: A systematic review and meta-analysis by Zhang Y, Zhang H, [...], Li Z.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32289871

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

Objectives:
Does protein supplementation yield beneficial effects on body composition and muscle function (strength and synthesis) in healthy adults, with an emphasis on the timing of protein intake?

Study design:
This review article included 65 RCTs with 2,907 participants (1,514 men and 1,380 women, 13 unknown sex). 26, 8 and 24 studies were used for meta-analysis on lean body mass, handgrip strength and leg press strength, respectively.

Results and conclusions:
The investigators found protein supplementation was effective in improving lean body mass (LBM) in adults [MD = 0.62 kg, 95% CI = 0.36 to 0.88] and older adults [MD = 0.46 kg, 95% CI = 0.23 to 0.70].
Sensitivity analyses removing studies without exercise training had no impact on the outcome.

The investigators found no association between protein supplementation and handgrip strength [older adults: MD = 0.26 kg, 95% CI = -0.51 to 1.04] and leg press strength [adults: MD = 5.80 kg, 95% CI = -0.33 to 11.93 and older adults: MD = 1.97 kg, 95% CI = -2.78 to 6.72].
Sensitivity analyses removing studies without exercise training had no impact on the outcome.

The investigators found data regarding muscle synthesis were scarce and inconclusive.

The investigators found subgroup analyses showed no beneficial effect of a specific timing of protein intake on lean body mass, handgrip strength and leg press strength.

The investigators concluded there is a positive impact of protein supplementation on lean body mass of healthy adults and older adults, independently of intake timing.

Original title:
The Role of Protein Intake and its Timing on Body Composition and Muscle Function in Healthy Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials by Wirth J, Hillesheim E and Brennan L.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32232404

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Find more information/studies on protein and sport nutrition right here.

The more lean body mass a person has, the higher their resting metabolic rate. Resting metabolic rate is the total number of calories burned when your body is completely at rest. Resting metabolic rate supports breathing, circulating blood, organ functions and basic neurological functions.

Objectives:
Is there a causal relationship between strawberry consumption and positive effects on cardiovascular risk factors?
 
Study design:
This review article included 11 RCTs (6 for blood pressure, 7 for lipid profile, 7 for fasting blood glucose and 6 for C-reactive protein).

There was little evidence of heterogeneity in the analysis and no evidence of publication bias.

Results and conclusions:
The investigators found overall, strawberry consumption significantly reduced C-reactive protein (CRP) levels by 0.63 mg/L [95% CI = -1.04 to -0.22] but did not affect blood pressure, lipid profile or fasting blood glucose in the main analyses.

The investigators found stratified by baseline endpoint levels, that strawberry consumption significantly reduced total cholesterol levels among people with baseline levels >5 mmol/L [-0.52 mmol/L, 95% CI = -088 to -0.15] and reduced LDL-cholesterol levels among people with baseline levels >3 mmol/L [-0.31 mmol/L, 95% CI = -0.60 to -0.02].

The investigators concluded strawberry consumption reduces C-reactive protein (CRP) levels and improves total cholesterol and LDL-cholesterol (bad cholesterol) in individuals with high baseline levels (level at the beginning of the study).

Original title:
Effects of strawberry intervention on cardiovascular risk factors: a meta-analysis of randomized controlled trials by Gao Q, Qin LQ, […], Dong JY.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32238201

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Find more information/studies on fruit consumption and lowering of cholesterol levels right here.

Objectives:
The objectives of this review article is to evaluate the effect of age at administration of the first dose of a measles-containing vaccine (MCV1) on protection against measles and on antibody response after one- and two-dose measles vaccinations.

Study design:
This review article included 41 (29 retrospective cohort studies and 12 case-control studies. Although 29 studies were conducted in large epidemics (≥100 cases), only 11 (27%) reported > 100 cases with data on vaccination status and age and 2 (5%) presented less than 10 cases) in the measles protection and 67 trials (8 RCTs, 25 non-RCTs and 34 before-after studies. Sample size varied from 21 to 1,633 participants and 72% include > 100 vaccinated children) in the immunogenicity analyses.

Funnel plots did not show much asymmetry but most of the effect estimates were plotted close to the pooled measure, suggesting that publication bias might exist but did not have a major impact on the results.

Results and conclusions:
The investigators found older age at MCV1, from 6 to ≥15 months, significantly improved antibody response and measles protection among one-dose recipients.

The investigators found pooled measles RR ranged from 3.56 [95% CI = 1.28 to 9.88] for MCV1 at  9 months to 0.48 [95% CI = 0.36 to 0.63] for MCV1 at ≥15 months, both compared to 12-14 months.

The investigators found pooled seroconversion RR ranged from 0.93 [95% CI = 0.90 to 0.96] for MCV1 at 9-11 months to 1.03 [95% CI = 1.00 to 1.06] for MCV1 at ≥15 months, both compared to 12 months.

The investigators found after a second dose, serological studies reported high seropositivity regardless of age at administration of MCV1 while epidemiological data based on few studies suggested lower protection with earlier age at MCV1.

The investigators concluded in children born to mothers who had measles, an earlier age at MCV1 decreases measles protection and immunogenicity after one dose and might also decrease protection after two doses of measles vaccine. While two-dose vaccination coverage is most critical to interrupt measles transmission, older age at first vaccination may be necessary to keep the high level of population immunity needed to maintain it.

Original title:
Effect of age at vaccination on the measles vaccine effectiveness and immunogenicity: systematic review and meta-analysis by Carazo S, Billard MN, […], Serres G.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7104533/

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

Objectives:
Is there an association between total meat, red meat, processed meat, poultry and fish intake and risk of type 2 diabetes (T2D)?

Study design:
This review article included 28 prospective cohort studies.

Results and conclusions:
The investigators found when compared with the lowest category, the highest category of total meat intake, significantly increased risk of type 2 diabetes with 33% [summary relative risk = 1.33, 95% CI = 1.16 to 1.52].
Significantly means that there is an association with a 95% confidence.

The investigators found when compared with the lowest category, the highest category of red meat intake, significantly increased risk of type 2 diabetes with 22% [summary relative risk = 1.22, 95% CI = 1.16 to 1.28].
Significantly because summary relative risk of 1 was not found in the 95% CI of 1.16 to 1.28. Summary relative risk of 1 means no risk/association.

The investigators found when compared with the lowest category, the highest category of processed meat intake, significantly increased risk of type 2 diabetes with 25% [summary relative risk = 1.25, 95% CI = 1.13 to 1.37].
Significantly means it can be said with a 95% confidence that the highest category of processed meat intake really increased risk of type 2 diabetes with 25%.

The investigators found no association between highest category of poultry intake and risk of type 2 diabetes [summary relative risk = 1.00, 95% CI = 0.93 to 1.07].
No association because summary relative risk of 1 was found in the 95% CI of 0.93 to 1.07. Summary relative risk of 1 means no risk/association.

The investigators found no association between highest category of fish intake and risk of type 2 diabetes [summary relative risk = 1.01, 95% CI = 0.93 to 1.10].

The investigators found in the dose-response analysis, each additional 100g/day of total and red meat and 50g/day of processed meat, were found to be associated with a 36% [95% CI = 1.23 to 1.49], 31% [95% CI = 1.19 to 1.45] and 46% [95% CI = 1.26 to 1.69] increased risk of type 2 diabetes, respectively.

The investigators found, in addition, there was evidence of a non-linear dose-response association between processed meat and type 2 diabetes [p = 0.004], with the risk increasing by 30% with increasing intakes up to 30g/day.

The investigators concluded 100g/day of total meat, 100g/day red meat and 50g/day of processed meat, increase risk of type 2 diabetes.

Original title:
Meat and fish intake and type 2 diabetes: dose-response meta-analysis of prospective cohort studies by Yang X, Li Y, […], Li L.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32302686

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Find more information/studies on fish and meat consumption and diabetes right here.

Objectives:
Previous studies did not draw a consistent conclusion about the effects of vitamin K combined with vitamin D on human skeletal quality. Therefore, this review article has been conducted.

Does vitamin K combined with vitamin D supplementation increase bone mineral density (BMD)?

Study design:
This review article included 8 RCTs with a total of 971 participants.

Results and conclusions:
The investigators found vitamin K combined with vitamin D supplementation significantly increased total bone mineral density (BMD) [pooled effect size = 0.316, 95% CI = 0.031 to 0.601].

The investigators found vitamin K combined with vitamin D supplementation significantly decreased levels of undercarboxylated osteocalcin [effect size = -0.945, 95% CI = -1.113 to -0.778].

The investigators found simultaneously, subgroup analysis showed that K2 or vitamin K (not specified) supplement less than 500 μg/d, when combined with vitamin D significantly increased total bone mineral density compared with the control group fed a normal diet or the group with no treatment [effect size = 0.479, 95% CI = 0.101 to 0.858 and effect size = 0.570, 95% CI = 0.196 to 0.945, respectively).

The investigators concluded the combination of vitamin K and D supplement increases the total bone mineral density (BMD) and decreases levels of undercarboxylated osteocalcin and a more favorable effect is expected when less than 500 μg/d vitamin K2 is used.

Original title:
The combination effect of vitamin K and vitamin D on human bone quality: a meta-analysis of randomized controlled trials by Kuang X, Liu C, […], Li D.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32219282

Additional information of El Mondo:
Find more information/studies on elderly, vitamin D and K right here.

Undercarboxylated osteocalcin represents inadequately carboxylated osteocalcin and this fraction increases with vitamin K insufficiency.

Objectives:
There are several guidelines that recommend pneumococcal vaccination (PPSV23 and/or PCV13) in adults with a history of cardiovascular disease (established heart failure, coronary disease, cerebrovascular disease) or at a very-high risk of cardiovascular disease. However, there is no Randomized Controlled Trial (RCT) systematic review that evaluates the impact of vaccination on all-cause mortality compared to no vaccination in this particular population. Therefore, this review article has been conducted.

Does pneumococcal vaccination decrease all-cause mortality in patients with cardiovascular disease or at a very high-cardiovascular risk?

Study design:
This review article included 5 observational studies enrolling a total of 163,756 participants.

Results and conclusions:
The investigators found pooled results from 5 studies enrolling a total of 163,756 participants showed a significant decrease of 22% for all-cause mortality [HR = 0.78, 95% CI = 0.73 to 0.83, I2 = 32%, very-low confidence].

The investigators concluded pneumococcal vaccination may decrease of all-cause mortality in patients with cardiovascular disease or at a very high-cardiovascular risk. However, limitations due to study design and the serious risk of bias in 3 of the included studies leads to a decreased level of result confidence.

Original title:
Pneumococcal vaccination in adults at very-high risk or established cardiovascular disease: systematic review and meta-analysis by Antunes MM, Duarte GS, […], Caldeira D.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32259237

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

Objectives:
Does fish consumption decrease risk of cardiovascular disease, depression, mortality and cancer?
 
Study design:
This review article included a total of 34 meta-analyses of prospective observational studies, reporting summary relative risks (SRR) for 40 different outcomes obtained from 298 primary prospective cohort studies.

The summary relative risk (SRR) for each meta-analysis was recalculated by using a random-effects model.

Results and conclusions:
The investigators found moderate-quality evidence showed that each 100-g/d increment in fish consumption was associated with a 8% lower risk of all-cause mortality [SRR = 0.92, 95% CI = 0.87 to 0.97].

The investigators found moderate-quality evidence showed that each 100-g/d increment in fish consumption was associated with a 25% lower risk of cardiovascular mortality [SRR = 0.75, 95% CI = 0.65 to 0.87].

The investigators found moderate-quality evidence showed that each 100-g/d increment in fish consumption was associated with a 12% lower risk of coronary heart disease [SRR = 0.88, 95% CI = 0.79 to 0.99].

The investigators found moderate-quality evidence showed that each 100-g/d increment in fish consumption was associated with a 25% lower risk of myocardial infarction [SRR = 0.75, 95% CI = 0.65 to 0.93].

The investigators found moderate-quality evidence showed that each 100-g/d increment in fish consumption was associated with a 14% lower risk of stroke [SRR = 0.86, 95% CI = 0.75 to 0.99].

The investigators found moderate-quality evidence showed that each 100-g/d increment in fish consumption was associated with a 20% lower risk of heart failure [SRR = 0.80, 95% CI = 0.67 to 0.95].

The investigators found moderate-quality evidence showed that each 100-g/d increment in fish consumption was associated with a 12% lower risk of depression [SRR = 0.88, 95% CI = 0.79 to 0.98].

The investigators found moderate-quality evidence showed that each 100-g/d increment in fish consumption was associated with a 35% lower risk of liver cancer [SRR = 0.65, 95% CI = 0.48 to 0.87].

The investigators concluded evidence of moderate quality shows that 100-g/d fish consumption is associated with a lower risk of cardiovascular disease, depression, mortality and liver cancer and therefore, can be considered as a healthy animal-based dietary source of protein. Further research is needed for outcomes for which the quality of the evidence was rated low and very low, considering types of fish consumed, different methods of cooking fish and all potential confounding variables.

Original title:
Fish Consumption and the Risk of Chronic Disease: An Umbrella Review of Meta-Analyses of Prospective Cohort Studies by Jayedi A and Shab-Bidar S.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32207773

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Find more information/studies on fish consumption, cancer and cardiovascular disease right here.

Objectives:
Is there a causal relationship between dietary intake of dairy products and a positive effect on bone mineral density (BMD) in healthy postmenopausal women?

Study design:
This review article included 6 RCTs with a total of 618 participants. Milk was the main dairy product used in the trials.

Results and conclusions:
The investigators found there was a significant association between dairy product consumption and bone mineral density of the lumbar spine [SMD = 0.21, 95% CI = 0.05 to 0.37, p = 0.009], femoral neck [SMD = 0.36, 95% CI = 0.19 to 0.53, p  0.001], total hip [SMD = 0.37, 95% CI = 0.20 to 0.55, p  0.001] and total body [SMD = 0.58, 95% CI = 0.39 to 0.77, p  0.001].

The investigators found subgroup analysis showed a positive effect of dairy product consumption on the bone mineral density of the total hip starting from 12 months and the femoral neck starting from 18 months. There was also a positive association with the bone mineral density in the 4 sites in people living in low-calcium intake countries.

The investigators concluded that there is a causal relationship between dietary intake of dairy products, particularly milk during at least 12 months and a positive effect on bone mineral density (BMD) in healthy postmenopausal women. Therefore, dairy product consumption should be considered an effective public health measure to prevent osteoporosis in postmenopausal women.

Original title:
Effects of dairy products on bone mineral density in healthy postmenopausal women: a systematic review and meta-analysis of randomized controlled trials by Shi Y, Zhan Y, [...], Jiang Y.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32185512

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Menopause is the point when a woman no longer has menstrual periods for at least 12 months. Postmenopause is the stage after menopause.