Nutrition and health

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

Additional information of El Mondo:
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

Additional information of El Mondo:
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

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

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

Objectives:
The majority of Plasmodium falciparum malaria cases in Africa are treated with the artemisinin combination therapies artemether-lumefantrine (AL) and artesunate-amodiaquine (AS-AQ), with amodiaquine being also widely used as part of seasonal malaria chemoprevention programs combined with sulfadoxine-pyrimethamine. While artemisinin derivatives have a short half-life, lumefantrine and amodiaquine may give rise to differing durations of post-treatment prophylaxis, an important additional benefit to patients in higher transmission areas. Therefore, this review article has been conducted.

Is there a difference in public health impact when artesunate-amodiaquine (AS-AQ) versus artemether-lumefantrine (AL) is used as first-line antimalarial drug for P. falciparum case management?

Study design:
This review article included individual patient data from 8 clinical trials of artemether-lumefantrine versus artesunate-amodiaquine in 12 sites in Africa (n = 4,214 individuals).

The median age in the study population was 2.8 years (IQR = 1.5-4.2).

Results and conclusions:
The investigators found a mean duration of post-treatment protection of 13.0 days [95% CI = 10.7-15.7] for artemether-lumefantrine and 15.2 days [95% CI = 12.8-18.4] for artesunate-amodiaquine overall.
However, the duration varied significantly between trial sites, from 8.7-18.6 days for artemether-lumefantrine and 10.2-18.7 days for artesunate-amodiaquine.

The investigators found significant predictors of time to reinfection in multivariable models were transmission intensity, age, drug and parasite genotype.
Where wild type pfmdr1 and pfcrt parasite genotypes predominated (=20% 86Y and 76T mutants, respectively), artesunate-amodiaquine provided ~ 2-fold longer protection than artemether-lumefantrine.
Conversely, at a higher prevalence of 86Y and 76T mutant parasites (> 80%), artemether-lumefantrine provided up to 1.5-fold longer protection than artesunate-amodiaquine.
These differences in the duration of protection could alter population-level clinical incidence of malaria by up to 14% in under-5-year-old children when the drugs were used as first-line treatments in areas with high, seasonal transmission.

The investigators concluded artesunate-amodiaquine provided a slightly longer median duration of post-treatment prophylaxis than artemether-lumefantrine (15.2 versus 13.0 days) when all data were pooled together. Furthermore, artesunate-amodiaquine provides longer protection than artemether-lumefantrine when most infections are by wild type parasites, while artemether-lumefantrine provides longer protection than artesunate-amodiaquine in areas with higher prevalence of the pfmdr1 86Y and pfcrt 76T mutations. Therefore, countries may wish to consider the prevalence of these mutations when deciding the first-line treatment.  

Original title:
The duration of chemoprophylaxis against malaria after treatment with artesunate-amodiaquine and artemether-lumefantrine and the effects of pfmdr1 86Y and pfcrt 76T: a meta-analysis of individual patient data by Bretscher MT, Dahal P, […], Okell LC.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7043031/

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

Objectives:
Do fermented dairy foods and probiotics supplementation improve risk factors (such as metabolic syndrome, type 2 diabetes, cholesterol) of cardiovascular diseases?

Study design:
This review article included 20 prospective cohort studies and 52 RCTs.

Results and conclusions:
The investigators found in prospective cohort studies, that fermented milk was associated with a 4% reduction in risk of stroke, ischemic heart disease and cardiovascular mortality [RR = 0.96, 95% CI = 0.94 to 0.98].

The investigators found in prospective cohort studies, that yogurt intake was associated with a risk reduction of 27% [RR = 0.73, 95% CI = 0.70 to 0.76] for type 2 diabetes.

The investigators found in prospective cohort studies, that yogurt intake was associated with a risk reduction of 20% [RR = 0.80, 95% CI = 0.74 to 0.87] for metabolic syndrome development.

The investigators found in RCTs, that probiotic supplementation added into dairy matrices produced a greater reduction in lipid biomarkers than when added into capsules/powder in hypercholesterolemic subjects.

The investigators found in RCTs, that probiotic supplementation by capsules/powder produced a greater reduction in type 2 diabetes biomarkers than when added into dairy matrices in diabetic subjects.

The investigators found in RCTs, that probiotic supplementation by both treatments (dairy matrix and capsules/powder) resulted in a significant reduction in anthropometric parameters in obese subjects.

The investigators concluded fermented milk consumption is associated with reduced cardiovascular risk, while yogurt intake is associated with a reduced risk of type 2 diabetes and metabolic syndrome development in the general population. Furthermore, probiotic supplementation added into dairy matrices is beneficial for lowering lipid concentrations and reduce anthropometric parameters. Additionally, probiotic capsule/powder supplementation contributes to type 2 diabetes management and reduces anthropometric parameters. However, these results should be interpreted with caution due to the heterogeneity of the studies and the different probiotic strains used in the studies.

Original title:
Fermented Dairy Products, Probiotic Supplementation, and Cardiometabolic Diseases: A Systematic Review and Meta-analysis by Companys J, Pla-Pagà L, […], Valls RM.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32277831

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

Objectives:
Does a high LDL cholesterol level (bad cholesterol) increase risk of Alzheimer's disease (AD)?

Study design:
This review article included 26 case-control studies involving 7,033 participants (2,266 Alzheimer's disease patients and 4,767 non-dementia controls).

There was no significant evidence of publication bias according to the results of Egger's test [p = 0.084].

Results and conclusions:
The investigators found results from the meta-analysis of 26 studies revealed higher levels of LDL cholesterol (>121 mg/dL) in Alzheimer's disease than that of non-dementia controls [SMD = 0.35, 95% CI = 0.12 to 0.58, p 0.01], which was consistent with the results of the fixed-effect model [SMD = 0.16, 95% CI = 0.10 to 0.22, p 0.01].
Sensitivity analyses showed that no single study exerted substantial influence on the pooled effect size after sequentially omitting a study.

The investigators found subgroup analysis of age showed LDL cholesterol levels in Alzheimer's disease patients aged 60-70 were higher than that of non-dementia [60 ≤ age 70: SMD = 0.80, 95% CI = 0.23 to 1.37, p 0.01].  

The investigators concluded that elevated concentration of LDL cholesterol (>121 mg/dL) is a risk factor for Alzheimer's disease. This strong association is significant in patients with Alzheimer's disease aged 60-70 years, but vanishes with increasing age. This review article provides a promising strategy for reducing the risk of Alzheimer's disease in patients with hyperlipidemia, which may be achieved by regulating LDL cholesterol concentration between 103.9 and 121 mg/dL with statins. Prospective studies that exclude potential confounders, more scientific design and adequate long-term follow-up are needed to validate this hypothesis.

Original title:
Low-Density Lipoprotein Cholesterol and Alzheimer's Disease: A Systematic Review and Meta-Analysis by Zhou Z, Liang Y, […], Zhao M.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7002548/

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

Objectives:
Previous studies have demonstrated some associations between dietary vitamin A intake and ovarian cancer risk with an inconsistent relationship. Therefore, this review article (meta-analysis) has been conducted.

Does higher dietary intake of vitamin A reduce ovarian cancer risk?

Study design:
This review article included 10 case-control studies and 5 cohort studies, involving 4,882 cases (persons with ovarian cancer) among 443,179 participants.

There was no publication bias.

Results and conclusions:
The investigators found higher dietary vitamin A intake significantly reduced ovarian cancer risk with 18.4% [RR = 0.816, 95% CI = 0.723 to 0.920, I2 = 48.4%, p for heterogeneity = 0.019].
Sensitivity analysis showed that no single study had a potential impact on the pooled RR.

The investigators found higher dietary vitamin A intake significantly reduced ovarian cancer risk with 23.1% [RR = 0.769, 95% CI = 0.655 to 0.902] in case-controle studies.
However, this reduced risk was not significant in cohort studies.

The investigators found higher dietary vitamin A intake significantly reduced ovarian cancer risk with 17.5% [RR = 0.825, 95% CI = 0.720 to 0.946] in North American populations.

The investigators concluded that higher dietary intake of vitamin A reduces ovarian cancer risk, especially among North Americans. As some limitations existed in this analysis, large scale studies with detailed amount of dietary vitamin A intake are needed to verify the results.

Original title:
Dietary vitamin A intake and the risk of ovarian cancer: A meta-analysis by Wang Q and He C.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7138903/

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

Objectives:
Anemia is the most common hematologic disorder of children in the globe. There are fragmented and inconclusive study findings on under-five anemia in Ethiopia. Understanding the distribution of anemia is an important step for program planners and policymakers. Therefore, this review article has been conducted.

What are the risk factors of under-five anemia in Ethiopia?

Study design:
This review article included 16 cross-sectional studies, published from 2013 to 2018 with a total of 11,924 under-five children.

Under-five anemia is diagnosed as hemoglobin (Hb) level below 11.0 grams per deciliter and it is classified as mild (Hb = 10-10.9 g/dL), moderate (Hb = 7-9.9 g/dL) and severe anemia (Hb less than 7 g/dL).

Results and conclusions:
The investigators found pooled prevalence of under-five anemia in Ethiopia was 44.83%.

The investigators found in subgroup analysis, the higher pooled prevalence of under-five anemia was observed from children's age less than 2 years old [50.36%, 95% CI = 39.53 to 61.18], poor dietary diversity [OR = 1.71, 95% CI = 1.10 to 2.68], stunting [OR = 2.59, 95% CI = 2.04 to 3.28], food insecurity [OR = 2.87, 95% CI = 1.25 to 6.61] and not dewormed [OR = 2.34, 95% CI = 1.77 to 3.09].

The investigators concluded that the magnitude of under-five anemia in Ethiopia is extremely high. Therefore, increased coverage of supplementation and fortification programs, periodic deworming, feeding diversified food, supplement food for those who are stunted and securing food in the households may all alleviate under-five anemia.

Original title:
Under-five anemia and its associated factors with dietary diversity, food security, stunted, and deworming in Ethiopia: systematic review and meta-analysis by Belachew A and Tewabe T

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7017616/

Additional information of El Mondo:
Find more information/studies on anemia, food fortificatiion and deworming right here.

Objectives:
Does tea consumption decrease risk of cardiovascular disease and all-cause mortality among adults?
 
Study design:
This review article included 39 prospective cohort studies.

Strength of evidence was rated as low and moderate (depending on study population age group) for cardiovascular disease-specific mortality outcome and was rated as low for cardiovascular disease events, stroke and all-cause mortality outcomes.

Results and conclusions:
The investigators found linear meta-regression showed that each cup (236.6 mL) increase in daily tea consumption (estimated 280 mg and 338 mg total flavonoids/d for black and green tea, respectively) was associated with an average 4% lower risk of cardiovascular disease mortality, a 2% lower risk of cardiovascular disease events, a 4% lower risk of stroke and a 1.5% lower risk of all-cause mortality.

The investigators found subgroup meta-analysis showed that each cup (236.6 mL) increase in daily tea consumption (estimated 280 mg and 338 mg total flavonoids/d for black and green tea, respectively) was associated with a 11% [pooled adjusted RR = 0.89, 95% CI = 0.83 to 0.96, p = 0.001, I2 = 72.4%, n = 4] lower risk of cardiovascular disease mortality in elderly individuals.

The investigators found subgroup meta-analysis showed that each cup (236.6 mL) increase in daily tea consumption (estimated 280 mg and 338 mg total flavonoids/d for black and green tea, respectively) was associated with a 8% [pooled adjusted RR = 0.92, 95% CI = 0.90 to 0.94, p 0.0001, I2 = 0.3%, n = 3] lower risk of all-cause mortality in elderly individuals.

The investigators found, generally, studies with higher risk of bias appeared to show larger magnitudes of associations than studies with lower risk of bias.

The investigators concluded that daily a cup (236.6 mL) of tea (estimated 280 mg and 338 mg total flavonoids/d for black and green tea, respectively) is associated with a lower risk of cardiovascular disease and all-cause mortality among elderly individuals.

Original title:
Dose-Response Relation between Tea Consumption and Risk of Cardiovascular Disease and All-Cause Mortality: A Systematic Review and Meta-Analysis of Population-Based Studies by Chung M, Zhao N, […], Wallace TC.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32073596

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

Objectives:
Epidemiologic studies of the relationship between nitrite or nitrate consumption and risk of non-Hodgkin lymphoma (NHL) remain controversial. Therefore, this review article has been conducted.

Does dietary intake of nitrite or nitrate increase risk of non-Hodgkin lymphoma?

Study design:
This review article included 8 case-control and 4 cohort studies with a total of 8,067 cases of non-Hodgkin lymphoma that reported the correlation between nitrate or nitrite consumption and risk of non-Hodgkin lymphoma published between 1996 and 2013.

NOS scores ranged from 4 to 8 with a mean value of 6.
Information on nitrate and nitrite intake was obtained by personal interview, telephone interview or mailed questionnaires.

There was no evidence of publication bias.

Results and conclusions:
The investigators found that high levels of nitrite dietary intake was linked to a significantly elevated risk of non-Hodgkin lymphoma of 55% [OR = 1.55, 95% CI = 1.27-1.88, I2 = 41.8%, p = 0.161]. 

The investigators found, however, no connection between the risk of non-Hodgkin lymphoma and high levels of nitrate dietary intake [OR = 1.02, 95% CI = 0.94-1.10, I2 = 14.2%, p = 0.308].

The investigators found that the risk of non-Hodgkin lymphoma increased by 26% for each additional microgram of nitrite consumed in the diet per day [OR = 1.26, 95% CI = 1.09-1.42].

The investigators found data from the high-quality studies indicated that nitrite consumption was positively associated with carcinogenicity, leading to non-Hodgkin lymphoma [OR = 1.44, 95% CI = 1.17-1.77] and positively correlated with the development of diffuse large B-cell lymphoma [OR = 1.55, 95% CI = 1.07-2.26], but not other non-Hodgkin lymphoma subtypes.

The investigators found, in addition, high levels of nitrite dietary intake was linked to a significantly elevated risk of non-Hodgkin lymphoma of 50% [OR = 1.50, 95% CI = 1.15-1.95] in females.
However, this increased risk was not significant in males [OR = 0.84, 95% CI = 0.52-1.36].

The investigators concluded that nitrite dietary intake, but not that of nitrate, raises the risk of developing non-Hodgkin lymphoma, particularly diffuse large B-cell lymphoma in females. In the future, better designed prospective research studies should be conducted to confirm these findings, clarify potential biological mechanisms and instruct clinicians about non-Hodgkin lymphoma prophylaxis.

Original title:
The relationship between consumption of nitrite or nitrate and risk of non-Hodgkin lymphoma by Yu M, Li C, [...], Jin J.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6969097/

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

The preservative sodium nitrite fights harmful bacteria in ham, salami and other processed and cured meats and also lends them their pink coloration.
 

Objectives:
Does influenza vaccination during pregnancy improve child health outcomes?

Study design:
This review article included 15 observational studies and 4 primary RCTs.

Results and conclusions:
The investigators found in a random effects meta-analysis of 2 RCTs including 5,742 participants, maternal influenza vaccination (influenza vaccination during pregnancy) was associated with an overall reduction of infant laboratory confirmed influenza of 34% [95% CI = 15-50%].
However, there was no effect of maternal influenza vaccination on infant laboratory confirmed influenza in infants ≤6 months old.

The investigators found overall observational studies showed an inverse (protective) association between maternal influenza vaccination and infant laboratory confirmed influenza, hospitalisation and clinic visits due to infant laboratory confirmed influenza or influenza-like illness in infants and other respiratory illness in infants ≤6 months old.

The investigators concluded that maternal influenza vaccination is a strategy to reduce infant laboratory confirmed influenza and influenza-related hospitalisations in young infants. Communicating these benefits to pregnant women may support their decision to accept influenza vaccination in pregnancy and increase vaccine coverage in pregnant women.  

Original title:
The effectiveness of influenza vaccination in pregnancy in relation to child health outcomes: Systematic review and meta-analysis by Jarvis JR, Dorey RB, […], Jones CE.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31932138

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

Objectives:
Results regarding the association between fish intake and risk of metabolic syndrome (MetS) are ambiguous. Therefore, this review article has been conducted.

Does fish consumption reduce risk of metabolic syndrome?

Study design:
This review article included 10 cross-sectional studies and 6 cohort studies.

Results and conclusions:
The investigators found fish consumption significantly reduced risk of metabolic syndrome with 20% [OR = 0.80, 95% CI = 0.66 to 0.96, p = 0.017, I2 = 62.9%] in cohort studies.
However, this reduced risk was not significant in cross-sectional studies [OR = 0.80, 95% CI = 0.70 to 1.02, p = 0.085, I2 = 50.1%].
Significantly because OR of 1 was not found in the 95% CI of 0.6 to 0.96. OR of 1 means no risk/association.

The investigators found a significant non-linear association between fish intake levels and risk of metabolic syndrome [p for non-linearity = 0.010].

The investigators concluded that fish consumption reduces risk of metabolic syndrome when combining data from prospective cohort studies. Further studies are needed to confirm such an effect.

Original title:
A systematic review and meta-analysis of the association between fish consumption and risk of metabolic syndrome by Karimi G, Heidari Z, [...], Haghighatdoost F.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32127332

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

Objectives:
Is there a causal relationship between dietary anthocyanins and reduced levels of systemic and vascular inflammation?

Study design:
This review article included 32 RCTs.

Results and conclusions:
The investigators found that dietary anthocyanins significantly decreased levels of C-reactive protein (CRP) [-0.33 mg/L, 95% CI = -0.55 to -0.11, p = 0.00], interleukin-6 (IL-6) [-0.41 ρg/mL, 95% CI = -0.70 to -0.13, p = 0.004], tumor necrosis factor-alpha (TNF-α) [-0.64 ρg/mL, 95% CI = -1.18 to -0.09, p = 0.023], intercellular adhesion molecule-1 [-52.4 ng/mL, 95% CI = -85.7 to -19.1, p = 0.002] and vascular adhesion molecule-1 (VCAM-1)  [-49.6 ng/mL, 95% CI = -72.7 to -26.5, p  0.001]. 

The investigators found that dietary anthocyanins significantly increased adiponectin level [0.75 μg/mL, 95% CI = 0.23 to 1.26, p = 0.004].

The investigators found subgroup analyses showed that administration of higher doses of anthocyanins (>300 mg/day) significantly decreased levels of CRP, IL-6, TNF-α and VCAM-1.

The investigators concluded that >300 mg/day dietary anthocyanins reduce the levels of systemic and vascular inflammation in the subjects.

Original title:
Impact of dietary anthocyanins on systemic and vascular inflammation: Systematic review and meta-analysis on randomised clinical trials by Fallah AA, Sarmast E, […], Jafari T.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31669599

Additional information of El Mondo:
Find here more information/studies about inflammation and anthocyanins.

Inflammation in the body can be measured by the following biomarker; the pro-inflammatory cytokines. The pro-inflammatory cytokines are the C-reactive protein (CRP), IL-1, interleukin-6 (IL-6), IL-8, MCP-1, the vascular adhesion molecule-1 (VCAM-1) and tumor necrosis factor alpha (TNF-α).

Objectives:
Does probiotic supplementation improve outcomes of preterm infants in India?

Study design:
This review article included 9 RCTs with a total of 1,514 preterm infants.

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 = 0.003].

The investigators found in 5 RCTs that probiotics supplementation significantly reduced the time to full feeds [MD = -4.09 d, 95% CI = -4.52 to -3.65, p  0.00001].

The investigators found in 6 RCTs that probiotics supplementation significantly reduced duration of hospital stay in fixed effects model [MD = -2.00 d, 95% CI = -2.46 to -1.53, p  0.00001].

The investigators concluded that current evidence from RCTs supports probiotic supplementation for optimizing 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

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

Objectives:
Previous studies had been published to explore the association about carbohydrate intake on esophageal cancer risk, with inconsistent results. Therefore, this review article (meta-analysis) has been conducted.

Does dietary intake of carbohydrate reduce esophageal cancer risk?

Study design:
This review article included 13 case-control studies that assessed a total of 3,033 patients.
The quality evaluation scores of each study ranged from 6 to 9 and the methodological quality was higher.

In the publication bias assessment, the results from funnel plots and Egger’s test detected no publication bias.

Results and conclusions:
The investigators found in overall analysis for the highest category versus lowest category of dietary carbohydrate a significantly reduced risk of 37.3% [summarized OR = 0.627, 95% CI = 0.505 to 0.778, I2 = 59.9%, p for heterogeneity = 0.001] for esophageal cancer.
Sensitivity analyses showed no single study had essential effect on the overall result.

The investigators found for the highest category versus lowest category of dietary carbohydrate a significantly reduced risk of 43.1% [summarized OR = 0.569, 95% CI = 0.417 to 0.777] for esophageal adenocarcinoma.

The investigators found for the highest category versus lowest category of dietary carbohydrate a significantly reduced risk of 33.5% [summarized OR = 0.665, 95% CI = 0.453 to 0.975] for esophageal squamous cell carcinoma.

The investigators found in subgroup analysis by study design that the association was significant in population-based case-control studies, but not in the hospital-based case-control studies.

The investigators concluded that dietary intake of carbohydrate may contribute to the lower development of esophageal cancer. May contribute because this review article only included case-control studies and no cohort studies. As some limitations existed in tbjs meta-analysis, large scale prospective studies with detailed type of dietary carbohydrate intake are needed to verify these results.

Original title:
Dietary carbohydrate intake and the risk of esophageal cancer: a meta-analysis by Xuan F, Li W, […], Liu C.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7042123/

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

The 2 main subtypes of esophageal cancer are esophageal squamous-cell carcinoma (often abbreviated to ESCC) and esophageal adenocarcinoma (EAC).
 

Objectives:
Which types of exercise training (whole body vibration training, aerobic training, strength training and combined training) increase lumbar spine and femoral neck bone mineral density (BMD) in older postmenopausal women (PMW)?

Study design:
This review article included 16 RCTs with 1,624 subjects.

Results and conclusions:
The investigators found no significant change in lumbar spine bone mineral density following exercise training [MD = 0.01 g/cm², 95% CI = -0.01 to 0.02].

The investigators found no significant change in femoral neck bone mineral density following exercise training [MD = 0.00 g/cm², 95% CI = -0.01 to 0.01].

The investigators found, however, subgroup analysis by type of exercise training revealed that lumbar spine bone mineral density [MD = 0.01, 95% CI = 0.00 to 0.02] raised significantly when whole-body vibration (WBV) was employed as intervention compared with RCTs that utilized aerobic [MD = -0.01, 95% CI = -0.02 to -0.01], resistance [MD = 0.01, 95% CI = -0.04 to 0.06] or combined training [MD = 0.03, 95% CI = -0.01 to 0.08].

The investigators found, on the other hand, lumbar spine bone mineral density [MD = - 0.01, 95% CI = -0.02 to -0.01] reduced significantly when aerobic exercise training was used as intervention compared with RCTs that utilized resistance training, combined training or whole-body vibration. 

The investigators concluded whole-body vibration is an effective method to improve lumbar spine bone mineral density in older postmenopausal women.

Original title:
The Impact of Different Modes of Exercise Training on Bone Mineral Density in Older Postmenopausal Women: A Systematic Review and Meta-analysis Research by Mohammad Rahimi GR, Smart NA, […], Mohammad Rahimi N.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32055889

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

Objectives:
Does flaxseed supplementation decrease plasma lipoprotein(a) levels?

Study design:
This review article included 7 RCTs with 629 individuals.

Results and conclusions:
The investigators found flaxseed supplementation significantly reduced plasma lipoprotein(a) levels [MD = -2.06 mg/dL, 95% CI = -3.846 to -0.274, p = 0.024, I2 = 0%, p = 0.986].

The investigators found subgroup analysis also revealed that longer duration only showed significant lowering effect of flaxseed supplementation on plasma lipoprotein(a) levels.

The investigators concluded that long duration of flaxseed supplementation decreases plasma lipoprotein(a) levels. However, future well-designed and long-term clinical trials are required to confirm these results.

Original title:
Impact of flaxseed supplementation on plasma lipoprotein(a) concentrations: A systematic review and meta-analysis of randomized controlled trials by Hadi A, Askarpour M, […], Ghavami A.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32073724

Additional information of El Mondo:
Find here more information/studies about flaxseed and heart disease.

Lipoprotein(a) is a risk factor for atherosclerosis and related diseases, such as coronary heart disease and stroke.

 

Objectives:
Does hepatitis C virus (HCV) infection increase risk of pancreatic cancer (PAC)?

Study design:
This review article included 8 cohort and 8 case-control studies.

Results and conclusions:
The investigators found hepatitis C virus infection significantly increased risk of pancreatic cancer with 51% [pooled OR = 1.51, 95 % CI = 1.31 to 1.74, I2 = 63.49%, p 0.001].
However, studies that adjusted their results for diabetes, chronic pancreatitis, alcohol intake and smoking showed lower ORs than studies that did not adjust for them.

The investigators concluded hepatitis C virus infection is associated with increased risk of pancreatic cancer, but this association is attenuated among studies that adjusted their results for potential risk factors for pancreatic cancer. Therefore, future prospective cohort studies are needed to confirm this association.

Original title:
Hepatitis C virus infection and risk of pancreatic cancer: A meta-analysis by Arafa A, Eshak ES, […], Anwar MM.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32088651

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

Objectives:
Omega-3 fatty acid and vitamin E or D co-supplementation may be an important approach to improve metabolic status in gestational diabetes, but the results are conflicting. Therefore, this review article has been conducted.

Do omega-3 fatty acid and vitamin E or D co-supplementation improve metabolic status in gestational diabetes?

Study design:
This review article included 4 RCTs.

Results and conclusions:
The investigators found omega-3 fatty acid and vitamin E or D co-supplementation was associated with a significantly reduced fasting plasma glucose level [MD = -10.47, 95% CI = -15.33 to -5.61, p  0.0001], homeostasis model of assessment-insulin resistance level [MD = -1.6, 95% CI= -2.44 to -0.77, p = 0.0002], malondialdehyde level [MD = -1.00, 95% CI = -1.05 to -0.95, p  0.00001] and triglycerides level [MD = 26.22, 95% CI = -38.94 to -13.51, p  0.0001].

The investigators found omega-3 fatty acid and vitamin E or D co-supplementation was associated with a significantly increased antioxidant capacity level [MD = 173.51, 95% CI = 164.72-182.30, p  0.00001].

The investigators found omega-3 fatty acid and vitamin E or D co-supplementation showed no effect on nitric oxide level [MD = 5.95, 95% CI = -7.48 to 19.37, p = 0.39] or total cholesterol level [MD = 1.63, 95% CI = -13.46 to 16.72, p = 0.83].

The investigators concluded omega-3 fatty acid and vitamin E or D co-supplementation have a favourable effect on metabolic status in gestational diabetes.

Original title:
Influence of omega-3 fatty acid and vitamin co-supplementation on metabolic status in gestational diabetes: A meta-analysis of randomized controlled studies by Li F, Pei L, […], Ye H.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32145487

Additional information of El Mondo:
Find more information/studies on diabetes, pregnancy, omega-3 fatty acid, vitamin D and E right here.

Objectives:
Does post-diagnosis dietary supplement use decrease total mortality, cancer mortality and recurrence among cancer survivors?

Study design:
This review article included observational studies and randomized clinical trials (RCT).

Results and conclusions:
The investigators found in 4 observational studies, compared to no supplementation, calcium supplementation significantly reduced total mortality with 12% [RR = 0.88, 95% CI = 0.77 to 1.00, I2 = 0%] among all cancer survivors.

The investigators found in 3 observational studies, compared to no supplementation, calcium supplementation significantly reduced cancer mortality with 29% [RR = 0.71, 95% CI = 0.53 to 0.95, I2 = 0%] among all cancer survivors.

The investigators found in 2 observational studies, compared to no supplementation, calcium supplementation significantly reduced cancer mortality with 34% [RR = 0.66, 95% CI = 0.47 to 0.94, I2 = 0%] among colorectal cancer survivors.

The investigators found in 2 observational studies and 2 RCT’s, compared to no supplementation, vitamin D supplementation significantly reduced total mortality with 14% [RR = 0.86, 95% CI = 0.76 to 0.99, I2 = 0%] among all cancer survivors.

The investigators found in 4 observational studies, compared to no supplementation, vitamin C supplementation significantly reduced total mortality with 21% [RR = 0.79, 95% CI = 0.68 to 0.92, I2 = 0%] among breast cancer survivors.

The investigators found in 2 observational studies, compared to no supplementation, vitamin D supplementation significantly reduced total mortality with 15% [RR = 0.85, 95% CI = 0.72 to 0.99, I2 = 0%] among breast cancer survivors.

The investigators found in 3 observational studies, compared to no supplementation, vitamin E supplementation significantly reduced total mortality with 24% [RR = 0.76, 95% CI = 0.64 tot 0.90, I2 = 0%] among breast cancer survivors.

The investigators found in 2 observational studies, compared to no supplementation, multivitamins supplementation significantly reduced cancer recurrence with 21% [RR = 0.79, 95% CI = 0.64 to 0.97, I2 = 0%] among breast cancer survivors.

The investigators found in 2 observational studies, compared to no supplementation, vitamin C supplementation significantly reduced cancer recurrence with 24% [RR = 0.76, 95% CI = 0.64 to 0.91, I2 = 0%] among breast cancer survivors.

The investigators found in 2 observational studies, compared to no supplementation, vitamin E supplementation significantly reduced cancer recurrence with 31% [RR = 0.69, 95% CI = 0.55 to 0.85, I2 = 0%] among breast cancer survivors.

The investigators concluded post-diagnosis dietary supplement use (particularly calcium, vitamin C, D and E) decreases total mortality, cancer mortality and recurrence among cancer survivors.

Original title:
Dietary Supplement Use after Cancer Diagnosis in Relation to Total Mortality, Cancer Mortality and Recurrence: A Systematic Review and Meta-Analysis by Kanellopoulou A, Riza E, […], Benetou V.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32148118

Additional information of El Mondo:
Find more information/studies on calcium, vitamin C, D, E, breast cancer and colorectal cancer right here.

Objectives:
Several epidemiological studies have been performed to evaluate the association of dietary intake of vitamin C-oriented foods (DIVCF) with risk of fracture and bone mineral density (BMD) loss, but the results remain controversial. Therefore, this review article has been conducted.

Does dietary intake of vitamin C-oriented foods decrease risk of fracture and bone mineral density loss?

Study design:
This review article included 4 cohort studies, 11 case-control studies and 2 cross-sectional studies with a total of 19,484 subjects.

The studies received a quality score of ≥5, indicating that the methodological quality of the studies was generally good.

No evidence of publication bias was found in the evaluation of dietary intake of vitamin C-oriented foods and the risk of hip fracture.

Results and conclusions:
The investigators found that the people with a higher dietary intake of vitamin C-oriented foods had a significantly 34% [RR = 0.66, 95% CI = 0.47 to 0.94, I2 = 79.5%, p = 0.000] lower risk of hip fracture.

The investigators found that the people with a higher dietary intake of vitamin C-oriented foods had a significantly 42% [RR = 0.58, 95% CI = 0.38 to 0.89] lower risk of hip fracture in case-control studies.
However, this reduced risk was not significant in cohort studies [RR = 0.92, 95% CI = 0.59 to 1.44]. 

The investigators found that the people with a higher dietary intake of vitamin C-oriented foods had a significantly 34% [RR = 0.66, 95% CI = 0.48 to 0.92] lower risk of osteoporosis.

The investigators found higher dietary intake of vitamin C-oriented foods was negatively associated with the risk of bone mineral density loss at the lumbar spine [pooled r = 0.15, 95% CI = 0.09 to 0.23] and at the femoral neck [pooled r = 0.20, 95% CI = 0.11 to 0.34].

The investigators concluded that higher dietary intake of vitamin C-oriented foods reduces the risk of hip fracture, osteoporosis and bone mineral density loss, suggesting that people should consume more vitamin C to decrease the risk of hip fracture, osteoporosis and bone mineral density loss, particularly lumbar spine and femoral neck.

Original title:
Can Dietary Intake of Vitamin C-Oriented Foods Reduce the Risk of Osteoporosis, Fracture, and BMD Loss? Systematic Review With Meta-Analyses of Recent Studies by Zeng LF, Luo MH, […], Liu J.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7008177/

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

Objectives:
The relationship between maternal folic acid supplementation in pregnancy and infant birth weight has not been well described in low- and middle-income countries. Therefore, this review article has been conducted.

Does maternal folic acid supplementation in pregnancy increase infant birth weight in low- and middle-income countries?

Study design:
This review article included 13 cohort studies and 4 randomized controlled trials (4 RCTs) with a total of  275,421 pregnant women.

Results and conclusions:
The investigators found in 9 cohort studies that maternal folic acid supplementation in pregnancy significantly increased birth weight [pooled MD = 0.37 kg, 95% CI = 0.24 to 0.50].

The investigators found in 3 RCTs that maternal folic acid supplementation in pregnancy significantly increased birth weight [pooled MD = 0.56 kg, 95% CI = 0.15 to 0.97].

The investigators found in 10 studies that maternal folic acid supplementation in pregnancy significantly reduced risk of getting a low birth weight with 41% [pooled OR = 0.59, 95% CI = 0.47 to 0.74]

The investigators found in 5 studies that maternal folic acid supplementation in pregnancy non-significantly reduced risk of small for gestational age with 37% [pooled OR = 0.63, 95% CI = 0.39 to 1.01]

The investigators concluded maternal folic acid supplementation in low- and middle-income countries is associated with an increased birth weight.

Original title:
Maternal folic acid supplementation and infant birthweight in low- and middle-income countries: A systematic review by Jonker H, Capelle N, […], Corsi DJ.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/31680411

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

Objectives:
Current evidence on associations between intakes of linoleic acid (LA), the predominant n-6 (ω-6) fatty acid and mortality is inconsistent and has not been summarized by a systematic review and meta-analysis. Therefore, this review article has been conducted.

Does higher linoleic acid intake, assessed by dietary surveys or biomarkers decrease mortality from all causes, cardiovascular disease (CVD) and cancer?

Study design:
This review article included 44 prospective cohort studies with 811,069 participants with dietary intake assessment (170,076 all-cause, 50,786 cardiovascular disease and 59,684 cancer deaths) and 65,411 participants with biomarker measurements (9,758 all-cause, 6,492 cardiovascular disease and 1,719 cancer deaths).

Meta-regressions suggested baseline age and dietary assessment methods as potential sources of heterogeneity for the association between linoleic acid and total mortality.

Results and conclusions:
The investigators found when compared with the lowest categories of dietary linoleic acid intake, that the highest categories of dietary linoleic acid intake significantly reduced total mortality risk with 13% [pooled RR = 0.87, 95% CI = 0.81 to 0.94, I2 = 67.9%].

The investigators found when compared with the lowest categories of dietary linoleic acid intake, that the highest categories of dietary linoleic acid intake significantly reduced cardiovascular disease mortality risk with 13% [pooled RR = 0.87, 95% CI = 0.82 to 0.92, I2 = 3.7%].

The investigators found when compared with the lowest categories of dietary linoleic acid intake, that the highest categories of dietary linoleic acid intake significantly reduced cancer mortality risk with 11% [pooled RR = 0.89, 95% CI = 0.85 to 0.93, I2 = 0%].

The investigators found for each standard deviation increment in linoleic acid concentrations in adipose tissue/blood compartments a significantly reduced total mortality risk of 9% [pooled RR = 0.91, 95% CI = 0.87 to 0.95, I2 = 64.1%].

The investigators found for each standard deviation increment in linoleic acid concentrations in adipose tissue/blood compartments a significantly reduced cardiovascular disease mortality risk of 11% [pooled RR = 0.89, 95% CI = 0.85 to 0.94, I2 = 28.9%].

The investigators found for each standard deviation increment in linoleic acid concentrations in adipose tissue/blood compartments a significantly reduced cancer mortality risk of 9% [pooled RR = 0.91, 95% CI = 0.84 to 0.98, I2 = 26.3%].

The investigators concluded higher linoleic acid intake, assessed by dietary surveys or biomarkers, reduces risk of mortality from all causes, cardiovascular disease and cancer. These data support the potential long-term benefits of PUFA intake in lowering the risk of cardiovascular disease and premature death.

Original title:
Dietary intake and biomarkers of linoleic acid and mortality: systematic review and meta-analysis of prospective cohort studies by Li J, Guasch-Ferré M, […], Hu FB.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/32020162

Additional information of El Mondo:
Find more information/studies on linoleic acid intake and mortality right here.
Linoleic acid is a PUFA.