Nutrition and health

Objectives:
Since WHO recommended introduction of at least a single dose of inactivated poliovirus vaccine (IPV) in routine immunisation schedules, there have been global IPV shortages. Fractional-dose IPV (fIPV) administration is one of the strategies to ensure IPV availability. Therefore, this review article has been conducted.

Is there a difference in seroconversion and antibodies response between fractional-dose IPV (fIPV) and full-dose IPV?

Study design:
This review article included 14 articles: 2 ongoing trials and 12 articles reporting on 10 completed studies.

The seroconversion meta-analysis for the three-dose comparison was homogeneous [p = 0.45, I2 = 0%], whereas heterogeneity was observed in the two-dose [p 0.00001, I2 = 88%] and one-dose [p = 0.0004, I2 = 74%] comparisons.
Heterogeneity was observed in meta-analyses of GMTs for one-dose [p 0.00001, I2 = 92%, two-dose [p = 0.002, I2 = 80%] and three-dose [p 0.00001, I2 = 93%] comparisons. Findings for types 1 and 3 were similar to those for type 2.
The certainty of the evidence was high for the three-dose comparisons and moderate for the rest of the comparisons.

Results and conclusions:
The investigators found for poliovirus type 2, there were no significant differences in the proportions of seroconversions between fractional and full doses of IPV for 2 or 3 doses: the risk ratio for serconversion at 1 dose was 0.61 [95% CI = 0.51 to 0.72], at 2 doses was 0.90 [95% CI = 0.82 to 1.00] and at 3 doses was 0.95 [95% CI = 0.91 to 1.00].

The investigators found geometric mean titres (GMTs) for poliovirus type 2 were lower for fIPV than for full-dose IPV [-0.51, 95% CI = -0.87 to -0.14] at 1 dose [-0.49, 95% CI = -0.70 to -0.28] at 2 doses and [-0.98, 95% CI = -1.46 to -0.51] at 3 doses.

The investigators concluded that there is no substantial difference in seroconversion between 3 doses of fractional-dose IPV (fIPV) and 3 doses of full-dose poliovirus vaccine (IPV), although the full dose gives higher titres of antibodies for poliovirus type 1, 2 and 3. Use of fractional IPV instead of the full dose can stretch supplies and possibly lower the cost of vaccination.

Original title:
Fractional dose compared with standard dose inactivated poliovirus vaccine in children: a systematic review and meta-analysis by Mashunye TR, Ndwandwe DE, [...], Wiysonge CS.

Link:
https://pubmed.ncbi.nlm.nih.gov/33939958/

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Objectives:
Previous meta-analysis studies have indicated inverse associations between some carotenoids and risks of metabolic syndrome, cardiovascular disease, cancer and all-cause mortality. However, the results for associations between carotenoids and type 2 diabetes (T2D) remain inconsistent and no systematic assessment has been done on this topic. Therefore, this review article (meta-analysis) has been conducted.

Do higher dietary intakes and circulating concentrations of carotenoids reduce risk of type 2 diabetes?

Study design:
This review article included 13 studies.

Results and conclusions:
The investigators found for the the highest versus the lowest categories of dietary intake of β-carotene a significantly reduced risk of 22% for type 2 diabetes [pooled RR = 0.78, 95% CI = 0.70 to 0.87, I2 = 13.7%, n = 6].
This significantly reduced risk was also found for total carotenoids (n = 2), α-carotene (n = 4), and lutein/zeaxanthin (n = 4), with pooled RRs ranging from 0.80 to 0.91, whereas no significant associations were observed for β-cryptoxanthin and lycopene.

The investigators found for the the highest versus the lowest categories of circulating concentration of β-carotene a significantly reduced risk of 40% for type 2 diabetes [pooled RR = 0.60, 95% CI = 0.46 to 0.78, I2 = 56.2%, n = 7].
This significantly reduced risk was also found for total carotenoids (n = 3), lycopene (n = 4), and lutein (n = 2), with pooled RRs ranging from 0.63 to 0.85, whereas no significant association was found for circulating concentrations of α-carotene and zeaxanthin when comparing extreme categories.

The investigators found dose-response analysis indicated that nonlinear relations were observed for circulating concentrations of α-carotene, β-carotene, lutein and total carotenoids [all p-nonlinearity 0.05], but not for other carotenoids or dietary exposures.

The investigators concluded that higher dietary intakes and circulating concentrations of total carotenoids, especially β-carotene, are associated with a lower risk of type 2 diabetes. More studies are needed to confirm the causality and explore the role of foods rich in carotenoids in prevention of type 2 diabetes.

Original title:
Dietary Intake and Circulating Concentrations of Carotenoids and Risk of Type 2 Diabetes: A Dose-Response Meta-Analysis of Prospective Observational Studies by Jiang YW, Sun ZH, [...], Pan A.

Link:
https://pubmed.ncbi.nlm.nih.gov/33979433/

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Objectives:
Do HPV vaccines reduce risk of HPV-related oropharyngeal cancer?

Study design:
This review article included 2 randomized controlled trials (RCTs) and 4 cross-sectional studies with a total of 15,240 participants.

Results and conclusions:
The investigators found in a meta-analysis that vaccinated individuals were 46% [risk ratio = 0.54, 95% CI = 0.32 to 0.91, p = 0.02] less likely to develop oral vaccine-type HPV infection compared to controls.  

The investigators found in a second meta-analysis of 4 studies (1 randomized controlled trial and 3 cross-sectional studies and 13,285 participants) an 80% [risk ratio = 0.20, 95% CI = 0.09 to 0.43, p 0.0001] less likelihood of oral HPV16 infection.

The investigators concluded that HPV vaccines show protection against oral vaccine-type HPV infection including high-risk HPV16 infection, thus reducing the incidence of HPV-related oropharyngeal cancer (OPC). Vaccination against HPV, especially in males, who are predominantly affected by HPV-related OPC, could result in the prevention of this disease.

Original title:
Human Papillomavirus Vaccine to End Oropharyngeal Cancer. A Systematic Review and Meta-Analysis by Tsentemeidou A, Fyrmpas G, […],Tsetsos N.

Link:
https://pubmed.ncbi.nlm.nih.gov/34110733/

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Objectives:
Does fruits and vegetables (FVs) consumption reduce risk of frailty?

Study design:
This review article included 10 cohort studies and 4 cross-sectional studies with 18,616 subjects with frailty and 101,969 controls (persons without frailty).

Based on the NutriGrade score, the quality of evidence for a protective effect of fruits and vegetables consumption on frailty was "moderate".

Results and conclusions:
The investigators found in 7 cohort studies for the highest versus lowest category of fruits and vegetables consumption a significantly reduced risk of 35% for frailty [RR = 0.65, 95% CI = 0.50 to 0.84, I2 = 81%].

The investigators found that every 200g per day increment in fruits and vegetables consumption was significantly associated with a 14% lower risk of frailty.
The risk of frailty decreased linearly up to fruits and vegetables consumption of 700 g/d, with flattening the curve at higher intake.

The investigators found that pooled analysis regarding fruits and vegetables separately did not indicate a significant association with the risk of frailty.

The investigators concluded that 200-700 g/d fruits and vegetables consumption decreases risk of frailty. Further large-scale prospective cohort studies are needed to reach more confident conclusions.

Original title:
Fruit and vegetable intake and risk of frailty: A systematic review and dose response meta-analysis by Ghoreishy SM, Asoudeh F, […], Mohammadi H.

Link:
https://pubmed.ncbi.nlm.nih.gov/34534684/

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Objectives:
Potential effects of inositol supplementation on blood pressure (BP) have been examined in several interventional studies. Nevertheless, findings in this context are controversial. Therefore, this review article has been conducted.

Do inositol supplements reduce blood pressure in humans?

Study design:
This review article included 7 eligible RCTs.

Results and conclusions:
The investigators found significant decline in both systolic blood pressure (SBP) [WMD = -5.69 mmHg, 95% CI = -7.35 to -4.02, p 0.001] and diastolic blood pressure (DBP) [WMD = -7.12 mmHg, 95% CI = -10.18 to -4.05, p 0.001] following supplementation with inositol.

The investigators found subgroup analysis showed that studies performed in individuals with metabolic syndrome with a longer duration (>8 weeks) and a dose of 4000 mg inositol supplements resulted in a more effective reduction in systolic blood pressure and diastolic blood pressure with acceptable homogeneity.

The investigators concluded that 4000 mg inositol supplements during at least 8 weeks reduce blood pressure, particularly in individuals with metabolic syndrome. Further large-scale RCTs with better design are needed to confirm these findings.

Original title:
The effect of inositol supplementation on blood pressure: A systematic review and meta-analysis of randomized-controlled trials by Tari SH, Sohouli MH, […], Rahideh ST.

Link:
https://pubmed.ncbi.nlm.nih.gov/34330516/

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Objectives:
What is the efficacy of vitamin D fortification and supplementation in children?

Study design:
This review article included 31 studies.

Results and conclusions:
The investigators found significant raises in circulating 25(OH)D concentrations were observed in both groups that took vitamin D supplement [MD = 28.7, 95% CI = 22.5 to 34.9] and vitamin D-fortified foods [MD = 20.29, 95% CI = 13.3 to 27.2].

The investigators found the meta-regression revealed a significant association between age of participants [B = -1.4, 95% CI = -2.8 to -0.02, p = 0.047] and dose of vitamin D [B = 0.007, 95% CI = 0.003 to 0.01, p 0.001], with the effect on serum 25(OH)D concentrations.

The investigators found that serum 25(OH)D concentration increased by 0.7 nmol/L for every 100 IU of vitamin D intake after adjustment for age, baseline serum 25(OH)D and latitude which is far less than the reported amount in adults.

The investigators concluded that serum 25(OH)D concentration increases by 0.7 nmol/L for every 100 IU of vitamin D intake. These findings indicate that in a mass vitamin D fortification program, circulating 25(OH)D concentration response in children may be lower in children than in adults and vitamin D supplementation may still be needed in this subpopulation.

Original title:
How Much Does Serum 25(OH)D Improve by Vitamin D Supplement and Fortified Food in Children? A Systematic Review and Meta-Analysis by Nikooyeh B, Ghodsi D and Neyestani TR.

Link:
https://pubmed.ncbi.nlm.nih.gov/34520402/

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Objectives:
It has been theorized that folic acid supplementation improves inflammation. However, its proven effects on inflammatory markers are unclear as clinical studies on this topic have produced inconsistent results. Therefore, this review article has been conducted.

Have folic acid supplements positive effects on inflammatory markers, like CRP, IL-6 and TNF-α?

Study design:
This review article included 12 RCTs with a total of 1,392 participants.
The studies were conducted between 2003 and 2018 and their sample size varied from 19 to 530 participants.
The mean age of the participants ranged from 24.1 to 68.1 years old.
The supplementation period ranged from 2 to 52 weeks.
The daily mentioned dosage of folic acid varied between 0.8 mg and 10 mg/d.

There was no publication bias.

Results and conclusions:
The investigators found a significant effect of folic acid supplementation on serum concentrations of CRP [WMD = -0.59 mg/L, 95% CI = -0.85 to -0.32, p 0.001, I2 = 91.3%, p 0.001].
This significantly reduced effect was also found in the subgroup and sensitivity analysis.
Subgroup analysis showed that baseline serum concentrations of CRP, duration of intervention, dosage and the participants’ age and gender explained this heterogeneity.

The investigators concluded that 0.8-10 mg/d folic acid supplements decrease serum concentrations of CRP.

Original title:
Effects of Folic Acid Supplementation on Inflammatory Markers: A Grade-Assessed Systematic Review and Dose-Response Meta-Analysis of Randomized Controlled Trials by Asbaghi O, Ashtary-Larky D, […], Naeini AA.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8308638/

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Objectives:
What is the association between red meat and poultry consumption and the risk of metabolic syndrome?

Study design:
This review article included 9 prospective cohort studies, which involved a total of 21,869 participants.
Among them, 8 studies were identified for red meat consumption.

No publication bias was observed according to the Begg's rank-correlation test and the Egger's test.  

Results and conclusions:
The investigators found that red meat consumption was significantly associated with a higher risk of 35% for metabolic syndrome [multi-variable adjusted RR = 1.35, 95% CI = 1.13 to 1.62, p = 0.001, I2 = 54.4%, p = 0.032].  
The same results were obtained in subgroup analysis for >5 years follow-up [RR = 1.36, 95% CI = 1.09 to 1.7, p = 0.006], non-National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP III) [RR = 1.34, 95% CI = 1.12 to 1.62, p = 0.002], Non-Asia [RR = 1.51, 95% CI = 1.29 to 1.77, p 0.001], adjustment of BMI [RR = 1.4, 95% CI = 1.23 to 1.6, p 0.001] and physical activity studies [RR = 1.48, 95% CI = 1.29 to 1.71, p 0.001].

The investigators found that unprocessed red meat consumption was significantly associated with a higher risk of 32% for metabolic syndrome [multi-variable adjusted RR = 1.32, 95% CI = 1.14 to 1.54, p = 0.0003, I2 = 0%, p = 0.397].  

The investigators found that processed red meat consumption was significantly associated with a higher risk of 48% for metabolic syndrome [multi-variable adjusted RR = 1.48, 95% CI = 1.11 to 1.97, p = 0.007, I2 = 64.7%, p = 0.097].  

The investigators found that poultry consumption was significantly associated with a lower risk of 15% for metabolic syndrome [multi-variable adjusted RR = 0.85, 95% CI = 0.75 to 0.97, p = 0.02, I2 = 0%, p = 0.707].  

The investigators concluded that red meat (processed and unprocessed) consumption is associated with a higher risk of metabolic syndrome, whereas, poultry consumption is associated with a lower risk of metabolic syndrome. More well-designed randomized controlled trials are still needed to address the issues further.

Original title:
Association of Red Meat and Poultry Consumption With the Risk of Metabolic Syndrome: A Meta-Analysis of Prospective Cohort Studies by Guo H, Ding J, [...], Zhang Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8295459/

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Objectives:
Can vitamin D-fortified products be a suitable solution for tackling vitamin D deficiency in adults?

Study design:
This review article included 23 studies.

Results and conclusions:
The investigators found pooled data comparing fortification with vitamin D +/- Ca with control showed statistically significant effect on total 25(OH)D concentrations [MD = 25.4 nmol/L, 95% CI = 19.5 to 31.3, n = 2,002 participants].

The investigators found the subgroup analysis by duration of intervention (less than 12 weeks versus more than 12 weeks) and type of vehicle (dairy product, juice, grain product, oil and combination of dairy and grain products), isoform of the vitamin (D3 versus D2) and dose of the fortificant (≥ 1000 IU/d versus 1000 IU/d) also indicated significant effect of fortification with vitamin D on serum 25(OH)D concentrations.

The investigators found an average of 2 nmol/L increase in circulating 25(OH)D concentration for each 100 IU vitamin D intake per day in general adult population.

The investigators concluded that the circulating 25(OH)D response to vitamin D-fortified food consumption is influenced by age, BMI and the baseline 25(OH)D concentrations. Notwithstanding, an average of 2 nmol/L increase in circulating 25(OH)D concentration for each 100 IU vitamin D intake per day is expected for general adult population. These findings can be informative for policymakers to tackle vitamin D deficiency through food fortification strategy.

Original title:
The effects of vitamin D-fortified foods on circulating 25(OH)D concentrations in adults: a systematic review and meta-analysis by Nikooyeh B and Neyestani TR.

Link:
https://pubmed.ncbi.nlm.nih.gov/34308818/

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Objectives:
Small-quantity lipid-based nutrient supplements (SQ-LNSs) were designed to provide multiple micronutrients within a food base that also provides energy, protein and essential fatty acids, targeted towards preventing malnutrition in vulnerable populations. Previous meta-analyses demonstrated beneficial effects of SQ-LNSs on child growth, anemia and mortality. However, to further examine the efficacy and effectiveness of SQ-LNSs and explore study-level and individual-level effect modifiers, this review article has been conducted.

Do small-quantity lipid-based nutrient supplements reduce child malnutrition and promote healthy development?

Study design:
This review article included 14 randomized controlled trials (RCTs) of small-quantity lipid-based nutrient supplements (SQ-LNSs) provided to children 6-24 months of age ( n = 37,066).

Most trials began child supplementation with SQ-LNSs at 6 mo of age and the intended duration ranged from 6 to 18 mo of supplementation; 4 trials included intervention arms that also provided SQ-LNSs to mothers during pregnancy and the first 6 mo postpartum.
All trials provided peanut- and milk-based SQ-LNS in at least 1 of the arms.

Results and conclusions:
The investigators found children who received small-quantity lipid-based nutrient supplements had a 12-14% lower prevalence of stunting, wasting and underweight compared with control group children.  

The investigators found children who received small-quantity lipid-based nutrient supplements were 16-19% less likely to score in the lowest decile for language, social-emotional and motor development compared with control group children.  

The investigators found children who received small-quantity lipid-based nutrient supplements had a 16% lower prevalence of anemia and had a 64% lower prevalence of iron-deficiency anemia compared with control group children.

The investigators found for most outcomes, beneficial effects of small-quantity lipid-based nutrient supplements were evident regardless of study-level characteristics, including region, stunting burden, malaria prevalence, sanitation, water quality, duration of supplementation, frequency of contact or average reported compliance with small-quantity lipid-based nutrient supplements.

The investigators found for development, the benefits of small-quantity lipid-based nutrient supplements were greater in populations with higher stunting burden, in households with lower socioeconomic status and among acutely malnourished children.

The investigators found for hemoglobin and iron status, benefits were greater in populations with higher anemia prevalence and among acutely malnourished children, respectively.

The investigators concluded that small-quantity lipid-based nutrient supplements reduce child malnutrition and promote healthy development. Therefore, policymakers and program planners should consider including small-quantity lipid-based nutrient supplements in strategies to reduce child mortality, stunting, wasting, anemia, iron deficiency and delayed development.

Original title:
Small-quantity lipid-based nutrient supplements for the prevention of child malnutrition and promotion of healthy development: overview of individual participant data meta-analysis and programmatic implications by Dewey KG, L Prado EL, […], Arnold CD.

Link:
https://academic.oup.com/ajcn/advance-article/doi/10.1093/ajcn/nqab279/6378016

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Objectives:
Epidemiological studies have shown that higher intake of flavonoid is inversely associated with coronary heart disease (CHD) risk. However, which flavonoid subclass (including anthocyanins, flavonols) could reduce CHD risk has remained controversial. Therefore, this review article has been conducted.

Do dietary intakes of anthocyanins, proanthocyanidins, flavonols, flavones and isoflavones reduce coronary heart disease?

Study design:
This review article included 19 independent prospective cohort studies with 894,471 participants and 34,707 persons with coronary heart disease.
 
Results and conclusions:
The investigators found that dietary intakes of anthocyanins significantly reduced risk of coronary heart disease with 10% [RR = 0.90, 95% CI = 0.83 to 0.98].

The investigators found that dietary intakes of proanthocyanidins significantly reduced risk of coronary heart disease with 22% [RR = 0.78, 95% CI = 0.65 to 0.94].

The investigators found that dietary intakes of flavonols significantly reduced risk of coronary heart disease with 12% [RR = 0.88, 95% CI = 0.79 to 0.98].

The investigators found that dietary intakes of flavones significantly reduced risk of coronary heart disease with 6% [RR = 0.94, 95% CI = 0.89 to 0.99].

The investigators found that dietary intakes of isoflavones significantly reduced risk of coronary heart disease with 10% [RR = 0.90, 95% CI = 0.83 to 0.98].

The investigators found in dose-response analysis that increment of 50 mg/d dietary anthocyanins significantly reduced risk of coronary heart disease with 5%.

The investigators found in dose-response analysis that increment of 100 mg/d dietary proanthocyanidins significantly reduced risk of coronary heart disease with 5%.

The investigators found in dose-response analysis that increment of 25 mg/d dietary flavonols significantly reduced risk of coronary heart disease with 5%.

The investigators found in dose-response analysis that increment of 5 mg/d dietary flavones significantly reduced risk of coronary heart disease with 5%.

The investigators found in dose-response analysis that increment of 0.5 mg/d dietary isoflavones significantly reduced risk of coronary heart disease with 5%.

The investigators found sensitivity and subgroup analyses supported these associations.

The investigators concluded that daily dietary intakes of 50mg anthocyanins, 100 mg proanthocyanidins, 25mg flavonols, 5mg flavones or 0.5mg isoflavones reduce coronary heart disease.

Original title:
Flavonoid subclasses and coronary heart disease risk: a meta-analysis of prospective cohort studies by Fan ZK, Wang C, [...], Li D.

Link:
https://pubmed.ncbi.nlm.nih.gov/34470681/

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Objectives:
Does breastfeeding reduce risk of ovarian cancer in women with BRCA1 mutation or BRCA2 mutation?

Study design:
This review article included 1 cohort study and 4 case-control studies with a total of 14,601 women with a BRCA1 or BRCA2 mutation.

There was no publication bias.

Results and conclusions:
The investigators found ever having performed breastfeeding significantly reduced risk of ovarian cancer with 23.3% [pooled OR = 0.767, 95% CI = 0.688 to 0.856, I2 = 0%] in women with BRCA1 mutation.

The investigators found ever having performed breastfeeding non-significantly reduced risk of ovarian cancer with 18.3% [pooled OR = 0.817, 95% CI = 0.650 to1.028, I2 = 0%] in women with BRCA2 mutation.

The investigators found breastfeeding for >1 year significantly reduced risk of ovarian cancer with 21.3% [pooled OR = 0.787, 95% CI = 0.682 to 0.907, I2 = 0%] in women with BRCA1 mutation.

The investigators found breastfeeding for >1 year significantly reduced risk of ovarian cancer with 43.3% [pooled OR = 0.567, 95% CI = 0.400 to 0.802, I2 = 0%] in women with BRCA2 mutation.

The investigators concluded that ever having performed breastfeeding reduces risk of ovarian cancer in women with BRCA1 mutation and breastfeeding for >1 year reduces risk of ovarian cancer in women with BRCA2 mutation.

Original title:
The preventive effect of breastfeeding against ovarian cancer in BRCA1 and BRCA2 mutation carriers: A systematic review and meta-analysis by Eoh KJ, Park EY, […], Lim MC.

Link:
https://pubmed.ncbi.nlm.nih.gov/34304906/

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Objectives:
The association between serum 25-hydroxyvitamin D 25(OH)D level (vitamin D level in blood) and asthma occurrence in children was controversial. Therefore, this review article has been conducted.

Does a low vitamin D level increase risk of asthma occurrence in children?

Study design:
This review article included 35 studies with 5,711 children with asthma and 21,561 children without asthma. Among them, 24 studies were included for analyzing the association between 25(OH)D level and asthma and 12 studies evaluated the treatment effect of vitamin D.

Results and conclusions:
The investigators found that the children with asthma had significant lower 25(OH)D level than children without asthma [21.7 ng/mL versus 26.5 ng/mL, SMD = -1.36, 95% CI = -2.40 to -0.32, p = 0.010].

The investigators found, besides, children with asthma treated with vitamin D supplement had a significantly lower recurrence rate of 65% than the placebo group [18.4% versus 35.9%, RR = 0.35, 95% CI = 0.35 to 0.79, p = 0.002].

The investigators concluded that children with asthma have a lower 25(OH)D level than healthy children. Vitamin D supplement could decrease the asthma recurrence rate in the follow-up years.

Original title:
Vitamin D and asthma occurrence in children: A systematic review and meta-analysis by Wang Q, Ying Q, [...], Chen J.

Link:
https://pubmed.ncbi.nlm.nih.gov/34366195/

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Objectives:
Findings on the link between dietary intakes of monounsaturated fatty acids (MUFA) and risk of mortality are conflicting. Therefore, this review article has been conducted.

Does monounsaturated fatty acids dietary intake reduce risk of mortality?

Study design:
This review article included 17 prospective cohort studies with a total of 1022,321 participants aged ≥ 20 years, of which 191,283 all-cause deaths, 55,437 cardiovascular diseases (CVD) deaths and 64,448 cancer deaths.

Results and conclusions:
The investigators found combining 15 effect sizes from 11 studies, monounsaturated fatty acids dietary intake was significantly associated with a reduced risk of 6% for all-cause mortality [RR = 0.94, 95% CI = 0.90 to 0.98, I2 = 55.5%, p = 0.005].
Significantly because RR of 1 was not found in the 95% CI of 0.90 to 0.98. RR of 1 means no risk/association.

The investigators found based on 17 effect sizes from 11 studies, no significant association between monounsaturated fatty acids dietary intake and risk of cardiovascular diseases mortality [RR = 0.95, 95% CI = 0.89 to 1.01, I2 =37.0%, p = 0.06].
No significant means that there is no association with a 95% confidence.

The investigators found when combining 10 effect sizes from 6 studies, monounsaturated fatty acids dietary intake was not significantly associated with cancer mortality [RR = 0.99, 95% CI = 0.96 to 1.03, I2 = 13.3%, p = 0.32].  
Not significantly because RR of 1 was found in the 95% CI of 0.96 to 1.03. RR of 1 means no risk/association.

The investigators found an additional 5% of energy (5 En%) from monounsaturated fatty acids was significantly associated with a 3% reduced risk of all-cause mortality [RR = 0.97, 95% CI = 0.96 to 0.98], but not with cardiovascular diseases [RR = 0.98, 95% CI = 0.95 to 1.01] and cancer mortality [RR = 0.99, 95% CI = 0.97 to 1.01].

The investigators concluded that monounsaturated fatty acids dietary intake reduces risk of all-cause mortality.

Original title:
Dietary intakes of monounsaturated fatty acids and risk of mortality from all causes, cardiovascular disease and cancer: A systematic review and dose-response meta-analysis of prospective cohort studies by Lotfi K, Salari-Moghaddam A, […], Esmaillzadeh A.

Link:
https://pubmed.ncbi.nlm.nih.gov/34560281/

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Objectives:
Vitamin D deficiency is frequently associated with several medical conditions. However, a comprehensive meta-analysis assessing the association between vitamin D level and acne is lacking. Therefore, this review article (meta-analysis) has been conducted.

Does a low vitamin D level (expressed as circulating 25(OH)D levels) increase risk of both acne and acne severity?

Study design:
This review article included 13 articles with a total of 1,362 acne patients and 1,081 healthy controls (persons without acne).

Results and conclusions:
The investigators found that the circulating 25(OH)D levels were significantly lower in patients with acne than in healthy controls [pooled MD = -9.02 ng/mL, 95% CI = -13.22 to -4.81, p 0.0001].

The investigators found that vitamin D deficiency was more prevalent in acne patients than in healthy controls [pooled OR = 2.97, 95% CI = 1.68 to 5.23, I2 = 72%].

The investigators found that vitamin D levels were negatively correlated with acne severity.

The investigators concluded that the vitamin D levels are low in acne patients. Also, there is evidence of an inverse association between vitamin D levels and acne severity. Therefore, vitamin D might be involved in the pathogenesis (the manner of development of a disease) of acne.

Original title:
Association between Vitamin D Level and Acne, and Correlation with Disease Severity: A Meta-Analysis by Hasamoh Y, Thadanipon K, […], Juntongjin P.

Link:
https://pubmed.ncbi.nlm.nih.gov/34348293/

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Objectives:
The safety of human papillomavirus (HPV) vaccines, one of the major challenges to public vaccination, has been controversial. Therefore, this review article has been conducted.

What is the safety of different human papillomavirus (HPV) vaccines?

Study design:
This review article included 23 RCTs.

Results and conclusions:
The investigators found in pooled analysis that the 2vHPV vaccine was associated with significantly more systemic adverse events than the 4vHPV vaccine [risk ratio = 1.28, 95% credible interval = 1.14 to 1.44), 9vHPV vaccine [risk ratio = 1.25, 95% credible interval = 1.06 to 1.49] and placebo [risk ratio = 1.31, 95% credible interval = 1.18 to 1.46].

The investigators found, however, there were no statistically significant differences in serious adverse events between the vaccinated and placebo groups.
For injection-site adverse events, there were substantial inconsistencies between the direct and indirect effects; therefore, the analysis results of the safety were presented only for systemic and serious adverse events.

The investigators concluded that the 2vHPV vaccine results in more systemic adverse events than other vaccines and placebo. Further studies are needed to obtain more information regarding the safety of HPV vaccines.

Original title:
The comparative safety of human papillomavirus vaccines: A Bayesian network meta-analysis by Huang R, Gan R, [...], Xiao J.

Link:
https://pubmed.ncbi.nlm.nih.gov/34453758/

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Cervarix is a 2-valent HPV (2vHPV) vaccine that has 2 virus-like particles (VLPs) including HPV 16 and 18 VLPs.

Objectives:
Do chair-based exercise programmes improve upper extremity and lower extremity function in older adults?

Study design:
This review article included 25 studies with a total of 1,388 participants.
19 studies were randomised controlled trials (RCTs).

The chair exercises included chair-based yoga, seated tai chi and rocking chair. The interventions lasted between 2 and 72 weeks, with the most common duration being 12 weeks, delivering 2 to 14 sessions per week. Sessions lasted between 15 and 110 minutes.

There was considerably heterogeneity in the age range of participants included.
The mean age of participants in studies ranges from 55 to 88 years.
17 studies had a low risk of bias and 5 had a high risk of bias.

Results and conclusions:
The investigators found that chair-based exercise programmes significantly improved upper extremity [handgrip strength: MD = 2.10, 95% CI = 0.76 to 3.43, I2 = 42% and 30 s arm curl test: MD = 2.82, 95% CI = 1.34 to 4.31, I2 = 71%] and lower extremity function [30 s chair stand: MD = 2.25, 95% CI = 0.64 to 3.86, I2 = 62%].

The investigators found no significant differences in the Berg balance scale, timed up and go test or gait speed between the intervention and control groups. Similarly, no significant differences were observed for self-reported activities of daily living or for falls efficacy, which were analyzed using standardised mean difference between the intervention and control groups as there were different instruments used to measure each outcome.

The investigators concluded that chair-based exercise programmes improve upper extremity (handgrip strength and 30 s arm curl test) and lower extremity (30 s chair stand) function in older adults. These changes are observed in short (12 weeks) and medium term (12 weeks to 6 months) interventions.

Original title:
The Effect of Chair-Based Exercise on Physical Function in Older Adults: A Systematic Review and Meta-Analysis by Klempel N, Blackburn NE, […], Tully MA.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7920319/

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

Upper extremity is part of the body that includes the arm, wrist and hand.
Lower extremity refers to the part of the body from the hip to the toes.

Objectives:
Malnutrition is a major public health issue that has been associated with high susceptibility for impaired brain development and mental functioning. However, to date studies on this topic have not been collated and appraised. Therefore, this review article has been conducted.

Is malnutrition associated with a poor cognitive development?

Study design:
This review article included 12 studies comprising 7,607 participants aged 1 to 12 years.

Results and conclusions:
The investigators found children with malnutrition had worse scores than controls for the Wechsler Intelligence Scale [SMD = -0.40, 95% CI = -0.60 to -0.20, p 0.0001, I2 = 77.1%], the Raven's Coloured Progressive Matrices [SMD = -3.75, 95% CI = -5.68 to -1.83, p 0.0001, I2 = 99.2%], visual processing [SMD = -0.85, 95% CI = -1.23 to -0.46, p = 0.009, I2 = 11.0%] and short memory [SMD = 0.85, 95% CI = -1.21 to -0.49, p 0.0001, I2 = 0%] tests.

The investigators concluded that normal cognitive development requires access to good and safe nutrition.

Original title:
Systematic review and meta-analysis found that malnutrition was associated with poor cognitive development by Pizzol D, Tudor F, […], Smith L.

Link:
https://pubmed.ncbi.nlm.nih.gov/34077582/

Additional information of El Mondo:
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Objectives:
Nuts are recommended for cardiovascular health, yet concerns remain that nuts may contribute to weight gain due to their high energy density. Therefore, this review article has been conducted.

Does nut consumption contribute to an increased adiposity risk?

Study design:
This review article included 6 prospective cohort studies with 569,910 participants and 86 RCTs with 114 comparisons and 5,873 participants.

Results and conclusions:
The investigators found nuts consumption was significantly associated with a lower risk of 7% for incidence of overweight/obesity [RR = 0.93, 95% CI = 0.88 to 0.98, p 0.001, moderate certainty of evidence] in prospective cohort studies.

The investigators found RCTs showed no adverse effect of nuts on body weight [MD = 0.09 kg, 95% CI = -0.09 to 0.27 kg, p 0.001, high certainty of evidence].

The investigators found meta-regression showed that higher nut intake was significantly associated with reductions in body weight and body fat.

The investigators concluded that current evidence demonstrates the concern that nut consumption contributes to increased adiposity appears unwarranted.

Original title:
Are fatty nuts a weighty concern? A systematic review and meta-analysis and dose-response meta-regression of prospective cohorts and randomized controlled trials by Nishi SK, Viguiliouk E, [...], Sievenpiper JL.

Link:
https://pubmed.ncbi.nlm.nih.gov/34494363/

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

Objectives:
Selenium (Se) is a trace element having significant effects on human metabolism. Recent studies suggest that selenium supplementation have a pivotal effect on the inflammatory markers. Therefore, this review article has been conducted.

Does selenium supplementation reduce plasma inflammatory markers including C-reactive protein (CRP) and high-sensitivity C-reactive protein (hs-CRP) and nitric oxide (NO) as a stress oxidative index, among patients with metabolic diseases?

Study design:
This review article included 7 RCTs.

Results and conclusions:
The investigators found subgroup analysis of CRP type showed that selenium supplementation significantly decreased hs-CRP level [pooled SMD = -0.44, 95% CI = -0.67 to -0.21] among patients with metabolic diseases.

The investigators concluded that selenium supplementation decreases hs-CRP level among patients with metabolic diseases.

Original title:
The effects of dietary selenium supplementation on inflammatory markers among patients with metabolic diseases: a systematic review and meta-analysis of randomized controlled trials by Djalalinia S, Hasani M, […], Qorbani M.

Link:
https://pubmed.ncbi.nlm.nih.gov/34222098/

Additional information of El Mondo:
Find here more information/studies about review article/significant, chronic disease and selenium.

Objectives:
LDL particle size and number (LDL-P) are emerging lipid risk factors. Nonsystematic reviews have suggested that diets lower in carbohydrates and higher in fats may result in increased LDL particle size when compared with higher-carbohydrate diets. Therefore, this review article has been conducted.

Do dietary interventions restricted in carbohydrates increase LDL peak particle size and decrease the numbers of total and small LDL particles?

Study design:
This review article included 38 randomized trials (of any length that reported on dietary carbohydrate restriction (intervention) compared with higher carbohydrate intake (control)) with a total of 1,785 participants.

Results and conclusions:
The investigators found dietary carbohydrate restriction were significantly associated with an increase in LDL peak particle size [SMD = 0.50, 95% CI = 0.15 to 0.86, p 0.01] and a reduction in LDL particle number [SMD = -0.24, 95% CI = -0.43 to -0.06, p = 0.02], when compared with higher carbohydrate intake.  

The investigators found the effect of carbohydrate-restricted dietary interventions on LDL peak particle size appeared to be partially explained by differences in weight loss between intervention groups and exploratory analysis revealed a shift from small dense to larger LDL subclasses.

The investigators found no statistically significant association between carbohydrate-restricted dietary interventions and mean LDL particle size [SMD = 0.20, 95% CI = -0.29 to 0.69, p = 0.37], when compared with higher carbohydrate intake.  

The investigators concluded that dietary interventions restricted in carbohydrates increase LDL peak particle size and decrease the numbers of total and small LDL particles.
 
Original title:
Effect of carbohydrate-restricted dietary interventions on LDL particle size and number in adults in the context of weight loss or weight maintenance: a systematic review and meta-analysis by Falkenhain K, Roach LA, […], Little JP.

Link:
https://pubmed.ncbi.nlm.nih.gov/34159352/

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

LDL particle number (LDL-P) is a much more accurate predictor of cardiovascular disease risk than either LDL or total cholesterol. Increased LDL-P could be one of the reasons that some people have heart attacks even though their total cholesterol and LDL cholesterol levels are not particularly high.

A low-carbohydrate diet is a diet with 20-40 En% carbohydrate. The easiest way to follow a diet with 20-40 En% carbohydrate is to choose only meals/products with 20-40 En% carbohydrate. Check here which products contain 20-40 En% carbohydrate.
However, the most practical way to follow a diet with 20-40 En% carbohydrate is, all meals/products that you eat on a daily basis should on average contain 20-40 En% carbohydrate.
20-40 En% carbohydrate means that the total amounts of carbohydrates make up for a 20-40% of the total kcal of the diet.

Use the 7-points nutritional profile app to see if your daily eaten products contain on average 20-40 En% carbohydrate.

Objectives:
Emergence of Plasmodium falciparum resistance to artemisinin and its derivatives poses a threat to the global effort to control malaria. The emergence of anti-malarial resistance has become a great public health challenge and continues to be a leading threat to ongoing malaria control efforts. Therefore, this review article has been conducted.

What is the efficacy of dihydroartemisinin-piperaquine (DHA-PQ) compared to artemether-lumefantrine (AL) for the treatment of uncomplicated falciparum malaria among children in Africa?

Study design:
This review article included 25 studies which involved a total of 13,198 participants.

Results and conclusions:
The investigators found PCR-unadjusted treatment failure in children aged between 6 months and 15 years was significantly lower in the dihydroartemisinin-piperaquine treatment arm on day 28 than that of artemether-lumefantrine [RR = 0.14, 95% CI = 0.08 to 0.26, I2 = 0%, studies = 4, participants = 1,302, high quality of evidence].

The investigators found, consistently, the PCR-adjusted treatment failure was significantly lower with the dihydroartemisinin-piperaquine treatment group on day 28 [RR = 0.45, 95% CI = 0.29 to 0.68, I2 = 51%, studies = 16, participants = 8,508, high quality of evidence] and on day 42 [RR = 0.60, 95% CI =0.47 to 0.78, I2 = 0%, studies = 17, participants = 5,959, high quality of evidence].
However, the efficacy was ≥ 95% in both treatment groups on day 28.

The investigators concluded that dihydroartemisinin-piperaquine reduces new infection and recrudescence (a new outbreak after a period of abatement or inactivity) on days 28 and 42 more than artemether-lumefantrine. This may trigger dihydroartemisinin-piperaquine to become a first-line treatment option.

Original title:
Efficacy of dihydroartemisinin-piperaquine versus artemether-lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria among children in Africa: a systematic review and meta-analysis of randomized control trials by Assefa DG, Yismaw G and Makonnen E.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8359548/

Additional information of El Mondo:
Find more information/studies on RCTs/cohort/significantly/review article, malaria and malnutrition right here.

Objectives:
Previous studies have provided limited evidence for the effect of carrot intake on bladder cancer incidence. Therefore, this review article has been conducted.

Is there a relationship between dietary carrot intake and bladder cancer incidence?

Study design:
This review article included 3 cohort studies.

Results and conclusions:
The investigators found in a meta-analyse of 3 cohort studies no significant association between dietary carrot intake and bladder cancer risk [summary HR = 1.02, 95% CI = 0.95 to 1.10, I2 = 0.0%, p = 0.859].

The investigators concluded that there is no association between dietary consumption of carrot and the risk of bladder cancer.

Original title:
Association of Dietary Carrot Intake With Bladder Cancer Risk in a Prospective Cohort of 99,650 Individuals With 12.5 Years of Follow-Up by Xu X, Zhu Y, […], Xia D.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8349976/

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Objectives:
The effects of vitamin and mineral supplementation on women with gestational diabetes mellitus (GDM) have not been well established. Therefore, this review article has been conducted.

Does vitamin and mineral supplementation improve glycemic control (like, fasting plasma glucose, serum insulin, homeostasis model assessment-insulin resistance and homeostasis model of assessment for β cell function) and decrease risk of inflammation and oxidative stress in women with gestational diabetes mellitus?

Study design:
This review article included 12 RCTs with 698 patients.

Patients included were in the age range of 18-40 years and all reported gestational diabetes mellitus screening was conducted between 24 weeks and 28 weeks gestation.

All trials gave vitamin and mineral supplementation orally.

Types, doses, dose regimens and duration of vitamin and mineral supplementation were as follows: magnesium (100-250 mg), zinc (4-233 mg), selenium (200 μg), calcium (400-1000 mg) and vitamin E (400 IU) every day for 6 weeks, vitamin D (200-50000 IU) every day or every 2 or 3 weeks for 6 weeks. Magnesium, zinc, selenium, calcium, vitamin D or E was given separately or in different combinations: magnesium and vitamin E; zinc and vitamin E; calcium and vitamin D; magnesium, zinc, calcium and vitamin D.

All trials used placebo as control intervention.

Among the 12 trials, 8 were judged to be at low risk of bias and 4 as being at unclear risk of bias. Unclear risks were related to attrition bias and other bias.

No significant publication bias was found for the effect of vitamin and mineral supplementation on all 8 outcomes.

Results and conclusions:
The investigators found magnesium, zinc, selenium, calcium, vitamin D and E (alone or in combination) supplementation significantly improved glycemic control in women with gestational diabetes mellitus compared to those receiving placebos:
-fasting plasma glucose (FPG) [MD = - 9.02, 95% CI = -12.09 to -5.96, p   0.00001];
-serum insulin [MD = -4.33, 95% CI = -5.35 to -3.32, p  0.00001];
-homeostasis model assessment-insulin resistance (HOMA-IR) [MD = -1.34, 95% CI = -1.60 to -1.07, p  0.00001] and;
-homeostasis model of assessment for β cell function (HOMA-B) [MD = - 15.58, 95% CI = -23.70 to -7.46, p = 0.0002].
Significantly because the calculated p-value of 0.0002 was less than the p-value of 0.05.

The investigators found vitamin and mineral supplementation (magnesium, zinc, selenium, calcium, vitamin D and E (alone or in combination)) significantly decreased risk of inflammation and oxidative stress through decreasing high-sensitivity C-reactive protein (hs-CRP) [MD = -1.29, 95% CI = -1.82 to -0.76, p  0.00001], malondialdehyde (MDA) [MD = -0.71, 95% CI = -0.97 to -0.45, p  0.00001] and increasing total antioxidant capacity (TAC) [MD = 45.55, 95% CI = 22.02 to 69.08, p = 0.0001].

The investigators concluded that vitamin and mineral supplementation improves glycemic control and decreases risk of inflammation and oxidative stress in women with gestational diabetes mellitus.

Original title:
The effects of vitamin and mineral supplementation on women with gestational diabetes mellitus by Li D, Cai Z, [...], Zhang J.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8145819/

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Objectives:
Studies indicate that onion supplementation may be effective in the treatment of dyslipidemia; however, the results remain controversial. Therefore, this review article has been conducted.

Does supplementation of onion improve levels of cholesterol and triglycerides or in other words, does eating onions causally lower cholesterol and triglycerides levels?  

Study design:
This review article included 10 RCTs with 446 participants, that were randomly assigned to either the placebo group or the onion group.

The number of participants in each study ranged from 12 to 92.
The duration of intervention in the included studies ranged from 2 to 12 weeks.
There was no evidence of publication bias.

Results and conclusions:
The investigators found the pooled findings of 10 studies showed that onion supplementation significantly increased high-density lipoprotein cholesterol (good cholesterol or HDL cholesterol) levels [MD = 2.29 mg/dL, 95% CI = 0.87 to 3.72, I2 = 0%], when compared to the control group.

The investigators found the pooled findings of 10 studies showed that onion supplementation significantly decreased low-density lipoprotein cholesterol (bad cholesterol or LDL cholesterol) levels [MD = -6.64 mg/dL, 95% CI = -10.91 to -2.36, I2 = 32%], when compared to the control group.
The pooled effect size of LDL cholesterol was not affected by any of the studies in sensitivity analysis.

The investigators found the pooled findings of 10 studies showed no association between onion supplementation and lower triglycerides (TG) levels [MD = -6.55 mg/dL, 95% CI = -15.64 to 2.53, I2 = 45%], when compared to the control group.

The investigators found the pooled findings of 9 studies showed that onion supplementation significantly increased total cholesterol (TC) levels [MD = -5.39 mg/dL, 95% CI = -10.68 to -0.09, I2 = 49%], when compared to the control group.

The investigators found in subgroup analysis that onion supplementation showed a greater benefit in lowering total cholesterol [MD = -17.23 mg/dL, 95% CI = -27.99 to -6.47, I2 = 8%] and LDL cholesterol levels [MD = -12.70 mg/dL, 95% CI = -23.12 to -2.27, I2 = 0%] in subjects with dyslipidemia.

The investigators found in subgroup analysis that onion supplementation longer than 10 weeks showed more increases in HDL cholesterol concentrations [MD = 2.81 mg/dL, 95% CI = 1.08 to 5.54, I2 = 17%].

The investigators concluded supplementation of onion is beneficial to control dyslipidemia, including improving levels of HDL, LDL and total cholesterol, but could not reduce triglycerides levels. The therapeutic benefits of onion for dyslipidemia need to be treated with caution considering that some of the results are not robust.

Original title:
Effect of onion on blood lipid profile: A meta-analysis of randomized controlled trials by Huang W, Tang G, [...], Wei Z.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8269690

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Dyslipidemia is defined as having blood lipid levels that are too high or low. Blood lipids are fatty substances, such as triglycerides and cholesterol.

A causal relationship can be found in RCTs.