Nutritional advice

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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Find more information/studies on breastfeeding and cancer right here.

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/

Additional information of El Mondo:
Find more information/studies on fatty acids, cardiovascular disease and elderly right here.

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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Find here more information/studies about review article/significant, chronic diseases and vitamin D.

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:
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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/

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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/

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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/

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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

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

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.

Objectives:
Low vitamin D status is a global public health issue that vitamin D food fortification and biofortification may help to alleviate. Therefore, this review article has been conducted.

Does vitamin D food fortification increase circulating 25(OH)D (vitamin D level in blood) concentrations in populations?

Study design:
This review article included data from 34 publications (2,398 adults: 1,345 intervention (group with vitamin D fortification), 1,053 controls (group without vitamin D fortification) and 1,532 children: 970 intervention, 562 controls).

Results and conclusions:
The investigators found random-effects meta-analysis of all studies combined (mean dose 16.2 μg/d) indicated a pooled treatment effect of 21.2 nmol/L [95% CI = 16.2 to 26.2, I2 > 75%], with a greater effect for studies using cholecalciferol (vitamin D3) than ergocalciferol (vitamin D2).

The investigators found metaregression analyses for all studies combined suggested positive effect differences for baseline circulating 25(OH)D concentrations 50 nmol/L, dose ≥10 μg/d and a negative effect difference when the intervention arm included a calcium dose ≥500 mg/d greater than the control arm.

The investigators found dose-response rates was nonlinear [Wald test for nonlinearity p 0.001].
For all studies combined, a threshold occurred at ∼26 nmol/L for a dose of ∼21 μg/d.

The investigators concluded that vitamin D food fortification (at least 10 μg/d) increases circulating 25(OH)D concentrations in populations.

Original title:
Vitamin D Food Fortification and Biofortification Increases Serum 25-Hydroxyvitamin D Concentrations in Adults and Children: An Updated and Extended Systematic Review and Meta-Analysis of Randomized Controlled Trials by Dunlop E, Kiely ME, […], Black LJ.

Link:
https://pubmed.ncbi.nlm.nih.gov/34113994/

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Objectives:
Although current guidelines recommend reduction of salt intake in patients with diabetes, the benefits of reducing salt intake in people with type 2 diabetes mellitus (T2DM) lack clear evidence. Therefore, this review articles has been conducted.

Does dietary sodium restriction causally reduce blood pressure in patients with type 2 diabetes mellitus (T2DM)?

Study design:
This review article included 8 RCTs with 10 trials (7 cross-over and 3 parallel designs).
No publication bias was found from Begg's and Egger's tests.

Results and conclusions:
The investigators found compared with ordinary sodium intake, dietary sodium restriction significantly decreased 24-hour urine sodium level [WMD = -38.430 mmol/24h, 95% CI = -41.665 mmol/24h to -35.194 mmol/24h].

The investigators found dietary sodium restriction significantly lowered systolic blood pressure [WMD = -5.574 mm Hg, 95% CI = -8.314 to -2.834 mm Hg, I2 = 0.0%] and diastolic blood pressure [WMD = -1.675 mm Hg, 95% CI = -3.199 to -0.150 mm Hg, I2 = 0.0%].

The investigators concluded that dietary sodium restriction causally reduces systolic blood pressure and diastolic blood pressure in patients with type 2 diabetes mellitus (T2DM).

Original title:
Effect of dietary sodium restriction on blood pressure in type 2 diabetes: A meta-analysis of randomized controlled trials by Ren Y, Liqiang Qin L, […], Ma Y.

Link:
https://pubmed.ncbi.nlm.nih.gov/33838996/

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

Salt consists of sodium and chloride. So a dietary sodium restriction means a reduction in dietary salt intake.

A diet with dietary salt restriction is a diet with maximum 0.2 grams of salt per 100 kcal.

The easiest way to follow this diet is to choose only products/meals with maximum 0.2 grams of salt per 100 kcal. These products from the supermarket contain maximum 0.2 grams of salt per 100 kcal.

However, the most practical way to follow this diet is, all your daily consumed products/meals should contain on average maximum 0.2 grams of salt per 100 kcal.
To do this, use the 7-points nutritional profile app to see if your daily diet contains maximum 0.2 grams of salt per 100 kcal.

Objectives:
Evidence regarding associations between potato consumption and type 2 diabetes (T2D) and gestational diabetes mellitus (GDM) risks is accumulating. Therefore, this review article has been conducted.

Does a high potato intake increase type 2 diabetes and gestational diabetes mellitus (diabetes mellitus during pregnancy) risk?

Study design:
This review article included 19 studies (13 for type 2 diabetes and 6 for gestational diabetes mellitus) with a total of 21,357 type 2 diabetes cases among 323,475 participants and 1,516 gestational diabetes mellitus cases among 29,288 pregnancies.

Results and conclusions:
The investigators found meta-analysis showed a significantly increased risk of 19% [RR = 1.19, 95% CI = 1.06 to 1.34] for type 2 diabetes for total potato intakes among Western populations.

The investigators found meta-analysis showed a significantly increased risk of 8% [RR = 1.08, 95% CI = 1.00 to 1.16] for type 2 diabetes for baked/boiled/mashed potato intakes among Western populations.

The investigators found meta-analysis showed a significantly increased risk of 33% [RR = 1.33, 95% CI = 1.03 to 1.70] for type 2 diabetes for French fries/fried potato intakes among Western populations.

The investigators found dose-response meta-analysis demonstrated a significantly increased type 2 diabetes risk by 10% [95% CI = 1.07 to 1.14, p for trend 0.001], 2% [95% CI = 1.00 to 1.04, p for trend = 0.02] and 34% [95% CI = 1.24 to 1.46, p for trend 0.001] among Western populations for each 80 g/day (serving) increment in total potato, unfried potato and fried potato intakes, respectively.

The investigators found dose-response meta-analysis demonstrated a significantly increased gestational diabetes mellitus risk by 22% [95% CI = 1.06 to 1.42, p for trend 0.007] among Western populations for each 80 g/day (serving) increment in total potato intakes.

The investigators found dose-response meta-analysis demonstrated a significantly increased gestational diabetes mellitus risk by 26% [95% CI = 1.07 to 1.48, p for trend = 0.006] among Western populations for each 80 g/day (serving) increment in unfried potato intakes.

The investigators concluded that higher potato intake (at least 80g per day) is associated with higher type 2 diabetes risk among Western populations. The positive relationship presents a significant dose-response manner. Wisely controlled potato consumption may confer potential glucometabolic benefits.

Original title:
Dietary potato intake and risks of type 2 diabetes and gestational diabetes mellitus by Guo F, Zhang Q, [...], Ma L.

Link:
https://pubmed.ncbi.nlm.nih.gov/34130021/

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Objectives:
Whether N-acetylcysteine (NAC) therapy can promote the improvement of clinical symptoms and lung function in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has not been verified by large-scale randomized controlled trials, only a few small sample studies. Therefore, this review article has been conducted.

Does n-acetylcysteine (NAC) supplementation improve clinical symptoms and lung function in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD)?

Study design:
This review article included 12 retrospective analyses and 3 randomized controlled trials (RCTs) with 1,605 patients.
The 15 included studies were small sample studies, with sample sizes ranging from 72 to 146.

9 studies had a Jadad score of 3-5 points and 6 studies had a Jadad score of 1-2 points.

Results and conclusions:
The investigators found the meta-analysis results of 10 studies (525 cases in the n-acetylcysteine group and 524 cases in the control group) showed that the forced expiratory volume in the first second (FEV1) of the n-acetylcysteine group was markedly higher than that of the control group; the mean difference was 30.63 [95% CI = 25.48 to 35.78, I2 = 92%] and the difference was statistically significant [z = 11.65 and p 0.0001].

The investigators found the meta-analysis results of 6 studies (347 cases in the n-acetylcysteine group and 350 cases in the control group) showed that forced expiratory volume in the first second/forced vital capacity (FEV1/FVC) of the n-acetylcysteine group was markedly higher than that of the control group; the mean difference was 30.42 [95% CI = 24.00 to 36.85, I2 = 93%] and the difference was statistically significant [z = 9.28 and p 0.0001].

The investigators found the meta-analysis results of 6 studies (323 cases in the n-acetylcysteine group and 322 cases in the control group) showed that the glutathione sulfur transferase (GSH-ST) activity of the n-acetylcysteine group was notably greater than that of the control group; the mean difference was 3.10 [95% CI = 1.38 to 4.82, I2 = 91%] and the difference was statistically significant [z = 3.63, p = 0.0004].

The investigators found the meta-analysis results of 4 studies (224 cases in the n-acetylcysteine group and 227 cases in the control group) showed that the ability of the n-acetylcysteine group to inhibit hydroxyl free radicals was higher than that of the control group; the mean difference was 77.52 [95% CI = 61.01 to 94.03, I2 = 44%] and the difference was statistically significant [z = 9.20 and p 0.0001]. 

The investigators found the meta-analysis results of 4 studies (224 cases in the n-acetylcysteine group and 227 cases in the control group) showed that the superoxide anion radical resistance ability of the n-acetylcysteine group was greater than the ability of the control group; the mean difference was 47.75 [95% CI = 36.26 to 59.25, I2 = 35%] and the difference was statistically significant [z = 8.14 and p 0.0001]. 

The investigators concluded n-acetylcysteine (NAC) supplementation could promote the symptom improvement rate of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), improve lung function in FEV1 and FEV1/FVC and enhance the body’s antioxidant capacity. Could because the sample size of the literature included in this review article was small. The sample size should be expanded in future randomized controlled trials to verify these findings. All in all, the results of this review article can provide a reliable theoretical basis for the clinical treatment of AECOPD, so that patients can benefit from NAC treatment.

Original title:
Systematic review and meta-analysis of the efficacy of N-acetylcysteine in the treatment of acute exacerbation of chronic obstructive pulmonary disease by Jiang C, Zou J, [...], Yang Y.

Link:
https://apm.amegroups.com/article/view/72787/html

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An acute exacerbation of chronic obstructive pulmonary disease is a sudden worsening of chronic obstructive pulmonary disease (COPD) symptoms including shortness of breath, quantity and color of phlegm that typically lasts for several days.
 

Objectives:
Zinc in one of the most abundant trace minerals in human body which is involved in numerous biological pathways and has variety of roles in the nervous system. It has been assumed that zinc exerts its role in nervous system through increasing brain derived neurotrophic factor (BDNF) concentrations. Therefore, this review article has been conducted.

Does zinc supplementation increase brain derived neurotrophic factor (BDNF) levels?

Study design:
This review article included 5 studies with 238 participants. These studies enrolled subjects with premenstrual syndrome, diabetic retinopathy, major depression disorder, overweight/obese and obese with mild to moderate depressive disorders.

Funnel plot did not suggest publication bias.

Results and conclusions:
The investigators found zinc supplementation failed to increase blood brain derived neurotrophic factor concentrations with effect size of 0.30 [95% CI = -0.08 to 0.67, p = 0.119].

The investigators concluded zinc supplementation does not increase brain derived neurotrophic factor (BDNF) levels. However, the small number of included articles and significant heterogeneity between them can increase the risk of a false negative result; therefore, the results should be interpreted with caution.

Original title:
The effect of zinc supplementation on brain derived neurotrophic factor: A meta-analysis by Jafari F, Mohammadi H and Amani R.

Link:
https://pubmed.ncbi.nlm.nih.gov/33831797/

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Brain Derived Neurotrophic Factor (BDNF) plays an important role in neuronal survival and growth, serves as a neurotransmitter modulator and participates in neuronal plasticity, which is essential for learning and memory.
Decreased levels of BDNF are associated with neurodegenerative diseases with neuronal loss, such as Parkinson's disease, Alzheimer's disease, multiple sclerosis and Huntington's disease.
 

Objectives:
What is the immunogenicity and safety of the 7 different Ebola virus vaccines in healthy adults?

Study design:
This review article included 21 randomized controlled trials (RCTs), evaluating 7 different vaccines with different doses with a  total of 5,275 participants.

Results and conclusions:
The investigators found the rVSVΔG-ZEBOV-GP (2 × 107) vaccine was more immunogenic [p-score = 0.80].

The investigators found for pain, rVSVΔG-ZEBOV-GP (≤105) had few events [p-score = 0.90].

The investigators found for fatigue and headache, the DNA-EBOV (≤ 4 mg) was the best one with [p-scores of 0.94 and 0.87], respectively.

The investigators found for myalgia, the ChAd3 (1010) had a lower risk [p-score = 0.94].

The investigators found for fever, the Ad5.ZEBOV (≤ 8 × 1010) was the best one [p-score 0.80].

The investigators concluded that the best vaccine to be used to stop future outbreak of Ebola is the rVSVDG-ZEBOV-GP vaccine at dose of 2 × 107 plaque-forming units (PFU).

Original title:
Immunogenicity and safety of Ebola virus vaccines in healthy adults: a systematic review and network meta-analysis by Diallo A, Carlos-Bolumbu M, […], Galtier F.

Link:
https://pubmed.ncbi.nlm.nih.gov/34270366/

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Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, is a rare but severe, often fatal illness in humans and is been caused by the Ebola virus. As the Ebola virus spreads through the body, it damages the immune system and organs. Ultimately, it causes levels of blood-clotting cells to drop. This leads to severe, uncontrollable bleeding.

The Ebola virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission.

The average Ebola virus disease case fatality rate is around 50%.

The Ebola virus was first discovered in 1976 near the Ebola River in what is now the Democratic Republic of Congo.

Recombinant vesicular stomatitis virus-Zaire Ebola virus (rVSV-ZEBOV), also known as Ebola Zaire vaccine live and sold under the brand name Ervebo, is an Ebola vaccine for adults (18 years and older) that prevents Ebola caused by the Zaire ebolavirus. Ervebo contains a virus known as vesicular stomatitis virus which has been weakened and modified to contain a protein from the Zaire Ebola virus.

Objectives:
Omega-3 polyunsaturated fatty acid (PUFA) supplementation has been proposed as a potential therapy for cancer-related malnutrition, which affects up to 70% of patients with cancer. Therefore, this review article has been conducted.

Do patients with cancer benefit from oral omega-3 PUFA supplements?

Study design:
This review article included 31 RCTs.
Trials supplementing ≥600 mg/d omega-3 PUFA (oral capsules, pure fish oil or oral nutritional supplements) compared with a control intervention for ≥3 weeks.

The Cochrane risk of bias tool graded most trials as “unclear” or “high” risk of bias.

Results and conclusions:
The investigators found meta-analyses showed no significant difference between omega-3 PUFA supplements and control intervention on muscle mass, quality of life and body weight.

The investigators found oral omega-3 PUFA supplements significantly reduced the likelihood of developing chemotherapy-induced peripheral neuropathy with 80% [OR = 0.20, 95% CI = 0.10 to 0.40, p 0.001, I2 = 0%].  

The investigators concluded that oral omega-3 PUFA supplementation may reduce the incidence of chemotherapy-induced peripheral neuropathy in patients with cancer. May reduce because most trials were graded as “unclear” or “high” risk of bias.

Original title:
The effect of oral omega-3 polyunsaturated fatty acid supplementation on muscle maintenance and quality of life in patients with cancer: A systematic review and meta-analysis by Lam CN, Watt AE, [...], van der Meij BS.

Link:
https://pubmed.ncbi.nlm.nih.gov/34130028/

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Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most frequent side effects caused by antineoplastic agents. Antineoplastic drugs are medications used to treat cancer. Antineoplastic drugs are also called anticancer, chemotherapy, chemo, cytotoxic or hazardous drugs.

Objectives:
Personalized nutrition and protective diets and lifestyles represent a key cancer research priority. The association between consumption of specific dietary components and colorectal cancer (CRC) incidence has been evaluated by a number of population-based studies, which have identified certain food items as having protective potential, though the findings have been inconsistent. Therefore, this review article has been conducted.

Which food groups reduce risk of colorectal cancer?

Study design:
This review article included 46 studies (case-control studies and cohort studies).

Results and conclusions:
The investigators found in pooled analyses that colorectal cancer risk was significantly reduced with 10% in patients with higher vs lower consumption of cruciferous vegetables [OR = 0.90, 95% CI = 0.85 to 0.95, p = 0.00, I2 = 31.02%].
This reduced risk was only significant in case-control studies, but not in cohort studies.

The investigators found in pooled analyses that colorectal cancer risk was significantly reduced with 10% in patients with higher vs lower consumption of citrus fruits [OR = 0.90, 95% CI = 0.84 to 0.96, p = 0.00, I2 = 21.65%].
This reduced risk was only significant in case-control studies, but not in cohort studies.

The investigators found in pooled analyses that colorectal cancer risk was significantly reduced with 17% in patients with higher vs lower consumption of garlic [OR = 0.83, 95% CI = 0.76 to 0.91, p = 0.00, I2 = 32.64%].
This reduced risk was only significant in case-control studies, but not in cohort studies.

The investigators found in pooled analyses that colorectal cancer risk was significantly reduced with 11% in patients with higher vs lower consumption of tomatoes [OR = 0.89, 95% CI = 0.84 to 0.95, p = 0.00, I2 = 0%].
This reduced risk was only significant in case-control studies, but not in cohort studies.

The investigators found in subgroup analysis of cohort studies that colorectal cancer risk was significantly reduced with 26% in patients with higher vs lower consumption of nut [OR = 0.74, 95% CI = 0.58 to 0.94, p = 0.01, I2 = 35.48%].

The investigators concluded that an increased consumption of cruciferous vegetables, citrus fruits, garlic and tomatoes may reduce colorectal cancer risk. May reduce because the reduced risk is only found in case-control studies and not in cohort studies.

Original title:
Phytochemically rich dietary components and the risk of colorectal cancer: A systematic review and meta-analysis of observational studies by Borgas P, Gonzalez G, […], Reza Mirnezami R.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8223713/

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Objectives:
Does vitamin C supplementation improve triglyceride and cholesterol levels in patients with type 2 diabetes mellitus?

Study design:
This review article included 15 studies with 872 participants.

Results and conclusions:
The investigators found, findings from 15 studies indicated that vitamin C supplementation significantly decreased triglyceride (TG) levels [WMD= -16.48 mg/dL, 95% CI = -31.89 to -1.08, p 0.001] and total cholesterol (TC) levels [WMD = -13.00 mg/dL, 95% CI = -23.10 to -2.91, p 0.001] in patients with type 2 diabetes mellitus.

The investigators found, however, vitamin C supplementation failed to improve LDL (bad cholesterol) and HDL cholesterol (good cholesterol) levels. 

The investigators found the meta-regression analysis suggested that lipid profile improvement was affected by duration of vitamin C treatment.

The investigators found dose-response analysis showed that vitamin C supplementation changed LDL cholesterol significantly based on vitamin C dose.

The investigators concluded that vitamin C supplementation improves lipid profile via decreases in triglyceride and total cholesterol levels in patients with type 2 diabetes mellitus. It appears that vitamin C supplementation is more beneficial to lipid profile in long-term vs. short term interventions.

Original title:
Does vitamin C supplementation exert profitable effects on serum lipid profile in patients with type 2 diabetes? A systematic review and dose-response meta-analysis by Namkhah Z, Ashtary-Larky D, […], Asbaghi O.

Link:
https://pubmed.ncbi.nlm.nih.gov/33984490/

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Objectives:
Do patients with knee osteoarthritis benefit from vitamin D supplementation?

Study design:
This review article included 6 articles with a total of 1,599 patients with osteoarthritis of the knee.

Results and conclusions:
The investigators found, the results of the meta-analysis showed that vitamin D supplementation statistically significantly improved WOMAC score [SMD = -0.67, 95% CI = -1.23 to -0.12) in patients with knee osteoarthritis, including WOMAC pain score [SMD = -0.32, 95% CI = -0.63 to -0.02], function score [SMD = -0.34, 95% CI = -0.60 to -0.08] and stiffness score [SMD = -0.13, 95% CI = -0.26 to -0.01].

The investigators found, in subgroup analysis, vitamin D supplementation less than 2000 IU (50 mcg) was statistically significant for the reduction of stiffness score [SMD = -0.22, 95% CI = -0.40 to -0.04].

The investigators found vitamin D supplements significantly reduced synovial fluid volume progression in patients with knee osteoarthritis [SMD = -0.20, 95% CI -0.39 to -0.02].

The investigators concluded vitamin D supplements improve WOMAC pain and function in patients with knee osteoarthritis.

Original title:
Does vitamin D improve symptomatic and structural outcomes in knee osteoarthritis? A systematic review and meta-analysis by Zhao ZX, He Y, […], Chen J.

Link:
https://pubmed.ncbi.nlm.nih.gov/33783714/

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The WOMAC is a validated patient-administered questionnaire that assesses 3 components: pain, stiffness and function, with the score range of 0-20 for pain, 0-8 for stiffness and 0-68 for physical function.
 

Objectives:
Vaccination and single-dose rifampin are the main proven effective intervention types for preventing leprosy among contacts of Mycobacterium leprae endemic areas. Currently, no high-quality evidence is available regarding the best prophylactic (preventing or contributing to the prevention of disease) intervention. Therefore, this review article has been conducted.

What is the most effective prophylactic intervention of leprosy among contacts?

Study design:
This review article included 11 RCTs with 326,264 patients; 8 were eligible for NMA while 4 were eligible for MA.

Results and conclusions:
The investigators found that BCG vaccination was the most effective intervention compared to placebo [risk ratio = 0.49, 95% CI = 0.30 to 0.80], followed by combined BCG vaccination and single-dose rifampicin (SDR) with similarly low values [risk ratio = 48%].

The investigators found BCG revaccination was the least effective intervention compared to placebo [RR = 1.08, 95% CI = 0.36 to 3.22].

The investigators concluded that the BCG vaccine is the most effective prophylactic intervention of leprosy among contacts. The combination of BCG vaccination + single-dose rifampicin (SDR) has nearly the same efficacy as BCG vaccination alone, while BCG revaccination is the least effective. Thus, vaccination is proven to be a more effective treatment than SDR alone. A well-designed multicenter RCT is warranted to evaluate the safety of these vaccines.

Original title:
Efficacy of chemoprophylaxis and immunoprophylaxis in leprosy prevention: a systematic review and network meta-analysis of randomized controlled trials by Tawfik GM, Biala M, […], Nguyen TH.

Link:
https://pubmed.ncbi.nlm.nih.gov/34332107/

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Leprosy is a chronic infectious disease, caused by Mycobacterium leprae, that can lead to severe life-long disabilities.

The BCG (Bacillus Calmette-Guérin) vaccination is used against tuberculosis.