Nutritional advice

Objectives:
Does consumption of fruits and vegetables reduce risk of endometrial cancer?

Study design:
This review article included  of 21 case-control studies and 6 cohort studies.

Results and conclusions:
The investigators found that vegetables consumption significantly reduced risk of endometrial cancer with 24% [pooled odds ratio [OR], relative risk [RR], hazard ratio [HR] = 0.76, 95% CI = 0.63 to 0.91].

The investigators found that cruciferous vegetables consumption significantly reduced risk of endometrial cancer with 19% [pooled OR = 0.81, 95% CI = 0.70 to 0.94].

The investigators found that dark green and yellow/orange combined vegetables consumption significantly reduced risk of endometrial cancer with 36% [pooled OR = 0.64, 95% CI = 0.42 to 0.97].

The investigators found that fruits consumption significantly reduced risk of endometrial cancer with 19% [pooled OR = 0.81, 95% CI = 0.70 to 0.92].

The investigators found these results were primarily based on studies of high quality and exhibited either by case-control only or a combination of case-control and cohort studies. Additionally, the results varied by geographic location, such as Western areas, the US and Italy.

The investigators concluded that consumption of fruits and vegetables has beneficial effects on endometrial cancer risk and that specific kinds of fruits and vegetables should be recommended differently due to their outstanding bioactive components.

Original title:
The influence of dietary vegetables and fruits on endometrial cancer risk: a meta-analysis of observational studies by Lu YT, Gunathilake M and Kim J.

Link:
https://pubmed.ncbi.nlm.nih.gov/36151331/

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

Objectives:
What is the incremental net benefit (INB) of the 13-valent PCV (PCV13) and 10-valent PCV (PCV10) in children?

Study design:
This review article included 70 studies.

Results and conclusions:
The investigators found when herd effects were considered, PCV13 was cost-effective compared to PCV10 from the payer perspective in both high-income countries (HICs) [INB = $103.94, 95% CI = $75.28 to $132.60] and low- and middle-income countries (LMICs) [INB = $53.49, 95% CI = $30.42 to $76.55] with statistical significance.
These findings were robust across a series of sensitivity analyses.

The investigators found PCV13 was cost-effective compared to no vaccination across perspectives and consideration of herd effects in both HICs and LMICs, while findings were less consistent for PCV10.

The investigators concluded PCVs are generally cost-effective compared to no vaccination in HICs and LMICs. Furthermore, PCV13 is cost-effective compared to PCV10 when herd effects are considered from the payer perspective in both HICs and LMICs. These findings are sensitive to the consideration of herd effects.

Original title:
Pneumococcal Vaccination in Children: A Systematic Review and Meta-Analysis of Cost-effectiveness Studies by Syeed MS, Ghule P, […], Chaiyakunapruk N.

Link:
https://pubmed.ncbi.nlm.nih.gov/36328324/

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

Objectives:
Dementia is a chronic progressive neurodegenerative disease that can lead to disability and death in humans, but there is still no effective prevention and treatment. Due to the neuroprotective effects of vitamin E, a large number of researchers have explored whether vitamin E can reduce the risk of dementia. Some researchers believe that vitamin E can reduce the risk of dementia, while others hold the opposite conclusion. Therefore, this review article has been conducted.

Do high intakes of diet or vitamin E supplements reduce the risk of dementia?

Study design:
This review article included 13 cohort studies (46,968 participants and 6,046 dementia patients after 4-23 years of follow-up) and 2 case-control studies with (3,157 controls and 3,459 patients).
The studies included in this meta-analysis (review article) were published between 1983 and 2022.
The literary NOS quality score ranged from 6 to 8.
There was no publication bias.

Results and conclusions:
The investigators found a high intake of diet or vitamin E supplements significantly decreased the risk of dementia by 21% [OR = 0.79, 95% CI = 0.70 to 0.88, I2 = 35.0%, p = 0.071].
This decreased risk was also significant in cohort studies [OR = 0.79, 95% CI = 0.69 to 0.89], dietary intake of vitamin E [OR = 0.78, 95% CI = 0.65 to 0.95], vitamin E supplement [OR = 0.83, 95% CI = 0.73 to 0.94] and studies with NOS scores >7 [OR = 0.85, 95% CI = 0.75 to 0.97].

The investigators found a high intake of diet or vitamin E supplements significantly decreased the risk of Alzheimer's disease by 22% [OR = 0.78, 95% CI = 0.64 to 0.94, I2 = 36.9%, p = 0.123].
This decreased risk was also significant in cohort studies [OR = 0.77, 95% CI = 0.63 to 0.94].

The investigators found in sensitivity analysis the pooled ORs fluctuated within a certain range after deleting each study, indicating that the results of this meta-analysis were stable.

The investigators concluded high intakes of diet or vitamin E supplements reduce the risk of dementia. Therefore, the elderly can reduce the risk of dementia by appropriately increasing foods rich in vitamin E, but also pay attention to the toxic side effects of vitamin E. Although the results are reliable, they should be further validated by large RCTs.

Original title:
Association of vitamin E intake in diet and supplements with risk of dementia: A meta-analysis by Zhao R, Han X, [...], You H.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9376618/

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

Objectives:
There is keen interest in better understanding the impacts of alpha-linolenic acid (ALA), a plant-derived n-3 fatty acid, in ameliorating the development of cancer. However, results of several prospective cohort studies present an inconsistent association between ALA intake and the incident colorectal cancer (CRC). Therefore, this review article has been conducted.

Does a high dietary intake of alpha-linolenic acid or a high level of alpha-linolenic acid in blood reduce risk of colorectal cancer (colon and rectal cancer)?

Study design:
This review article included 15 cohort studies (11 studies on diet and 5 studies on biomarkers including 4 on blood and 1 on adipose tissue) with 12,239 colorectal cancer cases occurred among 861,725 participants.
The mean follow-up was 9.3 years (ranging from 1 to 28 years).
Among all of the included studies, quality scores assessed by the 9-star NOS ranged from 7 to 9, with a median quality (≤7 stars) in 2 studies and high quality (≥ 8 stars) in 13 studies.

There was no publication bias.

Results and conclusions:
The investigators found higher level of alpha-linolenic acid in blood significantly reduced risk of colorectal cancer with 17% [summary RR = 0.83, 95% CI = 0.69 to 0.99, I2 = 0.0%].

The investigators found each 0.1% increase in the level of alpha-linolenic acid in blood was significantly associated with a 10% reduction in colorectal cancer risk [summary RR = 0.90, 95% CI = 0.80 to 0.99, I2 = 38.6%].

The investigators no significant dose-response association between dietary intake of alpha-linolenic acid and the incident colorectal cancer [p for non-linearity = 0.18; p for linearity = 0.24].

The investigators concluded that higher blood levels of alpha-linolenic acid reduce risk of colorectal cancer while higher dietary intake of alpha-linolenic acid does not reduce risk of colorectal cancer. Encouraging the consumption of foods rich in alpha-linolenic acid to improve its levels in the blood may potentially decrease the risk of colorectal cancer. Nevertheless, well-designed and large-scale cohort studies with biomarkers are still needed for better reconfirming the potential impacts of alpha-linolenic acid intake in the primary prevention of colorectal cancer.

Original title:
Association of Dietary Intake and Biomarker of α-Linolenic Acid With Incident Colorectal Cancer: A Dose-Response Meta-Analysis of Prospective Cohort Studies by Dai ZB, Ren XL, […], Xu L.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9301188/

Additional information of El Mondo:
Find more information/studies on colorectal cancer and alpha-linolenic acid consumption right here.

Objectives:
Undernutrition is a major risk factor for tuberculosis (TB), which is estimated to be responsible for 1.9 million TB cases per year globally. The effectiveness of micronutrient supplementation on TB treatment outcomes and its prognostic markers (sputum conversion, serum zinc, retinol and haemoglobin levels) has been poorly understood. Therefore, this review article has been conducted.

Do zinc and vitamin A supplementation improve tuberculosis treatment outcomes in adults with sputum-positive pulmonary tuberculosis?

Study design:
This review article included 9 RCTs with a total of 1,375 participants.
Study-specific sample sizes ranged from 26 to 499 participants.
The follow-up duration for outcome evaluation ranged from 2 to 6 months.

Results and conclusions:
The investigators found among adults with pulmonary tuberculosis, zinc [RR = 0.94, 95% CI = 0.86 to 1.03], vitamin A [RR = 0.90, 95% CI = 0.80 to 1.01] and combined zinc and vitamin A [RR = 0.98, 95% CI = 0.89 to 1.08] supplementation were not significantly associated with tuberculosis treatment success.

The investigators found combined zinc and vitamin A supplementation was significantly associated with increased sputum smear conversion at 2 months [RR = 1.16, 95% CI = 1.03 to 1.32], serum zinc levels at 2 months [MD = 0.86 μmol/L, 95% C I= 0.14 to 1.57], serum retinol levels at 2 months [MD = 0.06 μmol/L, 95% CI = 0.04 to 0.08] and 6 months [MD = 0.12 μmol/L, 95% CI = 0.10 to 0.14] and serum haemoglobin level at 6 months [MD = 0.29 μg/dL, 95% CI = 0.08 to 0.51] among adults with pulmonary tuberculosis.

The investigators concluded that combined zinc and vitamin A supplementation improves sputum smear conversion and increase serum retinol, zinc and haemoglobin levels at different durations of follow-up in adults with sputum-positive pulmonary tuberculosis. However, zinc and/or vitamin A supplementation during tuberculosis treatment has no effect on a successful tuberculosis treatment outcome.

Original title:
Effects of zinc and vitamin A supplementation on prognostic markers and treatment outcomes of adults with pulmonary tuberculosis: a systematic review and meta-analysis by Wagnew F, Alene Ka, […], Gray D.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9490634/

Additional information of El Mondo:
Find more information/studies on food fortification/malnutrition, vitamin A and zinc right here.

Sputum smear conversion is a key indicator of treatment response and reduced infectivity among bacteriologically confirmed pulmonary tuberculosis (PTB) patients.

Objectives:
Do plant-based diets improve age-related ocular outcomes among adults?

Study design:
This review article included 15 studies (n = 51,695 participants) assessed the impact of fish consumption, 8 studies (n = 28,753 participants) analyzed the effect of red meat intake and 3 studies (n = 7,723 participants) assessed the impact of omission of skim milk, poultry and non-meat animal products and the presence of disease incidence as indicated by age-related macular degeneration or cataract development.

Results and conclusions:
The investigators found in 15 studies (n = 51,695 participants) that regular consumption of fish significantly reduced the risk of age-related eye disease development among adults with 30% [odds ratio = 0.70, 95% CI = 0.62 to 0.79].
Significant means that there is an association with a 95% confidence.

The investigators found in 3 studies (n = 7,723 participants) that regular consumption of skim milk, poultry and non-meat animal products significantly reduced the risk of age-related eye disease development among adults with 30% [odds ratio = 0.70, 95% CI = 0.61 to 0.79].
Significant because odds ratio of 1 was not found in the 95% CI of 1.07 to 1.72. Odds ratio of 1 means no risk/association.

The investigators found in 8 studies (n = 28,753 participants) that regular consumption of red meat significantly increased the risk of age-related eye disease development among adults with 41% [odds ratio = 1.41, 95% CI = 1.07 to 1.86].

The investigators concluded that regular consumption of both fish and skim milk, poultry and non-meat animal products reduce the risk of age-related eye disease development among adults, while regular consumption of red meat increases the risk of age-related eye disease development among adults. Results suggest a need for more initiatives promoting a healthy and balanced diet.

Original title:
Linkage between a plant-based diet and age-related eye diseases: a systematic review and meta-analysis by Cirone C, Cirone KD and Malvankar-Mehta MS.

Link:
https://pubmed.ncbi.nlm.nih.gov/36102832/

Additional information of El Mondo:
Find more information/studies on fish, milk, meat and elderly right here.

In practice, regular fish consumption corresponds to at least twice (100-150g per time) a week.
 

Objectives:
Do COPD patients benefit from vitamin C supplementation?

Study design:
This review article included 10 RCTs with a total of 487 patients.

Results and conclusions:
The investigators found that vitamin C supplementation (≥400 mg/day) significantly improved the forced expiratory volume in one second as a percentage (FEV1%) of COPD patients [SMD = 1.08, 95% CI = 0.03 to 2.12, p = 0.04].

The investigators found, moreover, vitamin C supplementation (≥400 mg/day) significantly improved the ratio of forced expiratory volume in 1 second and forced vital capacity (FEV1/FVC) [WMD = 0.66, 95% CI = 0.26 to 1.06, p = 0.001], vitamin C level in serum [SMD = 0.63, 95% CI = 0.02 to 1.24, p = 0.04] and glutathione (GSH) level in serum [SMD = 2.47, 95% CI = 1.06 to 3.89, p = 0.0006] of COPD patients.

The investigators found no statistically significant difference was observed in body mass index (BMI), fat-free mass index (FFMI), vitamin E level and superoxide dismutase (SOD) level in serum.

The investigators concluded vitamin C supplementation increases the levels of antioxidation in serum (vitamin C and GSH) and improves lung function (FEV1% and FEV1/FVC) of COPD patients, especially when treated with vitamin C supplementation greater than 400 mg/day. However, further prospective studies are needed to explore the role of vitamin C in improving nutritional status.

Original title:
Efficacy of Vitamin C Supplementation on Chronic Obstructive Pulmonary Disease (COPD): A Systematic Review and Meta-Analysis by Lei T, Lu T, […], Liu J.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9473551/

Additional information of El Mondo:
Find here more information/studies about RCTs/significant and vitamin C.

Objectives:
Although several meta-analyses have revealed the beneficial effects of dietary fiber intake on human health, some have reported inconsistent findings. Therefore, this umbrella meta-analysis (review article) has been conducted.

Does higher dietary fiber intake improve causally cardiovascular risk factors?

Study design:
This umbrella review article included 52 meta-analyses of RCTs with a total of 47,197 subjects.

Of the 52 meta-analyses, 35 used high-quality studies, 9 used studies with moderate quality, 7 did not report the quality of the included studies and 1 used low-quality studies.

The dosages and durations of dietary fiber intervention ranged from 3 g/day to 30 g/day (except for one study, which used guar gum at 15 mg/day and another study that used brown rice at 225 g/d) and 4 to 13 weeks, respectively.

Results and conclusions:
The investigators found, overall, higher dietary fiber intake significantly reduced:
-fasting plasma glucose [ES = -0.55, 95% CI = -0.73 to -0.38, p 0.001];
-fasting plasma insulin [ES = -1.22, 95% CI = -1.63 to -0.82, p 0.001];
-homeostasis model assessment of insulin resistance (HOMA-IR) [ES = -0.43, 95% CI = -0.60 to -0.27, p 0.001];

-glycosylated hemoglobin (HbA1c) [ES = -0.38, 95% CI = -0.50 to -0.26, p 0.001];
-serum level of total cholesterol [ES = -0.28, 95% CI = -0.39 to -0.16, p 0.001];
-low-density lipoprotein cholesterol (bad cholesterol) [ES = -0.25, 95% CI = -0.34 to -0.16, p 0.001];
-tumor necrosis factor-alpha serum levels [ES = -0.78, 95% CI = -1.39 to -0.16, p = 0.013];
-systolic blood pressure [ES = -1.72, 95% CI= -2.13 to -1.30, p 0.001];
-diastolic blood pressure [ES = -0.67, 95% CI = -0.96 to -0.37, p 0.001].
Significant means that there is an association with a 95% confidence.

The investigators found sensitivity analysis showed that the overall ESs did not change by excluding any individual meta-analysis.

The investigators found subgroup analysis revealed that the study population and type of dietary fiber could be partial sources of heterogeneity.

The investigators concluded that the present umbrella meta-analysis strongly support the beneficial effects of dietary fiber intake for the improvement cardiovascular risk factors, in particular cholesterol, fasting blood sugar, HbA1c, tumor necrosis factor-alpha and fasting insulin level, blood pressure and HOMA-IR value. However, it should be noted that the health-promoting effects of dietary fiber intake may differ between populations with different metabolic diseases.

Original title:
Associations between dietary fiber intake and cardiovascular risk factors: An umbrella review of meta-analyses of randomized controlled trials by Fu L, Zhang G, […], Tan M.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9511151/

Additional information of El Mondo:
Find more information/studies on dietary fiber consumption, diabetes, high blood pressure and cardiovascular disease right here.

A high dietary fiber intake corresponds to a diet with at least 1.5 grams fiber per 100 kcal. Use the 7-points nutrition profile app to see if your daily diet contains 1.5 grams fiber per 100 kcal.
These products in the supermarket contain 1.5 grams fiber per 100 kcal.

An umbrella review article is a scientific article which only includes meta-analyses (also called review articles). The results found in an umbrella review article are more reliable than found in an individual review article.

One swallow does not make a summer. A famous Dutch saying that could not be any more obvious. Just because one single scientific study about a certain topic makes certain claims, it does not necessarily mean it is true. On the other hand, a review article (a collection of scientific studies on a certain topic) of randomized, placebo-controlled double blind clinical trials (RCTs) will answer the following question:
"Do taking dietary supplements make sense?" Yes for a positive conclusion and no for a negative conclusion.

One swallow does not make a summer. A famous Dutch saying that could not be any more obvious. Just because one single scientific study about a certain topic makes certain claims, it does not necessarily mean it is true. On the other hand, a review article (a collection of scientific studies on a certain topic) of (prospective) cohort studies or case-control studies will answer the following question:
"Should I change my diet?".

Objectives:
Although recent studies comparing various dosages and intervals of vitamin D supplementation have been published, it is yet to be elucidated whether there is an appropriate dose or interval to provide benefit regarding fracture risk. Therefore, this review article has been conducted.

What are the putative beneficial effects of vitamin D supplements on fractures and falls according to various dosages and intervals?

Study design:
This review article included 32 RCTs with a total of 104,363 patients, with a median of 3,162 patients per study (range 46 to 36,282).
The median daily dose of cholecalciferol (D3) was 800 IU/day and 8 studies reported 800 IU/day, 15 studies reported 800 to 1,000 IU/day and 9 studies reported >1,000 IU/day.
The median follow-up duration was 24 months (range 9 to 120) and the median age was 72 years (range 53 to 85).

Results and conclusions:
The investigators found vitamin D3 supplementation with daily dose of 800 to 1,000 IU was significantly associated with a lower risk of 13% for osteoporotic fracture [pooled relative risk = 0.87, 95% CI = 0.78 to 0.97, I2 = 23.5%] while studies with 800 or >1,000 IU/day did not.

The investigators found vitamin D3 supplementation with daily dose of 800 to 1,000 IU was significantly associated with a lower risk of 9% for fall [pooled relative risk = 0.91, 95% CI = 0.85 to 0.98, I2 = 70.9%] while studies with 800 or >1,000 IU/day did not.

The investigators found daily administration of vitamin D3 was associated with the reduced risk of falls, while intermittent dose was not.
Also, patients with vitamin D deficiency showed a significant risk reduction of falls after vitamin D3 supplementation.

The investigators concluded that daily vitamin D3 dose of 800 to 1,000 IU (20-25 mcg) during 24 months is the most probable way to reduce the fracture and fall risk among elderly. Further studies designed with various regimens and targeted vitamin D levels are required to elucidate the benefits of vitamin D supplements.

Original title:
Effect of Vitamin D Supplementation on Risk of Fractures and Falls According to Dosage and Interval: A Meta-Analysis by Kong SH, Jang HN, […], Shin CS.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9081312/

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

Objectives:
Do rheumatoid arthritis patients benefit from vitamin E supplements?

Study design:
This review article included 9 RCTs with a total of 39,845 patients.

Results and conclusions:
The investigators found that vitamin E supplements were shown to be more effective in individuals with rheumatoid arthritis for sensitive joints [MD = -1.66, 95% CI = -6.32 to -2.99, I2 = 93%, p 0.00001] and swollen joints [MD = -0.46, 95% CI = -1.98 to 1.07, I2 = 56%, p = 0.08].

The investigators concluded vitamin E's ability to restore the intestinal barrier and improve the gastrointestinal tract may be linked to the prevention and treatment of rheumatoid arthritis. Vitamin E supplements used on a regular basis can help individuals with rheumatoid arthritis reduce joint discomfort, edema and stiffness, as well as enhance their overall quality of life.

Original title:
Effect of vitamin E supplementation in rheumatoid arthritis: a systematic review and meta-analysis by Kou H, Qing Z, […], Ma J.

Link:
https://pubmed.ncbi.nlm.nih.gov/35468933/

Additional information of El Mondo:
Find here more information/studies about RCTs/significant and vitamin E.

Objectives:
Several epidemiological studies have suggested that flavonoid intake is associated with a decreased risk of cardiometabolic disease. However, the results remained inconsistent and there is no dose-response meta-analysis for specific outcomes. Therefore, this review article has been conducted.

Is there a dose-response relationship between dietary flavonoid intake and reduced risk of cardiometabolic disease?

Study design:
This review article included 47 prospective cohort studies with a total of 1,346,676 participants and 127,507 persons with cardiometabolic disease.

Results and conclusions:
The investigators found for every 500 mg/d increase in dietary flavonoid intake a reduced risk of 7% [summary RR = 0.93, 95% CI = 0.88 to 0.98] for cardiovascular disease.
Significant means that there is an association with a 95% confidence.

The investigators found for every 500 mg/d increase in dietary flavonoid intake a reduced risk of 11% [summary RR = 0.89, 95% CI = 0.84 to 0.94] for diabetes.
Significant because summary RR of 1 was not found in the 95% CI of 0.84 to 0.94. Summary RR of 1 means no risk/association.

The investigators found for every 500 mg/d increase in dietary flavonoid intake a reduced risk of 3% [summary RR = 0.97, 95% CI = 0.94 to 0.99] for hypertension.
Significantly means it can be said with a 95% confidence that every 500 mg/d increase in dietary flavonoid intake really reduced risk of hypertension with 3%.

The investigators found a linearity dose-response association between total dietary flavonoid intake and cardiovascular disease [p nonlinearity = 0.541] and diabetes [p nonlinearity = 0.077].

The investigators concluded that a higher level of dietary flavonoid intake, at least 500 mg/d  is beneficial for the prevention of cardiometabolic diseases, particularly cardiovascular disease, diabetes and hypertension.

Original title:
Total dietary flavonoid intake and risk of cardiometabolic diseases: A dose-response meta-analysis of prospective cohort studies by Li T, Zhao Y, […], Liu J.

Link:
https://pubmed.ncbi.nlm.nih.gov/36148848/

Additional information of El Mondo:
Find more information/studies on flavonoid, diabetes, cardiovascular disease and lowering blood pressure right here.

Cardiometabolic diseases are a group of common but often preventable conditions including heart attack, stroke, diabetes, insulin resistance and non-alcoholic fatty liver disease.

Objectives:
Vitamin D levels have been shown to be associated with diabetic retinopathy, however to date, no review has examined the relationship between vitamin D and sight threatening diabetic retinopathy (STDR) and non-sight threatening diabetic retinopathy (NSTDR). Therefore, this review article has been conducted. 

Does vitamin D deficiency (defined as 25(OH)D levels of 20 ng/mL) increase risk of diabetic retinopathy in patients with diabetes?

Study design:
This review article included 11 cross-sectional studies and 1 case-control study with a total of  9,057 participants.
There was no publication bias.

Results and conclusions:
The investigators found vitamin D deficiency significantly increased risk of sight threatening diabetic retinopathy with 80% [OR = 1.80, 95% CI = 1.40 to 2.30, p ≤ 0.001, I2 = 39.39%].
However, this increased risk was not found for non-sight threatening diabetic retinopathy [OR = 1.10, 95% CI = 0.90 to 1.27, p = 0.48, I2 = 30.21%].

The investigators concluded that vitamin D deficiency (defined as 25(OH)D levels of 20 ng/mL)  increases risk of sight threatening diabetic retinopathy but not non-sight threatening diabetic retinopathy. Given the well-reported associations between vitamin D deficiency and other unfavourable outcomes, it is important that vitamin D deficiency is managed appropriately and in a timely manner to reduce the risk of blindness in people with diabetes.

Original title:
Associations between vitamin D status and sight threatening and non-sight threatening diabetic retinopathy: a systematic review and meta-analysis by Trott M, Driscoll R, […], Pardhan S.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9167360/

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

Diabetic retinopathy, also known as diabetic eye disease (DED), is a complication of diabetes, caused by high blood sugar levels damaging the back of the eye (retina). It can cause blindness if left undiagnosed and untreated.

Objectives:
Findings of observational studies that evaluated the association of serum vitamin D status and high blood pressure were contradictory. Therefore, this review article has been conducted.

Does a high serum vitamin D concentration reduce risk of hypertension in the adult population?

Study design:
This review article included 10 prospective cohort, 1 nested case-control study and 59 cross-sectional studies.
Overall 66,757 and 260,944 participants were included in cohort and cross-sectional studies, respectively.
Among cohort studies, the NOS scores were between 6 and 9.
Among cross-sectional studies, the NOS scores ranged between 4 and 10.
There was no publication bias.

Results and conclusions:
The investigators found in the pooled analysis of cohort studies (66,757 participants) a 16% significant decrease in risk of hypertension in participants who had a high level of serum vitamin D compared with those with low level [pooled RR = 0.84, 95% CI = 0.73 to 0.96, I2 = 64%, p = 0.001].
Sensitivity analysis showed that excluding each stuy had no significant effect on pooled RR.

The investigators found combining effect sizes of 10 cohort studies involving a total of 63,602 individuals and 25,019 cases of hypertension showed that each 25 nmol/L increase in serum vitamin D level resulted in a 5% reduction in risk of hypertension [RR = 0.95, 95% CI = 0.90 to 1.00].
Also, a significant non-linear association between serum vitamin D levels and hypertension was observed [p non-inearity 0.001].
A reduction trend in risk of hypertension was observed for serum vitamin D levels between 45 and 70 nmol/L, although for higher vitamin D levels the risk did not decrease anymore and eventually started increasing.

The investigators found meta-analysis of cross-sectional studies showed that highest level of vitamin D in comparison to the lowest level was associated with a 16% significant decrease in risk of hypertension [OR overall = 0.86, 95% CI = 0.79 to 0.90, I2 = 67.5%, p 0.001].
Sensitivity analysis determined that the exclusion of each study did not significantly affect the overall estimate.

The investigators found combining effect sizes of 30 cross-sectional studies involving a total of 139,685 individuals and 40,178 cases of hypertension showed that each 25 nmol/L increase in serum vitamin D level resulted in a 6% reduction in risk of hypertension [OR = 0.94, 95% CI = 0.90 to 0.99].  

Also, a significant non-linear association between serum vitamin D levels and hypertension was seen [p non-linearity 0.001].
A reduction trend in risk of hypertension was observed for serum vitamin D levels between 40 and 75 nmol/L, although higher vitamin D levels did not reduce odds of hypertension.

The investigators concluded that serum vitamin D concentrations between 40 and 75 nmol/L reduce risk of hypertension in the adult population, in both prospective cohort and cross-sectional studies.

Original title:
Serum Vitamin D Levels in Relation to Hypertension and Pre-hypertension in Adults: A Systematic Review and Dose-Response Meta-Analysis of Epidemiologic Studies by Mokhtari E, Hajhashemy Z and Saneei P.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8961407/

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

Objectives:
Dietary fats are one of the well-known stimulators of carotenoid absorption, but the effects of the quantity and the type of dietary fats on carotenoid absorption have not yet been studied systematically. Therefore, this review article has been conducted.

Do dietary fats improve the absorption of carotenoids?

Study design:
This review article included a total of 27 in vitro studies and 12 RCTs.

Results and conclusions:
The investigators found meta-regression of in vitro studies showed that the bioaccessibility of carotenoids, except for lycopene, was positively associated with the concentration of dietary fats.

The investigators found meta-analysis of RCTs showed that the bioavailability of carotenoids was enhanced when a higher quantity of dietary fats was co-consumed.

The investigators found, moreover, fats rich in unsaturated fatty acids resulted in greater improvement in carotenoid bioavailability [SMD = 0.90, 95% CI = 0.69 to 1.11] as compared with fats rich in saturated fatty acids [SMD = 0.27, 95% CI = 0.08 to 0.47].

The investigators concluded that co-consuming dietary fats, particularly those rich in unsaturated fatty acids, with carotenoid-rich foods can improve the absorption of carotenoids.

Original title:
Effects of dietary fats on the bioaccessibility and bioavailability of carotenoids: a systematic review and meta-analysis of in vitro studies and randomized controlled trials by Yao Y, Tan P and Kim JE.

Link:
https://pubmed.ncbi.nlm.nih.gov/34897461/

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

Objectives:
Colorectal cancer is one of the most commonly diagnosed and deadly cancers worldwide. Epidemiological studies on the relationship between folate intake and the risk of colorectal cancer have reported inconsistent findings since folate fortification in the USA. Therefore, this review article has been conducted.

Does a high folate (folic acid) ietary intake reduce risk of colorectal cancer (colon and rectal cancer)?

Study design:
This review article included 24 cohort studies involving 6,165,894 individuals, of which 37,280 persons with colorectal cancer.

Results and conclusions:
The investigators found compared with the lowest dietary intake, the highest folate dietary intake significantly reduced risk of colorectal cancer with 12% [combined relative risk (RR) = 0.88, 95% CI = 0.83 to 0.92, p = 0.0004].
Significantly means that there is an association with a 95% confidence.

The investigators found compared with the lowest dietary intake, the highest folate dietary intake significantly reduced risk of colorectal cancer with 3% among persons witih medium alcohol consumption [RR = 0.97, 95% CI = 0.96 to 0.99, p = 0.008].
Significantly because RR of 1 was not found in the 95% CI of 0.96 to 0.99. RR of 1 means no risk/association.

The investigators found compared with the lowest dietary intake, the highest folate dietary intake significantly reduced risk of colorectal cancer with 5% among persons witih high alcohol consumption [RR = 0.95, 95% CI = 0.92 to 0.97, p = 0.003].

The investigators found compared with the lowest dietary intake, the highest folate dietary intake did not reduce risk of colorectal cancer among non-drinkers [RR = 1.00, 95% CI = 0.98 to 1.02, p = 0.827].

The investigators found compared with the lowest dietary intake, the highest folate dietary intake significantly reduced risk of colon cancer with 14% [RR = 0.86, 95% CI = 0.81 to 0.92, p = 0.0004].
Significantly because the calculated p-value of 0.0004 was less than the p-value of 0.05.

The investigators found compared with the lowest dietary intake, the highest folate dietary intake did not reduce risk of rectal cancer [RR = 0.92, 95% CI = 0.84 to 1.02, p = 0.112].

The investigators found compared with the lowest dietary intake, the highest folate dietary intake significantly reduced risk of colorectal cancer in USA and Europe but not in other regions.

The investigators concluded that high folate dietary intake reduces risk of colon cancer, particularly in people with medium or high alcohol consumption, but it still needs to be further confirmed.

Original title:
Folate intake and risk of colorectal cancer: a systematic review and up-to-date meta-analysis of prospective studies by Fu H, He J, […], Chang H.

Link:
https://pubmed.ncbi.nlm.nih.gov/35579178/

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

Colorectal cancer starts in the colon or the rectum. These cancers can also be called colon cancer or rectal cancer, depending on where they start.

Objectives:
The association between meat intake and hepatocellular carcinoma (HCC) risk is still unclear. Therefore, this review article has been conducted.

Does a higher dietary intake of meat increases the risk of hepatocellular carcinoma?

Study design:
This review article included 17 observational studies involving 2,915,680 participants, of which 4,953 cases of hepatocellular carcinoma.

10 studies reported red meat intake, 9 reported white meat intake, 9 reported fish intake, 7 reported processed meat intake and 5 reported total meat intake.

Results and conclusions:
The investigators found results showed that the consumption of red meat [relative risk = 1.04, 95% CI = 0.91 to 1.18, I2 = 50.50%, p = 0.033] and total meat intake [relative risk = 1.01, 95% CI =  0.90 to 1.13, I2 = 15.50%, p = 0.316] were not significantly associated with risk of hepatocellular carcinoma.

The investigators found, however, a higher dietary intake of processed meat significantly increased the risk of hepatocellular carcinoma with 20% [relative risk = 1.20, 95% CI = 1.02 to 1.41, I2 = 26.30%, p = 0.228].
Significant because relative risk of 1 was not found in the 95% CI of 1.02 to 1.41. Relative risk of 1 means no risk/association.

The investigators found, in contrast, a higher dietary intake of white meat significantly decreased the risk of hepatocellular carcinoma with 24% [relative risk = 0.76, 95% CI = 0.63 to 0.92, I2 = 68.30%, p = 0.001].

The investigators found, in contrast, a higher dietary intake of fish significantly decreased the risk of hepatocellular carcinoma with 9% [relative risk = 0.91, 95% CI = 0.86 to 0.96, I2 = 40.90%, p = 0.095].

The investigators concluded that a higher dietary intake of processed meat increases the risk of hepatocellular carcinoma, while a higher dietary intake of both white meat and fish decrease the risk of hepatocellular carcinoma. Therefore, these findings suggest that dietary intervention may be an effective approach to preventing hepatocellular carcinoma. These need to be verified with further well-designed observational studies and experimental clinical research.  

Original title:
Meat Intake and the Risk of Hepatocellular Carcinoma: A Meta-Analysis of Observational Studies by Yu J, Liu Z, […], Chen W.

Link:
https://pubmed.ncbi.nlm.nih.gov/35583453/

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

Processed meats are meats that have been preserved by smoking or salting, curing or adding chemical preservatives. They include deli meats, bacon and hot dogs.

Objectives:
In postmenopausal women, vitamin D deficiency (as defined by the circulating level of 25(OH)D being below 20 ng/mL (50 nmol/L)) is a regular occurrence. The effect of vitamin D supplementation on the muscle function of postmenopausal women has been controversial. Therefore, this review article has been conducted.

Does vitamin D supplementation enhance the muscular strength and mobility of postmenopausal women?

Study design:
This review article included 19 RCTs between 2003 and 2021, with 5,398 participants.
The sample size of the RCTs included in multiple countries ranges from 20 to 2,347. Furthermore, the duration of vitamin D supplementation ranged from 3 to 60 months.
Vitamin D3 was applied in 12 of the 19 retrieved trials, whose dosages ranged from 400 IU/day to 300,000 IU (10 tot 7500 mcg vitamin D3) in a single oral dose.
Visual inspection of the funnel plot and Egger’s linear regression test revealed no indication of publication bias in the meta-analysis of vitamin D supplementation on handgrip strength.

Results and conclusions:
The investigators found meta-analysis of 9 RCTs (1,997 participants supplemented with vitamin D and 2,232 participants as the control group (vitamin D in low dosage or placebo)), showed that vitamin D supplementation significantly improved handgrip strength in postmenopausal women [WMD = 0.876 kg, 95% CI = 0.180 to 1.571, p = 0.014, I2 = 68.5%, p = 0.001].
Moreover, according to subgroup analysis, vitamin D supplementation substantially raised handgrip strength when compared to baseline blood vitamin D levels >75 nmol/L (30 ng/ml) [WMD = 0.478 kg, 95% CI = 0.963 to 1.918, p = 0.003], without calcium [WMD = 1.931 kg, 95% CI = 0.166 to 3.697, p = 0.032] and subject to an age of more than 60 [WMD = 1.116 kg, 95% CI = 0.433 to 1.799, p = 0.001].

The investigators concluded that 400 IU/day to 300,000 IU vitamin D supplementation during 3 to 60 months improves handgrip strength in postmenopausal women over 60 years of age who are without calcium supplementation or whose baseline vitamin D is >75 nmol/L (30 ng/mL). These findings show that future trials should focus on determining the ideal dosage and duration and taking into account the several factors that may impair muscle performance, such as exercise, calcium consumption, frailty, a history of falls or fractures and baseline vitamin D status and the relationship between muscle function and/or strength with muscle composition.

Original title:
Vitamin D Supplementation Improves Handgrip Strength in Postmenopausal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials by Zhang JL, Poon CCW, […], Zhang Y.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9199366/

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

Objectives:
Data from studies support a beneficial effect of carotenoids and vitamins on an age-related macular degeneration (AMD) risk. However, studies on the relations between blood levels of these nutrients and AMD are limited and provided conflicting results. Therefore, this review article has been conducted.

Does a higher concentration of carotenoids (lutein/zeaxanthin, β-carotene, β-cryptoxanthin, lycopene) and vitamins in blood reduce age-related macular degeneration risk?

Study design:
This review article included 9 studies (1 cohort, 4 case-control and 4 cross-sectional studies) involving 15,674 participants and 2,077 AMD cases (persons with age-related macular degeneration).  
There was no evidence of publication bias.

Results and conclusions:
The investigators found in the meta-analysis that high blood lutein/zeaxanthin level significantly reduced risk of age-related macular degeneration with 47% [OR = 0.53, 95% CI = 0.40 to 0.72, p 0.001, I2 = 43.3%, p = 0.079], compared to those with low level.
Results stratified by factors yielded similar results to the main analysis.

The investigators found in the meta-analysis that high blood β-carotene level significantly reduced risk of age-related macular degeneration with 52% [OR = 0.48, 95% CI = 0.28 to 0.84, p = 0.01, I2 = 71.7%, p = 0.003], compared to those with low level.
A subgroup analysis by geographic region showed that the significant inverse association between blood β-carotene levels and risk of age-related macular degeneration was only found among the Asians.

The investigators found in the meta-analysis that high blood β-cryptoxanthin level significantly reduced risk of age-related macular degeneration with 52% [OR = 0.48, 95% CI = 0.23 to 1.00, p = 0.04, I2 = 83.5%, p 0.001], compared to those with low level.
In stratified analyses, no significant difference was observed for any subgroups.

The investigators found in the meta-analysis that high blood lycopene level significantly reduced risk of age-related macular degeneration with 30% [OR = 0.70, 95% CI = 0.54 to 0.90, p = 0.006, I2 = 0.0%, p = 0.67], compared to those with low level.

The investigators found in the meta-analysis that high blood α-tocopherol (vitamin E) level significantly reduced risk of age-related macular degeneration with 50% [OR = 0.50, 95% CI = 0.31 to 0.81, p = 0.005, I2 = 34.4%, p = 0.19], compared to those with low level.

The investigators found sensitivity analyses, that excluded one study at a time, did not change the statistical significance or the direction of the present findings, corroborating the robustness of the results.

The investigators concluded that there is a protective effect of higher concentration of carotenoids (lutein/zeaxanthin, β-carotene, β-cryptoxanthin, lycopene) and vitamin E in blood against age-related macular degeneration risk, which provides further evidence of the associations between carotenoid and vitamin status and the risk of age-related eye problems. Further randomized clinical trials are necessary for Asians to confirm such associations and to provide the most reliable direct information to base public health recommendations for age-related eye disease prevention by nutritional supplementation with carotenoids and vitamins.

Original title:
The Associations of Plasma Carotenoids and Vitamins With Risk of Age-Related Macular Degeneration: Results From a Matched Case-Control Study in China and Meta-Analysis by Jiang H, Fan  Y, […], Ma L.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8873933/

Additional information of El Mondo:
Find more information/studies on meta-analysis/cohort, carotenoids, vitamin E and elderly right here.

High blood levels of beta-carotene can be obtained by consuming beta-carotene-rich foods and/or taking beta-carotene supplements.
 

Objectives:
What is the association of total protein, animal protein and animal protein sources with risk of kidney stones in the general population?

Study design:
This review article included 14 prospective cohort studies.
According to NutriGrade scoring system, the credibility of evidence for most of the exposures was rated as low.
Some kind of publication bias was found in the association of animal protein intake and risk of kidney stones, according to Egger's and Begg's tests.
Sensitivity analysis of processed meat as well as dairy consumption with risk of kidney stones showed one study changed the overall estimate.

Results and conclusions:
The investigators found that higher dietary intake of non-dairy animal protein significantly increased risk of kidney stones with 11% [RR = 1.11, 95% CI = 1.03 to 1.20, I2 = 0%, n = 4].
Significant means that there is an association with a 95% confidence.

The investigators found that higher dietary intake of total meat and meat products significantly increased risk of kidney stones with 22% [RR = 1.22, 95% CI = 1.09 to 1.38, I2 = 13%, n = 3].
Significant because RR of 1 was not found in the 95% CI of 1.09 to 1.38. RR of 1 means no risk/association.

The investigators found that higher dietary intake of processed meat significantly increased risk of kidney stones with 22% [RR = 1.22, 95% CI = 1.10 to 1.51, I2 = 0%, n = 2]. 

The investigators found that higher intake of dairy protein significantly decreased risk of kidney stones with 9% [RR = 0.91, 95% CI = 0.84 to 0.99, I2 = 0%, n = 4].

The investigators found, moreover, each 100 gram increment of red meat dietary intake was significantly associated with an increased risk of 39% for kidney stones [RR = 1.39, 95% CI = 1.13 to 1.71].

The investigators concluded that higher dietary intake of meat and meat products may increase the risk of kidney stones in the general population, while higher dietary intake of dairy proteins may decrease the risk of kidney stones in the general population. May because the credibility of evidence for most of the exposures was rated as low and there was publication bias. Therefore, further observational studies are needed to confirm present results.

Original title:
Associations of Total Protein or Animal Protein Intake and Animal Protein Sources with Risk of Kidney Stones: A Systematic Review and Dose-Response Meta-Analysis by Asoudeh F, Talebi S, […], Mohammadi H.

Link:
https://pubmed.ncbi.nlm.nih.gov/35179185/

Additional information of El Mondo:
Find here more information/studies about RCTs/significant, meat and dairy consumption.

When the credibility of evidence of the studies in the review article is low and there is publication bias, the results will not be very reliable.
 

Objectives:
Is there a difference in the mean concentrations of ferritin, hepcidin, retinol or retinol binding protein between individuals with asymptomatic or clinical malaria and healthy controls?

Study design:
This review article included 44 studies.

Results and conclusions:
The investigators found mean ferritin concentrations were elevated by 28.2 µg/L [95% CI = 15.6 to 40.9] in children with asymptomatic malaria compared to individuals without malaria infection.

The investigators found mean ferritin concentrations were elevated by 28.5 µg/L [95% CI = 8.1 to 48.8] in adults with asymptomatic malaria compared to individuals without malaria infection.

The investigators found mean ferritin concentrations were elevated by 366 µg/L [95% CI = 162 to 570] in children with clinical malaria compared to individuals without malaria infection.

The investigators found mean hepcidin concentrations were elevated by 1.52 nmol/L [95% CI = 0.92 to 2.11] in children with asymptomatic malaria compared to individuals without malaria infection.

The investigators found mean retinol concentrations were reduced by 0.11 µmol/L [95% CI = -0.22 to -0.01] in children with asymptomatic malaria compared to individuals without malaria infection.

The investigators found mean retinol concentrations were reduced by 0.43 µmol/L [95% CI = -0.71 to -0.16] in children with clinical malaria compared to individuals without malaria infection.

The investigators found mean retinol concentrations were reduced by 0.73 µmol/L [95% CI = -1.11 to -0.36] in adults with clinical malaria compared to individuals without malaria infection.

The investigators found most of these results were stable in sensitivity analyses.

The investigators found in children with clinical malaria and pregnant women, difference in ferritin concentrations were greater in areas with higher transmission intensity.

The investigators concluded that biomarkers of iron and vitamin A status should be statistically adjusted for malaria and the severity of infection. Several studies analysing asymptomatic infections reported elevated ferritin concentrations without noticeable elevation of inflammation markers, indicating a need to adjust for malaria status in addition to inflammation adjustments.

Original title:
Measuring the impact of malaria infection on indicators of iron and vitamin A status: a systematic literature review and meta-analysis by Sandalinas F, Filteau S, […], Hopkins H.

Link:
https://pubmed.ncbi.nlm.nih.gov/35260210/

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

Objectives:
An enhanced risk for cardiovascular disease (CVD) still exists even when patients with type 2 diabetes have tight control on blood sugar. Thus, identification of treatment approaches that address CVD risk factors may be useful for patients beyond the blood sugar management. Although emerging evidence suggests that nuts consumption have beneficial effects on cardiometabolic health, the effects of almond intake in patients with type 2 diabetes are still controversial. Therefore, this review article has been conducted. 

Does almond consumption improve risk factors (cholesterol, triglycerides, fasting plasma glucose, insulin, hemoglobin A1c (HbA1c), body mass index, weight, body fat, systolic and diastolic blood pressure and CRP) of cardiovascular disease in patients with type 2 diabetes?

Study design:
This review article included 9 RCTs.

Results and conclusions:
The investigators found there was a causal relationship between almond dietary intake and a  significant reduction in low-density lipoprotein cholesterol (LDL cholesterol or bad cholesterol) [WMD = -5.28 mg/dL, 95% CI = -9.92 to -0.64, p = 0.026] in patients with type 2 diabetes compared with the control group.
This lowering effect of LDL cholesterol was robust in subgroups with almond consumption >50 g/day and baseline LDL cholesterol level 130 mg/dL.

The investigators found, however, the effect of almond on total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL cholesterol or good cholesterol), fasting plasma glucose, insulin, HbA1c, body mass index, weight, body fat, systolic and diastolic blood pressure and CRP was not significant compared with the control group.

The investigators concluded that a dietary intake of at least 50 g/d almond decreases causally LDL cholesterol (bad cholesterol) but has no favourable effect on other cardiometabolic outcomes in patients with type 2 diabetes. Further high-quality studies are needed to firmly establish the clinical efficacy of the almond.

Original title:
Effects of almond on cardiometabolic outcomes in patients with type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials by Moosavian SP, Rahimlou M, […], Jalili C.

Link:
https://pubmed.ncbi.nlm.nih.gov/35443097/

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

Objectives:
While there is growing research interest in the effects of nutrition and exercise on delaying sarcopenia, the results are inconclusive and there is scarce information on regional patterns. Therefore, this review article has been conducted.

Do protein supplements combined with exercise improve extremity strength in healthy older adults with sarcopenia?

Study design:
This review article included 14 RCTs, involving a total of 888 healthy older adults (>60 years).

4 studies in Asian countries provided data on lower-extremity strength, involving 280 participants (138 in protein supplements + exercise group and 142 in exercise group).
Lower-extremity strength was assessed using knee extension (n = 3) or leg extension (n = 1).
The intervention period of all studies was 12 weeks.
The dosage of protein ranged from 3 g/d to 40 g/d.

Results and conclusions:
The investigators found in 4 studies in Asian countries a significant increase in the lower-extremity strength in the protein supplementation + exercise group compared to the exercise group, with a SMD of 0.24 [95% CI = 0.00 to 0.47, p = 0.048, I2 = 0.0%, p = 0.513].

The investigators concluded that protein supplements (3 g/d to 40 g/d during 12 weeks) combined with exercise (knee extension and leg extension) exerts superior benefit on lower-extremity strength in healthy older adults with sarcopenia in Asian countries, when compared to exercise alone or with a placebo. However, no additional benefits from protein supplementation are observed on upper-extremity strength, muscle mass and physical performance regardless of the regions. More well-designed RCTs with information on baseline and total protein intake for longer follow-up periods are warranted to evaluate the effectiveness of protein supplementation and exercise on the prevention and management of sarcopenia in healthy older adults.

Original title:
Effects of protein supplementation and exercise on delaying sarcopenia in healthy older individuals in Asian and non-Asian countries: A systematic review and meta-analysis by Li L, He Y, […], Liu X.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8808080/

Additional information of El Mondo:
Find more information/studies on protein and elderly 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.

Sarcopenia is a type of muscle loss (muscle atrophy) that occurs with aging and/or immobility. Sarcopenia can affect people in their 30s and beyond.
 

Objectives:
Epidemiological studies indicate that higher intakes of flavonoids are associated with reduced stroke risk. However, which subtypes play significant roles to protect against stroke remain unclear. Therefore, this review article has been conducted.

Does dietary intake of different flavonoid subclasses (flavanones, flavan-3-ols) reduce risk of stroke?

Study design:
This review article included 10 independent prospective cohort studies with 387,076 participants and 9,564 events (persons with stroke).

Results and conclusions:
The investigators found higher intakes of flavanones significantly reduced risk of stroke with 15% [RR = 0.85, 95% CI = 0.78 to 0.93].

The investigators found dose-response analysis showed that 50 mg/day increment of flavanones dietary intake was significantly associated with 11% reduction in stroke risk [RR = 0.89, 95% CI = 0.84 to 0.94].

The investigators found dose-response analysis showed that 200 mg/day increment of flavan-3-ols dietary intake was significantly associated with 14% reduction in stroke risk [RR = 0.86, 95% CI = 0.75 to 0.98].

The investigators found no association with respect to other flavonoid subclasses.

The investigators concluded that both 50 mg/day flavanones and 200 mg/day flavan-3-ols dietary intake reduce stroke risk. The findings of these associations of the present study need to be confirmed in other regions and ethnic origins.

Original title:
A meta-analysis of prospective cohort studies of flavonoid subclasses and stroke risk by Li XQ, Wang C, […], Guo XF.

Link:
https://pubmed.ncbi.nlm.nih.gov/35023220/

Additional information of El Mondo:
Find more information/studies on flavonoid consumption and stroke prevention right here.

Objectives:
Is IL-6 is a candidate marker for severe malaria?

Study design:
This review article included 43 studies.

Most of the included studies were prospective observational studies (19, 44.2%) and the remaining study types included cross-sectional studies (16, 37.2%), case-controlled studies (6, 14%) and randomized controlled trials (RCTs) (2, 4.6%).

The studies enrolled patients with P. falciparum (32, 74.4%), P. vivax (4, 9.3%), P. falciparum/P. vivax (3, 6.98%), P. falciparum/P. knowlesi (1, 2.3%), P. falciparum/P. vivax/P. ovale (1, 2.3%), P. falciparum/P. vivax/mixed infection (1, 2.3%) and P. falciparum/P. vivax/P. ovale/P. malariae (1, 2.3%).

Some studies enrolled children (20, 46.5%), adults (16, 37.2%), all age groups (6, 14%) and not specified (1, 2.3%).

Most of the studies (31, 72.1%) used only microscopy for malaria detection although microscopy/PCR (5, 11.6%), microscopy/rapid diagnostic test (RDT; 5, 11.6%) and microscopy/RDT/PCR (2, 4.65%) were also used.

An ELISA was the most common method used for IL-6 measurements (30, 69.8%), followed by a bead-based assay (13, 30.2%).

Thirty-two studies (74.4%) were high quality, whereas 11 studies were moderate qualities.
Heterogeneity of the effect estimate among the included studies was the main limitation of this analysis.

Results and conclusions:
The investigators found results of the meta-analysis showed that patients with severe malaria had higher mean IL-6 levels than those with non-severe malaria [WMD = 96.63 pg/mL, 95% CI = 0.88 to 19.38 pg/mL, p = 0.04, I2 = 99.9%, 13 studies].

The investigators found that the pooled effect estimate was unchanged after the publication bias was adjusted [WMD = 96.60 pg/mL, 95% CI = 4.32 to 188.89 pg/mL, p = 0.04, 13 studies].

The investigators found results of the meta-analysis showed that patients with uncomplicated malaria had higher mean IL-6 levels than the controls [WMD = 42.86 pg/mL, 95% CI = 30.17 to 55.56 pg/mL, p 0.001, I2 = 100%, 17 studies].

The investigators found results of the meta-analysis showed no differences in the mean levels of IL-6 between patients with uncomplicated malaria and those with asymptomatic malaria [WMD = 42.07 pg/mL, 95% CI = -2.23 pg/mL to -86.37 pg/mL, p = 0.063, I2 = 99.1%, 8 studies] or between patients with asymptomatic malaria and healthy controls [WMD = 1.67 pg/mL, 95% CI = -2.73 pg/mL to -6.07 pg/mL, p = 0.45, I2 = 98.1%, 2 studies].

The investigators found subgroup analysis of continents showed no differences in IL-6 levels between patients with severe malaria and non-severe malaria for studies conducted in Africa and Asia.

The investigators found results of the meta-analysis showed that a higher mean level of IL-6 was observed in patients who died compared with the levels of those who survived [WMD = 1,399.19 pg/mL, 95% CI = 384.16 to  2,414.2 pg/mL, p = 0.007, I2 = 93.1%, 4 studies].

The investigators found meta-regression analyses of continents, malarial complications, parasitemia, age, male percentage, malaria diagnostic methods and IL-6 measurement methods showed that these co-variates did not confound the effect estimate [p > 0.05].

The investigators concluded significantly increased levels of IL-6 are observed in patients with severe malaria compared with those in patients with non-severe malaria, which indicates that IL-6 is a candidate marker for severe malaria. In addition, IL-6 might be a candidate marker for malaria infection and therefore could be used to differentiate malaria infection from other febrile diseases. Therefore, it is recommended that future studies should investigate the sensitivity and specificity of increased IL-6 levels to determine the effectiveness of measuring IL-6 levels to detect malaria infection and monitor malaria severity to improve the efficiency of malaria diagnosis and management.

Original title:
Increased interleukin-6 levels associated with malaria infection and disease severity: a systematic review and meta-analysis by Wilairatana P, Mala W, […], Kotepui M.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8993930/

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

Objectives:
Oat supplementation interventions (OSIs) may have a beneficial effect on cardiovascular disease (CVD) risk. However, dietary background can modulate such effect. Therefore, this review article has been conducted.

Does dietary oat supplementation lower levels of blood lipids (cholesterol, triglycerides) and improve anthropometric parameters (glucose level, body mass index, weight, blood pressure, waist circumference) among participants with predominantly mild metabolic disturbances?

Study design:
This review article included 74 RCTs with a total of 4,937 predominantly hypercholesterolemic, obese subjects, with mild metabolic disturbances. Of these, 59 RCTs contributed to the meta-analyses.

The majority of included RCTs (81.1%) had some concerns for risk of bias.

Results and conclusions:
The investigators found oat supplementation (as oat, oat beta-glucan-rich extracts or avenanthramides), compared to control arms without oats, significantly improved levels of:
-total cholesterol (TC) [WMD = -0.42 mmol/L, 95% CI = -0.61 to -0.22];
-LDL cholesterol [WMD = -0.29 mmol/L, 95% CI = -0.37 to -0.20];
-glucose [WMD = -0.25 nmol/L, 95% CI = -0.36 to -0.14];
-body mass index [WMD = -0.13 kg/m², 95% CI = -0.26 to -0.01];
-weight [WMD = -0.94 kg, 95% CI = -1.84 to -0.05] and;
-waist circumference [WMD = -1.06 cm, 95% CI = -1.85 to -0.27].

The investigators found RCTs on inflammation and/or oxidative stress markers were scarce and with inconsistent findings.

The investigators found RCTs comparing an oat supplementation intervention to heterogeneous interventions (e.g., wheat, eggs, rice, etc.), showed lowered levels of glycated haemoglobin, diastolic blood pressure, HDL cholesterol and apolipoprotein B.

The investigators concluded dietary oat supplementation (as oat, oat beta-glucan-rich extracts or avenanthramides) may lower levels of blood lipids and improve anthropometric parameters among obese participants with predominantly mild metabolic disturbances, regardless of dietary background or control. May lower because the majority of included RCTs had some concerns for risk of bias. Therefore, further high-quality trials are warranted to establish the role of oat supplementation intervention on blood pressure, glucose homeostasis and inflammation markers.

Original title:
Effect of oat supplementation interventions on cardiovascular disease risk markers: a systematic review and meta-analysis of randomized controlled trials by Llanaj E, Dejanovic GM, […], Muka T.

Link:
https://pubmed.ncbi.nlm.nih.gov/34977959/

Additional information of El Mondo:
Find more information/studies on oat consumption, overweight and cardiovascular diseases right here.

These products are suitable for persons with cardiovascular diseases.