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Oral Diseases Nov 2023This systematic review aims to determine the association between the consumption of sugar-sweetened beverages (SSBs) and periodontal disease. Preferred Reporting Items... (Review)
Review
This systematic review aims to determine the association between the consumption of sugar-sweetened beverages (SSBs) and periodontal disease. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to conduct a literature search on five electronic databases till January 2022. Systemically healthy individuals consuming SSBs and presenting periodontal disease (gingivitis/periodontitis) were included. The modified Newcastle-Ottawa Scale and the Grading of Recommendation Assessment Development and Evaluation criteria were respectively used to assess the risk of bias and the evidence's quality. Of the 1303 eligible records identified in the initial search, ten studies (nine cross-sectional and one case-control) were selected for the final review. Among the included articles, five reported SSBs intake in the form of carbonated soft drinks, two as sugary drinks, two as soft drinks, and one as coffee with added sugar. Four studies reported gingivitis as an outcome, while the remaining six studies reported periodontitis using validated indices. The included studies were of medium to high quality. Consumption of SSBs may increase gingival bleeding, thereby gingivitis and the risk of periodontitis. Intake of added sugars like SSBs should be considered as a potential factor during gingival/periodontal risk assessment. Further studies are warranted to establish additional evidence of association.
Topics: Humans; Beverages; Sugar-Sweetened Beverages; Dietary Sucrose; Cross-Sectional Studies; Periodontal Diseases; Periodontitis; Gingivitis
PubMed: 36062371
DOI: 10.1111/odi.14368 -
The American Journal of Gastroenterology Feb 2023Patients with hepatic encephalopathy (HE) suffer from significant symptoms and impaired quality of life. Improved understanding on the potential benefits of first-line... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Patients with hepatic encephalopathy (HE) suffer from significant symptoms and impaired quality of life. Improved understanding on the potential benefits of first-line HE therapies may aid patient-provider discussions regarding expected benefits of HE treatments. We aimed to perform a systematic review to assess the effects of lactulose and rifaximin on patient-reported outcomes (PROs).
METHODS
We searched MEDLINE, EMBASE, and Cochrane Library databases for randomized trials or prospective cohort studies using lactulose and/or rifaximin for the management of HE and assessing changes in PRO using PRO instruments. Physician reviewers independently reviewed titles, abstracts, and full texts and extracted data independently. We performed random-effects meta-analyses to examine the effects of lactulose and rifaximin on PROs.
RESULTS
We identified 16 studies representing 1,376 patients that met inclusion criteria. Most studies assessed treatment of covert HE. In patients with covert HE, lactulose significantly improved overall patient-reported health-related quality of life measured by the Sickness Impact Profile with an estimated pooled mean difference of 6.92 (95% confidence interval: 6.66-7.18) and showed improvements in several subscales. Conversely, rifaximin demonstrated a nonstatistically significant mean difference in the total Sickness Impact Profile of 4.76 (95% confidence interval: -4.23 to 13.76), with strong evidence of heterogeneity between these studies. Studies examining other PRO instruments showed improvements in overall health-related quality of life, social functioning, and sleep from both lactulose and rifaximin.
DISCUSSION
Patients with HE treated with lactulose or rifaximin reported improvements in important PROs. These results may inform provider-patient communication and help manage patient expectations regarding the potential benefits of HE therapies.
Topics: Humans; Rifaximin; Lactulose; Hepatic Encephalopathy; Prospective Studies; Quality of Life; Gastrointestinal Agents; Drug Therapy, Combination; Rifamycins
PubMed: 36730910
DOI: 10.14309/ajg.0000000000002008 -
Journal of Eating Disorders Dec 2022Anorexia nervosa (AN) is an eating disorder accompanied by a low body mass index and (self-) restricted food intake. Nutritional limitations can cause complaints of the... (Review)
Review
OBJECTIVES
Anorexia nervosa (AN) is an eating disorder accompanied by a low body mass index and (self-) restricted food intake. Nutritional limitations can cause complaints of the digestive system, because of a disturbed absorption of food components. The absorption of carbohydrates may be seriously affected and reduced to a minimum. On this basis, a possible connection between AN, and the prevalence of gastrointestinal symptoms due to malabsorption was examined.
METHODS
For the systematic literature research with the aim of a better understanding of the topic the databases PubMed, Web of Science, Cochrane Library, Livivo and Google Scholar were used.
RESULTS
After the manual selection process of 2215 retrieved studies, 89 full texts were read and according to the predetermined eligibility criteria, finally 2 studies on the monosaccharide fructose and disaccharide lactose were included in this review.
CONCLUSION
Malabsorption is often observed in patients with AN. It may contribute to the gastrointestinal complaints reported by patients and hamper body weight regain. Among others, mucosal atrophy and duodenal transporter dysfunction are discussed as main reasons. In the future more studies on carbohydrate malabsorption related to low body weight as observed in AN are warranted and may be conducted rather in an outpatient setting.
PubMed: 36474261
DOI: 10.1186/s40337-022-00713-8 -
Alimentary Pharmacology & Therapeutics Jun 2015Dietary fibre supplements have been advocated for the management of chronic constipation (CC) and irritable bowel syndrome (IBS). Recently, a fermentable... (Review)
Review
BACKGROUND
Dietary fibre supplements have been advocated for the management of chronic constipation (CC) and irritable bowel syndrome (IBS). Recently, a fermentable oligosaccharide, disaccharide, monosaccharide and polyol (FODMAP) restricted diet has been recommended for IBS.
AIM
To systematically examine recent evidence for dietary interventions with fibre in CC and IBS and FODMAP-restricted diet in IBS, and provide recommendations.
METHODS
We searched PUBMED, MEDLINE, OVID and COCHRANE databases from 2004 to 2014. Published studies in adults with CC and IBS and constipation-predominant IBS (IBS-C) that compared fibre with placebo/alternative and FODMAP-restricted diet with alternative were included.
RESULTS
Of 550 potentially eligible clinical trials on fibre, 11 studies were found and of 23 potentially eligible studies on FODMAPs, six were found. A meta-analysis was not performed due to heterogeneity and methodological quality. Fibre was beneficial in 5/7 studies in CC and 3/3 studies in IBS-C. FODMAP-restricted diet improved overall IBS symptoms in 4/4 and IBS-C symptoms in 1/3 studies and three studies did not meet inclusion criteria. There were significant disparities in subject selection, interventions and outcome assessments in both fibre and FODMAPs studies.
CONCLUSIONS
Fibre supplementation is beneficial in mild to moderate CC and IBS-C, although larger, more rigorous and long-term RCTs are needed (Fair evidence-Level II, Grade B). Although the FODMAP-restricted diet may be effective in short-term management of selected patients with IBS (Fair evidence-Level II, Grade C) and IBS-C (Poor evidence-Level III, Grade C), more rigorous trials are needed to establish long-term efficacy and safety, particularly on colonic health and microbiome.
Topics: Adult; Constipation; Diet Therapy; Dietary Fiber; Disaccharides; Disease Management; Fermentation; Humans; Irritable Bowel Syndrome; Monosaccharides; Oligosaccharides; Polymers
PubMed: 25903636
DOI: 10.1111/apt.13167 -
Clinics in Perinatology Mar 2017This study is a systematic review of the macronutrient and energy composition of preterm human milk to enable the practicing neonatologist to make informed nutritional... (Review)
Review
This study is a systematic review of the macronutrient and energy composition of preterm human milk to enable the practicing neonatologist to make informed nutritional decisions in preterm infants. Meta-analyses were conducted in all the studies that reported total energy, true protein, fat, and lactose. Protein content decreased massively (by one-half) and significantly from day 1 to 3 at week 10 to 12. There was a significant linear increase in fat, lactose, and energy content during the same timeframe. Theoretic calculations on energy and macronutrient intake of preterm infants must be made according to a lactation time-specific manner.
Topics: Adult; Carbohydrate Metabolism; Carbohydrates; Fats; Female; Gestational Age; Humans; Infant, Newborn; Infant, Premature; Lactation; Lactose; Milk Proteins; Milk, Human; Premature Birth
PubMed: 28159203
DOI: 10.1016/j.clp.2016.11.010 -
Clinical and Experimental... 2014Constipation is a common complaint in adults. Lactitol is an osmotic disaccharide laxative that increases fecal volume and stimulates peristalsis. In this paper, we... (Review)
Review
BACKGROUND
Constipation is a common complaint in adults. Lactitol is an osmotic disaccharide laxative that increases fecal volume and stimulates peristalsis. In this paper, we present the first meta-analysis on the efficacy and tolerance of lactitol for adult constipation.
METHODS
We searched MEDLINE(®) and Embase, with no date or language restrictions, for studies of lactitol supplementation on adult constipation. A random-effects meta-analysis was performed on pre- to posttreatment changes in stool frequency and consistency with lactitol among all studies, as well as a comparison of efficacy and tolerance outcomes in randomized controlled trials (RCTs) of lactitol versus lactulose.
RESULTS
A total of eleven studies representing 663 distinct patients were included in the final analysis, including five single-arm studies, four RCTs comparing lactitol with lactulose, one RCT comparing lactitol with placebo, and one nonrandomized controlled trial comparing lactitol with stimulant laxatives. Weekly stool frequency was significantly increased with lactitol compared with baseline (standardized mean difference [SMD]: 1.56, P<0.001). Stool consistency also improved over the supplementation period with lactitol (SMD: 1.04, P<0.001). Approximately one-third of patients experienced an adverse event; however, symptoms were generally mild and rarely (5%) resulted in study withdrawal. In RCTs of lactitol versus lactulose, lactitol was slightly more effective than lactulose in increasing weekly stool frequency (SMD: 0.19, P=0.06). No statistically significant differences between lactitol and lactulose were identified in any other efficacy or tolerance outcome. Lactitol demonstrated favorable efficacy and tolerance in individual studies when compared to stimulant laxatives and placebo.
CONCLUSION
Lactitol supplementation is well tolerated and improves symptoms of adult constipation. The efficacy and tolerance of lactitol and lactulose are similar, with a trend for more frequent stools with lactitol. Limited evidence suggests lactitol is superior to stimulant laxatives and placebo for relieving constipation symptoms.
PubMed: 25050074
DOI: 10.2147/CEG.S58952 -
Archives of Cardiovascular Diseases Apr 2016Several observational studies have suggested that high consumption of sugar-sweetened beverages (SSBs) and artificially sweetened beverages (ASBs) is associated with... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Several observational studies have suggested that high consumption of sugar-sweetened beverages (SSBs) and artificially sweetened beverages (ASBs) is associated with increased blood pressure, but this relationship has not been investigated comprehensively.
AIMS
To quantitatively examine the association between sugar-sweetened and artificially sweetened beverage intake and risk of hypertension.
METHODS
We performed a systematic review and meta-analysis of eligible prospective cohort studies, identified by searching PubMed, Embase and Web of Science databases up to May 2015. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were calculated using a random-effects model, and generalized least-squares trend estimation was used to assess dose-response relationships.
RESULTS
Six studies (246,822 subjects and 80,628 incident cases of hypertension) were identified for the meta-analysis of SSBs and hypertension. The pooled RR of hypertension in the highest category of SSB consumption (≥1 serving/day, mean) compared with the lowest category of SSB (<0.6 serving/month, mean) was 1.12 (95% CI: 1.07, 1.17). In a dose-response analysis, a 1 serving/day increase in SSB intake was associated with an 8% increased risk of hypertension (RR: 1.08, 95% CI: 1.06, 1.11). Four studies (227,254 subjects and 78,177 incident cases of hypertension) were included in the meta-analysis of ASBs and hypertension. The pooled RRs were 1.14 (95% CI: 1.10, 1.18) for highest versus lowest analysis and 1.09 (95% CI: 1.06, 1.11) for every additional 1 serving/day increase in ASB consumption. The positive association did not vary significantly by sex, duration of follow-up or adjustment for body mass index.
CONCLUSIONS
Our findings indicate that high SSB and ASB consumption is associated with an increased risk of hypertension.
Topics: Beverages; Dietary Sucrose; Humans; Hypertension; Risk Assessment; Sweetening Agents
PubMed: 26869455
DOI: 10.1016/j.acvd.2015.10.005 -
Sugar and artificially sweetened beverages linked to obesity: a systematic review and meta-analysis.QJM : Monthly Journal of the... Aug 2017Artificial sweeteners are used widely to replace caloric sugar as one of the strategies to lessen caloric intake. However, the association between the risk of obesity... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND/OBJECTIVES
Artificial sweeteners are used widely to replace caloric sugar as one of the strategies to lessen caloric intake. However, the association between the risk of obesity and artificially sweetened soda consumption is controversial. The objective of this meta-analysis aimed to assess the association between consumption of sugar and artificially sweetened soda and obesity.
METHODS
A literature search was performed using MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials from inception through May 2015. Studies that reported relative risks, odd ratios, or hazard ratios comparing the risk of obesity in patients consuming either sugar or artificially sweetened soda vs. those who did not consume soda were included. Pooled risk ratios (RRs) and 95% CI were calculated using a random-effect, generic inverse variance method.
RESULTS
Eleven studies were included in our analysis to assess the association between consumption of sugar-sweetened soda and obesity. The pooled RR of obesity in patients consuming sugar-sweetened soda was 1.18 (95% CI, 1.10-1.27). Three studies were included to assess the association between consumption of artificially sweetened soda and obesity. The pooled RR of obesity in patients consuming artificially sweetened soda was 1.59 (95% CI, 1.22-2.08).
CONCLUSIONS
Our study demonstrated a significant association between sugar and artificially sweetened soda consumption and obesity. This finding raises awareness and question of negative clinical impact on both sugar and artificially sweetened soda and the risk of obesity.
Topics: Beverages; Dietary Sucrose; Humans; Obesity; Randomized Controlled Trials as Topic; Risk Factors; Sweetening Agents; Weight Gain
PubMed: 28402535
DOI: 10.1093/qjmed/hcx068 -
Medicine Sep 2023Transjugular intrahepatic portosystemic shunt (TIPS) can be an effective treatment for cirrhotic patients who develop variceal bleeding and ascites. However, TIPS... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Transjugular intrahepatic portosystemic shunt (TIPS) can be an effective treatment for cirrhotic patients who develop variceal bleeding and ascites. However, TIPS placement is associated with an increased risk of developing hepatic encephalopathy (HE). Recently, there have been efforts to use the typical medical therapies prophylactically in patients undergoing TIPS placement to prevent post-TIPS HE.
METHODS
We conducted literature searches in MEDLINE, Embase, CINAHL, Scopus, and Cochrane to examine studies that use prophylactic medical therapy for preventing post-TIPS HE. A narrative synthesis and grading of recommendations assessment assessment were done for all studies. Meta-analysis was performed for eligible studies using the Mantel-Haenszel method random-effects model. Nine hundred twenty-one articles were screened and 5 studies were included in the study after 2 levels of screening. The medications studied were rifaximin, lactulose, lactitol, L-Ornithine-L-aspartate (LOLA), albumin, and combination therapies.
RESULTS
Narrative results showed that lactulose, lactitol, LOLA and albumin prophylaxis were not associated with reduction in HE occurrence or mortality. A combination of rifaximin and lactulose was found to be associated with lower occurrence of HE, and the results were not different when LOLA was added. Meta-analysis (n = 3) showed that rifaximin treatment was not associated with changes in HE occurrences.
CONCLUSION
In conclusion, a vast majority of medications were not found to be effective post-TIPS HE prophylaxis when used alone. A rifaximin and lactulose combination therapy may be beneficial. Overall, there is significant limitation in the current data and more studies are needed to yield more robust meta-analysis results in the future.
Topics: Humans; Hepatic Encephalopathy; Lactulose; Rifaximin; Esophageal and Gastric Varices; Gastrointestinal Hemorrhage; Albumins; Primary Prevention
PubMed: 37746955
DOI: 10.1097/MD.0000000000035266 -
Nutrition Reviews Feb 2016Studies suggest that appropriate nutritional modifications can improve the natural conception rate of infertile couples. (Review)
Review
CONTEXT
Studies suggest that appropriate nutritional modifications can improve the natural conception rate of infertile couples.
OBJECTIVES
The purpose of this study was to review the human trials that investigated the relation between nutrition and male infertility.
DATA SOURCES
A comprehensive systematic review of published human studies was carried out by searching scientific databases. Article selection was carried out in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The American Dietetic Association Research Design and Implementation Checklist was also used for quality assessment.
DATA EXTRACTION
A total of 502 articles were identified, of which 23 studies met the inclusion criteria.
DATA SYNTHESIS
Results indicated that a healthy diet improves at least one measure of semen quality, while diets high in lipophilic foods, soy isoflavones, and sweets lower semen quality.
CONCLUSION
The role of daily nutrient exposure and dietary quality needs to be highlighted in male infertility. Mechanistic studies addressing the responsible underlying mechanisms of action of dietary modifications are highly warranted.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO 2013: CRD42013005953. Available at: http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42013005953.
Topics: Diet; Dietary Sucrose; Humans; Infertility, Male; Isoflavones; Male; Nutritional Status; Semen Analysis
PubMed: 26705308
DOI: 10.1093/nutrit/nuv059