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Clinical Nutrition (Edinburgh, Scotland) Jan 2024Accumulating evidence supports the effects of dietary fiber on the risk of non-communicable diseases (NCDs). However, there is no updated systematic review and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Accumulating evidence supports the effects of dietary fiber on the risk of non-communicable diseases (NCDs). However, there is no updated systematic review and meta-analysis that compares and pools the effect of different types of fiber on mortality.
METHODS
In this systematic review and meta-analysis, all prospective cohort studies that evaluated the relationship between dietary fiber intake and all-cause or cause-specific mortality were included. The PubMed, SCOPUS, and Web of Science databases were searched up to October 2022. Data extraction and quality assessment were performed by two researchers independently. Heterogeneity between studies was assessed using Chi-square based test. Random/fixed effect meta-analysis was used to pool the hazard ratios (HR) or relative risks (RR) and 95 % confidence intervals (CI) for the association between different types of fiber and mortality.
RESULTS
This systematic review included 64 eligible studies, with a total sample size of 3512828 subjects, that investigated the association between dietary fiber intake and mortality from all-cause, cardiovascular disease (CVD), and cancer. Random-effect meta-analysis shows that higher consumption of total dietary fiber, significantly decreased the risk of all-cause mortality, CVD-related mortality, and cancer-related mortality by 23, 26 and 22 % (HR:0.77; 95%CI (0.73,0.82), HR:0.74; 95%CI (0.71,0.77) and HR:0.78; 95%CI (0.68,0.87)), respectively. The consumption of insoluble fiber tended to be more effective than soluble fiber intake in reducing the risk of total mortality and mortality due to CVD and cancer. Additionally, dietary fiber from whole grains, cereals, and vegetables was associated with a reduced risk of all-cause mortality, while dietary fiber from nuts and seeds reduced the risk of CVD-related death by 43 % (HR:0.57; 95 % CI (0.38,0.77)).
CONCLUSION
This comprehensive meta-analysis provides additional evidence supporting the protective association between fiber intake and all-cause and cause-specific mortality rates.
Topics: Humans; Cause of Death; Prospective Studies; Cardiovascular Diseases; Dietary Fiber; Neoplasms; Risk Factors
PubMed: 38011755
DOI: 10.1016/j.clnu.2023.11.005 -
Frontiers in Nutrition 2023The effect of viscous soluble dietary fiber on glucose and lipid metabolism in type 2 diabetes mellitus (T2DM) remains controversial, and the dose-response relationship...
Effect of viscous soluble dietary fiber on glucose and lipid metabolism in patients with type 2 diabetes mellitus: a systematic review and meta-analysis on randomized clinical trials.
BACKGROUND
The effect of viscous soluble dietary fiber on glucose and lipid metabolism in type 2 diabetes mellitus (T2DM) remains controversial, and the dose-response relationship of its effect on blood glucose and blood lipid level is still unclear.
METHODS
We conducted comprehensive searches in several databases up to 17 January 2023. We conducted a dose-response analysis of randomized controlled trials (RCTs) to investigate the effect of viscous dietary fiber on glucose and lipid metabolism in patients with T2DM.
RESULTS
Statistical significance was observed in the decreases of glycosylated hemoglobin (HbA1c) (mean difference) [MD = -0.47; 95%CI: (-0.66, -0.27)], fasting blood glucose (FBG) [MD = -0.93; 95%CI: (-1.46, -0.41)], total cholesterol (TC) [MD = -0.33; 95%CI: (-0.46, -0.21)], and low-density lipoprotein and cholesterol (LDL-C) [MD = -0.24; 95%CI: (-0.35, -0.13)]. Contrarily, no difference was observed regarding the level of high-density lipoprotein cholesterol (HDL-C) or triglyceride (TG). In addition, the effect on fasting insulin remains unclear. Results from the subgroup analyses showed that an intervention duration longer than 6 weeks had a significant effect on the HbA1c level; a treatment dosage higher than 8.3 g/day had a significant effect on the FBG level.
CONCLUSIONS
Supplementation of viscous dietary fiber is beneficial to control blood glucose and blood lipid in T2DM.
PubMed: 37720378
DOI: 10.3389/fnut.2023.1253312 -
Frontiers in Nutrition 2023To conduct a systematic review and meta-analysis of prospective cohort studies to investigate the association between total, vegetable, fruit, cereal, soluble and...
Dietary intake of total vegetable, fruit, cereal, soluble and insoluble fiber and risk of all-cause, cardiovascular, and cancer mortality: systematic review and dose-response meta-analysis of prospective cohort studies.
OBJECTIVES
To conduct a systematic review and meta-analysis of prospective cohort studies to investigate the association between total, vegetable, fruit, cereal, soluble and insoluble fiber intake and risk of all causes, cardiovascular disease (CVD), and cancer mortality and quantitatively assess the dose-response relation.
METHODS
Eligible studies were identified by searching PubMed, Embase and Web of science before August 2023. Random effects models were used to calculate summary relative risk (RR) and 95% confidence intervals (CI) and restricted cubic splines to model the linear/non-linear association.
RESULTS
The summary RR for all-cause, CVD and cancer mortality of dietary fiber was 0.90 (95% CI: 0.86,0.93), 0.87 (0.84,0.91), 0.91 (0.88,0.93), respectively. Significant association was observed for all-cause and CVD mortality with fruit, vegetable cereal and soluble fiber intake and cancer mortality with cereal fiber intake. No significant association was found for insoluble fiber, vegetable or fruit fiber intake and cancer mortality. Dose-response analysis showed a significant non-linear relation of dietary fiber intake with all-cause mortality, and linear relation for others.
CONCLUSIONS
Higher dietary fiber including different type and food sources of fiber intake were associated with lower risk of mortality. Our findings provide more comprehensive evidence on dietary fiber intake with mortality.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero, identifier: CRD42022338837.
PubMed: 37854351
DOI: 10.3389/fnut.2023.1153165 -
La Clinica Terapeutica 2023The legume tree known as carob (Ceratonia siliqua L.) is indigenous to the Mediterranean area and over the centuries its pods had been traditionally used mostly as... (Meta-Analysis)
Meta-Analysis Review
The legume tree known as carob (Ceratonia siliqua L.) is indigenous to the Mediterranean area and over the centuries its pods had been traditionally used mostly as animal feed. However, it has gained great attention in human nutrition due to the molecular compounds it contains, which could offer many potential health benefits: for example, carob is renowned for its high content of fiber, vitamins, and minerals. Moreover, in traditional medicine it is credited with the ability to control glucose metabolism and gut microbiome. Modern science has also extensively acknowledged the numerous health advantages deriving from its consumption, including its anti-diabetic, anti-inflammatory, and antioxidant properties. Due to its abundant contents of pectin, gums, and polyphenols (such as pinitol), carob has garnered significant attention as a well-researched plant with remarkable therapeutic properties. Notably, carob is extensively used in the production of semi-finished pastry products, particularly in ice cream and other creams (especially as a substitute for cocoa/chocolate): these applications indeed facilitate the exploration of its positive effects on glucose metabolism. Our study aimed at examining the effects of carob extract on intestinal microbiota and glucose metabolism. In this review, we conducted a thorough examination, comprising in vitro, in vivo, and clinical trials to appraise the consequences on human health of polyphenols and pectin from different carob species, including recently discovered ones with high polyphenol contents. Our goal was to learn more about the mechanisms through which carob extract can support a balanced gut flora and improve one's glucose metabolism. These results could influence the creation of novel functional foods and dietary supplements, to help with the management and prevention of chronic illnesses like diabetes and obesity.
Topics: Animals; Humans; Gastrointestinal Microbiome; Polyphenols; Glucose; Fabaceae; Pectins
PubMed: 37994761
DOI: 10.7417/CT.2023.2484 -
Nutrition Reviews Nov 2023Dietary fibers hold potential to influence depressive and anxiety outcomes by modulating the microbiota-gut-brain axis, which is increasingly recognized as an underlying...
CONTEXT
Dietary fibers hold potential to influence depressive and anxiety outcomes by modulating the microbiota-gut-brain axis, which is increasingly recognized as an underlying factor in mental health maintenance.
OBJECTIVE
Evidence for the effects of fibers on depressive and anxiety outcomes remains unclear. To this end, a systematic literature review and a meta-analysis were conducted that included observational studies and randomized controlled trials (RCTs).
DATA SOURCES
The PubMed, Embase, CENTRAL, CINAHL, and PsychINFO databases were searched for eligible studies.
DATA EXTRACTION
Study screening and risk-of-bias assessment were conducted by 2 independent reviewers.
DATA ANALYSIS
Meta-analyses via random effects models were performed to examine the (1) association between fiber intake and depressive and anxiety outcomes in observational studies, and (2) effect of fiber intervention on depressive and anxiety outcomes compared with placebo in RCTs. A total of 181 405 participants were included in 23 observational studies. In cross-sectional studies, an inverse association was observed between fiber intake and depressive (Cohen's d effect size [d]: -0.11; 95% confidence interval [CI]: -0.16, -0.05) and anxiety (d = -0.25; 95%CI, -0.38, -0.12) outcomes. In longitudinal studies, there was an inverse association between fiber intake and depressive outcomes (d = -0.07; 95%CI, -0.11, -0.04). In total, 740 participants were included in 10 RCTs, all of whom used fiber supplements. Of note, only 1 RCT included individuals with a clinical diagnosis of depression. No difference was found between fiber supplementation and placebo for depressive (d = -0.47; 95%CI, -1.26, 0.31) or anxiety (d = -0.30; 95%CI, -0.67, 0.07) outcomes.
CONCLUSION
Although observational data suggest a potential benefit for higher fiber intake for depressive and anxiety outcomes, evidence from current RCTs does not support fiber supplementation for improving depressive or anxiety outcomes. More research, including RCTs in clinical populations and using a broad range of fibers, is needed.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO registration no. CRD42021274898.
PubMed: 38007616
DOI: 10.1093/nutrit/nuad143 -
Journal of Stroke and Cerebrovascular... Aug 2023An analysis was conducted to explore the relationship between dietary fibre intake and stroke risk. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
An analysis was conducted to explore the relationship between dietary fibre intake and stroke risk.
METHODS
PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI) and WanFang and Weipu databases were systematically searched to obtain peer-reviewed literature on the relationship between dietary fibre and stroke risk. The search time was as of 1 April 2023. Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the included studies. The pooled hazard ratio (HR) and 95% confidence interval (CI) were calculated using Stata 16.0. The Q test and I statistics were used to evaluate the heterogeneity and sensitivity analysis to explore potential bias. Meta-regression analysis was conducted to explore the relationship between total dietary intake quality and stroke risk.
RESULTS
Sixteen high-quality studies, involving 855,671 subjects, met the inclusion criteria and were involved in the final meta-analysis. The results showed that higher total dietary fibre (HR: 0.81; 95% CI: 0.75-0.88), fruit fibre (HR: 0.88; 95% CI: 0.82-0.93), vegetable fibre (HR: 0.85; 95% CI: 0.81-0.89), soluble fibre (HR: 0.82; 95% CI: 0.72-0.93) and insoluble fibre (HR: 0.77; 95% CI: 0.66-0.89) had a positive effect on reducing the risk of stroke. However, cereal fibre (HR: 0.90; 95% CI: 0.81-1.00) was not statistically significant in reducing the risk of stroke. For different stroke types, higher total dietary fibre was associated with ischemic stroke (HR: 0.83; 95% CI: 0.79-0.88) and had a similar positive effect but was not found in haemorrhagic stroke (HR: 0.91; 95% CI: 0.80-1.03). Stroke risk decreased with increased total dietary fibre intake (β=-0.006189, P=0.001). No potential bias from the individual study was found from sensitivity analysis.
CONCLUSION
Increasing dietary fibre intake had a positive effect on reducing the risk of stroke. Different dietary fibres have various effects on stroke.
Topics: Humans; Stroke; Dietary Fiber; Hemorrhagic Stroke; Ischemic Stroke; China
PubMed: 37196565
DOI: 10.1016/j.jstrokecerebrovasdis.2023.107144 -
Nutrients Dec 2023Weight management during pregnancy and the postpartum period is an important strategy that can be utilized to reduce the risk of short- and long-term complications in... (Review)
Review
Weight Management during Pregnancy and the Postpartum Period in Women with Gestational Diabetes Mellitus: A Systematic Review and Summary of Current Evidence and Recommendations.
BACKGROUND
Weight management during pregnancy and the postpartum period is an important strategy that can be utilized to reduce the risk of short- and long-term complications in women with gestational diabetes mellitus (GDM). We conducted a systematic review to assess and synthesize evidence and recommendations on weight management during pregnancy and the postpartum period in women with GDM to provide evidence-based clinical guidance.
METHODS
Nine databases and eighteen websites were searched for clinical decisions, guidelines, recommended practices, evidence summaries, expert consensus, and systematic reviews.
RESULTS
A total of 12,196 records were retrieved and fifty-five articles were included in the analysis. Sixty-nine pieces of evidence were summarized, sixty-two of which focused on pregnancy, including benefits, target population, weight management goals, principles, weight monitoring, nutrition assessment and counseling, energy intake, carbohydrate intake, protein intake, fat intake, fiber intake, vitamin and mineral intake, water intake, dietary supplements, sugar-sweetened beverages, sweeteners, alcohol, coffee, food safety, meal arrangements, dietary patterns, exercise assessment and counseling, exercise preparation, type of exercise, intensity of exercise, frequency of exercise, duration of exercise, exercise risk prevention, and pregnancy precautions, and seven focused on the postpartum period, including target population, benefits, postpartum weight management goals, postpartum weight monitoring, dietary recommendations, exercise recommendations, and postpartum precautions.
CONCLUSIONS
Healthcare providers can develop comprehensive pregnancy and postpartum weight management programs for women with GDM based on the sixty-nine pieces of evidence. However, because of the paucity of evidence on postpartum weight management in women with GDM, future guidance documents should focus more on postpartum weight management in women with GDM.
Topics: Pregnancy; Female; Humans; Diabetes, Gestational; Postpartum Period; Diet; Dietary Supplements; Vitamins
PubMed: 38140280
DOI: 10.3390/nu15245022 -
JMIR Dermatology Nov 2023Atopic dermatitis (AD), also known as eczema, is a chronic inflammatory skin condition that presents with symptoms of intense pruritus, dryness, and erythema.... (Review)
Review
BACKGROUND
Atopic dermatitis (AD), also known as eczema, is a chronic inflammatory skin condition that presents with symptoms of intense pruritus, dryness, and erythema. Dissatisfaction with first-line therapies for AD, the desire to avoid steroids, and the extreme cost of effective biologics have created a demand for alternative treatment options such as oral vitamins and nutritional supplements.
OBJECTIVE
The purpose of this review was to assess the effectiveness of oral nutritional supplements, pre- and probiotics, and vitamin deficiencies and supplements on AD symptomology and clinical course.
METHODS
We searched Scopus, PubMed, and MEDLINE (Ovid interface) for English-language articles published between 1993 and 2023. The final search was conducted on June 22, 2023. The search terms comprised the following: "(Atopic Dermatitis or Atopic Eczema) AND (supplement OR vitamin OR mineral OR micronutrients OR Fish Oil OR Omega Fatty Acid OR Probiotics OR Prebiotics OR apple cider vinegar OR collagen OR herbal OR fiber)."
RESULTS
A total of 18 studies-3 (17%) evaluating vitamins, 4 (22%) evaluating herbal medicine compounds, 2 (11%) evaluating single-ingredient nutritional supplements, and 9 (50%) evaluating pre- and probiotics-involving 881 patients were included in this review.
CONCLUSIONS
Overall, there is weak evidence to support any one nutritional supplement intervention for the alleviation of AD symptoms. Multiple trials (4/18, 22%) showed promise for supplements such as Zemaphyte, kefir, and freeze-dried whey with Cuscuta campestris Yuncker extract. The most evidence was found on the effectiveness of probiotics on the clinical course of AD. Lactiplantibacillus plantarum, Ligilactobacillus salivarius, and Lactobacillus acidophilus specifically showed evidence of efficacy and safety across multiple studies (6/18, 33%). However, larger, more extensive randomized controlled trials are needed to determine the true effectiveness of these supplements on the broader population.
TRIAL REGISTRATION
PROSPERO CRD42023470596; https://tinyurl.com/4a9477u7.
PubMed: 38019566
DOI: 10.2196/40857 -
Neuropsychopharmacology Reports Jun 2024Children with attention deficit hyperactivity disorder (ADHD) may benefit from probiotics and prebiotics, but the effects are unclear. To determine whether probiotics... (Review)
Review
BACKGROUND
Children with attention deficit hyperactivity disorder (ADHD) may benefit from probiotics and prebiotics, but the effects are unclear. To determine whether probiotics and prebiotics affect children with ADHD, a systematic review was conducted.
METHODS
The present systematic review analyzed cohort studies and randomized controlled trials that examined whether prebiotics and probiotics are associated with ADHD. Seven randomized controlled trials and two cohort studies met our inclusion criteria.
RESULTS
Research on Lactobacillus rhamnosus GG (LGG) probiotic supplementation showed that children with ADHD had better emotional, physical, social, and school functioning, and a higher health-related quality of life compared to the placebo group. The studies also showed that Synbiotic 2000 reduces markers of intestinal and vascular inflammation in children with ADHD, in part through increasing SCFA levels.
CONCLUSION
The use of probiotics and prebiotics as adjuvants therapy in patients with ADHD is beneficial. Further studies with longer duration, including more participants and a variety of age groups, and using various evaluation techniques such as in vivo observation are required to examine the effects of prebiotics and probiotics on ADHD.
Topics: Humans; Attention Deficit Disorder with Hyperactivity; Prebiotics; Probiotics; Synbiotics; Child; Randomized Controlled Trials as Topic
PubMed: 38623929
DOI: 10.1002/npr2.12437 -
Nutrition Journal Oct 2023Pervious epidemiologic evidence indicates that soluble fiber is protective against hypertention: however, randomized controlled trials (RCTs) have presented varying... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Pervious epidemiologic evidence indicates that soluble fiber is protective against hypertention: however, randomized controlled trials (RCTs) have presented varying results. In the present study, we aimed to conduct a systematic review and dose-response meta-analysis to summarize published RCTs which assess the effect of soluble fiber supplementation on systolic blood pressure (SBP) and diastolic blood pressure (DBP).
METHODS
Scopus, PubMed, and ISI Web of Sciences were searched to identify relevant studies up to Aug 2022. We estimated the change in blood pressure for each 5 g/d increment in soluble fiber supplementation in each trial and then calculated the weighted mean difference (WMD) and 95%CI using a random-effects model. We estimated dose-dependent effects using a dose-response meta-analysis of differences in means. The risk of bias for study was assessed using the Cochrane tool. Publication bias was evaluated via funnel plot and Begg's test and Egger's test.
RESULTS
Eighty-three eligible studies with total sample size of 5,985 participants were included in the meta-analysis. Soluble fiber supplementation significantly decreased SBP (WMD: -1.36 mmHg, 95% CI: -2.13 to -0.60, P < 0.001; I = 47.1%, P < 0.001) and DBP (WMD: -0.72 mmHg, 95% CI: -1.26 to -0.18, P = 0.009; I = 45.4%, P < 0.001). Each 5 g/d increment in soluble fiber supplementation had a significant reduction in SBP (WMD: -0.54 mmHg; 95%CI: -0.86, -0.22, P = 0.001; I = 52.2, P < 0.001) and DBP (WMD: -0.28 mmHg; 95%CI: -0.49, -0.80, P = 0.007; I = 43.1%, P < 0.001). The levels of SBP decreased proportionally with the increase in soluble fiber supplementation up to 20 g/d (MD: -1.79 mmHg, 95%CI: -2.86, -0.71).
CONCLUSION
Current evidence indicated the beneficial effect of soluble fiber supplementation on blood pressure. Our findings suggest that soluble fiber supplementation could contribute to the management of hypertension and the reduction of cardiovascular disease risk.
Topics: Adult; Humans; Blood Pressure; Dietary Supplements; Randomized Controlled Trials as Topic; Hypertension; Bias
PubMed: 37833676
DOI: 10.1186/s12937-023-00879-0