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JNCI Cancer Spectrum Jan 2024Phytonutrient intakes may improve outcomes following breast cancer, but the impact of postdiagnosis introduction vs established prediagnostic exposure as well as optimum... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Phytonutrient intakes may improve outcomes following breast cancer, but the impact of postdiagnosis introduction vs established prediagnostic exposure as well as optimum doses has not been established. Evidence from observational studies for key exposures was evaluated, including dosage and intake time frames.
METHODS
MEDLINE, EMBASE, CINAHL, Cochrane Library, ClinicalTrials.gov, and the ISRCTN registry were searched for prospective and retrospective observational studies investigating the impact of soybean, lignans, cruciferous (cabbage-family) vegetables, green tea, or their phytonutrients on breast cancer survival outcomes. A random-effects model was used to calculate summary hazard ratios (HRs) and 95% confidence intervals (CIs). Nonlinear dose-response analyses were conducted using restricted cubic splines.
RESULTS
Thirty-two articles were included. Soy isoflavones were associated with a 26% reduced risk of recurrence (HR = 0.74, 95% CI = 0.60 to 0.92), particularly among postmenopausal (HR = 0.72, 95% CI = 0.55 to 0.94) and estrogen receptor-positive survivors (HR = 0.82, 95% CI = 0.70 to 0.97), with the greatest risk reduction at 60 mg/day. In mortality outcomes, the reduction was mostly at 20 to 40 mg/day. Soy protein and products were inversely associated with cancer-specific mortality for estrogen receptor-positive disease (HR = 0.75, 95% CI = 0.60 to 0.92). An inverse association was observed for serum or plasma enterolactone, measured prediagnosis and early postdiagnosis, with cancer-specific mortality (HR = 0.72, 95% CI = 0.58 to 0.90) and all-cause mortality (HR = 0.69, 95% CI = 0.57 to 0.83). No effects were observed for cruciferous vegetables. There was a 44% reduced risk of recurrence with prediagnostic green tea for stage I and II breast cancer (HR = 0.56, 95% CI = 0.38 to 0.83).
CONCLUSIONS
Soy, enterolactone, and green tea demonstrated significant risk reductions in outcomes following breast cancer. Evidence is needed regarding the impact of postdiagnostic introduction or substantial increase of these exposures.
Topics: Humans; Female; Prospective Studies; Retrospective Studies; Breast Neoplasms; Receptors, Estrogen; Tea
PubMed: 38070485
DOI: 10.1093/jncics/pkad104 -
Annali Di Igiene : Medicina Preventiva... 2023Aging is a complex and gradual biological process that represents the major risk factor with respect to the development of chronic degenerative diseases, often...
BACKGROUND
Aging is a complex and gradual biological process that represents the major risk factor with respect to the development of chronic degenerative diseases, often associated with disability. Diet and nu-trition, coupled with proper physical activity have a significant impact on the health status of the elderly with a decreased risk of disease being indicative of successful aging. Musculoskeletal conditions such as osteoporosis and sarcopenia are the most frequently reported disorders among the elderly community.
METHODS
This study presents a systematic review of the literature on the potential benefits of several nutra-ceuticals in promoting healthy aging and in reducing the risk of chronic diseases in elderly individuals.
RESULTS
Dietary components including vitamins (vitamin C, B vitamin and vitamin K) flavonoids (e.g., quercetin, anthocyanins, and isoflavones), minerals (e.g., magnesium, zinc and potassium) and other nutrients such phytoestrogens, amino acids, and omega-3 fatty acids help in slowing the aging process, which ultimately results in increased lifespan and longevity.
CONCLUSIONS
This paper highlights the key nutrients and phytochemicals of nutraceutical importance for the healthy aging of the elderly population. Although the scientific literature provides evidences of therapeutic effectiveness of nutraceuticals, more in-depth clinical investigations are needed.
Topics: Aged; Humans; Healthy Aging; Anthocyanins; Dietary Supplements; Vitamins; Diet; Vitamin K
PubMed: 36515582
DOI: 10.7416/ai.2022.2552 -
Archivio Italiano Di Urologia,... Oct 2023Urinary incontinence and other urinary symptoms tend to be frequent at menopause because of hormonal modifications and aging. Urinary symptoms are associated with the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Urinary incontinence and other urinary symptoms tend to be frequent at menopause because of hormonal modifications and aging. Urinary symptoms are associated with the genitourinary syndrome of menopause which is characterized by physical changes of the vulva, vagina and lower urinary tract. The treatment strategies for postmenopausal urinary incontinence are various and may include estrogens, anticholinergics, and pelvic floor muscle training. A comparison of these treatments is difficult due to the heterogeneity of adopted protocols. We systematically reviewed the evidence from randomized controlled trials (RCTs) focusing on treatment of postmenopausal women with urge incontinence.
METHODS
We conducted a systematic review and meta-analysis by searching PubMed and EMBASE databases for randomized controlled trials (RCTs) reporting results of treatments for postmenopausal urinary urge incontinence. Odds ratios for improvement of urinary incontinence were calculated using random effect Mantel-Haenszel statistics.
RESULTS
Out of 248 records retrieved, 35 eligible RCTs were assessed for risk of bias and included in the meta-analysis. Compared with placebo, systemic estrogens were associated with decreased odds of improving urinary incontinence in postmenopausal women (OR = 0.74, 95% CI: 0.61-0.91, 7 series, 17132 participants, Z = 2.89, P = 0.004, I2 = 72%). In most studies, no significant improvement in urinary symptoms was observed in patients treated with local estrogens, although they showed to be helpful in improving vaginal symptoms. Vitamin D, phytoestrogens and estrogen modulators were not effective in improving symptoms of incontinence and other symptoms of genitourinary menopause syndrome or yielded contradictory results. A randomized controlled trial demonstrated that oxybutynin was significantly better than placebo at improving postmenopausal urgency and urge incontinence. The combination of anticholinergics with local estrogens has not been shown to be more effective than anticholinergics alone in improving urinary incontinence symptoms in postmenopausal women. Physical therapy showed an overall positive outcome on postmenopausal urinary incontinence symptoms, although such evidence should be further validated in the frame of quality RCTs.
CONCLUSIONS
The evidence for effective treatment of postmenopausal urinary incontinence is still lacking. Welldesigned large studies having subjective and objective improvement primary endpoints in postmenopausal urinary incontinence are needed. At present, a combination of different treatments tailored to the characteristics of the individual patient can be suggested.
Topics: Female; Humans; Urinary Incontinence, Urge; Urinary Incontinence, Stress; Postmenopause; Pelvic Floor; Urinary Incontinence; Estrogens; Cholinergic Antagonists; Randomized Controlled Trials as Topic
PubMed: 37791545
DOI: 10.4081/aiua.2023.11718 -
International Journal of Community... Jul 2023The experience of hot flashes during menopause has a negative effect on quality of life and can cause disturbance in the workplace and disrupt daily activities.... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The experience of hot flashes during menopause has a negative effect on quality of life and can cause disturbance in the workplace and disrupt daily activities. Phytoestrogens in reduce menopause symptoms due to their anti-dopaminergic effects. This study was conducted to systematically review and summarize the results of clinical trials on the effect of on hot flashes in postmenopausal women.
METHODS
In this systematic review, databases including Pubmed, Web of Science, Cochrane library, Scopus, SID, and Magiran were searched using keywords such as menopause, hot flashes, , and herbal medicines; all possible combinations of these words were used with the Boolean operators of "OR" and "AND". To evaluate the quality of articles, we used Cochrane's Risk of bias tools.
RESULTS
After eliminating the duplicates, a total of 148 articles were found. Following the exclusion of irrelevant articles, 4 studies with number of 310 people were examined. Among them, 3 out of 4 studies examined the effect of on the frequency of hot flashes, 3 out of 4 studies examined the severity of hot flashes, and only 1 out of 4 studies examined the effect of on the duration of hot flashes. All 4 reviewed studies indicated that the use of reduced the frequency and severity of hot flashes in postmenopausal women. Meta-analysis results showed that the effect of Salvia Officinalis on the frequency [ES=-1.12 (%95 CI:-2.37; 0.14), I=71%] of hot flashes in postmenopausal women was significant compared to placebo, but severity [ES=-2.05 (%95 CI:-6.53; 2.43), I=70%] was not significant.
CONCLUSION
can be used to reduce the frequency of menopausal hot flashes. Expansive use of this plant can be suggested in case it is confirmed in further investigations.
Topics: Humans; Female; Hot Flashes; Salvia officinalis; Postmenopause; Quality of Life; Menopause
PubMed: 37489230
DOI: 10.30476/IJCBNM.2023.97639.2198 -
International Journal of Reproductive... Nov 2023The quality of life of a person and her sexual partner is impacted by sexual function. Sexual function disorders have a significant prevalence in society. There are... (Review)
Review
The quality of life of a person and her sexual partner is impacted by sexual function. Sexual function disorders have a significant prevalence in society. There are different treatments for sexual disorders, including herbal therapies. This study aimed to do a comparison of phytoestrogens and non-phytoestrogens medicinal plant's effects on sexual health in pre- and postmenopausal women. This systematic review and meta-analysis was performed to identify relevant articles in electronic databases such as Web of Science, Scopus, PubMed, Cochrane Library, Google Scholar, and SID for English- and Persian-language articles published up to December 2021. The Cochrane collaboration tool was used to assess the risk of bias. Heterogeneity was assessed using I statistics. Of 5428 records retrieved by searching the databases, after removing duplicate and irrelevant articles, 39 articles were included based on the inclusion criteria in the study. Finally, 18 articles with 1299 participants were included in the meta-analysis. 18 randomized clinical trial studies of phytoestrogens (n = 13) and non-phytoestrogens (n = 5) plants that used the female sexual function index questionnaire and reported the mean difference (MD) and standard deviation were included in the meta-analysis. The effects of phytoestrogens and non-phytoestrogens plants on the sexual health of postmenopausal women appear to differ significantly from one another, according to the meta-analysis (MD = 7.59; 95% CI = 4.56-10.60 and MD = 3.19; 95% CI = 1.25-5.13, respectively) but this difference was not observed in premenopausal women. The effect of phytoestrogens plants is more in menopausal women, and they can be advised to use these herbs.
PubMed: 38292511
DOI: 10.18502/ijrm.v21i11.14652