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Cardiology 2021Identification and modification of cardiovascular risk factors is paramount to reducing cardiovascular disease morbidity and mortality. Hypertension is a major risk... (Review)
Review
BACKGROUND
Identification and modification of cardiovascular risk factors is paramount to reducing cardiovascular disease morbidity and mortality. Hypertension is a major risk factor for cardiovascular disease, but its association with height remains largely underrecognized.
OBJECTIVES
The objective of this manuscript is to review the evidence examining the association between blood pressure and human stature and to summarize the plausible pathophysiological mechanisms behind such an association.
METHODS
A systematic review of adult human height and its association with hypertension and coronary artery disease was undertaken. The literature evidence is summarized and tabulated, and an overview of the pathophysiological basis for this association is presented.
RESULTS
Shorter arterial lengths found in shorter individuals may predispose to hypertension in a complex hemodynamic interplay, which is explained predominantly by summated arterial wave reflections and an elevated augmentation index. Our systemic review suggests that an inverse relationship between adult height and blood pressure exists. However, differences in the studied populations and heterogeneity in the methods applied across the various studies limit the generalizability of these findings and their clinical application.
CONCLUSION
Physiological studies and epidemiological data suggest a potential inverse association between adult height and blood pressure. Further research is required to define the relationship more clearly between adult height and blood pressure and to assess whether antihypertensive therapeutic approaches and goals should be modified according to patients' heights.
Topics: Adult; Antihypertensive Agents; Blood Pressure; Body Height; Cardiovascular Diseases; Humans; Hypertension
PubMed: 33721862
DOI: 10.1159/000514205 -
Eating and Weight Disorders : EWD May 2021The aims of this systematic review and meta-analysis are to provide a summary of the current literature concerning compulsory treatments in patients with eating... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
The aims of this systematic review and meta-analysis are to provide a summary of the current literature concerning compulsory treatments in patients with eating disorders (ED) and to understand whether compulsorily and involuntarily treated patients differ in terms of baseline characteristics and treatment outcomes.
METHODS
Relevant articles were identified following the PRISMA guidelines by searching the following terms: "treatment refusal", "forced feeding", "compulsory/coercive/involuntary/forced treatment/admission", "eating disorders", "feeding and eating disorders", "anorexia nervosa", "bulimia nervosa". Research was restricted to articles concerning humans and published between 1975 and 2020 in English.
RESULTS
Out of 905 articles retrieved, nine were included for the analyses allowing the comparisons between 242 compulsorily and 738 voluntarily treated patients. Mean body mass index (BMI) was slightly lower in patients compelled to treatments. Mean illness duration, BMI at discharge and BMI variation showed no significant differences between the two groups. Average length of hospitalization was 3 weeks longer among compulsory-treated patients, but this did not result in a higher increase in BMI. No significant risk difference on mortality was estimated (three studies).
CONCLUSIONS
Compulsory treatments are usually intended for patients having worse baseline conditions than voluntary ones. Those patients are unlikely to engage in treatments without being compelled but, after the treatments, albeit with longer hospitalisations, they do achieve similar outcomes. Therefore, we can conclude that forcing patients to treatment is a conceivable option.
LEVEL OF EVIDENCE
Level I, systematic review and meta-analysis.
Topics: Anorexia Nervosa; Body Mass Index; Bulimia Nervosa; Feeding and Eating Disorders; Humans; Treatment Outcome
PubMed: 33099675
DOI: 10.1007/s40519-020-01031-1 -
Nutrition Research (New York, N.Y.) Jun 2023Based on previous studies, we hypothesized that the dietary inflammatory potential in pregnant women might influence maternal and child health. The objective of this... (Meta-Analysis)
Meta-Analysis Review
Based on previous studies, we hypothesized that the dietary inflammatory potential in pregnant women might influence maternal and child health. The objective of this work is to review the literature on the association of Dietary Inflammatory Index (DII) during pregnancy with early and late maternal and child health outcomes. We searched Cochrane, Embase, PubMed, Scopus, Web of Science, and the Virtual Health Library. Observational studies on DII in the gestational period that met the objective of this review were selected. There was a double-blind evaluation of 185 studies, of which 16 were included in narrative synthesis and 9 in meta-analysis. High methodological quality, longitudinal studies (87.5%) and the Food Frequency Questionnaire for DII evaluation (68.8%) prevailed. Outcomes studied were gestational diabetes mellitus (n = 5), gestational age at delivery (n = 7), type of delivery (n = 3), gestational weight gain or pregestational body mass index (n = 11), and anthropometry at birth (n = 8) and of the child up to age 10 years (n = 4). Higher maternal DII was associated with increased risk of small-for-gestational-age babies (odds radio, 1.15; 95% confidence interval, 1.08-1.21; I, 29%; P = .24) and low birth weight (<2.500 g) (odds ratio, 1.16; 95% confidence interval, 1.06-1.26; I, 56%; P = .10). The association between higher maternal DII and higher risk of obesity in late childhood is also suggestive. Thus, maternal diet may be a modifiable factor of inflammation in pregnancy associated with health outcomes of the offspring.
Topics: Infant, Newborn; Humans; Child; Pregnancy; Female; Birth Weight; Obesity; Diet; Diabetes, Gestational; Anthropometry; Randomized Controlled Trials as Topic
PubMed: 37209507
DOI: 10.1016/j.nutres.2023.04.009 -
European Journal of Clinical Nutrition Nov 2023The effect of time-restricted eating (TRE) has been summarized in previous studies, but its benefits in combination with calorie restriction (CR) still need to be... (Meta-Analysis)
Meta-Analysis Review
The effect of time-restricted eating (TRE) has been summarized in previous studies, but its benefits in combination with calorie restriction (CR) still need to be determined. The present meta-analysis aimed to evaluate the efficacy of TRE with CR on weight loss and cardiometabolic risk. PubMed, Embase, Cochrane Library, and gray literature databases were searched from inception to October 18, 2022, for potential randomized controlled trial (RCT) studies based on predefined inclusion and exclusion criteria. Body weight and other cardiometabolic risk factors were described as weighted mean difference (WMD) with a 95% confidence interval (CI). Eight RCTs involving 579 participants were enrolled in the present analysis. The pooled results showed that TRE with CR reduced the body weight, fat mass, and waist circumference significantly (WMD: -1.40, 95% CI: -1.81 to -1.00, and I: 0%; WMD: -0.73, 95% CI: -1.39 to -0.07, and I: 0%; WMD: -1.87, 95% CI: -3.47 to -0.26, and I: 67.25%, respectively). However, compared with CR alone, TRE plus CR exhibited no significant benefit on the blood pressure, glucose profile, and lipid profile. Subgroup analysis suggested that early TRE is more effective in weight loss (WMD: -1.42, 95% CI: -1.84 to -1.01, and I: 0%) and improving fat mass (WMD: -1.06, 95% CI: -1.91 to -0.22, and I: 0%) than delayed or broader TRE when combined with CR. Although the combination of TRE and CR can effectively decrease body weight, fat mass, and waist circumference, the long-term effects, particularly those on cardiometabolic risk in participants with chronic cardiovascular disease and diabetes, remain to be explored.
Topics: Humans; Caloric Restriction; Body Weight; Weight Loss; Cardiovascular Diseases; Blood Pressure
PubMed: 37488260
DOI: 10.1038/s41430-023-01311-w -
BMJ Open Dec 2023The relevance of measures of general and central adiposity for cardiovascular disease (CVD) risks in populations of European descent is well established. However, it is... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The relevance of measures of general and central adiposity for cardiovascular disease (CVD) risks in populations of European descent is well established. However, it is less well characterised in South Asian populations, who characteristically manifest larger waist circumferences (WC) for equivalent body mass index (BMI). This systematic review and meta-analysis provide an overview of the literature on the association of different anthropometric measures with CVD risk among South Asians.
METHODOLOGY
MEDLINE and Embase were searched from 1990 to the present for studies in South Asian populations investigating associations of two or more adiposity measures with CVD. Random-effects meta-analyses were conducted on the associations of BMI, WC and waist-to-hip ratio (WHR) with blood pressure, hypertension and CVD. Quality assessment was performed using the Newcastle-Ottawa scale.
RESULTS
Titles and abstracts were screened for 7327 studies, yielding 147 full-text reviews. The final sample (n=30) included 2 prospective, 5 case-control and 23 cross-sectional studies. Studies reported generally higher risks of hypertension and CVD at higher adiposity levels. The pooled mean difference in systolic blood pressure (SBP) per 5 kg/m higher BMI was 3 mmHg (2.90 (95% CI 1.30 to 4.50)) and 6 mmHg (6.31 (95% CI 4.81 to 7.81) per 13 cm larger WC. The odds ratio (OR) of hypertension per 5 kg/m higher BMI was 1.33 (95% CI 1.18 to 1.51), 1.45 (95% CI 1.05 to 1.98) per 13 cm larger WC and 1.22 (95% CI 1.04 to 1.41) per 0.1-unit larger WHR. Pooled risk of CVD for BMI-defined overweight versus healthy-weight was 1.65 (95% CI 1.55 to 1.75) and 1.48 (95% CI 1.21 to 1.80) and 2.51 (95% CI 0.94 to 6.69) for normal versus large WC and WHR, respectively. Study quality was average with significant heterogeneity.
CONCLUSIONS
Measures of both general and central adiposity had similar, strong positive associations with the risk of CVD in South Asians. Larger prospective studies are required to clarify which measures of body composition are more informative for targeted CVD primary prevention in this population.
Topics: Humans; Cardiovascular Diseases; Adiposity; Cross-Sectional Studies; Prospective Studies; Risk Factors; Hypertension; Obesity; Obesity, Abdominal; Waist-Hip Ratio; Waist Circumference; Body Mass Index
PubMed: 38110373
DOI: 10.1136/bmjopen-2023-074050 -
Nutrition (Burbank, Los Angeles County,... 2021According to in vivo and in vitro studies, melatonin appears to be a potential supplement for obesity reduction. The aim of this study was to review the literature on... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
According to in vivo and in vitro studies, melatonin appears to be a potential supplement for obesity reduction. The aim of this study was to review the literature on randomized clinical trials that evaluated the effects of melatonin supplementation on anthropometric indicators of obesity in humans.
METHODS
We conducted a systematic review with meta-analysis in the following databases: Pubmed, LILACS, Scielo, Scopus, Web of Science, Cochrane, and Embase. We included studies that evaluated melatonin supplementation's effects, compared with placebo, on anthropometric measures, including body weight, body mass index (BMI), and waist circumference, in people ≥18 y of age. This systematic review and meta-analysis were registered on PROSPERO: CRD42021241079.
RESULTS
Of the 23 studies included, 11 showed significant results from melatonin supplementation on weight loss, BMI, or waist circumference, compared with placebo. In the meta-analysis, melatonin supplementation significantly reduced body weight (standardized mean difference, -0.48; 95% confidence interval, -0.94 to -0.02; P = <0.01; I = 92%). Results for BMI and waist circumference were null. The I tests were significant for the analyses with significant results.
CONCLUSION
The results demonstrated that melatonin supplementation was responsible for significantly reducing body weight. More studies are needed before melatonin can be recommended for weight loss.
Topics: Body Mass Index; Body Weight; Dietary Supplements; Humans; Melatonin; Obesity; Randomized Controlled Trials as Topic; Waist Circumference
PubMed: 34626955
DOI: 10.1016/j.nut.2021.111399 -
Clinics and Research in Hepatology and... Aug 2023Current nonalcoholic fatty liver disease (NAFLD) guidelines do not provide any recommendations regarding the waist-to-height ratio (WHtR), a simple obesity metric... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND AIMS
Current nonalcoholic fatty liver disease (NAFLD) guidelines do not provide any recommendations regarding the waist-to-height ratio (WHtR), a simple obesity metric calculated by dividing waist circumference by height. Therefore, we performed a systematic review and meta-analysis aiming to evaluate WHtR in NAFLD.
METHODS
We performed a systematic electronic search on PubMed, Embase, and Scopus, identifying observational studies assessing WHtR in NAFLD. QUADAS-2 tool was used to evaluate the quality of included studies. The two main statistical outcomes were the area under the curve (AUC) and the mean difference (MD).
RESULTS
We included a total of 27 studies in our quantitative and qualitative synthesis, with a total population of 93,536 individuals. WHtR was significantly higher in NAFLD patients compared to controls with an MD of 0.073 (95% CI 0.058 - 0.088). This was also confirmed after conducting a subgroup analysis according to the hepatic steatosis diagnosis method, for ultrasound (MD 0.066 [96% CI 0.051 - 0.081]) and transient elastography (MD 0.074 [96% CI 0.053 - 0.094]). Moreover, NAFLD male patients presented significantly lower WHtR compared to female patients (MD -0.022 [95% CI -0.041 - -0.004]). The AUC of WHtR for predicting NAFLD was 0.815 (95% CI 0.780 - 0.849).
CONCLUSIONS
WHtR is considerably higher in NAFLD patients compared to controls. Female NAFLD patients present higher WHtR compared to NAFLD male patients. In comparison to other presently suggested scores and markers, the WHtR's accuracy in predicting NAFLD is considered acceptable.
Topics: Humans; Male; Female; Non-alcoholic Fatty Liver Disease; Waist-Height Ratio; Waist Circumference; Ultrasonography; Elasticity Imaging Techniques; Body Mass Index
PubMed: 37321322
DOI: 10.1016/j.clinre.2023.102160 -
Systematic Reviews Jul 2023A limited number of studies have directly examined the effect of whole eggs on body weight and composition in adults, and they have led to inconsistent results. This... (Meta-Analysis)
Meta-Analysis
BACKGROUND
A limited number of studies have directly examined the effect of whole eggs on body weight and composition in adults, and they have led to inconsistent results. This study aimed to summarize the evidence on the effect of whole egg consumption on body weight and body composition in adults from clinical trials.
METHODS
Online databases were searched from inception to April 2023 for clinical trials that directly or indirectly assessed the effect of whole eggs consumption on anthropometric measures including body weight, body mass index (BMI), waist circumference (WC), and fat-free mass (FFM) in adults. A random effects model was used for meta-analysis.
RESULTS
In total, 32 controlled clinical trials were included in the systematic review. The analyses revealed that whole egg consumption has no significant effect on body weight (n = 22), BMI (n = 13), WC (n = 10), and FFM (n = 4, P > 0.05). The subgroup analyses showed that whole egg consumption has an increasing effect on body weight and BMI in studies that lasted more than 12 weeks and in unhealthy participants (P < 0.05). A significant increasing effect on BMI was found in studies that the control group did not receive any egg (P < 0.05). Moreover, in studies that there was no significant difference in energy intake between the intervention and control groups, weight, and WC were significantly increased (P < 0.05). Additionally, in studies that participants in the control group received another food or supplement, studies with calorie restriction, and studies on healthy subjects, whole egg intake significantly decreased BMI (P < 0.05).
CONCLUSIONS
Although whole egg consumption had no adverse effect on body composition and body weight, in overall, it might increase body weight in long term. Egg consumption beneficially affects BMI in healthy people and during weight loss diet.
SYSTEMATIC REVIEW REGISTRATION
This systematic review and meta-analysis is registered in the International Prospective Register of Systematic Reviews (PROSPERO, Registration number: CRD42022308045).
Topics: Humans; Adult; Body Weight; Body Mass Index; Body Composition; Energy Intake; Dietary Supplements; Waist Circumference
PubMed: 37461099
DOI: 10.1186/s13643-023-02277-3 -
Diabetes & Metabolic Syndrome Dec 2023To systematically review the effects of the ketogenic diet on glycaemic control, body weight, cardiovascular risk factors, and liver and kidney function in patients with... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To systematically review the effects of the ketogenic diet on glycaemic control, body weight, cardiovascular risk factors, and liver and kidney function in patients with type 2 diabetes.
METHODS
PubMed, MEDLINE, Embase, Cochrane Library and CINAHL were searched for randomised controlled trials published between 2001 and 2021 that compared the ketogenic diet to a control diet for effects on glycaemic control, body weight, cardiovascular risk factors, liver and renal function markers in adults with type 2 diabetes for >14 days. Meta-analyses using fixed or random effects models were conducted.
RESULTS
Nineteen reports from 11 randomised controlled trials were included. Compared to the control, the ketogenic diet showed no significant difference in changes in glycaemic control or body weight, but greater increases in HDL (standardised mean difference 0.19; 95%CI 0.02-0.37; I = 0 %; moderate-quality evidence) and greater reductions in triglycerides (standardised mean difference -0.41; 95%CI -0.64 to -0.18; I = 0 %; low-quality evidence).
CONCLUSIONS
The ketogenic diet may improve lipid profiles but showed no additional benefits for glycaemic control or weight loss compared to control diets in type 2 diabetes patients over two years.
Topics: Adult; Humans; Diabetes Mellitus, Type 2; Diet, Ketogenic; Body Weight; Diet; Weight Loss
PubMed: 38006799
DOI: 10.1016/j.dsx.2023.102905 -
BMC Pregnancy and Childbirth Apr 2022Women's diet and nutritional status during pregnancy are important in influencing birth outcomes. We conducted a systematic scoping review of the best available evidence... (Review)
Review
BACKGROUND
Women's diet and nutritional status during pregnancy are important in influencing birth outcomes. We conducted a systematic scoping review of the best available evidence regarding dietary intake of Malaysian pregnant women, and the associations of maternal diet, anthropometry, and nutrition-related co-morbidities with the infant's birth weight (IBW). The study objectives were to examine: (1) the adequacy of micronutrient intake among pregnant women; and (2) the association of maternal factors (anthropometry, diet, plasma glucose and blood pressure) during pregnancy with IBW.
METHODS
Eleven search engines such as Proquest, EbscoHost, Scopus, Cochrane Library, Science Direct, Wiley Online Library, PubMed, Google Scholar, MyJournal, BookSC and Inter Library Loan with Medical Library Group were extensively searched to identify the primary articles. Three reviewers independently screened the abstracts and full articles based on the inclusion and exclusion criteria. Extracted data included details about the population characteristics, study methods and key findings related to the review objectives. Seventeen studies published from 1972 to 2021 were included, following the PRISMA-ScR guideline.
RESULTS
Studies showed that maternal micronutrient intakes including calcium, iron, vitamin D, folic acid, and niacin fell short of the national recommendations. Increased maternal fruit intake was also associated with increased birth weight. Factors associated with fetal macrosomia included high pre-pregnancy body mass index (BMI), excess gestational weight gain (GWG) and high blood glucose levels. Low pre-pregnancy BMI, inadequate GWG, intake of confectioneries and condiments, and high blood pressure were associated with low birth weight.
CONCLUSION
This review identified several factors such as the mother's food habits, comorbidities, BMI and gestational weight gain as the determinants of low birth weight. This implies that emphasis should be given on maternal health and nutrition for the birth outcome.
Topics: Birth Weight; Body Mass Index; Diet; Female; Gestational Weight Gain; Humans; Malaysia; Nutritional Status; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Weight Gain
PubMed: 35387600
DOI: 10.1186/s12884-022-04616-z