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Gut Jun 2022A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) is recommended for irritable bowel syndrome (IBS), if general lifestyle... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) is recommended for irritable bowel syndrome (IBS), if general lifestyle and dietary advice fails. However, although the impact of a low FODMAP diet on individual IBS symptoms has been examined in some randomised controlled trials (RCTs), there has been no recent systematic assessment, and individual trials have studied numerous alternative or control interventions, meaning the best comparator is unclear. We performed a network meta-analysis addressing these uncertainties.
DESIGN
We searched the medical literature through to 2 April 2021 to identify RCTs of a low FODMAP diet in IBS. Efficacy was judged using dichotomous assessment of improvement in global IBS symptoms or improvement in individual IBS symptoms, including abdominal pain, abdominal bloating or distension, and bowel habit. Data were pooled using a random effects model, with efficacy reported as pooled relative risks (RRs) with 95% CIs, and interventions ranked according to their P-score.
RESULTS
We identified 13 eligible RCTs (944 patients). Based on failure to achieve an improvement in global IBS symptoms, a low FODMAP diet ranked first vs habitual diet (RR of symptoms not improving=0.67; 95% CI 0.48 to 0.91, P-score=0.99), and was superior to all other interventions. Low FODMAP diet ranked first for abdominal pain severity, abdominal bloating or distension severity and bowel habit, although for the latter it was not superior to any other intervention. A low FODMAP diet was superior to British Dietetic Association (BDA)/National Institute for Health and Care Excellence (NICE) dietary advice for abdominal bloating or distension (RR=0.72; 95% CI 0.55 to 0.94). BDA/NICE dietary advice was not superior to any other intervention in any analysis.
CONCLUSION
In a network analysis, low FODMAP diet ranked first for all endpoints studied. However, most trials were based in secondary or tertiary care and did not study effects of FODMAP reintroduction and personalisation on symptoms.
Topics: Abdominal Pain; Diet, Carbohydrate-Restricted; Disaccharides; Humans; Irritable Bowel Syndrome; Monosaccharides; Network Meta-Analysis; Oligosaccharides
PubMed: 34376515
DOI: 10.1136/gutjnl-2021-325214 -
Nutrients Feb 2023Diet can be a complementary treatment for Hashimoto's disease by affecting thyroid function and anti-inflammatory properties. It is still unclear which dietary strategy... (Review)
Review
Diet can be a complementary treatment for Hashimoto's disease by affecting thyroid function and anti-inflammatory properties. It is still unclear which dietary strategy would be the most beneficial. The aim of this systematic review is to examine all the data currently available in the literature on the effects of nutritional intervention on biochemical parameters (anti-thyroid antibody and thyroid hormones levels) and characteristic symptoms in the course of Hashimoto's thyroiditis. This systematic review was prepared based on PRISMA guidelines. Articles in PubMed and Scopus databases published up to November 2022 were searched. As a result of the selection, out of 1350 publications, 9 were included for further analysis. The nutritional interventions included the following: elimination of gluten (3 articles) or lactose (1 article), energy restriction with or without excluding selected foods ( = 2), consumption of ( = 2), or dietary iodine restriction ( = 1). The intervention duration ranged from 21 days to 12 months and included individuals with various thyroid function. Of the nine studies, three studies were female only. An improvement was observed during an energy deficit and after the elimination of selected ingredients (e.g., gluten, lactose, or goitrogens), as well as after the intervention of . These interventions improved antibody levels against peroxidase (anti-TPO), (thyrotropin) TSH, and free thyroxine (fT4). No improvement was seen on the iodine-restricted diet. Varied outcomes of analyzed dietary interventions may be due to the heterogeneous thyroid condition, high variability between patients, and differences in habitual intake of critical nutrients (e.g., iodine, selenium, and iron) in different populations. Therefore, there is a great need for further experimental studies to determine whether any nutritional interventions are beneficial in Hashimoto's disease.
Topics: Female; Humans; Male; Hashimoto Disease; Iodine; Lactose; Thyroid Hormones
PubMed: 36839399
DOI: 10.3390/nu15041041 -
Nutrients Dec 2021Anxiety disorders are the most common group of mental disorders. There is mounting evidence demonstrating the importance of nutrition in the development and progression...
Anxiety disorders are the most common group of mental disorders. There is mounting evidence demonstrating the importance of nutrition in the development and progression of mental disorders such as depression; however, less is known about the role of nutrition in anxiety disorders. This scoping review sought to systematically map the existing literature on anxiety disorders and nutrition in order to identify associations between dietary factors and anxiety symptoms or disorder prevalence as well as identify gaps and opportunities for further research. The review followed established methodological approaches for scoping reviews. Due to the large volume of results, an online program (Abstrackr) with artificial intelligence features was used. Studies reporting an association between a dietary constituent and anxiety symptoms or disorders were counted and presented in figures. A total of 55,914 unique results were identified. After a full-text review, 1541 articles met criteria for inclusion. Analysis revealed an association between less anxiety and more fruits and vegetables, omega-3 fatty acids, "healthy" dietary patterns, caloric restriction, breakfast consumption, ketogenic diet, broad-spectrum micronutrient supplementation, zinc, magnesium and selenium, probiotics, and a range of phytochemicals. Analysis revealed an association between higher levels of anxiety and high-fat diet, inadequate tryptophan and dietary protein, high intake of sugar and refined carbohydrates, and "unhealthy" dietary patterns. Results are limited by a large percentage of animal and observational studies. Only 10% of intervention studies involved participants with anxiety disorders, limiting the applicability of the findings. High quality intervention studies involving participants with anxiety disorders are warranted.
Topics: Anxiety Disorders; Diet; Diet, Healthy; Dietary Supplements; Humans; Nutritional Status
PubMed: 34959972
DOI: 10.3390/nu13124418 -
Nutrients Sep 2022Branched-chain amino acids (BCAAs) are oxidized in the muscle and result in stimulating anabolic signals-which in return may optimize performance, body composition and... (Review)
Review
Branched-chain amino acids (BCAAs) are oxidized in the muscle and result in stimulating anabolic signals-which in return may optimize performance, body composition and recovery. Meanwhile, among athletes, the evidence about BCAA supplementation is not clear. The aim of this study was to review the effects of BCAAs in athletic populations. The research was conducted in three databases: Web of Science (all databases), PubMed and Scopus. The inclusion criteria involved participants classified both as athletes and people who train regularly, and who were orally supplemented with BCAAs. The risk of bias was individually assessed for each study using the revised Cochrane risk of bias tool for randomized trials (RoB 2.0). From the 2298 records found, 24 studies met the inclusion criteria. Although BCAAs tended to activate anabolic signals, the benefits on performance and body composition were negligible. On the other hand, studies that included resistance participants showed that BCAAs attenuated muscle soreness after exercise, while in endurance sports the findings were inconsistent. The protocols of BCAA supplements differed considerably between studies. Moreover, most of the studies did not report the total protein intake across the day and, consequently, the benefits of BCAAs should be interpreted with caution.
Topics: Amino Acids, Branched-Chain; Athletes; Dietary Supplements; Exercise; Humans; Myalgia
PubMed: 36235655
DOI: 10.3390/nu14194002 -
International Journal of Trichology 2020Patients with major presentations of alopecia experience physically harmful effects and psychological comorbidities, such as depression and anxiety. Oral minoxidil (OM)... (Review)
Review
Patients with major presentations of alopecia experience physically harmful effects and psychological comorbidities, such as depression and anxiety. Oral minoxidil (OM) has been suggested by dermatologists as a potential remedy; however, its effectiveness remains unclear. This systematic review aims to collate published studies and to analyze the effect of OM among patients diagnosed with any type of alopecia. For this systematic review, Medline/PubMed, Cochrane Central, EMBASE, Web of Sciences, and Latin American and Caribbean Health Sciences Information System were searched for relevant studies from inception to September 21, 2019. Of 1960 studies retrieved in several electronic databases and three additional records identified though reference list from potentially eligible studies, nine studies (one randomized controlled trial and eight nonrandomized controlled trials) met the requirements and were used in our analysis. Although we found positive effects in favor of OM, this should be interpreted cautiously due to very low quality of the evidence of outcomes in the selected studies. Definitive conclusions are not possible without high-quality trials. This review has highlighted the absence of high-quality randomized controlled trials evaluating OM in the treatment of various types of alopecia. Given the mild adverse events of OM, future studies should also analyze doses and duration to maximize efficacy and decrease side effects.
PubMed: 33376283
DOI: 10.4103/ijt.ijt_19_20 -
BMJ Open Aug 2021To evaluate existing evidence for the use of probiotics in preventing antibiotic-associated diarrhoea (AAD) in adults. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To evaluate existing evidence for the use of probiotics in preventing antibiotic-associated diarrhoea (AAD) in adults.
DESIGN
Systematic review and meta-analysis of randomised controlled trials (RCTs).
DATA SOURCES
We performed a literature search of the electronic databases CINAHL Plus, EMBASE, MEDLINE (Ovid) and Web of Science from database inception to May 2021 as well as hand searching of trial registries and reference lists of related reviews.
STUDY SELECTION
Two reviewers identified whether RCTs met the following inclusion criteria: adult population to whom antibiotics were administered; a probiotic intervention; a placebo, alternative dose, alternative probiotic strain or no treatment control; and incidence of AAD as the outcome.
DATA EXTRACTION AND SYNTHESIS
Two reviewers independently collected data and assessed risk of bias using preconstructed data extraction forms. We used a random effects model for all analyses. Subgroup analyses were performed to evaluate species-specific and dose-specific response.
RESULTS
Forty-two studies (11,305 participants) were included in this review. The pooled analysis suggests that co-administration of probiotics with antibiotics reduces the risk of AAD in adults by 37% (risk ratio (RR)=0.63 (95% CI 0.54 to 0.73), p<0.00001). The overall quality of the evidence using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) criteria was found to be moderate. In subgroup analyses, high dose compared with low dose of the same probiotic demonstrated a positive protective effect (RR 0.54 (95% CI 0.38 to 0.76), p<0.01), and only certain species, mainly of the lactobacillus and bifidobacteria genera, were found to be effective. Studies with a low baseline AAD risk did not show any difference in risk but studies with moderate or high baseline AAD risk demonstrated a significant risk reduction.
CONCLUSIONS
Probiotics are effective for preventing AAD. Secondary analyses of higher dosages and certain species have shown increased effectiveness. Our results may not be applicable in clinical scenarios of lower baseline AAD risk.
Topics: Adult; Anti-Bacterial Agents; Diarrhea; Humans; Incidence; Lactobacillus; Probiotics
PubMed: 34385227
DOI: 10.1136/bmjopen-2020-043054 -
Nutrients Sep 2021Intermittent fasting has become popular in recent years and is controversially presented as a possible therapeutic adjunct. A bibliographic review of the literature on...
Intermittent fasting has become popular in recent years and is controversially presented as a possible therapeutic adjunct. A bibliographic review of the literature on intermittent fasting and obesity, diabetes, and multiple sclerosis was carried out. The scientific quality of the methodology and the results obtained were evaluated in pairs. Intermittent fasting has beneficial effects on the lipid profile, and it is associated with weight loss and a modification of the distribution of abdominal fat in people with obesity and type 2 diabetes as well as an improvement in the control of glycemic levels. In patients with multiple sclerosis, the data available are too scarce to draw any firm conclusions, but it does appear that intermittent fasting may be a safe and feasible intervention. However, it is necessary to continue investigating its long-term effects since so far, the studies carried out are small and of short duration.
Topics: Diabetes Mellitus, Type 2; Fasting; Glycemic Control; Humans; Multiple Sclerosis; Obesity; Randomized Controlled Trials as Topic
PubMed: 34579056
DOI: 10.3390/nu13093179 -
Pharmaceuticals (Basel, Switzerland) Mar 2021Levothyroxine (l-thyroxine, l-T4) is a drug of choice for treating congenital and primary hypothyroidism. Although clinically significant interactions between l-T4 and... (Review)
Review
Levothyroxine (l-thyroxine, l-T4) is a drug of choice for treating congenital and primary hypothyroidism. Although clinically significant interactions between l-T4 and food can alter the safety and efficacy of the treatment, they still seem to be generally underestimated by patients, physicians and pharmacists. This review aimed to investigate the effects of meals, beverages, and dietary supplements consumption on l-T4 pharmacokinetics and pharmacodynamics, to identify the most evident interactions, and to perform the recommendations for safe co-administering of l-T4 and food. A total of 121 studies were identified following a systematic literature search adhering to PRISMA guidelines. After full-text evaluation, 63 studies were included. The results proved that l-T4 ingestion in the morning and at bedtime are equally effective, and also that the co-administration of l-T4 with food depends on the drug formulation. We found limited evidence for l-T4 interactions with coffee, soy products, fiber, calcium or iron supplements, and enteral nutrition but interestingly they all resulted in decreased l-T4 absorption. The altered l-T4 efficacy when ingested with milk, juices, papaya, aluminium-containing preparations, and chromium supplements, as well as observed enhancement effect of vitamin C on l-T4 absorption, shall be further investigated in larger, well-designed studies. Novel formulations are likely to solve the problem of coffee, calcium and iron induced malabsorption of l-T4. Maintaining a proper time interval between l-T4 and food intake, especially for coffee and calcium, or iron supplements, provides another effective method of eliminating such interactions.
PubMed: 33801406
DOI: 10.3390/ph14030206 -
Obesity Facts 2021The very low-calorie ketogenic diet (VLCKD) has been recently proposed as an appealing nutritional strategy for obesity management. The VLCKD is characterized by a low... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The very low-calorie ketogenic diet (VLCKD) has been recently proposed as an appealing nutritional strategy for obesity management. The VLCKD is characterized by a low carbohydrate content (<50 g/day), 1-1.5 g of protein/kg of ideal body weight, 15-30 g of fat/day, and a daily intake of about 500-800 calories.
OBJECTIVES
The aim of the current document is to suggest a common protocol for VLCKD and to summarize the existing literature on its efficacy in weight management and weight-related comorbidities, as well as the possible side effects.
METHODS
This document has been prepared in adherence with Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Literature searches, study selection, methodology development, and quality appraisal were performed independently by 2 authors and the data were collated by means of a meta-analysis and narrative synthesis.
RESULTS
Of the 645 articles retrieved, 15 studies met the inclusion criteria and were reviewed, revealing 4 main findings. First, the VLCKD was shown to result in a significant weight loss in the short, intermediate, and long terms and improvement in body composition parameters as well as glycemic and lipid profiles. Second, when compared with other weight loss interventions of the same duration, the VLCKD showed a major effect on reduction of body weight, fat mass, waist circumference, total cholesterol and triglyceridemia as well as improved insulin resistance. Third, although the VLCKD also resulted in a significant reduction of glycemia, HbA1c, and LDL cholesterol, these changes were similar to those obtained with other weight loss interventions. Finally, the VLCKD can be considered a safe nutritional approach under a health professional's supervision since the most common side effects are usually clinically mild and easily to manage and recovery is often spontaneous.
CONCLUSIONS
The VLCKD can be recommended as an effective dietary treatment for individuals with obesity after considering potential contra-indications and keeping in mind that any dietary treatment has to be personalized. Prospero Registry: The assessment of the efficacy of VLCKD on body weight, body composition, glycemic and lipid parameters in overweight and obese subjects: a meta-analysis (CRD42020205189).
Topics: Adult; Diet, Ketogenic; Humans; Obesity; Obesity Management; Overweight; Weight Loss
PubMed: 33882506
DOI: 10.1159/000515381 -
Nutrients Feb 2023The performance of male soccer players (MSP) depends on multiple factors such as body composition. The physical demands of modern soccer have changed, so the ideal body... (Meta-Analysis)
Meta-Analysis Review
The performance of male soccer players (MSP) depends on multiple factors such as body composition. The physical demands of modern soccer have changed, so the ideal body composition (BC) requirements must be adapted to the present. The aim of this systematic review and meta-analysis was to describe the anthropometric, BC, and somatotype characteristics of professional MSP and to compare the values reported according to the methods and equations used. We systematically searched Embase, PubMed, SPORTDiscus, and Web of Science following the PRISMA statement. Random-effects meta-analysis, a pooled summary of means, and 95% CI (method or equation) were calculated. Random models were used with the restricted maximum likelihood (REML) method. Seventy-four articles were included in the systematic review and seventy-three in the meta-analysis. After comparing the groups according to the assessment method (kinanthropometry, bioimpedance, and densitometry), significant differences were found in height, fat mass in kilograms, fat mass percentage, and fat-free mass in kilograms ( = 0.001; < 0.0001). Taking into account the equation used to calculate the fat mass percentage and ∑skinfolds, significant differences were observed in the data reported according to groups ( < 0.001). Despite the limitations, this study provides useful information that could help medical technical staff to properly assess the BC of professional MSP, providing a range of guidance values for the different BC.
Topics: Humans; Male; Soccer; Body Composition; Anthropometry; Somatotypes
PubMed: 36904159
DOI: 10.3390/nu15051160