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Clinical Gastroenterology and... Aug 2023Eosinophilic esophagitis (EoE) can be treated by proton pump inhibitors, topical corticosteroids, or dietary measures. This study systematically assessed the efficacy of... (Meta-Analysis)
Meta-Analysis
BACKGROUND & AIMS
Eosinophilic esophagitis (EoE) can be treated by proton pump inhibitors, topical corticosteroids, or dietary measures. This study systematically assessed the efficacy of 4 major dietary treatment regimens in EoE, updating the evidence presented in a meta-analysis from 2014.
METHODS
Electronic databases such as PubMed, Scopus, and Web of Science, and other sources were searched up to September 2022 to identify studies on dietary treatment of EoE. Based on histologic remission criteria, the efficacy of these treatments was pooled and analyzed with respect to the type of dietary regimen: 6-food elimination diet (SFED), 4-food elimination diet (FFED), 1-food elimination diet (OFED), and a targeted elimination diet (TED). Clinical response rates, food sensitization, and efficacies for a pediatric subpopulation were calculated. Influencing variables on efficacies were estimated via meta-regression analyses.
RESULTS
Thirty-four studies with 1762 patients met the inclusion criteria. The overall rate of histologic remission was 53.8% (95% CI, 48.0%-59.6%), and in the individual dietary groups was 61.3% (95% CI, 53.0%-69.3%) for SFED, 49.4% (95% CI, 32.5%-66.3%) for FFED, 51.4% (95% CI, 42.6%-60.1%) for OFED, and 45.7% (95% CI, 32.0%-59.7%) for TED. Dietary regimen and patient age did not significantly affect rates of histologic remission. The overall rate of clinical response was 80.8% (95% CI, 72.3%-88.2%), with response rates of 92.8% (95% CI, 81.2%-99.6%) for SFED, 74.1% (95% CI, 49.8%-92.6%) for FFED, 87.1% (95% CI, 58.4%-99.9%) for OFED, and 69.0% (95% CI, 50.2%85.3%) for TED.
CONCLUSIONS
Dietary therapy is an effective treatment for EoE patients of any age. The current results could support a trend toward less-restrictive dietary regimens as a primary treatment option.
Topics: Child; Humans; Allergens; Diet; Elimination Diets; Eosinophilic Esophagitis; Food; Treatment Outcome
PubMed: 36731591
DOI: 10.1016/j.cgh.2023.01.019 -
Obesity Research & Clinical Practice 2020This report provides information on 14 behavioral and nutritional factors that can be addressed in childhood overweight/obesity prevention programs. (Meta-Analysis)
Meta-Analysis
BACKGROUND
This report provides information on 14 behavioral and nutritional factors that can be addressed in childhood overweight/obesity prevention programs.
METHODS
Web of Science, PubMed, and Scopus were searched through November 2018. Reference lists were also screened for additional references. Observational studies addressing the associations between overweight/obesity in children/adolescents aged between 5 to 19 years and associated risk factors were analyzed. Between-studies heterogeneity was assessed by χ, τ, and I statistics. The likelihood of publication bias was evaluated using the Begg and Egger tests and trim & fill analysis. Effect sizes were expressed as odds ratios (ORs) with 95% confidence intervals (CIs) using a random-effects model.
RESULTS
Of 34,537 retrieved studies, 199 including 1,636,049 participants were eligible. The ORs (95% CI) of factors associated with childhood overweight/obesity were as follows: sufficient physical activity 0.70 (0.66, 0.75); eating breakfast every day 0.66 (0.59, 0.74); sufficient consumption of fruits/vegetables 0.92 (0.84, 1.01); breastfeeding <4 months 1.24 (1.16, 1.33); inadequate sleep 1.26 (1.13, 1.40); watching TV >1-2 h/day 1.42 (1.35, 1.49); playing computer games >2 h/day 1.08 (0.95, 1.23); eating sweets ≥3 times/week 0.78 (0.71, 0.85); eating snack ≥4 times/week 0.84 (0.71, 1.00); drinking sugar-sweetened beverages ≥4 times/week 1.24 (1.07, 1.43); eating fast-food ≥3 times/week 1.03 (0.89, 1.18); eating fried-food ≥3 times/week 1.09 (0.90, 1.33); smoking 1.17 (1.07, 1.29); and drinking alcohol 1.05 (0.95, 1.16).
CONCLUSIONS
This meta-analysis provided a clear picture of the behavioral and nutritional factors associated with weight gain in children.
Topics: Adolescent; Adolescent Behavior; Child; Child Behavior; Child, Preschool; Diet; Exercise; Feeding Behavior; Female; Humans; Male; Observational Studies as Topic; Pediatric Obesity; Sedentary Behavior; Young Adult
PubMed: 32199860
DOI: 10.1016/j.orcp.2020.03.002 -
The British Journal of Nutrition May 2014The present systematic review examined the relationship between nutrition knowledge and dietary intake in adults (mean age ≥ 18 years). Relevant databases were... (Review)
Review
The present systematic review examined the relationship between nutrition knowledge and dietary intake in adults (mean age ≥ 18 years). Relevant databases were searched from the earliest record until November 2012. Search terms included: nutrition; diet or food knowledge and energy intake; feeding behaviour; diet; eating; nutrient or food intake or consumption. Included studies were original research articles that used instruments providing quantitative assessment of both nutrition knowledge and dietary intake and their statistical association. The initial search netted 1,193,393 potentially relevant articles, of which twenty-nine were eligible for inclusion. Most of them were conducted in community populations (n 22) with fewer (n 7) in athletic populations. Due to the heterogeneity of methods used to assess nutrition knowledge and dietary intake, a meta-analysis was not possible. The majority of the studies (65·5%: community 63·6%; athletic 71·4%) reported significant, positive, but weak (r< 0·5) associations between higher nutrition knowledge and dietary intake, most often a higher intake of fruit and vegetables. However, study quality ranged widely and participant representation from lower socio-economic status was limited, with most participants being tertiary educated and female. Well-designed studies using validated methodologies are needed to clarify the relationship between nutrition knowledge and dietary intake. Diet quality scores or indices that aim to evaluate compliance to dietary guidelines may be particularly valuable for assessing the relationship between nutrition knowledge and dietary intake. Nutrition knowledge is an integral component of health literacy and as low health literacy is associated with poor health outcomes, contemporary, high-quality research is needed to inform community nutrition education and public health policy.
Topics: Adult; Athletes; Diet; Energy Intake; Feeding Behavior; Female; Health Knowledge, Attitudes, Practice; Humans; Male; Nutrition Policy; Reproducibility of Results
PubMed: 24621991
DOI: 10.1017/S0007114514000087 -
Nutrients Aug 2021A debate is ongoing on the significance and appropriateness of the NOVA classification as a tool for categorizing foods based on their degree of processing. As such, the...
A debate is ongoing on the significance and appropriateness of the NOVA classification as a tool for categorizing foods based on their degree of processing. As such, the role of ultra-processed food (UPF) on human health is still not completely understood. With this review, we aimed to investigate the actual level of consumption of UPF across countries and target populations to determine the impact in real contexts. Suitable articles published up to March 2021 were sourced through the PubMed and SCOPUS databases. Overall, 99 studies providing data on the level of UPF consumption expressed as the percentage of total energy intake were identified, for a total of 1,378,454 participants. Most of them were published in Brazil ( = 38) and the United States ( = 15), and the 24 h recall was the most-used tool ( = 63). Analysis of the results revealed that the United States and the United Kingdom were the countries with the highest percent energy intake from UPF (generally >50%), whereas Italy had the lowest levels (about 10%); the latter was inversely associated with adherence to the Mediterranean diet. High variability was also observed based on sex, age, and body mass index, with men, young people, and overweight/obese subjects generally having higher levels of consumption compared to older subjects. Overall, our findings underline the large differences in UPF intake. Since most of the observations derived from studies conducted with food questionnaires are not specifically validated for UPF, further efforts are essential to confirm the results previously obtained and to investigate further the association between UPF consumption and health status, also considering the actual contribution within different dietary patterns, which has been less investigated to date.
Topics: Adolescent; Adult; Age Factors; Aged; Body Mass Index; Brazil; Child; Child, Preschool; Diet; Diet, Mediterranean; Energy Intake; Fast Foods; Feeding Behavior; Female; Food Handling; Health Status; Humans; Infant; Italy; Male; Middle Aged; Obesity; Overweight; Sex Factors; United Kingdom; United States; Young Adult
PubMed: 34444936
DOI: 10.3390/nu13082778 -
The American Journal of Clinical... Oct 2022A low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet is increasingly used to manage symptoms in irritable bowel syndrome (IBS).... (Meta-Analysis)
Meta-Analysis
BACKGROUND
A low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet is increasingly used to manage symptoms in irritable bowel syndrome (IBS). Although this approach may alter the colonic microbiome, the nature of these changes has not been comprehensively synthesized.
OBJECTIVES
The aim of this study was to conduct a systematic review with meta-analysis of randomized controlled trials examining the impact of a low FODMAP diet on the composition and function of the microbiome in patients with IBS.
METHODS
A systematic search was conducted for randomized controlled trials evaluating the effects of a low FODMAP diet on the colonic microbiome in patients with IBS in MEDLINE, EMBASE, CENTRAL, and Web of Science from inception to April 2022. Outcomes included diversity of the microbiome, specific bacterial abundances, fecal SCFA concentration, and fecal pH. For fecal SCFA concentrations and pH, meta-analyses were performed via a random-effects model.
RESULTS
Nine trials involving 403 patients were included. There were no clear effects of the low FODMAP diet on diversity of the microbiome. A low FODMAP diet consistently led to lower abundance of Bifidobacteria, but there were no clear effects on diversity of the microbiome or abundances of other specific taxa. There were no differences in total fecal SCFA concentration between the low FODMAP diet and control diets (standardized mean difference: -0.25; 95% CI: -0.63, 0.13; P = 0.20), nor were there differences for fecal concentrations of specific SCFAs or fecal pH.
CONCLUSIONS
In patients with IBS, the effects of a low FODMAP diet on the colonic microbiome appear to be specific to Bifidobacteria with no consistent impacts on other microbiome metrics, including diversity, fecal SCFA concentrations, and fecal pH. Further, adequately powered trials are needed to confirm these findings.This review was registered at https://www.crd.york.ac.uk/prospero/ as CRD42020192243.
Topics: Bifidobacterium; Diet; Diet, Carbohydrate-Restricted; Disaccharides; Fermentation; Humans; Irritable Bowel Syndrome; Microbiota; Monosaccharides; Oligosaccharides
PubMed: 35728042
DOI: 10.1093/ajcn/nqac176 -
Hepatology Communications Aug 2023Despite NAFLD being the most prevalent liver disease globally, currently there are no FDA-approved treatments, and weight loss through caloric restriction and enhanced... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND AIMS
Despite NAFLD being the most prevalent liver disease globally, currently there are no FDA-approved treatments, and weight loss through caloric restriction and enhanced physical activity is the recommended treatment strategy. Intermittent fasting (IF) has been proposed as an alternative strategy with additional cardiometabolic benefits. In this systematic review and meta-analysis, we evaluated the anthropometric, biochemical, and hepatic impacts of IF in patients with NAFLD.
METHODS
MEDLINE, EMBASE, Cochrane Central, and conference abstracts were searched for IF interventions in adults with NAFLD until April 2, 2023. Meta-analysis with a random effects model was used to compare pre-intervention and post-intervention changes in anthropometric, biochemical, and hepatic end points in the IF intervention group with the control group. Publication bias was assessed using Egger's test.
RESULTS
Fourteen studies were included in the systematic review and ten in the meta-analysis (n = 840 participants, 44.64% male). Studies varied in modalities for NAFLD diagnosis, duration of IF (4-52 weeks), and type of IF (5:2 diet, modern alternate-day fasting, time-restricted eating, or religious fasting). Body weight, body mass index, and waist to hip ratio all significantly improved following fasting intervention (p< 0.05). Adults with NAFLD showed an improvement in serum alanine transaminase, aspartate aminotransferase, hepatic steatosis (controlled attenuation parameter measured by vibration-controlled transient elastography), and hepatic stiffness (measured by vibration-controlled transient elastography) after fasting intervention (p < 0.05).
CONCLUSIONS
There is limited, but moderate- to high-quality evidence to suggest that IF can improve hepatic end points and promote weight loss in adults with NAFLD. Larger randomized controlled studies with extended duration are needed to further validate our findings.
Topics: Adult; Humans; Male; Female; Non-alcoholic Fatty Liver Disease; Intermittent Fasting; Diet; Weight Loss
PubMed: 37534936
DOI: 10.1097/HC9.0000000000000212 -
Advances in Nutrition (Bethesda, Md.) Mar 2019This meta-analysis summarizes the evidence of a prospective association between the intake of foods [whole grains, refined grains, vegetables, fruit, nuts, legumes,... (Meta-Analysis)
Meta-Analysis
This meta-analysis summarizes the evidence of a prospective association between the intake of foods [whole grains, refined grains, vegetables, fruit, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages (SSBs)] and risk of general overweight/obesity, abdominal obesity, and weight gain. PubMed and Web of Science were searched for prospective observational studies until August 2018. Summary RRs and 95% CIs were estimated from 43 reports for the highest compared with the lowest intake categories, as well as for linear and nonlinear relations focusing on each outcome separately: overweight/obesity, abdominal obesity, and weight gain. The quality of evidence was evaluated with use of the NutriGrade tool. In the dose-response meta-analysis, inverse associations were found for whole-grain (RRoverweight/obesity: 0.93; 95% CI: 0.89, 0.96), fruit (RRoverweight/obesity: 0.93; 95% CI: 0.86, 1.00; RRweight gain: 0.91; 95% CI: 0.86, 0.97), nut (RRabdominal obesity: 0.42; 95% CI: 0.31, 0.57), legume (RRoverweight/obesity: 0.88; 95% CI: 0.84, 0.93), and fish (RRabdominal obesity: 0.83; 95% CI: 0.71, 0.97) consumption and positive associations were found for refined grains (RRoverweight/obesity: 1.05; 95% CI: 1.00, 1.10), red meat (RRabdominal obesity: 1.10; 95% CI: 1.04, 1.16; RRweight gain: 1.14; 95% CI: 1.03, 1.26), and SSBs (RRoverweight/obesity: 1.05; 95% CI: 1.00, 1.11; RRabdominal obesity: 1.12; 95% CI: 1.04, 1.20). The dose-response meta-analytical findings provided very low to low quality of evidence that certain food groups have an impact on different measurements of adiposity risk. To improve the quality of evidence, better-designed observational studies, inclusion of intervention trials, and use of novel statistical methods (e.g., substitution analyses or network meta-analyses) are needed.
Topics: Diet; Humans; Obesity; Obesity, Abdominal; Overweight; Prospective Studies; Risk Factors; Weight Gain
PubMed: 30801613
DOI: 10.1093/advances/nmy092 -
European Heart Journal Jul 2023Due to growing environmental focus, plant-based diets are increasing steadily in popularity. Uncovering the effect on well-established risk factors for cardiovascular... (Meta-Analysis)
Meta-Analysis
AIMS
Due to growing environmental focus, plant-based diets are increasing steadily in popularity. Uncovering the effect on well-established risk factors for cardiovascular diseases, the leading cause of death worldwide, is thus highly relevant. Therefore, a systematic review and meta-analysis were conducted to estimate the effect of vegetarian and vegan diets on blood levels of total cholesterol, low-density lipoprotein cholesterol, triglycerides, and apolipoprotein B.
METHODS AND RESULTS
Studies published between 1980 and October 2022 were searched for using PubMed, Embase, and references of previous reviews. Included studies were randomized controlled trials that quantified the effect of vegetarian or vegan diets vs. an omnivorous diet on blood lipids and lipoprotein levels in adults over 18 years. Estimates were calculated using a random-effects model. Thirty trials were included in the study. Compared with the omnivorous group, the plant-based diets reduced total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B levels with mean differences of -0.34 mmol/L (95% confidence interval, -0.44, -0.23; P = 1 × 10-9), -0.30 mmol/L (-0.40, -0.19; P = 4 × 10-8), and -12.92 mg/dL (-22.63, -3.20; P = 0.01), respectively. The effect sizes were similar across age, continent, duration of study, health status, intervention diet, intervention program, and study design. No significant difference was observed for triglyceride levels.
CONCLUSION
Vegetarian and vegan diets were associated with reduced concentrations of total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B-effects that were consistent across various study and participant characteristics. Plant-based diets have the potential to lessen the atherosclerotic burden from atherogenic lipoproteins and thereby reduce the risk of cardiovascular disease.
Topics: Adult; Humans; Diet, Vegan; Diet, Vegetarian; Randomized Controlled Trials as Topic; Lipids; Vegetarians; Cholesterol, LDL; Lipoproteins; Cardiovascular Diseases; Atherosclerosis; Apolipoproteins
PubMed: 37226630
DOI: 10.1093/eurheartj/ehad211 -
Nutrients Aug 2022During the complementary feeding period, any nutritional deficiencies may negatively impact infant growth and neurodevelopment. A healthy diet containing all essential... (Review)
Review
During the complementary feeding period, any nutritional deficiencies may negatively impact infant growth and neurodevelopment. A healthy diet containing all essential nutrients is strongly recommended by the WHO during infancy. Because vegetarian diets are becoming increasingly popular in many industrialized countries, some parents ask the pediatrician for a vegetarian diet, partially or entirely free of animal-source foods, for their children from an early age. This systematic review aims to evaluate the evidence on how vegetarian complementary feeding impacts infant growth, neurodevelopment, risk of wasted and/or stunted growth, overweight and obesity. The SR was registered with PROSPERO 2021 (CRD 42021273592). A comprehensive search strategy was adopted to search and find all relevant studies. For ethical reasons, there are no interventional studies assessing the impact of non-supplemented vegetarian/vegan diets on the physical and neurocognitive development of children, but there are numerous studies that have analyzed the effects of dietary deficiencies on individual nutrients. Based on current evidence, vegetarian and vegan diets during the complementary feeding period have not been shown to be safe, and the current best evidence suggests that the risk of critical micronutrient deficiencies or insufficiencies and growth retardation is high: they may result in significantly different outcomes in neuropsychological development and growth when compared with a healthy omnivorous diet such as the Mediterranean Diet. There are also no data documenting the protective effect of vegetarian or vegan diets against communicable diseases in children aged 6 months to 2-3 years.
Topics: Animals; Diet, Vegan; Diet, Vegetarian; Eating; Humans; Infant; Infant Nutritional Physiological Phenomena; Malnutrition; Vegetarians
PubMed: 36079848
DOI: 10.3390/nu14173591 -
Biological Research For Nursing Jul 2022Current guidelines for obesity treatment recommend reducing daily caloric intake for weight loss. However, long-term weight loss continues to be an issue in obesity...
Current guidelines for obesity treatment recommend reducing daily caloric intake for weight loss. However, long-term weight loss continues to be an issue in obesity management. Alternative weight loss strategies have increased in popularity, such as intermittent energy restriction (IER), a type of eating pattern with periods of fasting alternating with unrestricted eating. The effects of IER on weight loss, cardiovascular risk factors, inflammation, and appetite are not clear. The purpose of this systematic review was to analyze short- (<24 weeks) and long-term (≥24 weeks) effects of IER on anthropometric, cardiometabolic, inflammatory, and appetite outcomes in adults with overweight/obesity. PubMed, CINAHL, Embase, and PsycInfo were searched from inception to July 2020. Human randomized controlled trials (RCTs) on IER with participants with a body mass index ≥25 kg/m were included in this review. A total of 42 articles (reporting on 27 different RCTs) were included. In short-term studies, IER showed pre-to-post treatment improvements in eight of nine studies that assessed weight. Weight outcomes were sustained in the long-term. However, no significant long-term between group differences were observed in fat mass, other anthropometric, cardiometabolic, inflammatory, or appetite outcomes. Compared to continuous energy restriction (CER), IER showed no significant long-term differences in anthropometric, cardiometabolic, inflammatory, or appetite outcomes in included studies. More long-term studies are needed to assess the benefits of IER on health outcomes.
Topics: Adult; Appetite; Caloric Restriction; Cardiovascular Diseases; Diet, Reducing; Energy Intake; Humans; Obesity; Weight Loss
PubMed: 35531785
DOI: 10.1177/10998004221078079