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BMC Nephrology Jul 2020Dietary and lifestyle factors may play an important role in the increasing prevalence of nephrolithiasis. We aimed to review and quantify the associations between... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Dietary and lifestyle factors may play an important role in the increasing prevalence of nephrolithiasis. We aimed to review and quantify the associations between lifestyle factors and incident nephrolithiasis and suggest lifestyle changes for the primary prevention of nephrolithiasis.
METHODS
PubMed, EMBASE, and Cochrane Library were searched up to May 2019, for observational studies and randomized controlled trials (RCTs) that assessed modifiable lifestyle factors and risk of nephrolithiasis in adults. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were computed using a random effects model. The I statistic was employed to evaluate heterogeneity. Subgroup analysis, sensitivity analysis and meta-regression were also conducted whenever possible.
RESULTS
Fifty relevant articles with 1,322,133 participants and 21,030 cases in total were identified. Prominent risk factors for incident stones were body mass index (1.39,1.27-1.52), dietary sodium (1.38, 1.21-1.56), fructose, meat, animal protein, and soda. In contrast, protective factors included fluid intake (0.55, 0.51-0.60), a Dietary Approaches to Stop Hypertension (DASH) style diet (0.69, 0.64-0.75), alcohol (0.69, 0.56-0.85), water, coffee, tea, vegetables, fruits, dietary fiber, dietary calcium (0.83, 0.76-0.90), and potassium. Vitamin D (1.22, 1.01-1.49) and calcium (1.16, 1.00-1.35) supplementation alone increased the risk of stones in meta-analyses of observational studies, but not in RCTs, where the cosupplementation conferred significant risk.
CONCLUSIONS
Several modifiable factors, notably fluid intake, dietary patterns, and obesity, were significantly associated with nephrolithiasis. Long-term RCTs are required to investigate the cost-effectiveness of dietary patterns for stone prevention. The independent and combined effects of vitamin D and calcium supplementation on nephrolithiasis need further elucidation.
Topics: Alcohol Drinking; Calcium, Dietary; Carbonated Beverages; Coffee; Diet; Dietary Approaches To Stop Hypertension; Dietary Fiber; Dietary Supplements; Drinking Behavior; Drinking Water; Fruit; Humans; Life Style; Nephrolithiasis; Potassium, Dietary; Primary Prevention; Tea; Vegetables; Vitamin D
PubMed: 32652950
DOI: 10.1186/s12882-020-01925-3 -
Cancer Jul 2020Associations between fiber intake and breast cancer risk have been evaluated in prospective studies, but overall, the evidence is inconsistent. The authors performed a... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Associations between fiber intake and breast cancer risk have been evaluated in prospective studies, but overall, the evidence is inconsistent. The authors performed a systematic review and meta-analysis of prospective studies to investigate the relation between intake of total and types of fiber with breast cancer incidence.
METHODS
The MEDLINE and Excerpta Medica dataBASE (EMBASE) databases were searched through July 2019 for prospective studies that reported on the association between fiber consumption and incident breast cancer. The pooled relative risk (RR) and 95% confidence intervals (95% CI) were estimated comparing the highest versus the lowest category of total and types of fiber consumption, using a random-effects meta-analysis.
RESULTS
The authors identified 17 cohort studies, 2 nested case-control studies, and 1 clinical trial study. Total fiber consumption was associated with an 8% lower risk of breast cancer (comparing the highest versus the lowest category, pooled RR, 0.92; 95% CI, 0.88-0.95 [I = 12.6%]). Soluble fiber was found to be significantly inversely associated with risk of breast cancer (pooled RR, 0.90 [95% CI, 0.84-0.96; I = 12.6%]) and insoluble fiber was found to be suggestively inversely associated with risk of breast cancer (pooled RR, 0.93 [95% CI, 0.86-1.00; I = 33.4%]). Higher total fiber intake was associated with a lower risk of both premenopausal and postmenopausal breast cancers (pooled RR, 0.82 [95% CI, 0.67-0.99; I = 35.2%] and pooled RR, 0.91 [95% CI, 0.88-0.95; I = 0.0%], respectively). Furthermore, the authors observed a nonsignificant inverse association between intake of total fiber and risk of both estrogen and progesterone receptor-positive and estrogen and progesterone receptor-negative breast cancers.
CONCLUSIONS
A random-effects meta-analysis of prospective observational studies demonstrated that high total fiber consumption was associated with a reduced risk of breast cancer. This finding was consistent for soluble fiber as well as for women with premenopausal and postmenopausal breast cancer.
Topics: Adult; Aged; Aged, 80 and over; Breast Neoplasms; Cohort Studies; Dietary Fiber; Female; Humans; Middle Aged; Premenopause; Prospective Studies; Risk Factors; Young Adult
PubMed: 32249416
DOI: 10.1002/cncr.32816 -
The American Journal of Clinical... Feb 2023Soluble dietary fibers are known to reduce the levels of blood glucose and lipids in patients with type 2 diabetes mellitus (type 2 diabetes). Although several different... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Soluble dietary fibers are known to reduce the levels of blood glucose and lipids in patients with type 2 diabetes mellitus (type 2 diabetes). Although several different dietary fiber supplements are utilized, to our knowledge, no previous study has ranked their efficacy yet.
OBJECTIVES
We performed this systematic review and network meta-analysis to rank the effects of different types of soluble dietary fibers.
METHODS
We performed our last systematic search on November 20, 2022. Eligible randomized controlled trials (RCTs) included adult patients with type 2 diabetes and compared the intake of soluble dietary fibers with that of another type of dietary fiber or no fiber. The outcomes were related to glycemic and lipid levels. The Bayesian method was used to perform a network meta-analysis and calculate the surface under the cumulative ranking (SUCRA) curve values to rank the interventions. The Grading of Recommendations Assessment, Development, and Evaluation system was applied to evaluate the overall quality of the evidence.
RESULTS
We identified 46 RCTs, including data from 2685 patients who received 16 types of dietary fibers as intervention. Galactomannans had the highest effect on reducing the levels of HbA1c (SUCRA: 92.33%) and fasting blood glucose (SUCRA: 85.92%). With regard to fasting insulin level, HOMA-IR, β-glucans (SUCRA: 73.45%), and psyllium (SUCRA: 96.67%) were the most effective interventions. Galactomannans were ranked first in reducing the levels of triglycerides (SUCRA: 82.77%) and LDL cholesterol (SUCRA: 86.56%). With regard to cholesterol and HDL cholesterol levels, xylo-oligosaccharides (SUCRA: 84.59%) and gum arabic (SUCRA: 89.06%) were the most effective fibers. Most comparisons had a low or moderate certainty of evidence.
CONCLUSIONS
Galactomannans were the most effective dietary fiber for reducing the levels of HbA1c, fasting blood glucose, triglycerides, and LDL cholesterol in patients with type 2 diabetes. This study was registered at PROSPERO as ID CRD42021282984.
Topics: Adult; Humans; Cholesterol, LDL; Blood Glucose; Network Meta-Analysis; Glycated Hemoglobin; Triglycerides; Dietary Fiber; Diabetes Mellitus, Type 2
PubMed: 36811560
DOI: 10.1016/j.ajcnut.2022.12.015 -
The American Journal of Clinical... Dec 2014In high-income countries, high socioeconomic status (SES) is generally associated with a healthier diet, but whether social differences in dietary intake are also... (Review)
Review
BACKGROUND
In high-income countries, high socioeconomic status (SES) is generally associated with a healthier diet, but whether social differences in dietary intake are also present in low- and middle-income countries (LMICs) remains to be established.
OBJECTIVE
We performed a systematic review of studies that assessed the relation between SES and dietary intake in LMICs.
DESIGN
We carried out a systematic review of cohort and cross-sectional studies in adults in LMICs and published between 1996 and 2013. We assessed associations between markers of SES or urban and rural settings and dietary intake.
RESULTS
A total of 33 studies from 17 LMICs were included (5 low-income countries and 12 middle-income countries; 31 cross-sectional and 2 longitudinal studies). A majority of studies were conducted in Brazil (8), China (6), and Iran (4). High SES or living in urban areas was associated with higher intakes of calories; protein; total fat; cholesterol; polyunsaturated, saturated, and monounsaturated fatty acids; iron; and vitamins A and C and with lower intakes of carbohydrates and fiber. High SES was also associated with higher fruit and/or vegetable consumption, diet quality, and diversity. Although very few studies were performed in low-income countries, similar patterns were generally observed in both LMICs except for fruit intake, which was lower in urban than in rural areas in low-income countries.
CONCLUSIONS
In LMICs, high SES or living in urban areas is associated with overall healthier dietary patterns. However, it is also related to higher energy, cholesterol, and saturated fat intakes. Social inequalities in dietary intake should be considered in the prevention and control of noncommunicable diseases in LMICs.
Topics: Brazil; China; Diet; Dietary Fiber; Dietary Proteins; Energy Intake; Fatty Acids; Fatty Acids, Monounsaturated; Fatty Acids, Unsaturated; Feeding Behavior; Food, Organic; Fruit; Health Behavior; Humans; Iran; Micronutrients; Rural Population; Socioeconomic Factors; Urban Population; Vegetables
PubMed: 25411287
DOI: 10.3945/ajcn.114.089029 -
Respirology (Carlton, Vic.) Feb 2014Dietary intake attracts increasing interest in the risk for and progression of chronic obstructive pulmonary disease (COPD). In particular, dietary fibre and fatty acids... (Review)
Review
Dietary intake attracts increasing interest in the risk for and progression of chronic obstructive pulmonary disease (COPD). In particular, dietary fibre and fatty acids have drawn specific attention for their immunomodulating potential. The study aimed to review the current evidence on the potential roles of dietary fibre or fatty acid intake in the risk and progression of COPD. Pubmed, EMBASE, Cochrane Collaboration Database and conference databases for original studies in adults addressing the association between fibre or fatty acid intake and COPD in terms of risk, lung function and respiratory symptoms were searched. Nine articles were included of which four reported on dietary fibre and five on fatty acids. Data of studies could not be pooled because of methodological diversity. Greater intake of dietary fibre has been consistently associated with reduced COPD risk, better lung function and reduced respiratory symptoms. Results on the associations between fatty acids and COPD are inconsistent. Dietary quality deserves further attention in developing COPD prevention and management programs.
Topics: Dietary Fats; Dietary Fiber; Disease Progression; Humans; Pulmonary Disease, Chronic Obstructive; Risk; Vital Capacity
PubMed: 24372903
DOI: 10.1111/resp.12229 -
European Journal of Clinical Nutrition Mar 2019Humans appear to have innate energy regulation mechanisms that manifest in sensations of satiation during a meal and satiety post ingestion. Interactions between these...
BACKGROUND/OBJECTIVES
Humans appear to have innate energy regulation mechanisms that manifest in sensations of satiation during a meal and satiety post ingestion. Interactions between these mechanisms and the macronutrient profile of their contemporary food environment could be responsible for the dysregulation of this mechanism, resulting in a higher energy intake. The aim of this systematic review was to determine the impact of dietary fibre and fat both in isolation and combination on satiation and satiety.
SUBJECTS/METHODS
A systematic review of the literature was undertaken, from inception until end December 2017, in accordance with the PRISMA guidelines, in: Scopus, Food Science and Tech, CINAHL, and Medline databases. The search strategy was limited to articles in English language, published in peer-reviewed journals and human studies. Studies were selected based on inclusion/exclusion criteria.
RESULTS
A total of 1490 studies were found initially using the selected search terms that were reduced to 12 studies suitable for inclusion. Following on from this, a meta-analysis was also conducted to determine any satiety effects from any potential interaction between dietary fat and fibre on satiety, no significant effects were found.
CONCLUSIONS
Owing to high energy density, fat (per kJ) had a weak effect on satiation as determined by the effect per gram for each unit of energy. The addition of fibre theoretically improves satiety by slowing the absorption of various nutrients including fat, although the meta-analysis as part of this review was unable to demonstrate an effect, perhaps reflecting a lack of sensitivity in research design. The potential to improve satiation and satiety responses by consuming fat together with carbohydrates containing fibre warrants further investigation.
Topics: Dietary Fats; Dietary Fiber; Humans; Satiation; Satiety Response
PubMed: 30166637
DOI: 10.1038/s41430-018-0295-7 -
Critical Reviews in Food Science and... 2023This study aimed to summarize the evidence regarding the effects of dietary intake before conception on pregnancy outcomes by performing a systematic review and... (Meta-Analysis)
Meta-Analysis
This study aimed to summarize the evidence regarding the effects of dietary intake before conception on pregnancy outcomes by performing a systematic review and meta-analysis of prospective studies. Electronic databases were searched from inception up to August 2021. Overall, 65 studies involving 831 798 participants were included and 38 studies were quantitatively pooled. With regard to maternal outcomes, pre-pregnancy intake of fried food, fast food, red and processed meat, heme iron and a low-carbohydrate dietary pattern was positively associated with the risk of gestational diabetes mellitus (GDM) (all P < 0.05). However, a high dietary fiber intake and folic acid supplementation were negatively associated with GDM risk (both P < 0.05). With regard to neonatal outcomes, maternal caffeine intake before pregnancy significantly increased the risk of spontaneous abortion, while folic acid supplementation had protective effects on total adverse neonatal outcomes, preterm birth, and small-for-gestational age (SGA, all P < 0.05). However, no significant associations were found between adverse pregnancy outcomes (i.e., GDM and SGA) and the pre-pregnancy dietary intake of sugar-sweetened beverages, potato, fish, and carbohydrates and the Healthy Eating Index. Our study suggests that maintaining a healthy diet before conception has significant beneficial effects on pregnancy outcomes.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2021.1989658.
Topics: Infant, Newborn; Pregnancy; Female; Humans; Prospective Studies; Premature Birth; Pregnancy Outcome; Diabetes, Gestational; Eating; Folic Acid
PubMed: 34666569
DOI: 10.1080/10408398.2021.1989658 -
Inflammatory Bowel Diseases Mar 2014Dietary fiber may favorably influence fermentation, gastrointestinal inflammation, and disease progression in Crohn's disease, ulcerative colitis (UC), and pouchitis and... (Review)
Review
BACKGROUND
Dietary fiber may favorably influence fermentation, gastrointestinal inflammation, and disease progression in Crohn's disease, ulcerative colitis (UC), and pouchitis and offer an attractive therapeutic addition to pharmacological treatment. This systematic review appraised data from randomized controlled trials of fiber in the management of inflammatory bowel disease.
METHODS
The review followed Cochrane and PRISMA recommendations. Seven electronic databases were searched along with hand searching and contacting experts. Inclusion criteria were randomized controlled trials of the effects of fiber on clinical endpoints (primarily disease activity for treatment or maintenance) or physiological outcomes in patients with inflammatory bowel disease.
RESULTS
In total, 23 randomized controlled trials fulfilled the inclusion criteria (UC, 10; Crohn's disease, 12; and pouchitis, 1) recruiting 1296 patients. In UC, 3/10 studies reported fiber supplementation to benefit disease outcomes. In Crohn's disease, 0/12 studies and in pouchitis 1/1 study reported a benefit on disease activity. Despite this, a number of studies reported favorable intragroup effects on physiological outcomes including fecal butyrate, fecal calprotectin, inflammatory cytokines, microbiota, and gastrointestinal symptom indices. Meta-analysis was not possible.
CONCLUSIONS
There is limited weak evidence for the efficacy of fiber in improving disease outcomes in UC and pouchitis. The potential antiinflammatory role of fiber is intriguing and merits further investigation in adequately powered clinical trials. Excluding overt gastrointestinal obstruction, there was no evidence that fiber intake should be restricted in patients with inflammatory bowel disease.
Topics: Dietary Fiber; Humans; Inflammatory Bowel Diseases; Prognosis; Randomized Controlled Trials as Topic
PubMed: 24445775
DOI: 10.1097/01.MIB.0000437984.92565.31 -
Nutricion Hospitalaria Dec 2022Introduction: the main treatment for people with autism spectrum disorder (ASD) corresponds to cognitive behavioral therapy in conjunction with pharmacotherapy. Together...
Introduction: the main treatment for people with autism spectrum disorder (ASD) corresponds to cognitive behavioral therapy in conjunction with pharmacotherapy. Together they seek to attenuate the behavioral symptoms of these patients, as well as to increase their social functionality. However, other strategies have become popular to achieve the same goal of classical treatment. Particularly, nutritional interventions are positioned above others, and it is necessary to investigate their effectiveness, considering that children with ASD present a marked food selectivity, as well as gastrointestinal alterations. Objective: to evaluate the effectiveness of nutritional interventions in the behavioral symptomatology of infants with ASD. Methods: a systematic search was carried out in the Scopus and PubMed databases, in Spanish and English. The filters of clinical studies and original articles were used, choosing only nutritional interventions in children under 19 years of age and who had had at least 4 weeks of intervention. Results: evidence was found on gluten- and casein-free diets, ketogenic diet, omega-3 supplementation, prebiotics/probiotics, and vitamins/minerals presenting positive results in most of the articles analyzed; however, the heterogeneity presented requires a greater body of evidence to promote its use. Conclusion: the five types of nutritional interventions evaluated show varied evidence that does not allow defining the degree of effectiveness between one or the other in terms of behavioral improvements in the population with ASD.
Topics: Child; Humans; Autism Spectrum Disorder; Diet; Probiotics; Caseins; Prebiotics
PubMed: 36454020
DOI: 10.20960/nh.04155 -
Alimentary Pharmacology & Therapeutics Jun 2015Dietary fibre supplements have been advocated for the management of chronic constipation (CC) and irritable bowel syndrome (IBS). Recently, a fermentable... (Review)
Review
BACKGROUND
Dietary fibre supplements have been advocated for the management of chronic constipation (CC) and irritable bowel syndrome (IBS). Recently, a fermentable oligosaccharide, disaccharide, monosaccharide and polyol (FODMAP) restricted diet has been recommended for IBS.
AIM
To systematically examine recent evidence for dietary interventions with fibre in CC and IBS and FODMAP-restricted diet in IBS, and provide recommendations.
METHODS
We searched PUBMED, MEDLINE, OVID and COCHRANE databases from 2004 to 2014. Published studies in adults with CC and IBS and constipation-predominant IBS (IBS-C) that compared fibre with placebo/alternative and FODMAP-restricted diet with alternative were included.
RESULTS
Of 550 potentially eligible clinical trials on fibre, 11 studies were found and of 23 potentially eligible studies on FODMAPs, six were found. A meta-analysis was not performed due to heterogeneity and methodological quality. Fibre was beneficial in 5/7 studies in CC and 3/3 studies in IBS-C. FODMAP-restricted diet improved overall IBS symptoms in 4/4 and IBS-C symptoms in 1/3 studies and three studies did not meet inclusion criteria. There were significant disparities in subject selection, interventions and outcome assessments in both fibre and FODMAPs studies.
CONCLUSIONS
Fibre supplementation is beneficial in mild to moderate CC and IBS-C, although larger, more rigorous and long-term RCTs are needed (Fair evidence-Level II, Grade B). Although the FODMAP-restricted diet may be effective in short-term management of selected patients with IBS (Fair evidence-Level II, Grade C) and IBS-C (Poor evidence-Level III, Grade C), more rigorous trials are needed to establish long-term efficacy and safety, particularly on colonic health and microbiome.
Topics: Adult; Constipation; Diet Therapy; Dietary Fiber; Disaccharides; Disease Management; Fermentation; Humans; Irritable Bowel Syndrome; Monosaccharides; Oligosaccharides; Polymers
PubMed: 25903636
DOI: 10.1111/apt.13167