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The Cochrane Database of Systematic... Feb 2017Preterm infants are born with low skeletal stores of calcium and phosphorus. Preterm human milk provides insufficient calcium and phosphorus to meet the estimated needs... (Review)
Review
BACKGROUND
Preterm infants are born with low skeletal stores of calcium and phosphorus. Preterm human milk provides insufficient calcium and phosphorus to meet the estimated needs of preterm infants for adequate growth. Supplementation of human milk with calcium and phosphorus may improve growth and development of preterm infants.
OBJECTIVES
To determine whether addition of calcium and phosphorus supplements to human milk leads to improved growth and bone metabolism of preterm infants without significant adverse effects.
SEARCH METHODS
We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 3), MEDLINE via PubMed (1966 to 14 April 2016), Embase (1980 to 14 April 2016) and the Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1982 to 14 April 2016). We also searched clinical trials databases (11 May 2016) and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials.
SELECTION CRITERIA
Randomised and quasi-randomised trials comparing supplementation of human milk with calcium and/or phosphorus versus no supplementation in hospitalised preterm infants were eligible for inclusion in this review.
DATA COLLECTION AND ANALYSIS
Two review authors (JB, JW) independently extracted data and assessed trial quality using standard methods of the Cochrane Neonatal Review Group. We reported dichotomous data as risk ratios (RRs) and continuous data as mean differences (MDs) with 95% confidence intervals (CIs). We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to assess the quality of evidence.
MAIN RESULTS
This is an update of a 2001 review that identified no eligible trials. One trial including 40 infants met the inclusion criteria for this review. Using GRADE criteria, we judged the quality of the evidence as low owing to risk of bias (inadequate reporting of methods of randomisation, allocation concealment and/or blinding) and imprecision (wide confidence intervals and data from a single small trial). We found no evidence of a difference between calcium and phosphorus supplementation versus no supplementation for neonatal growth outcomes (weight, length, head circumference) at any time point reported (two, four or six weeks postnatal age). At six weeks postnatal age, supplementation with calcium/phosphorus was associated with a decrease in serum alkaline phosphatase concentration (MD -56.85 IU/L, 95% CI -101.27 to -12.43; one randomised controlled trial (RCT); n = 40 infants). Investigators provided no data on growth at 12 to 18 months, neonatal fractures, feed intolerance, breastfeeding or any of the prespecified childhood outcomes for this review (fractures, growth, neurodevelopmental outcomes).
AUTHORS' CONCLUSIONS
We identified one small trial including only 40 infants that compared supplementation of human milk with calcium and phosphorus versus no supplementation in hospitalised preterm infants. We judged the evidence to be of low quality and found no evidence of differences between groups for clinically important outcomes including growth and fractures. Although serum alkaline phosphatase concentration was reduced in the group receiving supplementation at six weeks postnatal age, this difference is unlikely to be of clinical significance. We conclude that evidence is insufficient to determine whether benefit or harm ensues when human milk is supplemented with calcium and/or phosphorus for the hospitalised preterm infant. We see no advantage of conducting further trials of this intervention because with the advent of multi-component human milk fortifier, supplementation of human milk with calcium and/or phosphorus alone is no longer common practice. Future trials should consider assessing effects of multi-component fortifiers with different mineral compositions on clinically important outcomes during the neonatal period and in later childhood.
Topics: Alkaline Phosphatase; Calcium; Dietary Supplements; Humans; Infant, Newborn; Infant, Premature; Milk, Human; Phosphorus; Randomized Controlled Trials as Topic
PubMed: 28238222
DOI: 10.1002/14651858.CD003310.pub2 -
The Cochrane Database of Systematic... 2001Preterm infants are born with low skeletal stores of calcium and phosphorus. Preterm human milk provides insufficient calcium and phosphorus to meet their estimated... (Review)
Review
BACKGROUND
Preterm infants are born with low skeletal stores of calcium and phosphorus. Preterm human milk provides insufficient calcium and phosphorus to meet their estimated needs.
OBJECTIVES
To determine if addition of calcium and phosphorus supplements to human milk leads to improved growth and bone metabolism without significant adverse effects in preterm infants.
SEARCH STRATEGY
The standard search strategy of the Cochrane Neonatal Review Group (NRG) was used. This includes searches of the Oxford Database of Perinatal Trials, MEDLINE, previous reviews including cross references, abstracts, conferences and symposia proceedings, expert informants, journal handsearching mainly in the English language.
SELECTION CRITERIA
All trials utilizing random or quasi-random allocation to supplementation of human milk with calcium and/or phosphorus or no supplementation in preterm infants within a hospital were eligible.
DATA COLLECTION AND ANALYSIS
Data were extracted using the standard methods of the Cochrane NRG, with separate evaluation of trial quality and data extraction by each author and synthesis of data using relative risk and weighted mean difference.
MAIN RESULTS
No studies which met selection criteria were identified. Excluded studies that were identified included minerals as one component of a multicomponent fortifier or reported only non-clinical outcomes (for example, urinary excretion of calcium). Two studies were excluded because of methodological concerns.
REVIEWER'S CONCLUSIONS
There are no randomized controlled data evaluating clinical outcomes of calcium and phosphorus supplementation of human milk for preterm infants on which to base practice recommendations. Further trials should assess the clinical benefits and potential adverse effects of supplementation of human milk with minerals. This may best be done in the context of manipulation of the composition of human milk fortifiers containing multiple nutrients (carbohydrate, protein, and minerals).
Topics: Calcium; Dietary Supplements; Humans; Infant, Newborn; Milk, Human; Phosphorus
PubMed: 11687186
DOI: 10.1002/14651858.CD003310 -
Critical Reviews in Food Science and... 2021Over the past 30-years, the U.S. Dietary Guidelines for Americans have included recommendations around dairy consumption, largely based on meeting recommendations for...
Over the past 30-years, the U.S. Dietary Guidelines for Americans have included recommendations around dairy consumption, largely based on meeting recommendations for calcium intake with the intended purpose of osteoporosis prevention. Although dairy products provide more bone-beneficial nutrients (e.g., calcium, magnesium, potassium, zinc, phosphorus, and protein) per unit of energy than any other food group, the relevance of dairy products for long-term bone health and fracture prevention has resurged as some observational studies have suggested consumption to be associated with a greater risk of fractures. Given this controversy, we sought to synthesize the evidence on dairy consumption and bone health across the lifespan. We searched the PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials databases for English-language publications through June 2, 2020. Case-controlled, cross-sectional, prospective cohort or nestled case-control (or case cohort), and clinical trials reporting the effect of dairy products on bone mineral density, bone mineral content, and/or fractures were included in the systematic review. Two reviewers independently performed data extractions. Data from 91 publications, including 30 RCTs, 28 prospective cohorts, 23 cross-sectional studies, and 10 case-control studies were included in the systematic review. We assigned a "D" grade or "insufficient evidence" for the effect of dairy in infants and toddlers (0- to <36-months), children (3- to <10-years), and young adults (19- to <50-years). A "C" grade or "limited evidence" was assigned for the effect of dairy in adolescents (10- to <19-years). A "B" grade or "moderate" evidence was assigned for the effect of dairy in middle aged to older adults (≥50-years). Research on bone mass in adults between the ages of 20- to 50-years and individuals from other ethnic groups apart from Chinese females and Caucasians is greatly needed. Daily intake of low or nonfat dairy products as part of a healthy habitual dietary pattern may be associated with improved BMD of the total body and at some sites and associated with fewer fractures in older adults.
Topics: Adolescent; Adult; Aged; Bone Density; Cross-Sectional Studies; Dairy Products; Female; Humans; Infant; Longevity; Middle Aged; Prospective Studies; Young Adult
PubMed: 32924543
DOI: 10.1080/10408398.2020.1810624 -
Helicobacter Feb 2012Many micronutrients depend on a healthy stomach for absorption. Helicobacter pylori chronic gastritis may alter gastric physiology affecting homeostasis of vitamins and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Many micronutrients depend on a healthy stomach for absorption. Helicobacter pylori chronic gastritis may alter gastric physiology affecting homeostasis of vitamins and minerals.
OBJECTIVES
Systematic review to assess whether H. pylori infection is associated with reduced micronutrient levels (other than iron) in the plasma or gastric juice and whether low micronutrient levels are modified by eradication treatment.
METHOD
Medline was searched for relevant publications from inception to June 2010. Studies describing micronutrient levels in H. pylori-infected and not-infected adults and/or the effect of eradication treatment on micronutrient levels were included.
FINDINGS
Fifty-two publications were selected: 46 investigated the association between H. pylori infection and reduced micronutrient levels and 14 the effect of eradication treatment on micronutrient levels. Sixty-four studies investigated vitamins (23 ascorbic acid, four ß-carotene, 21 cobalamin, 11 folate, and five α-tocopherol) and 10 addressed minerals (one calcium, one copper, one magnesium, one phosphorus, three selenium, and three zinc). Pooled standardized mean differences in micronutrient levels showed positive associations with H. pylori infection for ascorbic acid (gastric juice, -1.087) and cobalamin (-0.744), and a positive effect of eradication treatment, which increased ascorbic acid in the gastric juice (-1.408) and serum cobalamin (-1.910). No significant association between infection and low folate levels was observed. Meta-analyses for other micronutrients were not performed owing to insufficient data.
CONCLUSIONS
Meta-analyses indicate that H. pylori infection is associated with reduced levels of ascorbic acid and cobalamin, supported by the positive effect of eradication treatment. For other micronutrients, further studies are needed.
Topics: Ascorbic Acid; Helicobacter Infections; Helicobacter pylori; Humans; Iron, Dietary; Micronutrients; Vitamin B 12; beta Carotene
PubMed: 22221610
DOI: 10.1111/j.1523-5378.2011.00892.x -
Frontiers in Physiology 2023In vertebrates fibroblast growth factor 23 (FGF23) is a phosphate regulating hormone closely linked to calcium regulation by vitamin D and parathyroid hormone (PTH)....
In vertebrates fibroblast growth factor 23 (FGF23) is a phosphate regulating hormone closely linked to calcium regulation by vitamin D and parathyroid hormone (PTH). Although phosphorus, calcium and vitamin D are important for poultry well-being, relatively little is known about their levels of FGF23. Our objective was to quantitatively estimate the blood FGF23 level in birds, and to examine its relationship to diet and blood levels of other components of phosphate and calcium homeostasis. A systematic search of Agricola, Embase and Medline identified 86 studies focused on FGF23 in birds, from which 12 manuscripts reporting data for 60 independent groups of chickens were included in the analysis. FGF23 levels were 256 pg/ml (Confidence interval (CI): 215, 297) in broilers (39 datasets containing 435 birds), and 256 pg/ml (CI: 178, 339) in egg-laying hens (21 datasets containing 208 birds). FGF23 levels did not correlate with dietary phosphorus, calcium or vitamin D, or with plasma calcium or PTH. FGF23 levels demonstrated a trend to positively correlate with plasma phosphate and a strongly and positive correlation with plasma vitamin D. This study provides normative estimates of FGF23 levels in poultry birds and new insights into the regulation of calcium and phosphate homeostasis.
PubMed: 37908340
DOI: 10.3389/fphys.2023.1279204 -
Frontiers in Nutrition 2023Optimizing dietary intake during pregnancy and lactation is crucial to the growth and development of children and their lifelong health. We performed a systematic review...
INTRODUCTION
Optimizing dietary intake during pregnancy and lactation is crucial to the growth and development of children and their lifelong health. We performed a systematic review and meta-analysis to describe the nutrient intakes of pregnant and lactating women in Indonesia and Malaysia, countries that are experiencing rapid nutrition transition in Southeast Asia.
METHODS
We screened 2,258 studies published between January 1980 and March 2021. The nutrient intakes of pregnant and lactating women were quantitatively analyzed to calculate the percentage of adequacy using national recommended daily allowances or nutrient intakes (RDA/RNI) and estimated average requirements (EAR) for micronutrients. Standardized mean differences (SMD) between dietary intake and RDA/RNI were determined for selected nutrients.
RESULTS
Fifty-three studies were included and showed that energy and macronutrient intakes among pregnant and lactating women in both countries were below the RDA/RNI. In addition, most studies reported that women failed to meet the EAR for vitamin D (<70% EAR), vitamin E (<50% EAR), and water-soluble vitamins (<80% EAR) except for vitamin C and A among Malaysians. Moreover, calcium, potassium, and iron intakes of pregnant women were <60% EAR in Indonesia and <80% EAR in Malaysia. Phosphorus intake among pregnant women in both countries and sodium intake among Malaysian pregnant women exceeded 100% EAR. Indonesian lactating women had <60% EAR for calcium and potassium intakes, while Malaysian women had more than 100% EAR. For 21 studies reporting overall protein intakes, the standard mean difference (SMD) was -2.26 (95% CI; -2.98, -1.54) below the RDA/RNI for pregnant women and -0.67 SMD (95% CI -15.7, -11.5) for lactating women. When the four studies from Malaysia were analyzed separately, protein intakes of pregnant women were above the RNI. Moreover, low intakes of vitamin D, vitamin C, calcium, and iron, but sufficient intakes in vitamin A, zinc, and phosphorus were observed in pregnant women in both countries.
CONCLUSION
Dietary intakes of energy, macronutrients, and micronutrients (vitamin D, vitamin E, water-soluble vitamins, calcium, and iron) of pregnant and lactating women in Indonesia and Malaysia were below the recommendations. Important heterogeneities were observed even between these two countries for specific essential nutrient intakes. Innovative research and targeted programs to address specific deficiencies should be prioritized.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021252204, identifier: CRD42021252204.
PubMed: 37063336
DOI: 10.3389/fnut.2023.1030343 -
Phytotherapy Research : PTR Nov 2023Resveratrol (RES) has extensively been utilized to treat osteoporosis (OP) in animal models. However, the anti-OP effects of RES have not been tested during clinical... (Meta-Analysis)
Meta-Analysis
Resveratrol (RES) has extensively been utilized to treat osteoporosis (OP) in animal models. However, the anti-OP effects of RES have not been tested during clinical application due to the lack of evidence and poor knowledge of the underlying mechanisms. Moreover, there is little preclinical evidence to support the use of RES in the management of OP. In the present paper, we conducted a preclinical systematic review and meta-analysis to assess the efficacy of RES in animal OP models. The potential mechanisms underlying the efficacy of RES against OP were summarized. The online databases PubMed, CNKI, EMBASE, Wanfang, Web of Science, Chinese Biomedical Literature, Cochrane Library, and Chinese VIP were retrieved from inception to December 2021. The CAMARADES 10-item quality checklist was utilized to assess the risk of bias of the included studies. STATA 12.0 software was employed to analyze the data. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Thirteen studies containing 248 animals were included yielding a mean risk of bias score of 5.54 (range 4-7). The pooled estimates showed that the administration of RES could significantly elevate the bone mineral density (BMD) both at femur (SMD = 2.536; 95% CI = 1.950-3.122; p < 0.001) and lumbar spine (SMD = 1.363; 95% CI = 0894-1.832; p < 0.001), bone volume over total volume (BV/TV) (SMD = 2.543; 95% CI = 2.023-3.062; p < 0.001), trabecular linear density (Tb.N) (SMD = 2.724; 95% CI = 2.186-3.262; p < 0.001) and trabecular thickness (Tb.Th) (SMD = 1.745; 95% CI = 1.294-2.196; p < 0.001), while serum phosphorus (S-P) (SMD = -2.168; 95% CI = -2.753 to -1.583; p < 0.001) and trabecular separation (Tb.Sp) (SMD = -2.856; 95% CI = -4.218 to -1.494; p < 0.001) were significantly reduced in animal OP models. No significant change in serum calcium (S-Ca) (SMD = -2.448; 95% CI = -5.255-0.360; p = 0.087) was observed after RES treatment. Furthermore, RES could significantly improve the bone biomechanical indexes: bone maximum load (BML) (SMD = 2.563; 95% CI = 1.827-3.299; p < 0.001) and connectivity density (Conn.D) (SMD = 1.512; 95% CI = 0.909-2.116; p < 0.001) and decrease the structural model index (SMI) (SMD = -2.522; 95% CI = -3.243 to -1.801; p < 0.001). Overall, the present study revealed that RES has huge prospects as a medicine or dietary supplement for the clinical treatment of OP. High-quality studies with stringent designs and larger sample sizes are warranted to substantiate our conclusion.
Topics: Animals; Resveratrol; Osteoporosis; Bone Density; Bone and Bones; Models, Animal
PubMed: 37482965
DOI: 10.1002/ptr.7954 -
Journal of Vascular Nursing : Official... Sep 2017Cardiovascular disease has been associated with elevated serum phosphorus levels, which have been associated with cardiovascular mortality. This is commonly seen in the... (Review)
Review
Cardiovascular disease has been associated with elevated serum phosphorus levels, which have been associated with cardiovascular mortality. This is commonly seen in the chronic kidney disease (CKD) population where studies have shown that high phosphorus levels cause coronary artery calcification. Although studies have independently associated vascular stiffness and serum phosphorus in those with and without CKD, there are fewer data in individuals without CKD. Therefore, the aim of this systematic review was to analyze whether serum phosphorus levels are associated with cardiovascular calcification in healthy individuals. A systematic review of the literature that was conducted revealed 10 articles, all cross-sectional studies, that met eligibility criteria. These criteria were peer-reviewed studies on a healthy, adult population written in the English language. Studies lacking data on serum phosphorus and measured to assess its association with vascular calcification were excluded. Studies on subjects with CKD, other chronic diseases, or on children were also excluded. Of the 10 studies located, 8 indicated an association between serum phosphorus and vascular calcification. One study did not indicate an association. One study indicated a statistically significant association between serum phosphorus and vascular calcification prevalence, but not incidence. Studies were limited since no randomized controlled trials were available. This systematic review generates gaps in research. Due to considerable amounts of phosphorus additives in the food supply, there may be a connection to dietary phosphorus and vascular calcification. Additionally, phosphorus binders may assist in the prevention of vascular calcification but have not been studied in a healthy population. Further study on both dietary phosphorus restriction and phosphorus binders is needed. While 8 out of 10 cross-sectional studies found an association in this systematic review, the topic of vascular calcification and serum phosphorus needs further study if a cause and effect relationship is to be detected.
Topics: Calcium, Dietary; Healthy Volunteers; Humans; Phosphorus, Dietary; Vascular Calcification; Vascular Stiffness
PubMed: 28838591
DOI: 10.1016/j.jvn.2017.01.003 -
Journal of Diabetes Research 2022Chronic kidney disease (CKD) is a main health problem associated with increased risk of cardiovascular disease, morbidity, and mortality. Recent studies shown that the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Chronic kidney disease (CKD) is a main health problem associated with increased risk of cardiovascular disease, morbidity, and mortality. Recent studies shown that the progression of CKD may be related to the change of intestinal flora. Resistant starch (RS) is a type of dietary fiber that can act as a substrate for microbial fermentation. Some studies have found that the supplementation of RS can improve the intestinal flora disorder in CKD patients. However, the specific effect of RS on CKD patients remains controversial.
OBJECTIVE
We designed this meta-analysis to identify and assess the effects of RS on patients with CKD.
METHODS
A comprehensive search of MEDLINE, Embase, Web of Science, and Cochrane systematic review databases was conducted in January 2020, and all new trials were updated in August 2021. Randomized trials were collected to assess the effects of RS on patients with CKD. The weighted average effect size of the net change was calculated by using the random-effects model.
RESULTS
The meta-analysis included 8 studies involving 301 participants. RS intake significantly reduced serum indolephenol sulfate (IS), blood phosphorus, IL-6, and uric acid levels in dialysis patients. The mean difference (MD) of serum IS ( = 0.0002) in the dialysis subgroup was -12.57 mol/L (95% CI: -19.28, -5.86 mol/L). The MD of blood phosphorus ( = 0.03) was -0.39 mg/dl (95% CI: -0.78, -0.01 mg/dl). The MD of serum uric acid ( = 0.004) between the dialysis subgroup and the nondialysis subgroup was -31.58 mmol/L (95% CI: -52.99, -10.17 mmol/L). The mean difference (MD) of IL-6 ( = 0.02) in the dialysis subgroup was -1.16 mol/L (95% CI: -2.16, -0.16 mol/L). However, there was no significant change of RS on hs-CRP, serum creatinine, blood urea nitrogen (BUN), blood paracresol sulfate, and blood lipid.
CONCLUSIONS
The intake of RS reduced the serum IS, serum phosphorus, IL-6, and uric acid levels significantly in dialysis patients, while hs-CRP, serum creatinine, BUN, serum paracresol sulfate, and blood lipid showed no significant changes.
Topics: C-Reactive Protein; Creatinine; Humans; Interleukin-6; Phosphorus; Renal Insufficiency, Chronic; Resistant Starch; Sulfates; Uric Acid
PubMed: 35899018
DOI: 10.1155/2022/1861009 -
Nutrition Reviews Dec 2023There is growing evidence that insufficient dietary intake is associated with sarcopenia.
Energy and nutrient intake by people with and without sarcopenia diagnosed by the European Working Group on Sarcopenia in Older People: a systematic review and meta-analysis.
CONTEXT
There is growing evidence that insufficient dietary intake is associated with sarcopenia.
OBJECTIVE
In this systematic review and meta-analysis, the energy and nutrient intakes by people with and without sarcopenia were compared using only the European Working Group on Sarcopenia in Older People 2010 (EWGSOP1) and 2019 (EWGSOP2) consensus diagnostic criteria.
DATA SOURCES
Only observational studies that compared energy and nutrient intake from food alone by individuals with and without sarcopenia were included. Studies were searched in the following databases: Embase, PubMed, Scopus, Web of Science, Lilacs, Ovid, and Scopus. The review followed the PRISMA checklist and submitted the protocol to PROSPERO.
DATA EXTRACTION
Data were extracted by 2 authors independently. The methodological quality of the studies was assessed using the Newcastle-Ottawa scale.
DATA ANALYSIS
A total of 8648 articles were identified and 12 were selected. Among individuals with sarcopenia, lower intakes of energy and some nutrients, mainly with antioxidant properties, were observed compared with those without sarcopenia. Meta-analyses showed that individuals with sarcopenia consume fewer calories/day than individuals without sarcopenia (n = 10 studies; standardized mean difference (SMD) -0.15; 95% confidence interval: -0.29, -0.01) diagnosed by EWGSOP1 and EWGSOP2. Individuals with sarcopenia consume less omega-3, folate, magnesium, phosphorus, selenium, zinc, and vitamins C, D, and E when compared with those without sarcopenia.
CONCLUSION
The results of the present study suggest that insufficient intake of energy and nutrients with antioxidant potential may be associated with sarcopenia.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO registration no. CRD 42020195698.
PubMed: 38114090
DOI: 10.1093/nutrit/nuad154