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Drugs Apr 2023Nutritional therapies are effective alternative treatments for male infertility or subfertility. These are cost-effective and easily implementable, unlike other advanced... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Nutritional therapies are effective alternative treatments for male infertility or subfertility. These are cost-effective and easily implementable, unlike other advanced invasive treatments. Even moderate improvements in sperm quality could improve spontaneous pregnancy.
OBJECTIVE
We aimed to compare the effectiveness of all nutritional therapies in male infertility/subfertility treatment and ranked their efficacy based on type and etiology. We intend to aid clinicians with an evidence-based approach to affordable and safer initial infertility treatment for those who mainly do not wish to have other advanced invasive treatments or could not afford or have access to them.
METHODS
We included 69 studies with 94 individual study arms identified from bibliographic databases and registries. We included studies in adult men with proven infertility or subfertility that investigated nutritional or dietary supplement therapies compared with control or placebo and at least reported on a sperm parameter. We undertook a network meta-analysis and performed a pairwise meta-analysis on all sperm parameter outcomes and meta-regression. No language or date restriction was imposed. A systematic article search was concluded on August 29, 2022.
RESULTS
Our network meta-analysis is the first to compare all dietary interventions in a single analysis, sub-grouped by intervention type and type of infertility. L-Carnitine with micronutrients, antioxidants, and several traditional herbal supplements showed statistically and clinically significant improvement in sperm quality. Meta-regression identified that improvement in the sperm count, motility and morphology translated into increased pregnancy rates (p < 0.001; p < 0.001; p < 0.002, respectively). In particular, L-carnitine with micronutrient therapy (risk ratio [RR]: 3.60, 95% CI 1.86, 6.98, p = 0.0002), followed by zinc (RR 5.39, 95% CI 1.26, 23.04, p = 0.02), significantly improved pregnancy rates. Men with oligozoospermia (RR 4.89), followed by oligoasthenozoospermia (RR 4.20) and asthenoteratozoospermia (RR 3.53), showed a significant increase in pregnancy rates.
CONCLUSION
We ranked nutritional therapies for their ability to improve sperm quality in men with infertility. Nutritional therapies, particularly L-carnitine alone or combined with micronutrients, significantly improved sperm parameters and pregnancy rates even under severe conditions. We believe these affordable solutions may be valuable for people without access to or who do not wish to undergo more invasive and costly fertility treatments.
Topics: Pregnancy; Adult; Female; Male; Humans; Network Meta-Analysis; Semen; Infertility, Male; Micronutrients; Carnitine
PubMed: 36943634
DOI: 10.1007/s40265-023-01853-0 -
American Journal of Obstetrics and... Apr 2016Gestational weight gain within the recommended range produces optimal pregnancy outcomes, yet many women exceed the guidelines. Official recommendations to increase... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Gestational weight gain within the recommended range produces optimal pregnancy outcomes, yet many women exceed the guidelines. Official recommendations to increase energy intake by ∼ 1000 kJ/day in pregnancy may be excessive.
OBJECTIVE
To determine by metaanalysis of relevant studies whether greater increments in energy intake from early to late pregnancy corresponded to greater or excessive gestational weight gain.
DATA SOURCES
We systematically searched electronic databases for observational and intervention studies published from 1990 to the present. The databases included Ovid Medline, Cochrane Library, Excerpta Medica DataBASE (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Science Direct. In addition we hand-searched reference lists of all identified articles.
STUDY ELIGIBILITY CRITERIA
Studies were included if they reported gestational weight gain and energy intake in early and late gestation in women of any age with a singleton pregnancy. Search also encompassed journals emerging from both developed and developing countries.
STUDY APPRAISAL AND SYNTHESIS METHODS
Studies were individually assessed for quality based on the Quality Criteria Checklist obtained from the Evidence Analysis Manual: Steps in the academy evidence analysis process. Publication bias was plotted by the use of a funnel plot with standard mean difference against standard error. Identified studies were meta-analyzed and stratified by body mass index, study design, dietary methodology, and country status (developed/developing) by the use of a random-effects model.
RESULTS
Of 2487 articles screened, 18 studies met inclusion criteria. On average, women gained 12.0 (2.8) kg (standardized mean difference = 1.306, P < .0005) yet reported only a small increment in energy intake that did not reach statistical significance (∼475 kJ/day, standard mean difference = 0.266, P = .016). Irrespective of baseline body mass index, study design, dietary methodology, or country status, changes in energy intake were not significantly correlated to the amount of gestational weight gain (r = 0.321, P = .11).
CONCLUSION
Despite rapid physiologic weight gain, women report little or no change in energy intake during pregnancy. Current recommendations to increase energy intake by ∼ 1000 kJ/day may, therefore, encourage excessive weight gain and adverse pregnancy outcomes.
Topics: Diet; Dietary Supplements; Energy Intake; Female; Humans; Micronutrients; Pregnancy; Prenatal Care; Weight Gain
PubMed: 26739796
DOI: 10.1016/j.ajog.2015.12.049 -
Nutrition Reviews Apr 2022Previous reviews have focused on evaluating the efficacy and effectiveness of rice fortification, despite the need to also understand the outcomes of micronutrient...
CONTEXT
Previous reviews have focused on evaluating the efficacy and effectiveness of rice fortification, despite the need to also understand the outcomes of micronutrient retention, organoleptic properties, and acceptability to inform nutrition programs.
OBJECTIVE
This systematic review aims to consolidate existing evidence on micronutrient retention, organoleptic properties, and acceptability of fortified rice.
DATA SOURCES
Eligible articles were identified from 22 electronic databases and personal referrals and reviews.
STUDY SELECTION
Studies on rice fortified via extrusion or coating technologies were included in the review if they reported outcomes in at least 1 of 3 domains: micronutrient retention, organoleptic or physicochemical properties, and acceptability (evaluated by sensory tests and consumer surveys). Any years of publication and study populations were considered for inclusion. A total of 15 391 articles were screened, yielding 49 for inclusion.
DATA EXTRACTION
Study results were summarized descriptively through discussions by intervention conditions, study population, measurement methods, and key findings. The included studies were independently reviewed by 2 of the 3 authors, and all 3 authors reached consensus on the quality and major findings from the included articles.
RESULTS
Extrusion and coating fortification technologies were found to be comparable across studies that assessed retention, organoleptic properties, and acceptability. Cooking fortified rice in excess water increased micronutrient loss for both technologies. Fortified kernels containing ferric pyrophosphate, zinc oxide, or zinc sulfate showed the most positive results for all outcomes reviewed, while retention rates of vitamin A in multiple-micronutrient-fortified rice were variable.
CONCLUSIONS
The current practice of fortifying rice with ferric pyrophosphate provides high micronutrient stability and results in rice with organoleptic properties and consumer acceptance levels comparable to those of unfortified milled rice, although it presents challenges regarding the effect of vitamin A-fortified rice on vitamin A status.
Topics: Food, Fortified; Humans; Micronutrients; Oryza; Sensation; Trace Elements; Vitamin A
PubMed: 35146517
DOI: 10.1093/nutrit/nuab107 -
Nutrients Feb 2024Over the past few decades, vitamin D has been found to play a crucial role in bone homeostasis, muscle function, oncogenesis, immune response and metabolism. In the... (Meta-Analysis)
Meta-Analysis Review
Over the past few decades, vitamin D has been found to play a crucial role in bone homeostasis, muscle function, oncogenesis, immune response and metabolism. In the context of the COVID-19 pandemic, numerous researchers have tried to determine the role vitamin D might play in the immune response to the virus. The aim of this systematic review and meta-analysis is to demonstrate that preventive vitamin D supplementation can play a protective role in the incidence of COVID-19, mortality and admission to intensive care units (ICUs). A comprehensive search on the PubMed/MEDLINE, Scopus, Cochrane and Google Scholar databases was performed on 15 May 2023, and two of the authors independently screened the literature. As effect measures, we calculated the Odds Ratios with their corresponding 95% confidence intervals (ICs). The assessment of potential bias and the evaluation of study quality will be conducted independently by two researchers. Sixteen publications were selected for inclusion in the meta-analysis. Our findings indicate that vitamin D supplementation has a protective effect against the incidence of COVID-19 in RCT studies (OR 0.403, 95% IC 0.218, 0.747), in the incidence of COVID-19 in analytical studies (OR = 0.592, 95% IC 0.476-0.736) and in ICU admission (OR 0.317, 95% IC 0.147-0.680). Subsequent analyses were conducted by type of subject treated (patient/healthcare workers) and type of supplementation (vitamin D vs. placebo/no treatment or high dose vs. low dose). Our meta-analysis suggests a definitive and significant association between the protective role of vitamin D and COVID-19 incidence and ICU admission.
Topics: Humans; Vitamin D; Pandemics; COVID-19; Vitamins; Dietary Supplements
PubMed: 38474807
DOI: 10.3390/nu16050679 -
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 -
Nutrients Apr 2024A healthy, well-balanced diet plays an essential role in respiratory diseases. Since micronutrient deficiency is relatively common in patients with chronic obstructive... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
A healthy, well-balanced diet plays an essential role in respiratory diseases. Since micronutrient deficiency is relatively common in patients with chronic obstructive pulmonary disease (COPD), micronutrient supplementation might have the beneficial health effects in those patients. This systematic review and meta-analysis aimed to demonstrate the impact of micronutrient supplementation on the lung function of patients with COPD.
METHODS
The PubMed, Cochrane Library, and Web of Science databases were searched from their corresponding creation until February 2024. Search terms included 'chronic obstructive pulmonary disease', 'COPD', 'micronutrients', 'dietary supplements', 'vitamins', 'minerals', and 'randomized controlled trials'. Meta-analysis was performed to evaluate the effects of micronutrient supplementation alone or complex on lung function in patients with COPD.
RESULTS
A total of 43 RCTs fulfilled the inclusion criteria of this study. Meta-analysis revealed that vitamin D supplementation could significantly improve FEV1% (WMD: 6.39, 95% CI: 4.59, 8.18, < 0.01; WMD: 7.55, 95% CI: 5.86, 9.24, < 0.01) and FEV1/FVC% (WMD: 6.88, 95%CI: 2.11, 11.65, WMD: 7.64, 95% CI: 3.18, 12.10, < 0.001), decrease the odds of acute exacerbations, and improve the level of T-cell subsets, including CD3%, CD4%, CD8%, and CD4/CD8% (all < 0.01). The effects of compound nutrients intervention were effective in improving FEV1% (WMD: 8.38, 95%CI: 1.89, 14.87, WMD: 7.07, 95%CI: -0.34, 14.48) and FEV1/FVC% (WMD: 7.58, 95% CI: 4.86, 10.29, WMD: 6.00, 95% CI: 3.19, 8.81). However, vitamin C and vitamin E supplementation alone had no significant effects on lung function ( > 0.05).
CONCLUSIONS
Micronutrient supplementation, such as vitamin D alone and compound nutrients, has improved effect on the lung function of patients with COPD. Therefore, proper supplementation with micronutrients would be beneficial to stabilize the condition and restore ventilation function for COPD patients.
Topics: Humans; Pulmonary Disease, Chronic Obstructive; Vitamins; Respiration; Micronutrients; Vitamin D; Dietary Supplements; Lung
PubMed: 38613061
DOI: 10.3390/nu16071028 -
Acta Clinica Croatica Apr 2023Vitamin D is involved in many different functions in the human body. Despite the well-known benefits of vitamin D and increasing trends of testing and supplementation,... (Review)
Review
Vitamin D is involved in many different functions in the human body. Despite the well-known benefits of vitamin D and increasing trends of testing and supplementation, there is still a high prevalence of vitamin D deficiency worldwide, present in the general but also in the highly-active population such as athletes and dancers. Dancers are at a higher risk of vitamin D deficiency due to their long working hours spent indoors, without exposure to sunlight. The high level of workload and physical demands also put dancers at a high risk of injuries. The aim of this review was to systematically analyze the existing evidence on the association of vitamin D (serum level and supplementation) and injuries in dancers. Medline, Scopus, SportDiscus and Web of Science were searched to identify the available peer-reviewed articles. Five articles met the inclusion criteria (two interventional and three observational studies), three of which additionally investigated the relationship between vitamin D and muscle function. The reported results on positive influence of vitamin D serum level or vitamin D supplementation effect on reduced injury occurrence and enhanced muscular function in adolescent and elite professional ballet dancers are promising but the evidence is limited due to a low number of studies, small samples, and methodological limitations.
Topics: Adolescent; Humans; Vitamin D; Vitamins; Vitamin D Deficiency
PubMed: 38304359
DOI: 10.20471/acc.2023.62.01.25 -
Nutrition Reviews Jan 2022Approximately 7.3 million births occur annually among adolescents in low- and middle-income countries. Pregnant adolescents constitute a nutritionally vulnerable group... (Meta-Analysis)
Meta-Analysis
Multiple-micronutrient supplementation in pregnant adolescents in low- and middle-income countries: a systematic review and a meta-analysis of individual participant data.
CONTEXT
Approximately 7.3 million births occur annually among adolescents in low- and middle-income countries. Pregnant adolescents constitute a nutritionally vulnerable group that could benefit from intervention to mitigate the mortality and adverse birth outcomes associated with adolescent pregnancy.
OBJECTIVE
The aim of this systematic review and meta-analysis was to assess the following: (1) the effect of multiple-micronutrient (MMN) supplementation vs iron and folic acid (IFA) supplementation among adolescents on maternal morbidity, birth outcomes, and mortality outcomes, (2) the effects of MMN supplementation in adolescents compared with the effects in adult women, and (3) the effect modification, if any, of MMN supplementation by baseline and geographic characteristics of adolescents.
DATA SOURCES
MEDLINE and Cochrane databases were searched, along with the reference lists of relevant reviews.
STUDY SELECTION
Multiple-micronutrient supplementation trials in pregnancy that were conducted in a low- or middle-income country and had included at least 100 adolescents (10-19 years of age) were eligible for inclusion. Two independent reviewers assessed study eligibility.
DATA EXTRACTION
Thirteen randomized controlled trials conducted in Africa and Asia were identified from 1792 reviews and 1578 original trials. Individual-level data was shared by study collaborators and was checked for completeness and extreme values. One- and two-stage individual participant data meta-analyses were conducted using data from randomized controlled trials of MMN supplementation.
RESULTS
A total of 15 283 adolescents and 44 499 adult women with singleton births were included in the individual participant data meta-analyses of MMN supplementation vs IFA supplementation. In adolescents, MMN supplementation reduced low birth weight (1-stage OR = 0.87, 95%CI 0.77-0.97; 2-stage OR = 0.81; 95%CI 0.74-0.88), preterm birth (1-stage OR = 0.88, 95%CI 0.80-0.98; 2-stage OR = 0.86, 95%CI 0.79-0.95), and small-for-gestational-age births (1-stage OR = 0.90, 95%CI 0.81-1.00; 2-stage OR = 0.86, 95%CI 0.79-0.95) when compared with IFA supplementation. The effects of MMN supplementation did not differ between adolescents and older women, although a potentially greater reduction in small-for-gestational-age births was observed among adolescents. Effect modification by baseline characteristics and geographic region was inconclusive.
CONCLUSIONS
Multiple-micronutrient supplementation can improve birth outcomes among pregnant adolescents in low- and middle-income countries. Policy related to antenatal care in these settings should prioritize MMN supplementation over the currently recommended IFA supplementation for all pregnant women, especially adolescents.
Topics: Adolescent; Aged; Developing Countries; Dietary Supplements; Female; Humans; Infant, Newborn; Micronutrients; Pregnancy; Pregnant Women; Premature Birth
PubMed: 33846729
DOI: 10.1093/nutrit/nuab004 -
The Journal of Laryngology and Otology Sep 2023Smell impairment affects 60-80 per cent of individuals aged over 80 years. This review aimed to identify any association between vitamin D deficiency and smell... (Review)
Review
OBJECTIVE
Smell impairment affects 60-80 per cent of individuals aged over 80 years. This review aimed to identify any association between vitamin D deficiency and smell impairment, and determine the efficacy of vitamin D to treat smell impairment.
METHODS
A literature search was conducted across four databases between the years 2000 and 2022. The literature screen was performed by two independent reviewers.
RESULTS
Seven articles were included in this review. Four studies examined the association between vitamin D deficiency and smell impairment, with three studies identifying a significant relationship. Three studies investigated the use of vitamin D as treatment for smell impairment, which found complete resolution or significant symptom improvement after vitamin D deficiency was treated.
CONCLUSION
This review identified limited studies on this topic. As vitamin D supplementation is relatively cost-efficient, further large-scale studies should be carried out to investigate the efficacy of vitamin D for treating anosmia.
Topics: Humans; Aged, 80 and over; Vitamin D; Smell; Vitamins; Vitamin D Deficiency; Olfaction Disorders
PubMed: 36341550
DOI: 10.1017/S0022215122002389 -
Public Health Nutrition Nov 2014The present study aimed to review the literature on micronutrient deficiency and other factors influencing a deficiency status among children living in China. (Review)
Review
OBJECTIVE
The present study aimed to review the literature on micronutrient deficiency and other factors influencing a deficiency status among children living in China.
DESIGN
A systematic review was performed to analyse the literature.
SETTING
Studies were identified through a search of PubMed and secondary references.
SUBJECTS
Children living in China aged less than 18 years.
RESULTS
Sixty-one articles were included. The prevalence of vitamin A deficiency decreased to approximately 10 % in 1995-2009. It increased with age but no significant difference was found between genders. The prevalence of thiamin and vitamin B12 deficiency was 10·5 % in Yunnan and 4·5 % in Chongqing provinces, respectively. Higher vitamin D deficiency rates were seen in spring and winter. The incidence of bleeding due to vitamin K deficiency was 3·3 % in 1998-2001 and more prevalent in rural areas. Both iodine deficiency and excess iodine intake were observed. Goitre rates were reported in Tibet, Jiangxi, Gansu and Hong Kong (3·5-46 %). Anaemia rates ranged from 20 % to 40 % in 2007-2011. High Se deficiency rates were found in Tibet, Shaanxi and Jiangsu. High Zn deficiency rates were also found (50-70 %) in 1995-2006. Few studies reported Ca deficiency rates (19·6-34·3 %). The degrees of deficiency for vitamin A, vitamin B12, Fe and Zn were more substantial in rural areas compared with urban areas.
CONCLUSIONS
The prevalence of micronutrient deficiency rates varied. Socio-economic status, environmental factors and the Chinese diet may influence micronutrient deficiency. Public health policies should consider implementing programmes of supplementation, food fortification and nutrition education to address these deficiencies among Chinese children.
Topics: Adolescent; Anemia, Iron-Deficiency; Child; Child, Preschool; China; Diet; Humans; Infant; Infant, Newborn; Iodine; Malnutrition; Micronutrients; Nutritional Status; Prevalence; Public Health; Rural Population; Seasons; Socioeconomic Factors; Vitamin A Deficiency; Vitamin B 12 Deficiency; Vitamin D Deficiency; Zinc
PubMed: 25248458
DOI: 10.1017/S1368980013002978