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Nutrients Mar 2024Nonalcoholic fatty liver disease (NAFLD), the most common chronic liver disorder, is closely associated with insulin resistance, obesity, and metabolic syndromes. A body... (Meta-Analysis)
Meta-Analysis
The Effects of Olive Oil Consumption on Biochemical Parameters and Body Mass Index of People with Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Nonalcoholic fatty liver disease (NAFLD), the most common chronic liver disorder, is closely associated with insulin resistance, obesity, and metabolic syndromes. A body of research has proposed that olive oil, a basic component of the Mediterranean diet with antioxidant and anti-inflammatory properties, may alleviate metabolic disturbances and retard the progression of NAFLD. We conducted a systematic review and meta-analysis to assess the effectiveness of olive oil intake in people with NAFLD. We systematically searched the major electronic databases (PubMed/MEDLINE, Scopus, Cochrane Central Register of Controlled Trials), as well as grey literature sources, to identify randomized controlled trials (RCTs) investigating the effects of olive oil consumption on biochemical and anthropometric parameters of individuals with NAFLD. The quality of the studies was evaluated using the risk-of-bias tool 2.0 (RoB 2). The mean difference (MD) and the 95% confidence interval (CI) were calculated using fixed-effects and random-effects models. Seven RCTs involving 515 subjects were included in the analysis. In the random-effects model, no statistically significant differences were identified with respect to alanine transaminase (MD = -1.83 IU/L, 95% CI: -5.85, 2.19 IU/L, = 0.37, = 69%) and aspartate transaminase (MD = -1.65 IU/L, 95% CI: -4.48, 1.17 IU/L, = 0.25, = 72%) levels or waist circumference values (MD = -0.23 cm, 95% CI: -1.23, 0.76 cm, = 0.65, = 0%). However, a significant effect on body mass index was observed (MD = -0.57 kg/m, 95% CI: -1.08, -0.06 kg/m, = 0.03, = 51%) for subjects who received olive oil compared to those who received an alternative diet or placebo. The findings of the present meta-analysis suggest a modestly positive impact of olive oil intake on body weight in people with NAFLD.
Topics: Humans; Body Mass Index; Body Weight; Non-alcoholic Fatty Liver Disease; Olive Oil; Randomized Controlled Trials as Topic
PubMed: 38542768
DOI: 10.3390/nu16060857 -
Obesity Reviews : An Official Journal... Jun 2024Effect sizes from previously reported trials are often used to determine the meaningful change in weight in childhood obesity prevention interventions because... (Meta-Analysis)
Meta-Analysis Review
Effect sizes from previously reported trials are often used to determine the meaningful change in weight in childhood obesity prevention interventions because information on clinically meaningful differences is lacking. Estimates from previous trials may be influenced by statistical significance; therefore, it is important that they have a low risk of type 1 error. A systematic review and meta-analysis were conducted to report on the design of child obesity prevention randomized controlled trials and effectiveness according to risk of type 1 error. Eighty-four randomized controlled trials were identified. A large range of assumptions were applied in the sample size calculations. The most common primary outcome was BMI, with detectable effect size differences used in sample size calculations ranging from 0.25 kg/m (followed up at 2 years) to 1.1 kg/m (at 9 months) and BMI z-score ranging from 0.1 (at 4 years) to 0.67 (at 3 years). There was no consistent relationship between low risk of type 1 error and reports of higher or lower effectiveness. Further clarity of the size of a meaningful difference in weight in childhood obesity prevention trials is required to support evaluation design and decision-making for intervention and policy. Type 1 error risk does not appear to impact effect sizes in a consistent direction.
Topics: Humans; Pediatric Obesity; Randomized Controlled Trials as Topic; Child; Research Design; Body Mass Index
PubMed: 38529530
DOI: 10.1111/obr.13736 -
European Journal of Orthodontics Apr 2024Craniofacial skeletal discrepancies have been associated with upper airway dimensions. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Craniofacial skeletal discrepancies have been associated with upper airway dimensions.
OBJECTIVE
To identify differences in upper airway volume across different sagittal and vertical skeletal patterns.
SEARCH METHODS
Unrestricted literature searches in eight databases/registers for human studies until May 2023.
SELECTION CRITERIA
Cross-sectional studies measuring upper airway volumes using three-dimensional imaging in healthy patients of different sagittal (Class I, Class II, and Class III) or vertical (normodivergent, hypodivergent, and hyperdivergent) craniofacial morphology.
DATA COLLECTION AND ANALYSIS
Duplicate independent study selection, data extraction, and risk of bias assessment. Random-effects frequentist network meta-analysis was performed followed by subgroup-analyses and assessment of the quality of clinical recommendations (confidence in effect estimates) with the CINeMA (Confidence in Network Meta-Analysis) approach.
RESULTS
Seventy publications pertaining to 66 unique studies were included with 56 studies (5734 patients) contributing to meta-analyses. Statistically significant differences were found for total pharyngeal airway volume, with Class II having decreased airway volume (-2256.06 mm3; 95% Confidence Interval [CI] -3201.61 to -1310.51 mm3) and Class III increased airway volume (1098.93 mm3; 95% CI 25.41 to 2172.45 mm3) compared to Class I. Significant airway volume reductions for Class II were localized mostly at the oropharynx, followed by the palatopharynx, and the glossopharynx. Significant airway volume increases for Class III were localized mostly at the oropharynx, followed by the intraoral cavity, and hypopharynx. Statistically significant differences according to vertical skeletal configuration were seen only for the oropharynx, where hyperdivergent patients had reduced volumes compared to normodivergent patients (-1716.77 mm3; 95% CI -3296.42 to -137.12 mm3). Airway differences for Class II and Class III configurations (compared to Class I) were more pronounced in adults than in children and the confidence for all estimates was very low according to CINeMA.
CONCLUSIONS
Considerable differences in upper airway volume were found between sagittal and vertical skeletal configurations. However, results should be interpreted with caution due to the high risk of bias, owing to the retrospective study design, inconsistencies in anatomic compartment boundaries used, samples of mixed children-adult patients, and incomplete reporting.
CLINICAL TRIAL REGISTRATION
PROSPERO (CRD42022366928).
Topics: Adult; Child; Humans; Cross-Sectional Studies; Network Meta-Analysis; Retrospective Studies; Cephalometry; Pharynx; Cone-Beam Computed Tomography
PubMed: 38526866
DOI: 10.1093/ejo/cjae010 -
Burns : Journal of the International... Aug 2024Major burn injury, despite advancements in care and prevention, can have a profound impact on long-term morbidity, affecting quality of life and socioeconomic standing....
BACKGROUND
Major burn injury, despite advancements in care and prevention, can have a profound impact on long-term morbidity, affecting quality of life and socioeconomic standing. We aim to explore factors predicting recovery of independence, the expected rate and time in majorly burned patients, and the measures of progress used.
METHOD
A systematic search of four databases (MEDLINE, EMBASE, COCHRANE, CINAHL) was conducted for studies reporting outcomes pertaining to physical ability indicative of independent function in adult (>15 y) cohorts who had suffered a major burn (>20% TBSA) up to 30 years after treatment in a developed specialised burn service. Data extracted included factors affecting rate of and time to achievement of function in five independence domains, as well as the outcome measures used.
RESULTS
21 eligible studies were included comprising 1298 major burns survivors with a combined mean age of 39.6 y and a mean TBSA of 25.8%. The most significant recurring factors impacting recovery of independent function were older age, female gender, burn severity, prolonged ICU and hospital admission, preceding mental health conditions, and post-acute psychological issues. Exercise-based rehabilitation conferred benefits on major burn patients even over 2 years following injury. Discharge to independent living from hospital occurred in 27% to 97% of patients, while reported return to work rates varied from 52% to 80%. Burns Specific Health Scale-Brief, Functional Independence Measure, and Physical Composite Score (SF-36) were the most widely used outcome scoring systems.
CONCLUSION
Major burn survivors have protracted recovery with potential for persistent chronic impairments, remaining consistently below baseline levels of function. Non-modifiable factors such as age and gender, and disease characteristics such as burn size with associated physical, physiological and psychosocial sequelae are contributory. Further research is required to explore achievement of specific milestones of major burn and polytrauma critical care patients, while early targeted rehabilitation addressing physical, psychological, and vocational needs has promising potential benefit.
Topics: Humans; Activities of Daily Living; Age Factors; Body Surface Area; Burns; Exercise Therapy; Independent Living; Length of Stay; Mental Disorders; Quality of Life; Recovery of Function; Return to Work; Sex Factors
PubMed: 38492981
DOI: 10.1016/j.burns.2024.02.017 -
BMC Public Health Mar 2024Regular participation in physical activity (PA) benefits children's health and well-being and protects against the development of unhealthy body weight. A key factor in... (Meta-Analysis)
Meta-Analysis
Systematic review and meta-analysis of physical activity interventions to increase elementary children's motor competence: a comprehensive school physical activity program perspective.
BACKGROUND
Regular participation in physical activity (PA) benefits children's health and well-being and protects against the development of unhealthy body weight. A key factor in children's PA participation is their motor competence (MC). The comprehensive school physical activity program (CSPAP) framework offers a way to classify existing PA interventions that have included children's MC development and understand the potential avenues for supporting children's MC. However, there have been no systematic reviews or meta-analyses of PA interventions and their effects on the MC of elementary school children (aged 5-12 years) from a CSPAP perspective.
METHODS
This study was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. We searched seven electronic databases (PubMed/Medline, Embase, ERIC, SPORTDiscus, CINAHL, Web of Science, and PsycINFO) for articles on 29 November 2021. The CSPAP framework was used to categorize the different intervention approaches. This review was registered with PROSPERO (CRD42020179866).
RESULTS
Twenty-seven studies were included in the review, and twenty-six studies were included in the meta-analysis. A wide range of PA intervention approaches (e.g., single component or multicomponent) within the context of the CSPAP framework appear to be promising pathways in enhancing children's MC. The results of the aggregate meta-analysis presented that effect sizes for the development of MC from pre-and post- intervention ranged from moderate to large (Hedges' g = 0.41-0.79). The analysis revealed that the predicted moderators, including study length, delivery agent, and study design, did not result in statistically significant moderate variations in MC outcomes. There was, however, considerable heterogeneity in study design, instruments, and study context, and studies were implemented in over 11 countries across diverse settings.
CONCLUSIONS
This study uniquely contributes to the literature through its primary focus on the effectiveness of PA interventions on elementary children's MC. This review emphasizes the importance of customizing CSPAP to fit the specific characteristics of each school setting, including its environmental, demographic, and resource attributes. The effectiveness of CSPAP, particularly its physical education (PE) component, is significantly enhanced when these programs are adapted to address the unique needs of each school. This adaptation can be effectively achieved through targeted professional teacher training, ensuring that PE programs are not only contextually relevant but also optimized for maximum impact in diverse educational environments. Researchers and practitioners should pursue how to effectively translate the evidence into practice to better conceptualize CSPAPs designed for children's MC development.
Topics: Child; Humans; Exercise; Body Weight; Schools
PubMed: 38491432
DOI: 10.1186/s12889-024-18145-1 -
Primary Care Diabetes Jun 2024To explore the effectiveness of the Taiwanese Diabetes Shared Care Program (DSCP) on improving the metabolic indicators of people with type 2 diabetes. (Meta-Analysis)
Meta-Analysis Review
AIMS
To explore the effectiveness of the Taiwanese Diabetes Shared Care Program (DSCP) on improving the metabolic indicators of people with type 2 diabetes.
METHODS
Relevant studies published between January 2002 and August 2021 were retrieved from Chinese- and English-language electronic databases, including PubMed, MEDLINE, CINAHL, ProQuest, Cochrane Library, Airiti Library, and Taiwan Periodical Literature System. After screening, studies that met inclusion criteria were included in the literature review. RevMan 5.4 was employed for a meta-analysis.
RESULTS
Ten studies published between 2007 and 2021 were included in the systematic review, with nine of them contributing to the meta-analysis. In total, 1506 and 1388 participants were classified into DSCP and non-DSCP groups, respectively, for the meta-analysis. The results revealed that the DSCP significantly improved glycated hemoglobin levels (mean difference [MD]: -0.50, 95% Confidence Interval [CI]: -0.83 to -0.17) and body weights (MD: -0.83, 95% CI: -1.29 to -0.38) within 1-year follow-up. However, it did not show significant improvement in other metabolic indicators.
CONCLUSIONS
Taiwanese DSCP led to improvements in glycated hemoglobin levels and body weights among people with type 2 diabetes. This study suggests that people with diabetes and health-care institutions should consider participating in the DSCP.
Topics: Diabetes Mellitus, Type 2; Humans; Glycated Hemoglobin; Biomarkers; Middle Aged; Female; Male; Treatment Outcome; Delivery of Health Care, Integrated; Glycemic Control; Blood Glucose; Aged; Taiwan; Program Evaluation; Adult; Time Factors; Hypoglycemic Agents; Body Weight
PubMed: 38490914
DOI: 10.1016/j.pcd.2024.03.003 -
International Journal of Obesity (2005) Jun 2024Legislation aimed at reducing sugar intake assumes that sweet-liking drives overconsumption. However, evidence that a greater liking for sweet taste is associated with... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Legislation aimed at reducing sugar intake assumes that sweet-liking drives overconsumption. However, evidence that a greater liking for sweet taste is associated with unhealthier body size is mixed and complicated by relatively small samples, an overreliance on body mass index (BMI) and lack of classification using sweet-liking phenotypes.
METHODS
We first examined body size data in two larger samples with sweet-liking phenotyping: extreme sweet-likers, moderate sweet-likers and sweet-dislikers. Adults (18-34yrs), attended a two-session lab-based experiment involving phenotyping for sweet-liking status and a bioelectrical impedance body composition measurement (Experiment One: N = 200; Experiment Two: N = 314). Secondly, we conducted an individual participant data (IPD) meta-analysis: systematic searches across four databases identified 5736 potential articles. Of these, 53 papers met our search criteria: a taste assessment that measured liking using sucrose (>13.7% w/v), which allowed sweet-liking phenotyping and included either BMI, body fat percentage (BF%), fat-free mass (FFM) or waist-circumference.
RESULTS
A significant effect of sweet-liking phenotype on FFM was found in both Experiment One and Two, with extreme sweet-likers having significantly higher FFM than sweet-dislikers. In Experiment One, sweet-dislikers had a significantly higher BF% than extreme sweet-likers and moderate sweet-likers. However, as these data are from one research group in a young, predominantly westernised population, and the results did not perfectly replicate, we conducted the IPD meta-analyses to further clarify the findings. Robust one-stage IPD meta-analyses of 15 studies controlling for sex revealed no significant differences in BF% (n = 1836) or waist-circumference (n = 706). For BMI (n = 2368), moderate sweet-likers had slightly lower BMI than extreme sweet-likers, who had the highest overall BMI. Most interestingly, for FFM (n = 768), moderate sweet-likers and sweet-dislikers showed significantly lower FFM than extreme sweet-likers.
CONCLUSION
The higher BMI often seen in sweet-likers may be due to a larger FFM and questions the simple model where sweet liking alone is a risk factor for obesity.
Topics: Humans; Body Composition; Phenotype; Adult; Male; Female; Food Preferences; Taste; Body Mass Index; Young Adult; Adolescent
PubMed: 38467727
DOI: 10.1038/s41366-024-01494-7 -
Comprehensive Psychiatry May 2024Eating Disorders (ED) are characterized by low remission rates, treatment drop-out, and residual symptoms. To improve assessment and treatment of ED, the staging... (Review)
Review
Eating Disorders (ED) are characterized by low remission rates, treatment drop-out, and residual symptoms. To improve assessment and treatment of ED, the staging approach has been proposed. This systematic scoping review is aimed at mapping the existing staging models that explicitly propose stages of the progression of ED. A systematic search of PubMed, PsycINFO, Scopus was conducted with the terms staging, anorexia nervosa, bulimia nervosa, binge-eating disorders, eating disorders. Eleven studies met inclusion criteria presenting nine ED staging models, mostly for anorexia nervosa. Three were empirically tested, one of which was through an objective measure specifically developed to differentiate between stages. Most staging models featured early stages in which the exacerbation of EDs unfolds and acute phases are followed by chronic stages. Intermediate stages were not limited to acute stages, but also residual phases, remission, relapse, and recovery. The criteria for stage differentiation encompassed behavioral, psychological, cognitive, and physical features including body mass index and illness duration. One study recommended stage-oriented interventions. The current review underscores the need to empirically test the available staging models and to develop and test new proposals of staging models for other ED populations. The inclusion of criteria based on medical features and biomarkers is recommended. Staging models can potentially guide assessment and interventions in daily clinical settings.
Topics: Humans; Feeding and Eating Disorders; Bulimia Nervosa; Anorexia Nervosa; Binge-Eating Disorder; Body Mass Index
PubMed: 38460478
DOI: 10.1016/j.comppsych.2024.152468 -
Pediatric Obesity May 2024The effectiveness of anti-obesity medications for children and adolescents is unclear. (Meta-Analysis)
Meta-Analysis Review
IMPORTANCE
The effectiveness of anti-obesity medications for children and adolescents is unclear.
OBJECTIVE
To update the evidence on the benefits and harms of anti-obesity medication.
DATA SOURCES
Cochrane CENTRAL, MEDLINE, ClinicalTrials.gov and WHO ICTRP (1/1/16-17/3/23).
STUDY SELECTION
Randomized controlled trials ≥6 months in people <19 years living with obesity.
DATA EXTRACTION AND SYNTHESIS
Screening, data extraction and quality assessment conducted in duplicate, independently.
MAIN OUTCOMES AND MEASURES
Body mass index (BMI): 95th percentile BMI, adverse events and quality of life.
RESULTS
Thirty-five trials (N = 4331), follow-up: 6-24 months; age: 8.8-16.3 years; BMI: 26.2-41.7 kg/m. Moderate certainty evidence demonstrated a -1.71 (95% confidence interval [CI]: -2.27 to -1.14)-unit BMI reduction, ranging from -0.8 to -5.9 units between individual drugs with semaglutide producing the largest reduction of -5.88 kg/m (95% CI: -6.99 to -4.77, N = 201). Drug type explained ~44% of heterogeneity. Low certainty evidence demonstrated reduction in 95th percentile BMI: -11.88 percentage points (95% CI: -18.43 to -5.30, N = 668). Serious adverse events and study discontinuation due to adverse events did not differ between medications and comparators, but medication dose adjustments were higher compared to comparator (10.6% vs 1.7%; RR = 3.74 [95% CI: 1.51 to 9.26], I = 15%), regardless of approval status. There was a trend towards improved quality of life. Evidence gaps exist for children, psychosocial outcomes, comorbidities and weight loss maintenance.
CONCLUSIONS AND RELEVANCE
Anti-obesity medications in addition to behaviour change improve BMI but may require dose adjustment, with 1 in 100 adolescents experiencing a serious adverse event.
Topics: Child; Adolescent; Humans; Quality of Life; Obesity; Body Mass Index; Anti-Obesity Agents; Weight Loss
PubMed: 38454737
DOI: 10.1111/ijpo.13113 -
Primary Care Diabetes Jun 2024This systematic review and meta-analysis aimed to investigate the impact of COVID19 lockdown on the anthropometric and glycaemic outcomes of adults with type 2 diabetes... (Meta-Analysis)
Meta-Analysis Review
AIM
This systematic review and meta-analysis aimed to investigate the impact of COVID19 lockdown on the anthropometric and glycaemic outcomes of adults with type 2 diabetes mellitus (T2DM) and assess whether socioeconomic status (SES) was relevant to these changes.
METHODS
A search of three databases was conducted. Meta-analyses using random effects models were undertaken to combine anthropometric and glycaemic measures pre- and post-confinement. Subgroup analyses according to SES were also conducted.
RESULTS
This systematic review of 19 articles demonstrated that prolonged pandemic-related confinement is associated with a deterioration in both anthropometric and glycaemic outcomes among adults with T2DM. Furthermore, SES was found to be relevant to these changes. Specifically, BMI (kg/m) showed an increase in mean difference of 0.72 (95% CI; 0.13, 1.31; p<0.05) between pre and post lockdown cohorts. High income countries displayed a greater increase in BMI compared to their lower middle-income counterparts. Regarding, fasting blood glucose (FBG), a statistically significant difference was observed in the upper middle-income group (mean difference: 5.10; 95% CI: 2.92, 7.27), and high-income group (mean difference: 6.03; 95% CI: 0.04, 12.02). There were no significant changes to weight, waist circumference, or HbA1C over the lockdown period.
CONCLUSION
Our findings suggest adults with T2DM may have received less effective care over the lockdown period, particularly in high income countries. Clinics and care providers may need to adopt more intensive contact and treatment plans in the post lockdown period to prevent lasting impacts on disease progression and metabolic sequelae.
Topics: Humans; Diabetes Mellitus, Type 2; COVID-19; Blood Glucose; Social Class; Male; Female; Middle Aged; SARS-CoV-2; Quarantine; Glycated Hemoglobin; Time Factors; Body Mass Index; Aged; Adult; Biomarkers; Risk Factors
PubMed: 38448261
DOI: 10.1016/j.pcd.2024.02.002