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Maturitas Apr 2024The Nordic or Baltic Sea diet is a healthy plant-based dietary pattern composed of foods originating from Nordic countries, closely related to the Mediterranean diet.... (Review)
Review
BACKGROUND
The Nordic or Baltic Sea diet is a healthy plant-based dietary pattern composed of foods originating from Nordic countries, closely related to the Mediterranean diet. Adherence to the Mediterranean diet has been found to be associated with a reduced risk of frailty. Although adherence to the Nordic diet has been associated with health benefits, little is known about its association with frailty.
OBJECTIVES
To investigate the evidence from observational studies regarding the association between the Nordic/Baltic Sea diet and frailty among older adults.
DESIGN
Systematic review.
METHODS
Three databases (Medline/Ovid, Embase/Ovid, and Scopus) were systematically searched in February 2023 for observational studies examining the association between adherence to the Nordic diet and frailty among adults ≥60 years. The two authors independently assessed the full text of the papers for eligibility of studies and risk of bias.
RESULTS
Three studies (the results of which were reported across 6 papers) met the inclusion criteria, among which one study (2 papers) included only women. Greater adherence to the Nordic diet was associated with a reduced risk of frailty measured by modified Fried criteria in women (one study). Moreover, greater adherence to the Nordic diet was associated with improved muscle (handgrip/leg) strength (one study) and physical performance (two studies), but these differences were seen only in women, with no significant results in men in two studies. Greater adherence to the Nordic diet was also associated with a lower risk of mobility limitations and improved ability to carry out self-care tasks (one study) and a borderline non-significant difference in Activities of Daily Living (one study). A meta-analysis was not performed due to heterogenous outcomes. Although all studies were of good quality, the results should be carefully interpreted due to methodological limitations.
CONCLUSIONS
Adherence to the Nordic diet could be promising in reducing frailty risk, but more robust studies with equal gender representation and frailty-specific outcomes are needed.
Topics: Male; Humans; Female; Aged; Frailty; Activities of Daily Living; Hand Strength; Diet, Mediterranean; Dietary Patterns
PubMed: 38325135
DOI: 10.1016/j.maturitas.2024.107923 -
Advances in Nutrition (Bethesda, Md.) Mar 2024The Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) diet seems a promising approach to preserve brain function... (Review)
Review
The Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) diet seems a promising approach to preserve brain function during aging. Previous systematic reviews have demonstrated benefits of the MIND diet for cognition and dementia, though an update is needed. Additionally, other outcomes relevant to brain aging have not been summarized. Therefore, this systematic review aims to give an up-to-date and complete overview on human studies that examined the MIND diet in relation to brain aging outcomes in adults aged ≥40 y. Ovid Medline, Web of Science core collection, and Scopus were searched up to July 25, 2023. Study quality was assessed using the Newcastle-Ottawa Scale and the Cochrane Risk-of-Bias tool. We included 40 articles, of which 32 were unique cohorts. Higher MIND diet adherence was protective of dementia in 7 of 10 cohorts. Additionally, positive associations were demonstrated in 3 of 4 cohorts for global cognition and 4 of 6 cohorts for episodic memory. The protective effects of the MIND diet on cognitive decline are less apparent, with only 2 of 7 longitudinal cohorts demonstrating positive associations for global decline and 1 of 6 for episodic memory decline. For other brain outcomes (domain-specific cognition, cognitive impairments, Parkinson's disease, brain volume, and pathology), results were mixed or only few studies had been performed. Many of the cohorts demonstrating protective associations were of North American origin, raising the question if the most favorable diet for healthy brain aging is population-dependent. In conclusion, this systematic review provides observational evidence for protective associations between the MIND diet and global cognition and dementia risk, but evidence for other brain outcomes remains mixed and/or limited. The MIND diet may be the preferred diet for healthy brain aging in North American populations, though evidence for other populations seems less conclusive. This review was registered at PROSPERO as CRD42022254625.
Topics: Adult; Humans; Dietary Approaches To Stop Hypertension; Diet, Mediterranean; Aging; Cognition; Brain; Dementia
PubMed: 38311314
DOI: 10.1016/j.advnut.2024.100184 -
Archives of Iranian Medicine Sep 2023Obesity is a serious chronic disease that adversely affects health and quality of life. However, a significant percentage of people do not participate in or adhere to... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Obesity is a serious chronic disease that adversely affects health and quality of life. However, a significant percentage of people do not participate in or adhere to weight loss programs. Therefore, a multidisciplinary approach is needed to identify critical barriers to effective obesity management and to examine health practitioners' attitudes and behaviors towards effective obesity treatment.
METHODS
This systematic review was conducted in accordance with PRISMA 2020. Eligible studies were identified through a systematic review of the literature using Medline, Scopus, Cochrane, Google Scholar, Web of Science, and Embase databases from January 1, 2011 to March 2, 2021.
RESULTS
A total of 57 articles were included. Data on 12663 physicians were extracted from a total of 35 quantitative articles. Some of the most commonly perceived attitude issues included "obesity has a huge impact on overall health", "obesity is a disease" and "HCPs are to blame". Health professionals were more inclined to believe in "using BMI to assess obesity," "advice to increase physical activity," and "diet/calorie reduction advice." The major obstacles to optimal treatment of obesity were "lack of motivation", "lack of time" and "lack of success".
CONCLUSION
Although the majority of health care professionals consider obesity as a serious disease which has a large impact on overall health, counseling for lifestyle modification, pharmacologic or surgical intervention occur in almost half of the visits. Increasing the length of physician visits as well as tailoring appropriate training programs could improve health care for obesity.
Topics: Humans; Quality of Life; Obesity; Health Personnel; Delivery of Health Care; Perception
PubMed: 38310408
DOI: 10.34172/aim.2023.78 -
European Review For Medical and... Jan 2024The purpose of this meta-analysis is to evaluate the efficacy of a keto-supplemented low-protein diet (sLPD) in enhancing nutritional status among individuals undergoing... (Meta-Analysis)
Meta-Analysis
Efficacy and safety of keto-supplemented low-protein diet on nutritional status of peritoneal-dialysis patients: a systematic review and meta-analysis of randomized controlled trials.
OBJECTIVE
The purpose of this meta-analysis is to evaluate the efficacy of a keto-supplemented low-protein diet (sLPD) in enhancing nutritional status among individuals undergoing peritoneal dialysis (PD) compared to a low-protein diet (LPD).
MATERIALS AND METHODS
Studies from PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang Data were searched and reviewed up to January 2023. Randomized controlled trials (RCTs) were enrolled and analyzed using STATA MP 17. In this review, serum albumin (Alb), body mass index (BMI), and serum prealbumin (PA) were included for efficacy evaluation and serum calcium (CA) for safety evaluation. Potential heterogeneity was detected using subgroup analyses.
RESULTS
7 RCTs were included. Compared with LPD, sLPD can improve the Alb [Weighted Mean Difference (WMD)=4.16; 95% CI: 2.50, 5.83; p<0.0001), BMI [WMD=1.35; 95% CI: 0.59, 2.11; p<0.0001] and PA [WMD=0.07; 95% CI: 0.04, 0.10; p<0.0001] level of patients undergoing PD. Subgroup analyses showed that, although Alb had no difference with LPD within 12 months of PD duration, sLPD treatment could improve the levels of Alb and PA regardless of PD duration or course of treatment. sLPD can improve the BMI of patients with a PD duration of more than 24 months, regardless of the duration of treatment.
CONCLUSIONS
A sLPD is an effective intervention for improving the nutritional status of PD patients. It is suggested that patients undergoing PD should initiate sLPD at the beginning of PD to ensure sufficient nutritional intake.
Topics: Humans; Nutritional Status; Diet, Protein-Restricted; Renal Dialysis; Randomized Controlled Trials as Topic; Peritoneal Dialysis
PubMed: 38305613
DOI: 10.26355/eurrev_202401_35071 -
International Journal of Medical... Apr 2024A proper nutrition is essential for human life. Recently, special attention on this topic has been given in relation to three health statuses: obesity, malnutrition and... (Review)
Review
INTRODUCTION
A proper nutrition is essential for human life. Recently, special attention on this topic has been given in relation to three health statuses: obesity, malnutrition and specific diseases that can be related to food or treated with specific diets. Mobile technology is often used to assist users that wish to regulate their eating habits, and identifying which fields of application have been explored the most by the app developers and which main functionalities have been adopted can be useful in view of future app developments.
METHODS
We selected 322 articles mentioning nutrition support apps through a literature database search, all of which have undergone an initial screening. After the exclusion of papers that were already reviews, not presenting apps or not focused on nutrition, not relevant or not developed for human subjects, 100 papers were selected for subsequent analyses that aimed at identifying the main treated conditions, outcome measures and functionalities implemented in the Apps.
RESULTS
Of the selected studies, 33 focus on specific diseases, 24 on obesity, 2 on malnutrition and 41 on other targets (e.g., weight/diet control). Type 2 diabetes is the most targeted disease, followed by gestational diabetes, hypertension, colorectal cancer and CVDs which all were targeted by more than one app. Most Apps include self-monitoring and coaching functionalities, educational content and artificial intelligence (AI) tools are slightly less common, whereas counseling, gamification and questionnaires are the least implemented. Body weight and calories/nutrients were the most common general outcome measures, while glycated hemoglobin (HbA1c) was the most common clinical outcome. No statistically significant differences in the effectiveness of the different functionalities were found.
CONCLUSION
The use of mobile technology to improve nutrition has been widely explored in the last years, especially for weight control and specific diseases like diabetes; however, other food-related conditions such as Irritable Bowel Diseases appear to be less targeted by newly developed smartphone apps and their related studies. All different kinds of functionalities appear to be equally effective, but further specific studies are needed to confirm the results.
Topics: Humans; Mobile Applications; Smartphone; Diabetes Mellitus, Type 2; Artificial Intelligence; Obesity; Malnutrition
PubMed: 38295584
DOI: 10.1016/j.ijmedinf.2024.105351 -
BMC Public Health Jan 2024Childhood obesity remains a significant public health concern. Sleep duration and quality among children and youth are suboptimal worldwide. Accumulating evidence... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Childhood obesity remains a significant public health concern. Sleep duration and quality among children and youth are suboptimal worldwide. Accumulating evidence suggests an association between inadequate sleep and obesity risk, yet it is unclear whether this relationship is causal. This systematic review examines the efficacy of sleep interventions alone or as a part of lifestyle interventions for the management of overweight or obesity among children and adolescents.
METHODS
A keyword/reference search was performed twice, in January 2021 and May 2022 in MEDLINE/PubMed, EMBASE/Ovid, PsycINFO/EBSCO, The Cochrane Library, Web of Science Core Collection/Web of Science, SciELO/Web of Science, and CINAHL/EBSCO. Study eligibility criteria included youth with overweight or obesity between 5 and 17, were RCTs or quasi-randomized, and focused on the treatment of overweight and obesity with a sleep behavior intervention component. Risk of bias was assessed using the Cochrane Risk of Bias assessment tool (RoB2). A Meta-analysis was conducted to estimate the effect of interventions with a sleep component on BMI. The study protocol was registered in PROSPERO (CRD42021233329).
RESULTS
A total of 8 studies (2 quasi-experiments, 6 RCTs) met inclusion criteria and accounted for 2,231 participants across 7 countries. Only one study design isolated the effect of sleep in the intervention and reported statistically significant decreases in weight and waist circumference compared to control, though we rated it at high risk of bias. Our meta-analysis showed no significant overall effect on children's BMI as a result of participation in an intervention with a sleep component (Cohen's d = 0.18, 95% CI= -0.04, 0.40, Z = 1.56, P = .11), though caution is warranted due to substantial heterogeneity observed across studies (Tau = 0.08; X = 23.05, df = 7; I = 83.73%).
CONCLUSIONS
There were mixed results on the effect of sleep interventions across included studies on BMI, other weight-related outcomes, diet, physical activity, and sleep. Except for one study at low risk of bias, three were rated as 'some concerns' and four 'high risk of bias'. Findings from this study highlight the need for additional RCTs isolating sleep as a component, focusing on children and adolescents living with overweight and obesity.
Topics: Adolescent; Child; Humans; Overweight; Pediatric Obesity; Life Style; Diet; Sleep
PubMed: 38287352
DOI: 10.1186/s12889-024-17708-6 -
European Geriatric Medicine Feb 2024Dysphagia is associated with long-term conditions including strokes, dementia, Parkinson's disease and frailty. Dysphagia affects 30-40% of the population aged over...
INTRODUCTION
Dysphagia is associated with long-term conditions including strokes, dementia, Parkinson's disease and frailty. Dysphagia affects 30-40% of the population aged over 65 years-old. Adults with dysphagia often experience long-term conditions requiring multiple medications (often > 5) to manage these. The thickening of liquids is a common compensatory strategy in dysphagia management. Studies suggest that immersion in thickened liquids affects medicines' solubility in vitro. Clinicians and pharmacists are unaware of the pharmacokinetic/therapeutic effects of thickened liquids on oral medicines. We conducted a systematic review of existing literature on thickeners' effects on drug bioavailability.
METHODOLOGY
We performed a literature search of MEDLINE & EMBASE. Search terms included: dysphagia/thickened diet (EMBASE only)/ bioavailability or absorption of medicines or pharmacokinetics; excluded: NG feeds/animal studies.
STUDIES INCLUDED
all genders, countries, > 18 years, community and hospital settings. PRISMA guidance was followed.
RESULTS
Five hundred seventy results were found, and 23 articles identified following the reference list review. Following an abstract and full-text review, 18 were included. Most articles evaluated thickeners on dissolution profiles in-vitro, with a few investigating in-vivo. Most studies were single-centre prospective studies identifying that thickeners generally affect dissolution rates of medications. Few studies assessed bioavailability or used clinical outcomes.
CONCLUSION
Dysphagia and polypharmacy are common in older adults, but little is known about the effects of altering liquid viscosity on the therapeutic effect of most medications. Further larger-scale studies are required to evaluate the therapeutic impact of thickener, on a bigger range of medications, factoring in other variables such as type of thickener, viscosity of thickener and duration of immersion.
Topics: Animals; Female; Male; Deglutition Disorders; Beverages; Biological Availability; Prospective Studies; Food Additives
PubMed: 38280090
DOI: 10.1007/s41999-023-00896-6 -
European Urology Oncology Jun 2024Active surveillance (AS) is a standard of care for patients with low-risk and selected intermediate-risk prostate cancer (PCa). Nevertheless, there is a lack of summary... (Meta-Analysis)
Meta-Analysis Review
CONTEXT
Active surveillance (AS) is a standard of care for patients with low-risk and selected intermediate-risk prostate cancer (PCa). Nevertheless, there is a lack of summary evidence on how to impact disease trajectory during AS.
OBJECTIVE
To assess which interventions prevent PCa progression effectively during AS.
EVIDENCE ACQUISITION
We queried PubMed, Scopus, and Web of Science databases to identify studies examining the impact of interventions aimed at slowing disease progression during AS. The primary endpoint was PCa progression, the definition of which must have included pathological upgrading. The secondary endpoint included treatment toxicities.
EVIDENCE SYNTHESIS
We identified 22 studies, six randomized controlled trials and 16 observational studies, which analyzed the association between different interventions and PCa progression during AS. The interventions considered in the studies included 5-alpha reductase inhibitors (5-ARIs), statins, diet, exercise, chlormadinone, fexapotide triflutate (FT), enzalutamide, coffee, vitamin D3, and PROSTVAC. We found that administration of 5-ARIs was associated with improved progression-free survival (PFS; hazard ratio: 0.59; 95% confidence interval 0.48-0.72), with no increased toxicity signals. Therapies such as vitamin D3, chlormadinone, FT, and enzalutamide have shown some efficacy. However, these anticancer drugs have been associated with treatment-related adverse events in up to 88% of patients.
CONCLUSIONS
The use of 5-ARIs in PCa patients on AS is associated with longer PFS. However, for the other interventions, it is difficult to draw clear conclusions based on the weak available evidence.
PATIENT SUMMARY
Patients with prostate cancer managed with active surveillance (AS) who are treated with 5-alpha reductase inhibitors have a lower risk of disease progression, with minimal adverse events. Other interventions require more studies to determine their efficacy and safety profile in men on AS.
Topics: Humans; Male; Prostatic Neoplasms; Disease Progression; Watchful Waiting; 5-alpha Reductase Inhibitors
PubMed: 38277189
DOI: 10.1016/j.euo.2023.10.010 -
International Journal of Environmental... Dec 2023International prenatal care guidelines set a standard for clinicians to discuss gestational weight gain with their patients along with the complications associated with... (Review)
Review
BACKGROUND
International prenatal care guidelines set a standard for clinicians to discuss gestational weight gain with their patients along with the complications associated with prepregnancy obesity and excessive gestational weight gain. Clinicians often lack evidence-based eating, nutrition, and activity strategies to share with patients.
METHODS
This systematic review aimed to find eating patterns and behaviors that could be used safely during pregnancy to limit excessive gestational weight gain. PubMed, MEDLINE, and Web of Science were searched for research or systematic reviews performed in the United States or Canada and published in English from 2013 to 2023. Keyword search terms included weight, manage, behavior, strategy, strategies, gestational weight gain, and nutrition. Excluded research used pediatric or adolescent populations, restrictive diets, such as no carbohydrate or no fat diets, fasting, bariatric surgery, weight loss medications, private industry or profit-earning programs using food brands, or specific diet programs.
RESULTS
A total of 844 abstracts were retrieved, with 103 full-text studies reviewed. Behaviors had to be useful for maintaining a healthy gestational weight gain and had to be safe for use during pregnancy. Behaviors useful during pregnancy included meal planning, home meal preparation, portion control, using diets such as the Mediterranean diet, the low-glycemic index diet, and the Dietary Approaches to Stop Hypertension diet (DASH), regular physical activity, sleeping 6-7 h a night, mindful eating, intuitive eating, and regular seif-weighing.
CONCLUSION
The evidence-based strategies outlined in this review are safe for use during pregnancy and can assist patients in avoiding excessive gestational weight gain while maintaining the nutrition needed for healthy fetal growth.
Topics: Pregnancy; Female; Adolescent; Humans; Child; Gestational Weight Gain; Exercise; Pregnancy Complications; Weight Gain; Diet; Diet, Mediterranean
PubMed: 38276803
DOI: 10.3390/ijerph21010015 -
Nutrients Jan 2024Intermittent fasting (IF) and caloric restriction (CR) are dietary strategies to prevent and attenuate obesity associated with conditions and aging-related outcomes.... (Review)
Review
Intermittent fasting (IF) and caloric restriction (CR) are dietary strategies to prevent and attenuate obesity associated with conditions and aging-related outcomes. This scoping review examined the cardiometabolic, cancer, and neurocognitive outcome differences between IF and CR interventions among adults. We applied a systematic approach to scope published randomized controlled trials (databases: PubMed, CINAHL Plus, PsychInfo, Scopus, and Google Scholar) from inception through August 2023. The initial search provided 389 unique articles which were critically appraised. Thirty articles met the eligibility criteria for inclusion: 12 were IF, 10 were CR, and 8 were combined IF and CR interventions. IF and CR were associated with weight loss; however, IF studies tended to report greater adherence compared with CR. Overall, IF and CR were equivalently effective across cardiometabolic, cancer, and neurocognitive outcomes. Our findings suggest that IF has health benefits in a variety of conditions and may be better accepted and tolerated than CR, but more comparative research is required.
Topics: Adult; Humans; Aging; Caloric Restriction; Cardiovascular Diseases; Fasting; Intermittent Fasting; Neoplasms; Randomized Controlled Trials as Topic
PubMed: 38276554
DOI: 10.3390/nu16020316