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Dietary Interventions in Ulcerative Colitis: A Systematic Review of the Evidence with Meta-Analysis.Nutrients Sep 2023(1) Background: Ulcerative colitis (UC) is a chronic colon inflammation caused by genetic and environmental factors, including diet. This systematic review and... (Meta-Analysis)
Meta-Analysis Review
(1) Background: Ulcerative colitis (UC) is a chronic colon inflammation caused by genetic and environmental factors, including diet. This systematic review and meta-analysis aims to assess the impact of diet on UC management in children and adults (2) Methods: A comprehensive search across databases yielded relevant studies, and risk of bias in randomized controlled trials (RCTs) was assessed using the Cochrane Risk of Bias tool. This study was conducted in conformity to the 2020 PRISMA guidelines. The certainty of evidence for outcomes was evaluated using GRADE methodology. Meta-analysis was performed using Review Manager software version 5.4. (3) Results: Fourteen RCTs were included, results indicated higher clinical response, remission, and endoscopic remission rates in diet-treated groups. Carrageenan-free, anti-inflammatory, and cow milk protein elimination diets showed no significant advantages in maintaining clinical remission. However, a study involving fermented cow milk with bifidobacterial demonstrated favorable outcomes. Overall, pooled analysis leaned in favor of dietary intervention for sustaining clinical remission; (4) Conclusions: The relationship between diet and UC is an evolving terrain that demands deeper exploration. This systematic review and meta-analysis highlight the evolving relationship between diet and UC, necessitating further exploration. While understanding grows, adopting personalized dietary approaches could alleviate symptoms, and support a more positive disease trajectory.
Topics: Adult; Child; Humans; Colitis, Ulcerative; Remission Induction; Anti-Inflammatory Agents, Non-Steroidal; Inflammation
PubMed: 37836478
DOI: 10.3390/nu15194194 -
Food Science & Nutrition Oct 2023Diet can affect the inflammatory state of the body. Accordingly, the dietary inflammatory index (DII) has been developed to quantify the inflammatory properties of food... (Review)
Review
Diet can affect the inflammatory state of the body. Accordingly, the dietary inflammatory index (DII) has been developed to quantify the inflammatory properties of food items. This study sought to investigate the association between dietary inflammation index (DII) and the odds ratio of elevated CRP (E-CRP) through a systematic review and meta-analysis study. The International electronic databases of PubMed, Web of Science (ISI), and Scopus were searched until May 2023 to find related articles. From 719 studies found in the initial search, 14 studies, with a total sample size of 59,941 individuals, were included in the meta-analysis. The calculated pooled odds ratio (OR) of E-CRP in the highest DII category was 1.39 (95% CI: 1.06, 1.14, test for heterogeneity: = .63, and = .0%) in comparison with the lowest DII category. Also, the results of this study showed that each unit increase in DII as a continuous variable generally elicited a 10% increase in the odds of E-CRP (OR 1.10, 95% CI 1.06, 1.14, test for heterogeneity: = .63, and = .0%). Subgroup meta-analyses showed that there is a higher E-CRP odds ratio for the articles that reported energy-adjusted DII (E-DII) instead of DII, the studies that measured CRP instead of hs-CRP, and the studies that used 24-h recall instead of FFQ as the instrument of dietary intake data collection. Individuals with a higher DII were estimated to have higher chances of developing elevated serum CRP. This value was influenced by factors such as the participants' nationality, instruments of data collection, methods used to measure inflammatory biomarkers, study design, and data adjustments. However, future well-designed studies can help provide a more comprehensive understanding of the inflammatory properties of diet and inflammatory serum biomarkers.
PubMed: 37823095
DOI: 10.1002/fsn3.3553 -
Nutrition Journal Oct 2023It is suggested that supplementation with milk protein (MP) has the potential to ameliorate the glycemic profile; however, the exact impact and certainty of the findings... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
It is suggested that supplementation with milk protein (MP) has the potential to ameliorate the glycemic profile; however, the exact impact and certainty of the findings have yet to be evaluated. This systematic review and dose-response meta-analysis of randomized controlled trials (RCTs) assessed the impact of MP supplementation on the glycemic parameters in adults.
METHODS
A systematic search was carried out among online databases to determine eligible RCTs published up to November 2022. A random-effects model was performed for the meta-analysis.
RESULTS
A total of 36 RCTs with 1851 participants were included in the pooled analysis. It was displayed that supplementation with MP effectively reduced levels of fasting blood glucose (FBG) (weighted mean difference (WMD): -1.83 mg/dL, 95% CI: -3.28, -0.38; P = 0.013), fasting insulin (WMD: -1.06 uU/mL, 95% CI: -1.76, -0.36; P = 0.003), and homeostasis model assessment of insulin resistance (HOMA-IR) (WMD: -0.27, 95% CI: -0.40, -0.14; P < 0.001) while making no remarkable changes in serum hemoglobin A1c (HbA1c) values (WMD: 0.01%, 95% CI: -0.14, 0.16; P = 0.891). However, there was a significant decline in serum levels of HbA1c among participants with normal baseline body mass index (BMI) based on sub-group analyses. In addition, HOMA-IR values were significantly lower in the MP supplement-treated group than their untreated counterparts in short- and long-term supplementation (≤ 8 and > 8 weeks) with high or moderate doses (≥ 60 or 30-60 g/d) of MP or whey protein (WP). Serum FBG levels were considerably reduced upon short-term administration of a low daily dose of WP (< 30 g). Furthermore, the levels of serum fasting insulin were remarkably decreased during long-term supplementation with high or moderate daily doses of WP.
CONCLUSION
The findings of this study suggest that supplementation with MP may improve glycemic control in adults by reducing the values of fasting insulin, FBG, and HOMA-IR. Additional trials with longer durations are required to confirm these findings.
Topics: Adult; Humans; Glycated Hemoglobin; Blood Glucose; Milk Proteins; Diabetes Mellitus, Type 2; Dietary Supplements; Insulin; Insulin Resistance; Whey Proteins
PubMed: 37798798
DOI: 10.1186/s12937-023-00878-1 -
Nutrition Journal Oct 2023The present systematic review and meta-analysis sought to evaluate the effects of conjugated linoleic acid (CLA) supplementation on glycemic control, adipokines,... (Meta-Analysis)
Meta-Analysis Review
The effects of conjugated linoleic acid supplementation on glycemic control, adipokines, cytokines, malondialdehyde and liver function enzymes in patients at risk of cardiovascular disease: a GRADE-assessed systematic review and dose-response meta-analysis.
BACKGROUND
The present systematic review and meta-analysis sought to evaluate the effects of conjugated linoleic acid (CLA) supplementation on glycemic control, adipokines, cytokines, malondialdehyde (MDA) and liver function enzymes in patients at risk of cardiovascular disease.
METHODS
Relevant studies were obtained by searching the PubMed, SCOPUS and Web of Science databases (from inception to January 2023). Weighted mean differences (WMD) and 95% confidence intervals (CIs) were pooled using a random-effects model. Heterogeneity, sensitivity analysis, and publication bias were reported using standard methods.
RESULTS
A pooled analysis of 13 randomized controlled trials (RCTs) revealed that CLA supplementation led to a significant increment in fasting blood glucose (FBG) (WMD: 4.49 mg/dL; 95%CI: 2.39 to 6.59; P < 0.001), and aspartate aminotransferase (AST) (WMD: 2.54 IU/L; 95%CI: 0.06 to 5.01; P = 0.044). Moreover, CLA supplementation decreased leptin (WMD: -1.69 ng/ml; 95% CI: -1.80 to -1.58; P < 0.001), and interleukin 6 (IL-6) (WMD: -0.44 pg/ml; 95%CI: -0.86 to -0.02; P = 0.037). However, there was no effect on hemoglobin A1c (HbA1c), homeostatic model assessment for insulin resistance (HOMA-IR), C-reactive protein (CRP), tumor necrosis factor alpha (TNF-α), and alanine aminotransferase (ALT) adiponectin compared to the control group.
CONCLUSION
Our findings showed the overall favorable effect of CLA supplementation on the adipokines and cytokines including serum IL-6, and leptin, while increasing FBG and AST. It should be noted that the mentioned metabolic effects of CLA consumption were small and may not reach clinical importance.
PROSPERO REGISTERATION COD
CRD42023426374.
Topics: Humans; Dietary Supplements; Leptin; Cytokines; Linoleic Acids, Conjugated; Interleukin-6; Adipokines; Cardiovascular Diseases; Glycemic Control; Malondialdehyde; Liver; Blood Glucose
PubMed: 37794481
DOI: 10.1186/s12937-023-00876-3 -
European Journal of Nutrition Feb 2024This umbrella review aimed to assess whether dietary protein intake with regard to quantitative (higher vs. lower dietary protein intake) and qualitative considerations... (Review)
Review
Protein intake and body weight, fat mass and waist circumference: an umbrella review of systematic reviews for the evidence-based guideline on protein intake of the German Nutrition Society.
PURPOSE
This umbrella review aimed to assess whether dietary protein intake with regard to quantitative (higher vs. lower dietary protein intake) and qualitative considerations (total, plant-based or animal-based protein intake) affects body weight (BW), fat mass (FM) and waist circumference (WC).
METHODS
A systematic literature search was conducted in PubMed, Embase and Cochrane Database of Systematic Reviews for systematic reviews (SRs) with and without meta-analyses of prospective studies published between 04 October 2007 and 04 January 2022. Methodological quality and outcome-specific certainty of evidence of the retrieved SRs were assessed by using AMSTAR 2 and NutriGrade, respectively, in order to rate the overall certainty of evidence using predefined criteria.
RESULTS
Thirty-three SRs were included in this umbrella review; 29 were based on randomised controlled trials, a few included cohort studies. In studies without energy restriction, a high-protein diet did not modulate BW, FM and WC in adults in general (all "possible" evidence); for older adults, overall certainty of evidence was "insufficient" for all parameters. Under hypoenergetic diets, a high-protein diet mostly decreased BW and FM, but evidence was "insufficient" due to low methodological quality. Evidence regarding an influence of the protein type on BW, FM and WC was "insufficient".
CONCLUSION
"Possible" evidence exists that the amount of protein does not affect BW, FM and WC in adults under isoenergetic conditions. Its impact on the reduction in BW and FM under hypoenergetic conditions remains unclear; evidence for an influence of protein type on BW, FM and WC is "insufficient".
Topics: Aged; Humans; Body Weight; Dietary Proteins; Prospective Studies; Systematic Reviews as Topic; Waist Circumference
PubMed: 37794213
DOI: 10.1007/s00394-023-03220-x -
Advances in Nutrition (Bethesda, Md.) Nov 2023Overweight and obesity are highly prevalent worldwide and are associated with cardiovascular disease (CVD) risk factors, including systematic inflammation, dyslipidemia,... (Meta-Analysis)
Meta-Analysis Review
Effect of Alpha-Linolenic Acid Supplementation on Cardiovascular Disease Risk Profile in Individuals with Obesity or Overweight: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Overweight and obesity are highly prevalent worldwide and are associated with cardiovascular disease (CVD) risk factors, including systematic inflammation, dyslipidemia, and hypertension. Alpha-linolenic acid (ALA) is a plant-based essential polyunsaturated fatty acid associated with reduced CVD risks. This systematic review and meta-analysis aimed to investigate the effects of supplementation with ALA compared with the placebo on CVD risk factors in people with obesity or overweight (International Prospective Register of Systematic Reviews Registration No. CRD42023429563). This review included studies with adults using oral supplementation or food or combined interventions containing vegetable sources of ALA. All studies were randomly assigned trials with parallel or crossover designs. The Cochrane Collaboration tool was used for assessing the risk of bias (Version 1). PubMed, Web of Science, Embase, and Cochrane library databases were searched from inception to April 2023. Nineteen eligible randomized controlled trials, including 1183 participants, were included in the meta-analysis. Compared with placebo, dietary ALA supplementation significantly reduced C-reactive protein concentration (standardized mean difference [SMD] = -0.38 mg/L; 95% confidence interval [CI]: -0.72, -0.04), tumor necrosis factor-α concentration (SMD = -0.45 pg/mL; 95% CI: -0.73, -0.17), triglyceride in serum (SMD = -4.41 mg/dL; 95% CI: -5.99, -2.82), and systolic blood pressure (SMD = -0.37 mm Hg; 95% CI: -0.66, -0.08); but led to a significant increase in low-density lipoprotein cholesterol concentrations (SMD = 1.32 mg/dL; 95% CI: 0.05, 2.59). ALA supplementation had no significant effect on interleukin-6, diastolic blood pressure, total cholesterol, or high-density lipoprotein cholesterol (all P ≥ 0.05). Subgroup analysis revealed that ALA supplementation at a dose of ≥3 g/d from flaxseed and flaxseed oil had a more prominent effect on improving CVD risk profiles, particularly where the intervention duration was ≥12 wk and where the baseline CVD profile was poor.
Topics: Adult; Humans; Cardiovascular Diseases; alpha-Linolenic Acid; Overweight; Randomized Controlled Trials as Topic; Cholesterol, HDL; Obesity; Dietary Supplements
PubMed: 37778442
DOI: 10.1016/j.advnut.2023.09.010 -
Nutrients Sep 2023Maintaining muscle mass, strength, and function is crucial for our aging population. Exercise and dietary protein intake are recommended strategies; however, animal... (Review)
Review
Effects of Plant-Based Protein Interventions, with and without an Exercise Component, on Body Composition, Strength and Physical Function in Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Maintaining muscle mass, strength, and function is crucial for our aging population. Exercise and dietary protein intake are recommended strategies; however, animal proteins have been the most studied. Plant-based protein sources have lower digestibility and incomplete amino acid profiles. However new innovative plant-based proteins and products may have overcome these issues. Therefore, this systematic review aimed to synthesize the current research and evaluate the effects of plant-based protein interventions compared to placebo on body composition, strength, and physical function in older adults (≥60 years old). The secondary aim was whether exercise improved the effectiveness of plant-based protein on these outcomes. Randomized controlled trials up to January 2023 were identified through Medline, EMBASE, CINAHL, and Cochrane Library databases. Studies contained a plant-protein intervention, and assessed body composition, strength, and/or physical function. Thirteen articles were included, all using soy protein (0.6-60 g daily), from 12 weeks to 1 year. Narrative summary reported positive effects on muscle mass over time, with no significant differences compared to controls (no intervention, exercise only, animal protein, or exercise + animal protein interventions). There was limited impact on strength and function. Meta-analysis showed that plant-protein interventions were comparable to controls, in all outcomes. In conclusion, plant-protein interventions improved muscle mass over time, and were comparable to other interventions, warranting further investigation as an anabolic stimulus in this vulnerable population.
PubMed: 37764843
DOI: 10.3390/nu15184060 -
Nutrients Sep 2023Active-duty military personnel are subjected to sustained periods of energy deficit during combat and training, leaving them susceptible to detrimental reductions in... (Review)
Review
Active-duty military personnel are subjected to sustained periods of energy deficit during combat and training, leaving them susceptible to detrimental reductions in body weight. The importance of adequate dietary protein intake during periods of intense physical training is well established, where previous research has primarily focused on muscle protein synthesis, muscle recovery, and physical performance. Research on how protein intake may influence body weight regulation in this population is lacking; therefore, the objective of this review was to evaluate the role of dietary protein in body weight regulation among active-duty military during an energy deficit. A literature search based on fixed inclusion and exclusion criteria was performed. English language peer-reviewed journal articles from inception to 3 June 2023 were selected for extraction and quality assessment. Eight studies were identified with outcomes described narratively. The study duration ranged from eight days to six months. Protein was directly provided to participants in all studies except for one. Three studies supplied additional protein via supplementation. The Downs and Black Checklist was used to assess study quality. Five studies were classified as good, two as fair, and one as excellent. All studies reported mean weight loss following energy deficit: the most severe was 4.0 kg. Protein dose during energy deficit varied from 0.5 g/kg/day to 2.4 g/kg/day. Six studies reported mean reductions in fat mass, with the largest being 4.5 kg. Four studies reported mean reductions in fat-free mass, while two studies reported an increase. Results support the recommendation that greater than 0.8 g/kg/day is necessary to mitigate the impact of energy deficit on a decline in lean body mass, while intakes up to 1.6 g/kg/day may be preferred. However, exact recommendations cannot be inferred as the severity and duration of energy deficit varied across studies. Longer and larger investigations are needed to elucidate protein's role during energy deficit in active-duty military.
Topics: Humans; Energy Intake; Military Personnel; Dietary Proteins; Exercise; Body Weight
PubMed: 37764730
DOI: 10.3390/nu15183948 -
Advances in Nutrition (Bethesda, Md.) Nov 2023Characterization of the nutrients in human milk is important to understand the dietary and developmental requirements of infants. The objective of this review was to... (Review)
Review
Characterization of the nutrients in human milk is important to understand the dietary and developmental requirements of infants. The objective of this review was to summarize the state-of-the-science on the nutrient composition of human milk in the United States and Canada published from 2017 to 2022. Four databases were searched for randomized controlled studies and others given the scoping nature of this review. We limited type to mature milk collected 21 d postpartum and beyond from lactating individuals in the United States and Canada who gave birth at 37-wk gestation or later (full-term). Outcomes of interest included traditional macro- and micronutrients, including human milk oligosaccharides (HMOs), and milk volume. The publication date range was selected as January 1, 2017, to the day the literature search was performed. A total of 32 articles were included in the scoping review from primarily longitudinal cohort or cross-sectional designs. The most prevalent sample collection method was full-breast expression (n = 20) with most studies (n = 26) collecting samples from a single timepoint. Carbohydrates (HMOs [n = 12], glucose [n = 8], and lactose [n = 6]) and protein (n = 5) were the most frequently assessed nutrients in this body of work, with consensus among studies that glucose is present in limited concentrations compared to lactose (24-64 mg/dL compared with 6-7 g/dL) and that HMOs are influenced by temporality and secretor status. Included studies displayed an overall level of heterogeneity and sparsity paralleling previous reports and nutrient data in the USDA FoodData Central system. Much of the data extracted from retained articles generally provided analysis of a specific nutrient or group of nutrients. Moreover, many studies did not use the preferred analytical methods as outlined by the Human Milk Composition Initiative to increase measurement confidence. Up-to-date nutrient composition data of human milk is still greatly needed as it is paramount for the management of infant feeding, assessment of infant and maternal nutritional and health needs, and as a reference for infant formula development.
Topics: Infant; Female; Humans; United States; Milk, Human; Lactation; Cross-Sectional Studies; Lactose; Oligosaccharides; Micronutrients; Glucose; Infant Nutritional Physiological Phenomena
PubMed: 37758059
DOI: 10.1016/j.advnut.2023.09.007 -
Advances in Nutrition (Bethesda, Md.) Nov 2023The effects of isoflavones on postmenopausal female's blood lipid profile have yielded conflicting results in previous studies. Further investigation is necessary to... (Meta-Analysis)
Meta-Analysis Review
The effects of isoflavones on postmenopausal female's blood lipid profile have yielded conflicting results in previous studies. Further investigation is necessary to determine the potential benefits of isoflavone therapy in managing cardiovascular health in this population. This meta-analysis aimed to assess the effects of isoflavones on blood lipid concentrations in postmenopausal females. A comprehensive search was conducted in major databases for randomized controlled trials published between 2000 and 2023. Eighteen studies were included in the analysis, which examined the impact of isoflavone intake on blood lipids in postmenopausal females. Isoflavone consumption resulted in a significant reduction in triacylglycerol (TG) concentrations (-12.50 mg/dL; 95% CI: -23.09, -1.91) and a modest increase in high-density lipoprotein cholesterol (HDL cholesterol) concentrations (1.83 mg/dL; 95% CI: 0.03, 3.64). Subgroup analysis showed that isoflavones significantly decreased TG (-15.79 mg/dL; 95% CI: -28.36, -3.22) and increased HDL cholesterol (2.49 mg/dL; 95% CI: 1.80, 3.19) in postmenopausal females under 65 y old. No significant effects were observed in females over 65 y old. Both low (≤80 mg/d) and high (>80 mg/d) doses of isoflavones exhibited TG-lowering effects, whereas only the high dose increased HDL cholesterol. Longer treatment duration (≥24 wk) was associated with a significant reduction in TG, whereas HDL cholesterol improvement occurred during the early period (<24 wk) of supplementation. The consumption of isoflavones resulted in a significant reduction in TG concentrations and an increase in HDL cholesterol concentrations among postmenopausal females under 65 y of age.
Topics: Female; Humans; Isoflavones; Cholesterol, HDL; Cholesterol, LDL; Postmenopause; Soybean Proteins; Randomized Controlled Trials as Topic; Triglycerides; Lipids
PubMed: 37758058
DOI: 10.1016/j.advnut.2023.09.008