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Nutrients May 2024Gut microbiome-modulating agents (MMAs), including probiotics, prebiotics, postbiotics, and synbiotics, are shown to ameliorate type 1 diabetes (T1D) by restoring the... (Meta-Analysis)
Meta-Analysis Review
Gut microbiome-modulating agents (MMAs), including probiotics, prebiotics, postbiotics, and synbiotics, are shown to ameliorate type 1 diabetes (T1D) by restoring the microbiome from dysbiosis. The objective of this systematic review and meta-analysis was to assess the impact of MMAs on hemoglobin A1c (HbA1c) and biomarkers associated with (T1D). A comprehensive search was conducted in PubMed, Web of Science, Embase, Cochrane Library, National Knowledge Infrastructure, WeiPu, and WanFang Data up to 30 November 2023. Ten randomized controlled trials ( = 630) were included, with study quality evaluated using the Cochrane risk-of-bias tool. Random-effect models with standardized mean differences (SMDs) were utilized. MMA supplementation was associated with improvements in HbA1c (SMD = -0.52, 95% CI [-0.83, -0.20]), daily insulin usage (SMD = -0.41, 95% confidence interval (CI) [-0.76, -0.07]), and fasting C-peptide (SMD = 0.99, 95% CI [0.17, 1.81]) but had no effects on FBG, CRP, TNF-α, IL-10, LDL, HDL, and the Shannon index. Subgroup analysis of HbA1c indicated that a long-term intervention (>3 months) might exert a more substantial effect. These findings suggest an association between MMAs and glycemic control in T1D. Further large-scale clinical trials are necessary to confirm these findings with investigations on inflammation and gut microbiota composition while adjusting confounding factors such as diet, physical activity, and the dose and form of MMA intervention.
Topics: Diabetes Mellitus, Type 1; Humans; Gastrointestinal Microbiome; Randomized Controlled Trials as Topic; Glycated Hemoglobin; Probiotics; Prebiotics; Biomarkers; Synbiotics; Dietary Supplements; Female; Dysbiosis; Adult; Male
PubMed: 38892608
DOI: 10.3390/nu16111675 -
Cureus May 2024Gastrointestinal permeability refers to the movement of substances across the gut wall. This is mediated by endotoxemia (bacterial products entering the systemic... (Review)
Review
Gastrointestinal permeability refers to the movement of substances across the gut wall. This is mediated by endotoxemia (bacterial products entering the systemic circulation), and is associated with metabolic disease. The effect of bariatric surgery on permeability remains uncertain; the associated dietary, metabolic and weight changes are suggested to influence, or trigger, altered permeability. The primary aim of this study is to synthesize evidence and analyze the effect of bariatric surgery on permeability. A systematic review was performed, searching MEDLINE, EMBASE, and Scopus until February 2023, using MESH terms "intestinal permeability", "bariatric", for studies reporting in vivo assessment of permeability. Three cohort studies and two case series were identified (n=96). Data was heterogeneous; methodology and controls preclude meta-analysis. Gastroduodenal permeability reduced post-sleeve gastrectomy (SG). Two studies showed an increase in small intestinal permeability after biliopancreatic diversion. Two studies revealed a decrease in post-Roux-en-Y gastric bypass. One study identified increased colonic permeability six months post-SG. Evidence regarding permeability change after bariatric surgery is conflicting, notably for the small intestine. Impaired colonic permeability post-SG raises concerns regarding colonic protein fermentation and harmful dietary sequelae. There are multiple interacting variables confounding gastrointestinal permeability change; procedure type, altered microbiota and metabolic response to surgery. Further understanding of this important aspect of obesity is required, both before and after bariatric surgery.
PubMed: 38883053
DOI: 10.7759/cureus.60480 -
Progress in Neuro-psychopharmacology &... Jun 2024The various pharmacological interventions, ranging from mood stabilizers and antipsychotics to antidepressants, reflect the diff/iculty of treating depressive/manic... (Review)
Review
BACKGROUND
The various pharmacological interventions, ranging from mood stabilizers and antipsychotics to antidepressants, reflect the diff/iculty of treating depressive/manic symptomatology of bipolar disorder (BD). Among a broad range of mechanisms implicated, immune dysregulation may contribute to the increased inflammation that influences the course of BD. Inflammatory, neurotrophic and oxidative stress factors may be identified as promising peripheral biomarkers in brain functioning, perhaps serving as predictors of an effective response to treatment for BD. The present systematic review aimed to examine the evidence supporting the pharmacotherapeutic value of inflammatory and neurotrophic biomarkers in BD.
METHODS
PubMed, PsychINFO, Scopus and Web of Science were searched from inception to May 2024 by two independent reviewers. A total of 40 studies with 3371 patients with diagnosis and intervention of BD were selected.
RESULTS
Inconsistencies in the effects of pharmacological treatments on the connection between the expected anti-inflammatory response and symptomatologic improvement were identified. Mood stabilizers (lithium), antipsychotics (quetiapine), antidepressants (ketamine) or their combination were described to increase both pro-inflammatory (TNFα, IL-6) and anti-inflammatory (IL-4, IL-8) factors. Other medications, such as memantine and dextromethorphan, autoimmune (infliximab) non-steroidal anti-inflammatory (aspirin, celecoxib) drugs, antidiabetics (pioglitazone), and even dietary supplementation (omega-3), or their combination, clearly decrease inflammatory factors (TNFα, IL-6, IL-1β, C-reactive protein) and/or increase the neurotrophic factor BDNF in BD patients.
CONCLUSION
Inflammation in BD requires further investigation to understand the underlying immunologic mechanism, to identify predictors of treatment response, and to make informed decisions about the use and development of more effective pharmacological interventions for BD.
PubMed: 38879067
DOI: 10.1016/j.pnpbp.2024.111056 -
PeerJ 2024The optimal range of protein dosage and effect of high-dose protein on critically ill patients remain controversial. We conducted a meta-analysis to compare higher and... (Meta-Analysis)
Meta-Analysis
PURPOSE
The optimal range of protein dosage and effect of high-dose protein on critically ill patients remain controversial. We conducted a meta-analysis to compare higher and lower doses of protein supplementation for nutritional support in critically ill patients.
METHODS
We searched the PubMed, Embase, Scopus, and Cochrane Library databases for randomized controlled trials that compared higher (≥1.2 g/kg per day) lower (<1.2 g/kg per day) doses of protein supplementation among critically ill adult patients. This search spanned from the inception of relevant databases to November 20, 2023. Our primary endpoint of interest was overall mortality, while secondary endpoints included length of stay in the intensive care unit, length of hospital stay, duration of mechanical ventilation, and incidence of acute kidney injury.
RESULTS
Seventeen studies including 2,965 critically ill patients were included in our meta-analysis. The pooled analyses showed no significant difference in overall mortality (RR 1.03, 95%CI [0.92-1.15], = 0.65, I = 0%), length of intensive care unit stay (MD 0.19, 95%CI [-0.67 to 1.04], = 0.66, I = 25%), length of hospital stay (MD 0.73, 95%CI [-1.59 to 3.04], = 0.54, I = 27%), duration of mechanical ventilation (MD -0.14, 95%CI [-0.83 to 0.54], = 0.68, I = 8%), and incidence of acute kidney injury (RR 1.11, 95%CI [0.87-1.41], = 0.38, I = 0%) between critically ill patients receiving higher or lower doses of protein supplementation.
CONCLUSIONS
For critically ill patients, the protein supplementation dose had no significant effect on clinical outcomes, including overall mortality, length of intensive care unit and hospital stay, duration of mechanical ventilation, and incidence of acute kidney injury.
Topics: Humans; Critical Illness; Randomized Controlled Trials as Topic; Length of Stay; Respiration, Artificial; Acute Kidney Injury; Intensive Care Units; Dietary Proteins; Dietary Supplements; Nutritional Support; Dose-Response Relationship, Drug
PubMed: 38799065
DOI: 10.7717/peerj.17433 -
Clinical Nutrition ESPEN Jun 2024International guidelines recommend a target protein intake of ≥1.2 g/kg/day to all critically ill patients for optimal outcomes. There are however various conflicting... (Review)
Review
International guidelines recommend a target protein intake of ≥1.2 g/kg/day to all critically ill patients for optimal outcomes. There are however various conflicting data related to this recommendation. The primary objective of this review was to compare a protein intake group (≥1.2 g/kg/day) with a lower protein intake group (<1.2 g/kg/day) in critically ill adult patients on mortality, length of intensive care unit (ICU) and hospital stay. Secondly, the effect of protein intake on length of mechanical ventilation, adverse nutrition-related events and muscle mass and strength parameters were investigated. Sixteen randomised controlled trials (RCTs) of adult patients admitted to an intensive or high care unit and receiving nutrition support in the form of enteral- and/or parenteral nutrition were selected against prespecified eligibility criteria. Two independent reviewers extracted relevant data and assessed the risk of bias of the included studies. Review Manager 5.4.1 was used to analyse data and GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) was used to evaluate the certainty of the evidence. The higher protein group, when compared to the lower protein group, probably results in little to no difference in mortality (risk ratio [RR] 1.01; 95% confidence interval [CI]: 0.89 to 1.14; moderate-certainty evidence); with a probable slight increase in length of ICU stay (mean difference [MD] 0.33; 95% CI -0.57 to 1.23; moderate-certainty) and length of hospital stay (MD 1.72; 95% CI -0.58 to 4.01; moderate-certainty evidence), on average. For secondary outcomes, it was found that the higher protein group probably does not reduce the length of mechanical ventilation (MD 0.08; 95% CI -0.38 to 0.53; moderate-certainty evidence). Higher protein group probably reduces the occurrence of diarrhoea and high gastric residual volume and may reduce the occurrence of constipation. It may also increase nitrogen balance (MD 3.66; 95% CI 1.81 to 5.51; low-certainty evidence). Importantly, there does not seem to be harm associated with the higher protein group, though it should be mentioned that for many of the adverse events in this study, the certainty of evidence was low or very low.
Topics: Humans; Critical Illness; Intensive Care Units; Dietary Proteins; Length of Stay; Respiration, Artificial; Adult; Randomized Controlled Trials as Topic; Practice Guidelines as Topic; Enteral Nutrition; Critical Care; Parenteral Nutrition; Hospital Mortality
PubMed: 38777455
DOI: 10.1016/j.clnesp.2024.04.003 -
Clinical Nutrition ESPEN Jun 2024Colorectal cancer (CRC) is the third most common malignancy in developed countries. Therefore, omega-3 fatty acids (O3FAs) have been suggested as a beneficial... (Meta-Analysis)
Meta-Analysis
BACKGROUND & AIMS
Colorectal cancer (CRC) is the third most common malignancy in developed countries. Therefore, omega-3 fatty acids (O3FAs) have been suggested as a beneficial complementary treatment due to their ability to regulate inflammatory responses and improve nutrition levels.This study aimed to evaluate the effects of O3FAs as a complementary treatment for inflammation, nutrition levels, post-operative infectious complications, and enhancement of recovery in CRC patients.
METHODS
The literature search was carried out through three databases. The outcomes of interest were assessed by measuring pro-inflammatory cytokines (IL-1β, IL-6, and TNF-α) and CRP levels, serum albumin levels for nutrition assessment, post-operative infectious complications, and length of stay for recovery evaluation. Quality appraisal and meta-analysis were performed using RoB 2.0 and RevMan 5.4, respectively.
RESULTS
The result showed that O3FAs significantly reduced IL-6, CRP, and TNF-α, but did not affect IL-1β. Furthermore, the variable slightly increased serum albumin levels and the supplementation led to a decrease in post-operative infectious complications and shortened hospital stays.
CONCLUSION
O3FAs as a complementary treatment provided advantages for CRC patients, Further clinical trials and experiments should also be made emphasizing the impact and clinical implementation of O3FA in the nutritional status of CRC patients.
Topics: Humans; Fatty Acids, Omega-3; Colorectal Neoplasms; Nutritional Status; Dietary Supplements; C-Reactive Protein; Complementary Therapies; Inflammation; Postoperative Complications; Cytokines
PubMed: 38777451
DOI: 10.1016/j.clnesp.2024.04.002 -
Archives of Gerontology and Geriatrics May 2024Frailty, a prevalent geriatric syndrome, presents challenges exacerbated by malnutrition. Nutritional Management Interventions (NMIs) offer hope in frailty reversal,... (Review)
Review
BACKGROUND
Frailty, a prevalent geriatric syndrome, presents challenges exacerbated by malnutrition. Nutritional Management Interventions (NMIs) offer hope in frailty reversal, necessitating exploration of their multi-dimensional outcomes.
OBJECTIVES
Assess NMIs' impact on frail and pre-frail older adults across diverse outcomes.
METHODS
A systematic review and meta-analysis of 13 studies (2012-2023) evaluated NMIs' effects on physical, dietary, psychological, and frailty aspects. Literature quality was assessed, and data analyzed with Review Manager 5.3.
RESULTS
A total of 13 studies involving participants were included in the analysis. Participants numbered 968, with the intervention group averaging 77.05±0.77 years and the control group 78.75±0.8 years. Compared to control groups,NMIs significantly increased body weight (SMD = 0.26, P = 0.03) and improved gait speed (SMD = 0.18, P = 0.03). Protein intake showed significance for interventions≤12 weeks (SMD = 1.04, P < 0.001). No significant differences in energy intake (SMD = 0.20, P = 0.60), but >12 weeks NMIs reduced energy intake (SMD = -0.73, P = 0.006). No significant differences in depressive symptoms, frailty scores, BMI, TUG, Handgrip Strength, or SPPB.
CONCLUSION
This meta-analysis underscores NMIs' potential benefits for frail and pre-frail older adults. Personalized, multidimensional interventions are recommended despite study limitations, emphasizing extended interventions and diverse assessments for holistic care.
PubMed: 38776700
DOI: 10.1016/j.archger.2024.105480 -
Cureus Apr 2024The systematic review investigates the impact of different nutrients and dietary patterns on metabolism and immunity to answer the research question: "Can personalized... (Review)
Review
The systematic review investigates the impact of different nutrients and dietary patterns on metabolism and immunity to answer the research question: "Can personalized nutritional approaches boost immunity?" The importance of diet in supporting the immune system has come to light in today's environment, where a strong immune system is crucial for protection against infectious illnesses, as highlighted by the COVID-19 pandemic. This systematic review adhered to the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020. Four databases were screened for relevant data published in 2022-2023: PubMed, PubMed Central (PMC), MEDLINE, and Cochrane Library. Inclusion and exclusion criteria were utilized, and 13 papers were finalized after screening and employing the quality appraisal tool Cochrane Bias assessment for randomized controlled trials (RCT). Personalized nutrition can strengthen immunity and enhance overall health by adjusting dietary recommendations and following a person's genetic makeup, lifestyle, and health state. An adequate supply of vitamins, minerals, proteins, and fatty acids as well as an optimum caloric intake are essential for immune health, and individual requirements can vary significantly due to genetic factors, lifestyle choices, and underlying health conditions. Personalized nutrition considers these factors, enabling tailored dietary recommendations to address specific nutrient needs and optimize nutrient intake, leading to better health outcomes. The review concludes that personalized nutrition is more effective than a one-size-fits-all approach in boosting immunity, and its potential impact on health and immune function is highly important.
PubMed: 38765327
DOI: 10.7759/cureus.58553 -
The International Journal of Behavioral... May 2024This systematic review contributes to the understanding of the characteristics of built food environments that may be associated with choices of alternative protein... (Review)
Review
BACKGROUND
This systematic review contributes to the understanding of the characteristics of built food environments that may be associated with choices of alternative protein foods (APF). Using the built food environment typology proposed by Downs et al., we investigated various environmental structures (e.g., supermarkets, other retailers, farmers' markets, restaurants, schools, and online vendors) and the characteristics that may facilitate or hinder consumers' choices. For example, facilitators and barriers may refer to the physical characteristics of environmental structures, food presentation practices, the organizational strategies or policies operating in the setting, or the actions that retailers or consumers engage in while selling, serving, choosing, trying, or purchasing APF in these environmental structures.
METHODS
A systematic review (PROSPERO database preregistration; no. CRD42023388700) was conducted by searching 13 databases for peer-reviewed journals focusing on the fields of economics and business, agriculture, medical sciences, and social sciences. Data searches, coding, and quality evaluations were conducted by at least 2 researchers. A total of 31 papers (36 original studies) were included. The risk of bias was evaluated with the Joanna Briggs Institute quality evaluation tool, with 24 publications presenting low risk of bias.
RESULTS
The findings indicate that perceived and actual availability facilitate consumers' APF choices across a built food environment. Several barriers/facilitators were associated with APF choices in specific types of built food environments: the way food is presented in produce sections (supermarkets), consumer habits in terms of green and specialty shopping (grocery stores), and mismatches among retailer actions in regard to making APF available in one type of food environment structure (e-commerce) and consumers' preferences for APF being available in other food environment structures (supermarkets, grocery stores). The effect of a barrier/facilitator may depend on the APF type; for example, social norms regarding masculinity were a barrier affecting plant-based APF choices in restaurants, but these norms were not a barrier affecting the choice of insect-based APF in restaurants.
CONCLUSIONS
Addressing barriers/facilitators identified in this review will help in developing environment-matching interventions that aim to make alternative proteins mainstream.
TRIAL REGISTRATION
PROSPERO database registration: #CRD42023388700.
Topics: Humans; Food Preferences; Choice Behavior; Dietary Proteins; Consumer Behavior; Restaurants; Built Environment; Supermarkets; Commerce
PubMed: 38755618
DOI: 10.1186/s12966-024-01606-6 -
BMC Geriatrics May 2024Sarcopenia and sarcopenic obesity (SO) are age-related syndromes that may compromise physical and mental health among older adults. The Nordic countries differ from... (Review)
Review
BACKGROUND
Sarcopenia and sarcopenic obesity (SO) are age-related syndromes that may compromise physical and mental health among older adults. The Nordic countries differ from other regions on prevalence of disease, life-style behavior, and life expectancy, which may impact prevalence of sarcopenia and SO. Therefore, the aim of this study is to review the available evidence and gaps within this field in the Nordic countries.
METHODS
PubMed, Embase, and Web of science (WOS) were searched up to February 2023. In addition, grey literature and reference lists of included studies were searched. Two independent researcher assessed papers and extracted data.
RESULTS
Thirty-three studies out of 6,363 searched studies were included in this scoping review. Overall prevalence of sarcopenia varied from 0.9 to 58.5%. A wide prevalence range was still present for community-dwelling older adults when definition criteria and setting were considered. The prevalence of SO ranged from 4 to 11%, according to the only study on this field. Based on the included studies, potential risk factors for sarcopenia include malnutrition, low physical activity, specific diseases (e.g., diabetes), inflammation, polypharmacy, and aging, whereas increased levels of physical activity and improved dietary intake may reduce the risk of sarcopenia. The few available interventions for sarcopenia were mainly focused on resistance training with/without nutritional supplements (e.g., protein, vitamin D).
CONCLUSION
The findings of our study revealed inadequate research on SO but an increasing trend in the number of studies on sarcopenia. However, most of the included studies had descriptive cross-sectional design, small sample size, and applied different diagnostic criteria. Therefore, larger well-designed cohort studies that adhere to uniform recent guidelines are required to capture a full picture of these two age-related medical conditions in Nordic countries, and plan for prevention/treatment accordingly.
Topics: Humans; Sarcopenia; Aged; Obesity; Scandinavian and Nordic Countries; Prevalence; Risk Factors; Aged, 80 and over
PubMed: 38741067
DOI: 10.1186/s12877-024-04970-x