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Nutrients Jul 2015Enteral immunomodulatory nutrition is considered as a promising therapy for the treatment of acute lung injury and acute respiratory distress syndrome (ALI/ARDS).... (Meta-Analysis)
Meta-Analysis Review
Enteral Immunomodulatory Diet (Omega-3 Fatty Acid, γ-Linolenic Acid and Antioxidant Supplementation) for Acute Lung Injury and Acute Respiratory Distress Syndrome: An Updated Systematic Review and Meta-Analysis.
UNLABELLED
Enteral immunomodulatory nutrition is considered as a promising therapy for the treatment of acute lung injury and acute respiratory distress syndrome (ALI/ARDS). However, there are still some divergences, and it is unclear whether this treatment should be recommended for patients with ALI/ARDS. Therefore, we conducted this systematic review and meta-analysis to assess the efficacy and safety of an enteral immunomodulatory diet on the clinical outcomes of ALI/ARDS patients.
METHODS
We retrieved potentially relevant clinical trials though electronic databases. All trials of enteral immunomodulatory diet for ALI/ARDS were included. Analyses of the overall all-cause mortality, 28-day ventilator-free days and 28-day intensive care unit (ICU) free days were conducted.
RESULTS
In total six controlled trials were evaluated. The pooled results did not show a significant reduction in the risk of all-cause mortality (M-H RR (the overall Mantel-Haenszel relative risk), 0.81 (95% CI, 0.50-1.31); p = 0.38; 6 trials, n = 717) in ALI/ARDS patients treated with the immunomodulatory diet. This treatment also did not extend the ventilator-free days and ICU-free days. However, patients with high mortality might benefit from this treatment.
CONCLUSIONS
The enteral immunomodulatory diet could not reduce the severity of the patients with ALI/ARDS. Whereas, for ALI/ARDS patients with high mortality, this treatment might reduce the all-cause mortality, but its use should be treated with discretion.
Topics: Acute Lung Injury; Antioxidants; Dietary Fats; Enteral Nutrition; Humans; Respiratory Distress Syndrome; gamma-Linolenic Acid
PubMed: 26184293
DOI: 10.3390/nu7075239 -
International Journal of Evidence-based... Jun 2016This systematic review sought to identify the association of dietary intake and supplementation of specific polyunsaturated fatty acids with inflammation and function in... (Review)
Review
The association of dietary intake and supplementation of specific polyunsaturated fatty acids with inflammation and functional capacity in chronic obstructive pulmonary disease: a systematic review.
OBJECTIVE
This systematic review sought to identify the association of dietary intake and supplementation of specific polyunsaturated fatty acids with inflammation and function in people with chronic obstructive pulmonary disease (COPD).
DATA SOURCES
We searched electronic databases including PubMed, CINAHL, MEDLINE, EMBASE, The Cochrane Library, ProQuest Dissertations and Theses, Scopus, Google Scholar, Trove, and WHO International Clinical Trials Registry Platform and reference lists of retrieved articles published prior to August 2014.
INCLUSION CRITERIA
We considered observational studies that evaluated dietary intake of omega-3 (eicosapentaenoic acid, docosahexaenoic acid or α-linolenic acid) and/or omega-6 fatty acids (γ-linoleic acid or arachidonic acid), and experimental studies that evaluated omega-3 fatty acid supplementation (containing predominantly one or more omega-3 fatty acids) on airway and systemic inflammatory markers and/or functional capacity outcomes in people with COPD-related diagnoses.
DATA SYNTHESIS
Since statistical pooling was not possible, the findings were presented in narrative form including tables and figures to aid in data presentation when appropriate.
RESULTS
One 8-week randomized controlled trial conducted in 80 COPD patients in the Netherlands showed polyunsaturated fatty acid supplementation significantly improved exercise capacity compared with the control condition [between-group difference in mean peak workload was 9.7 W (2.5-17.0; P = 0.009); and mean duration was 4.3 min (0.6-7.9; P = 0.023)]. One cross-sectional study conducted in 250 COPD patients in Spain found associations of specific dietary omega-3 fatty acids with inflammation were inconsistent.
CONCLUSIONS
Limited evidence provides weak support for the use of omega-3 fatty acid supplementation for reducing chronic inflammation and some support for improving functional capacity in COPD patients. There is no consistent evidence showing that low dietary intake of specific omega-3 fatty acids worsens inflammation and/or function. More evidence is required before routinely incorporating this therapy within COPD management plans.
Topics: Dietary Supplements; Fatty Acids, Omega-3; Fatty Acids, Omega-6; Humans; Inflammation; Pulmonary Disease, Chronic Obstructive; Respiratory Function Tests
PubMed: 26134547
DOI: 10.1097/XEB.0000000000000056 -
Obesity Reviews : An Official Journal... Jun 2015Long-chain polyunsaturated fatty acid (LCPUFA) status has recently been related to the pathogenesis of obesity. Our aims were to systematically review observational... (Meta-Analysis)
Meta-Analysis Review
Long-chain polyunsaturated fatty acid (LCPUFA) status has recently been related to the pathogenesis of obesity. Our aims were to systematically review observational studies investigating LCPUFA status from different blood compartments in overweight or obese subjects and to assess the relationship between LCPUFA profile and obesity. The Ovid MEDLINE, Scopus and Cochrane Library CENTRAL databases were searched from inception to January 2014. The meta-analysis showed significant differences in the LCPUFA composition of total plasma lipids, plasma phospholipids and plasma cholesteryl esters between overweight or obese subjects and controls. Dihomo-γ-linolenic acid (DGLA) values were significantly higher in overweight or obese subjects compared with controls in all the investigated biomarkers. In addition, the DGLA/linoleic acid ratio (surrogate parameter for Δ6 desaturase activity) in plasma phospholipids was significantly elevated (mean difference [MD]: 0.05; 95% confidence interval [CI]: 0.02, 0.08; n = 280), while the arachidonic acid/DGLA ratio (surrogate parameter for Δ5 desaturase activity) was significantly decreased (MD: -0.55; 95% CI: -0.71, -0.39; n = 347) in overweight or obese subjects compared with controls. The results of the present meta-analysis confirm that LCPUFA profile is altered in obesity and suggest that the differences observed in desaturase activities may be responsible for the disturbed LCPUFA metabolism in obesity.
Topics: Biomarkers; Deficiency Diseases; Delta-5 Fatty Acid Desaturase; Evidence-Based Medicine; Fatty Acid Desaturases; Fatty Acids, Unsaturated; Humans; Linoleoyl-CoA Desaturase; Nutritional Status; Obesity; Observational Studies as Topic; Overweight
PubMed: 25828602
DOI: 10.1111/obr.12280 -
Journal of Epidemiology 2015Epidemiological studies have suggested inconsistent associations between omega-3 polyunsaturated fatty acids (n-3 PUFAs) and prostate cancer (PCa) risk. We performed a... (Meta-Analysis)
Meta-Analysis Review
Epidemiological studies have suggested inconsistent associations between omega-3 polyunsaturated fatty acids (n-3 PUFAs) and prostate cancer (PCa) risk. We performed a dose-response meta-analysis of prospective observational studies investigating both dietary intake and circulating n-3 PUFAs and PCa risk. PubMed and EMBASE prior to February 2014 were searched, and 16 publications were eligible. Blood concentration of docosahexaenoic acid, but not alpha-linolenic acid or eicosapentaenoic acid, showed marginal positive association with PCa risk (relative risk for 1% increase in blood docosahexaenoic acid concentration: 1.02; 95% confidence interval, 1.00-1.05; I(2) = 26%; P = 0.05 for linear trend), while dietary docosahexaenoic acid intake showed a non-linear positive association with PCa risk (P < 0.01). Dietary alpha-linolenic acid was inversely associated with PCa risk (relative risk for 0.5 g/day increase in alpha-linolenic acid intake: 0.99; 95% confidence interval, 0.98-1.00; I(2) = 0%; P = 0.04 for linear trend), which was dominated by a single study. Subgroup analyses indicated that blood eicosapentaenoic acid concentration and blood docosahexaenoic acid concentration were positively associated with aggressive PCa risk and nonaggressive PCa risk, respectively. Among studies with nested case-control study designs, a 0.2% increase in blood docosapentaenoic acid concentration was associated with a 3% reduced risk of PCa (relative risk 0.97; 95% confidence interval, 0.94-1.00; I(2) = 44%; P = 0.05 for linear trend). In conclusion, different individual n-3 PUFA exposures may exhibit different or even opposite associations with PCa risk, and more prospective studies, especially those examining dietary n-3 PUFAs and PCa risk stratified by severity of cancer, are needed to confirm the results.
Topics: Dose-Response Relationship, Drug; Fatty Acids, Omega-3; Humans; Male; Prospective Studies; Prostatic Neoplasms; Risk
PubMed: 25787237
DOI: 10.2188/jea.JE20140120 -
The Journal of Nutrition Apr 2015High blood pressure is a major health burden positively associated with the risk of cardiovascular disease and other chronic diseases. Flaxseed is a rich dietary source... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
High blood pressure is a major health burden positively associated with the risk of cardiovascular disease and other chronic diseases. Flaxseed is a rich dietary source of α-linolenic acid, lignans, and fiber, with a number of positive health benefits on blood pressure.
OBJECTIVE
The purpose of this study was to clarify the effect of flaxseed consumption on blood pressure. Further, the influence of baseline blood pressure, type of flaxseed supplementation, and duration of flaxseed supplementation on blood pressure was explored.
METHOD
PubMed (MEDLINE), Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library (Central) were searched through July 2014 for studies in which humans supplemented their habitual diet with flaxseed or its extracts (i.e., oil, lignans, fiber) for ≥2 wk.
RESULTS
A total of 11 studies (14 trials) were included in the analysis. Random-effects meta-analyses were conducted for the mean difference in blood pressure. Results indicated that flaxseed supplementation reduced systolic blood pressure (-1.77 mm Hg; 95% CI: -3.45, -0.09 mm Hg; P = 0.04) and diastolic blood pressure (-1.58 mm Hg; 95% CI: -2.64, -0.52 mm Hg; P = 0.003). These results were not influenced by categorization of participants into higher baseline blood pressure (≥130 mm Hg). An improvement in diastolic blood pressure was observed in subgroup analysis for consuming whole flaxseed (-1.93 mm Hg; 95% CI: -3.65, -0.21 mm Hg; P < 0.05) and duration of consumption ≥12 wk (-2.17 mm Hg; 95% CI: -3.44, -0.89 mm Hg; P < 0.05).
CONCLUSION
The present meta-analysis suggests that consumption of flaxseed may lower blood pressure slightly. The beneficial potential of flaxseed to reduce blood pressure (especially diastolic blood pressure) may be greater when it is consumed as a whole seed and for a duration of >12 wk.
Topics: Blood Pressure; Databases, Factual; Diet; Flax; Humans; Hypertension; Phytotherapy; Plant Preparations; Randomized Controlled Trials as Topic; Seeds; Sensitivity and Specificity
PubMed: 25740909
DOI: 10.3945/jn.114.205302 -
Prostaglandins, Leukotrienes, and... Apr 2015This paper presents a systematic review of human studies investigating the effect of altering dietary omega-3 polyunsaturated fatty acid (n-3 PUFA) alpha-linolenic acid... (Review)
Review
The effect of modifying dietary LA and ALA intakes on omega-3 long chain polyunsaturated fatty acid (n-3 LCPUFA) status in human adults: a systematic review and commentary.
This paper presents a systematic review of human studies investigating the effect of altering dietary omega-3 polyunsaturated fatty acid (n-3 PUFA) alpha-linolenic acid (ALA) and omega-6 polyunsaturated fatty acid (n-6 PUFA) linoleic acid (LA) intakes on n-3 long-chain polyunsaturated fatty acid (LCPUFA) status in adult humans. The results suggest that it is possible to increase n-3 LCPUFA status by reducing LA and/or increasing ALA intake in humans, although decreasing LA intake to below 2.5%E may be required to specifically increase levels of the n-3 LCPUFA docosahexaenoic acid (DHA). The majority of studies in this area to date have been relatively poor in quality, which limits the ability to draw robust conclusions, and we present a series of recommendations to improve the quality of future studies in fatty acid nutrition in humans.
Topics: Adult; Clinical Trials as Topic; Dietary Fats, Unsaturated; Fatty Acids, Omega-3; Female; Humans; Linoleic Acid; MEDLINE; Male; alpha-Linolenic Acid
PubMed: 25687496
DOI: 10.1016/j.plefa.2015.01.001 -
Cancer Causes & Control : CCC Mar 2015To investigate the association between fish consumption and n-3 polyunsaturated fatty acids (n-3 PUFA) and the risk of hepatocellular carcinoma (HCC). (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To investigate the association between fish consumption and n-3 polyunsaturated fatty acids (n-3 PUFA) and the risk of hepatocellular carcinoma (HCC).
METHODS
We identified eligible studies in MEDLINE and EMBASE up to July 2014 and the reference lists of original studies and review articles on this topic. Summary relative risks (SRR) with their 95 % confidence intervals (CI) were calculated with a random effects model.
RESULTS
Eleven studies (three cohort studies, seven retrospective case-control studies, and one nested case-control study) met eligibility criteria. Ten articles investigated fish consumption, two articles investigated n-3 PUFA, and two articles investigated alpha-linolenic acid (ALA). The current data suggest that fish consumption was associated with 35 % reduction in HCC risk (highest vs. lowest category SRRs = 0.65, 95 % CI 0.51-0.79; test for heterogeneity p = 0.057, I (2) = 44.1 %). n-3 PUFA was associated with 51 % reduction in HCC risk (highest vs. lowest category SRRs = 0.49, 95 % CI 0.19-0.79). However, no significant inverse association was found in ALA (SRRs = 0.70, 95 % CI 0.30-1.10).
CONCLUSION
Our meta-analysis of observational studies provides evidence that fish consumption and n-3 PUFA has inverse association with the risk of HCC.
Topics: Animals; Anticarcinogenic Agents; Carcinoma, Hepatocellular; Case-Control Studies; Cohort Studies; Diet; Fatty Acids, Omega-3; Female; Fish Products; Fishes; Humans; Liver Neoplasms; Male; Observational Studies as Topic; Retrospective Studies; Risk; alpha-Linolenic Acid
PubMed: 25534918
DOI: 10.1007/s10552-014-0512-1 -
The Indian Journal of Surgery Jun 2014Breast pain or mastalgia is the common symptom in the breast. The two most common concerns of patients presenting with mastalgia are: the fear that breast pain is a...
Breast pain or mastalgia is the common symptom in the breast. The two most common concerns of patients presenting with mastalgia are: the fear that breast pain is a symptom of breast cancer and the presence of severe pain that affects a woman's quality of life. Breast pain requires thorough assessment and should be investigated in the same manner as any other breast symptom. We conducted a systematic review of treatment for breast pain. We searched various reviews, randomized controlled trial, and observational studies over Pubmed and Medline via internet. Searches were carried out on MEDLINE (1950-present), EMBASE (1980-present), and CINAHL (1981-present) using the NHS Evidence Healthcare Databases Advanced Search interface. A further search was also carried out on Cochrane Database of Systematic Reviews (issue 12 of 12, Dec 2011) and Central Register of Controlled Trials (issue 4 of 4, Oct 2011). If no abnormality is found in the breast on assessment, then a combination of reassurance, breast support brassiere, and topical NSAID gel massage are usually effective. Antiestrogen (centchroman/tamoxifen) therapy for 3 to 6 months is the second-line treatment of choice. Danazol may be used in resistant cases. Gamma-linolenic acid or evening primrose oil though commonly prescribed is not effective.
PubMed: 25177120
DOI: 10.1007/s12262-013-0813-8 -
Meat Science Dec 2014Nutritional quality of pork is a significant factor for consumers' health. Feeding n-3 PUFA to pigs, using linseed, improves pork nutritional quality. A meta-analysis... (Meta-Analysis)
Meta-Analysis Review
Nutritional quality of pork is a significant factor for consumers' health. Feeding n-3 PUFA to pigs, using linseed, improves pork nutritional quality. A meta-analysis involving 1006 pigs reported in 24 publications was carried out to assess the effects of dietary linseed on alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA) content in muscle and adipose tissue. Data showed positive effects of n-3 PUFA on muscle fatty acid composition: ALA+137%, EPA+188%, DPA+51% and DHA+12%. Same results were observed in adipose tissue: ALA+297%, EPA+149%, DPA+88% and DHA+18%. A positive correlation between dietary treatment and ALA and EPA content in muscle (P<0.001) and adipose tissue (P=0.036) was observed. A significant association between DPA (P=0.04) and DHA (P=0.011) and live weight in muscle was observed. Feeding linseed to pig improves the nutritional pork quality, raising the n-3 PUFA content in muscle and adipose tissue.
Topics: Animal Feed; Animals; Diet; Food Quality; Linseed Oil; Meat; Nutritive Value; Swine
PubMed: 25089794
DOI: 10.1016/j.meatsci.2014.06.041 -
ALA, fatty fish or marine n-3 fatty acids for preventing DM?: a systematic review and meta-analysis.Current Diabetes Reviews May 2014Diabetes mellitus (T2DM) has become a global problem. Role of n-3 FA in its prevention is still not completely understood. We carried out this systematic review and... (Meta-Analysis)
Meta-Analysis Review
Diabetes mellitus (T2DM) has become a global problem. Role of n-3 FA in its prevention is still not completely understood. We carried out this systematic review and meta-analysis to assess the relation of dietary intake of fish and n-3PUFA with risk of diabetes. We searched PUBMED, EMBASE and GOOGLE with cross references to identify relevant articles. Since no RCTs were available, we searched for prospective cohort studies. Sixteen studies with 6,79,763 participants which assessed the association of dietary intake of fish and n-3 PUFA (marine or alpha-linolenic acid) with incidence of T2DM in > 18 years population and provided relative risk (RR) or hazard ratio (HR) with the corresponding 95% confidence interval (CI) of T2DM for each category of fish or n-3 PUFA intake were included. Three independent reviewers reviewed all eligible studies and abstracted the relevant information from individual studies. Meta-analysis confirmed the previous finding that marine n-3 FA increased risk of T2DM in Americans but reduced the same in Asians. We observed that two and seven times increased intake of ALA and fatty fish respectively reduced the risk of T2DM significantly and ALA did not increase the risk in Americans. We concluded that ALA may have some role in preventing T2DM, but is not studied widely. Hence, it should be studied in greater details (with higher degrees of intake; more than two times) to aid in developing effective preventive strategies against diabetes.
Topics: Animals; Diabetes Mellitus, Type 2; Diet; Diet Surveys; Fatty Acids, Omega-3; Fishes; Humans; Incidence; Seafood; alpha-Linolenic Acid
PubMed: 24828061
DOI: 10.2174/1573399810666140515113137