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Diseases (Basel, Switzerland) May 2024Breast cancer is the fifth-ranked cancer globally. Despite early diagnosis and advances in treatment, breast cancer mortality is increasing. This meta-analysis aims to... (Review)
Review
Breast cancer is the fifth-ranked cancer globally. Despite early diagnosis and advances in treatment, breast cancer mortality is increasing. This meta-analysis aims to examine all possible prognostic factors that improve/deteriorate breast cancer-specific survival. MEDLINE, PubMed, ScienceDirect, Ovid, and Google Scholar were systematically searched until September 16, 2023. The retrieved studies from 1995 to 2022 accumulated 1,386,663 cases from 30 countries. A total of 13 out of 22 prognostic factors were significantly associated with breast cancer-specific survival. A random-effects model provided a pooled estimate of the top five poorest prognostic factors, including Stage 4 (HR = 12.12; 95% CI: 5.70, 25.76), followed by Stage 3 (HR = 3.42, 95% CI: 2.51, 4.67), a comorbidity index ≥ 3 (HR = 3.29; 95% CI: 4.52, 7.35), the poor differentiation of cancer cell histology (HR = 2.43; 95% CI: 1.79, 3.30), and undifferentiated cancer cell histology (HR = 2.24; 95% CI: 1.66, 3.01). Other survival-reducing factors include positive nodes, age, race, HER2-receptor positivity, and overweight/obesity. The top five best prognostic factors include different types of mastectomies and breast-conserving therapies (HR = 0.56; 95% CI: 0.44, 0.70), medullary histology (HR = 0.62; 95% CI: 0.53, 0.72), higher education (HR = 0.72; 95% CI: 0.68, 0.77), and a positive estrogen receptor status (HR = 0.78; 95% CI: 0.65, 0.94). Heterogeneity was observed in most studies. Data from developing countries are still scarce.
PubMed: 38920543
DOI: 10.3390/diseases12060111 -
Frontiers in Endocrinology 2024According to data from the World Health Organization (WHO), there is a significant public health issue regarding the increasing number of individuals affected by obesity... (Meta-Analysis)
Meta-Analysis
BACKGROUND
According to data from the World Health Organization (WHO), there is a significant public health issue regarding the increasing number of individuals affected by obesity and overweight on an annual basis. Therefore, it is imperative to urgently identify interventions that can effectively control and improve this condition. Baduanjin, as a medium-intensity exercise, appears a suitable approach for weight reduction among individuals with obesity. This paper aimed to provide a systematic review and meta-analysis of the efficacy of Baduanjin in addressing obesity and overweight, with the ultimate goal of assisting individuals with obesity in finding an effective, safe, and engaging method for weight reduction.
METHODS
We conducted a comprehensive search of multiple databases including PubMed, Cochrane Library, Web of Science, Embase, The China National Knowledge Infrastructure (CNKI), The Chinese Scientific Journal Database (VIP), The Chinese Biomedical Literature Database (CBM), and WanFang Database to identify relevant articles published from the inception of each database until September 2023. Specifically, we focused on randomized controlled trials (RCTs) investigating the effects of Baduanjin on weight reduction. Data from these studies were extracted and analyzed using appropriate statistical methods. In cases where there was no significant heterogeneity ( < 50%, > 0.1), we employed a fixed effects model for data synthesis; otherwise, a random effects model was selected. Funnel plots were used to assess publication bias, and the mean difference (MD) was reported as an indicator of treatment group differences.
RESULTS
A total of 420 participants were included in 10 studies. The MD results of the experimental group when compared with the control group were -3.69 (95%CI = -4.97 to -2.40, < 0.001) for body weight (BW), -5.42 (95%CI = -6.56 to -4.28, < 0.001) for body mass index (BMI), -1.36 (95%CI = -1.76 to -0.96, < 0.001) for waist circumference (WC), -3.40 (95%CI = -4.43 to -2.37, < 0.001) for hip circumference (HC), and -0.03 (95%CI = -0.04 to -0.02, > 0.1) for the waist-to-hip ratio (WHR). All of the values in the experimental group showed significant difference. The results of the Egger's test ( = 1.43, = 0.190) suggest that there was no substantial bias present within the data analysis process. The safety profile revealed no adverse events reported across all 10 studies.
CONCLUSION
Baduanjin could be effective in reducing weight, and the practice of Baduanjin has the potential to regulate BW, BMI, WC, HC, and WHR. However, further well-designed RCTs are still necessary to provide more robust evidence in the future.
SYSTEMATIC REVIEW REGISTRATION
http://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024513789.
Topics: Humans; Obesity; Overweight; Weight Loss; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 38919476
DOI: 10.3389/fendo.2024.1338094 -
Frontiers in Nutrition 2024Obesity is reaching epidemic proportions with 51% of the population expected to be obese by 2030. Recently, polyphenols have been highlighted as an effective approach to...
BACKGROUND
Obesity is reaching epidemic proportions with 51% of the population expected to be obese by 2030. Recently, polyphenols have been highlighted as an effective approach to managing obesity and associated risks. Polyphenols are a large class of bioactive plant compounds classified into two major categories: flavonoids which are distinguished by the fundamental C6-C3-C6 skeleton and non-flavonoids.
OBJECTIVE
This systematic review evaluated the effect of different polyphenol sources in overweight and obese people with and without type 2 diabetes. The primary outcome was lipid profile and the secondary outcomes were blood glucose, HbA1c (%), HOMA-IR, weight, and body mass index.
METHOD
A search was undertaken in PubMed, Web of Science, Medline, and Wiley for randomized control trials that assessed different sources of polyphenols in overweight and obese people with or without type 2 diabetes. The quality of the included studies was assessed using the National Heart, Lung, and Blood Institute Quality Assessment Tool.
RESULT
The search yielded 935 studies, of which six randomized control trials met the inclusion criteria. Five studies found no significant difference in lipid profile between the control and intervention groups in triglycerides, total cholesterol, LDL cholesterol, and HDL cholesterol. However, one study showed significant differences in triglycerides ( = 0.04) and HDL cholesterol ( = 0.05) between the two groups with no significant difference in total cholesterol and LDL cholesterol. There were no significant changes in blood glucose observed in the included studies, with only two studies reporting a significant difference in A1c between the groups. Four studies found no difference in HOMA-IR, while one study showed a significant decrease in HOMA-IR in the intervention group compared to the control group. Three studies reported no difference in BMI or weight between the two groups.
CONCLUSION
The data associated with the specific health benefits of polyphenols and their sources in people with overweight, obese, and type 2 diabetes are still limited, so further research is required to support their use and prove their benefits.
PubMed: 38919387
DOI: 10.3389/fnut.2024.1376508 -
Obesity Surgery Jun 2024Several studies have indicated that miRNAs play crucial roles in adipogenesis, insulin resistance, and inflammatory pathways associated with obesity and change after... (Review)
Review
Several studies have indicated that miRNAs play crucial roles in adipogenesis, insulin resistance, and inflammatory pathways associated with obesity and change after metabolic bariatric surgery (MBS). This systematic review explores and maps the existing literature on how miRNAs are expressed and investigates the unique miRNAs with the effects after MBS. The Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, and EMBASE were searched from 2019 until February 2024. This SR found 825 miRNAs from 25 studies, identifying 507 unique ones not used twice in the same study. A total of 21 studies (84%) measured RNA before and after surgery. The miRNA used per study ranged from 1 to 146 miRNA types, with a median study sample size of just 27 patients per study, raising concerns about some conclusions' robustness. From the 507 unique miRNAs, only 16 were consistently analyzed in 4 to 7 studies, which gave 77 different outcomes in relation to miRNA after MBS. MiRNA 122 and 122-5p were analyzed the most. Others were 106b-5p, 140-5p, 183-5p, 199b-5p, 20b-5p, 424-5p, 486-5p, 7-5p, 92a, 93-5p, 194-5p, 21-5p, 221, 320a, and 223-3p. A gap was observed in many studies, whereby the results were not the same, or there was no explanation for the effects after MBS was given within the same miRNA. Fifteen miRNAs were reported to have the same upward and downward trend, although not within the same study, and only 26.1% employed some form of statistical modeling to account for bias or confounding factors. Directions and effects in miRNA are visible, but still, inconsistent outcomes linked to the same miRNA after MBS, underscoring the need for clarity in miRNA-outcome relationships. Collaborative efforts, consensus-driven miRNA dictionaries, and larger, more rigorous studies are necessary to improve methodology designs and improve outcomes.
PubMed: 38916799
DOI: 10.1007/s11695-024-07302-5 -
BMC Public Health Jun 2024Obesity is a global health concern, and understanding its prevalence among medical students is crucial for shaping targeted interventions. This systematic review and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Obesity is a global health concern, and understanding its prevalence among medical students is crucial for shaping targeted interventions. This systematic review and meta-analysis aim to comprehensively assess the prevalence of obesity and overweight among medical students.
METHODS
A systematic literature search was conducted across major databases, including PubMed, Scopus, and Web of Science, in order to identify relevant studies that evaluated obesity and overweight among medical students. Inclusion criteria encompassed published and peer-reviewed studies reporting the prevalence of obesity among medical students.
RESULTS
A total of 1245 studies were screened based on their titles and abstracts, and 99 studies comprised a total sample size of 47,455 medical students across diverse geographical regions were included in this study. The overall pooled prevalence of overweight among medical students was estimated at 18% (95% CI: 17%-20%), with obesity at 9% (95% CI: 7%-11%). The combined prevalence of excess weight (overweight and obesity) was calculated to be 24% (95% CI: 22%-27%). Meta-regression results indicated a significant correlation between study year and overweight/obesity prevalence (p < 0.05), with a trend towards increasing prevalence over time. Male medical students exhibited a higher pooled prevalence, increasing with the percentage of male participants.
CONCLUSION
This systematic review and meta-analysis provide a comprehensive overview of the prevalence of obesity among medical students globally. In summary, obesity and overweight present a substantial worldwide health concern, especially among susceptible groups such as medical students, whose prevalence is on the rise. It is crucial to grasp the extent and contributing factors of obesity among medical students to formulate precise interventions aimed at fostering healthier habits and alleviating the adverse impacts of obesity on both physical and mental health.
Topics: Humans; Students, Medical; Prevalence; Obesity; Overweight; Global Health; Male; Female
PubMed: 38915047
DOI: 10.1186/s12889-024-19184-4 -
Pediatric Research Jun 2024Childhood obesity is a global public health issue, and the status of clinical practice guidelines (CPGs) as instruction manuals for the management of childhood obesity...
BACKGROUND
Childhood obesity is a global public health issue, and the status of clinical practice guidelines (CPGs) as instruction manuals for the management of childhood obesity remains unclear. This study aims to identify and apprise the methodological and reporting quality of CPGs focused on childhood obesity and provide an overview of key recommendations.
METHODS
Databases and websites reporting guidelines were searched from January, 2018 to September, 2023. The methodological quality was graded using the AGREE II, and RIGHT was used to assess the reporting completeness.
RESULTS
Among the six included CPGs, two were rated as high quality and considered "Recommended" and three were reported no less than 80%. CPGs included 184 recommendations cover diagnosis, assessment and management of complications, interventions and prevention. The diagnostic criteria for children with obesity over 2 years of age are based on normative BMI percentiles, depending on sex and age. CPGs recommended the delivery of multi-component behavior-changed interventions included controlling diet and increasing physical activity. Pharmacological interventions and bariatric surgery are considered as complementary therapies.
CONCLUSION
CPGs for childhood obesity should emphasize the impact of psychological factors and consider the provision of interventions from multiple settings, and could consider the role of complementary alternative therapies.
IMPACT
Six guidelines have been published in the past 5 years focusing children obesity. Recommendations covered diagnosis, multiple intervention and prevention. Guidelines should focus on the role of complementary alternative therapies. Guidelines should emphasize the impact of psychological factors. Guidelines should consider the provision of interventions from multiple settings.
PubMed: 38914759
DOI: 10.1038/s41390-024-03357-3 -
Indian Journal of Endocrinology and... 2024Obesity has erupted as an epidemic around the world. It has set itself as a fast wave among other prevailing specific clusters of non-communicable diseases. The current... (Review)
Review
Obesity has erupted as an epidemic around the world. It has set itself as a fast wave among other prevailing specific clusters of non-communicable diseases. The current study reviews and presents an updated meaningful review of the vast research work performed at schools located in different cities of India. A systematic search was conducted in PubMed, Scopus, Google Scholar and PEDro. Studies representing data on obesity and overweight among children in Indian cities were included in the review. A total of 21 articles with 71,466 participants were included in the review for analysis. Obesity developed in childhood and adolescence is greatly associated with heart disease, stroke and cancer (breast and ovarian in women and prostate in men) in the late stage of life. In India, despite being a country with a faster rate of population becoming overweight and obese in urban areas, in contrast, rural areas are still struggling with malnutrition.
PubMed: 38911116
DOI: 10.4103/ijem.ijem_365_23 -
Proceedings (Baylor University. Medical... 2024Nonalcoholic fatty liver disease (NAFLD) or metabolic dysfunction-associated steatotic liver disease (MASLD) is a significant contributor to chronic liver disease... (Review)
Review
Nonalcoholic fatty liver disease (NAFLD) or metabolic dysfunction-associated steatotic liver disease (MASLD) is a significant contributor to chronic liver disease worldwide. Orlistat blocks intestinal fat absorption, leading to decreased liver fat content. Therefore, it is a viable option for NAFLD management. We performed a systematic review and metaanalysis using randomized controlled trials (RCTs). We used mean difference (MD) to pool continuous outcomes presented with the corresponding confidence interval (CI). We included four RCTs with a total of 379 patients. Orlistat was effective in reducing liver fat content (MD: -5.02, 95% CI [-7.23, -2.82], = 0.00001), alanine transferase (MD: -10.03, 95% CI [-17.80, -2.26], = 0.01), aspartate transferase (MD: -4.29, 95% CI [-7.59, -0.99], = 0.01), waist circumference (MD: -3.18, 95% CI [-4.25, -2.10], = 0.00001), body mass index (MD: -1.03, 95% CI [-1.34, -0.73], = 0.00001), total cholesterol (MD: -3.75, 95% CI [-4.02, -3.49], = 0.00001), and low-density lipoprotein (MD: -3.83, 95% CI [-4.05, -3.61], = 0.00001). However, orlistat was associated with increased serum triglycerides (MD: 7.46, 95% CI [6.48, 8.44], = 0. 00001). Orlistat is a viable option for NAFLD management; however, it increases triglyceride levels. Larger RCTs are required.
PubMed: 38910819
DOI: 10.1080/08998280.2024.2335829 -
Probiotics and Antimicrobial Proteins Jun 2024The aim of this systematic review is to evaluate musculoskeletal changes in response to prebiotics, probiotics, or synbiotics supplementation in older adults or in...
The aim of this systematic review is to evaluate musculoskeletal changes in response to prebiotics, probiotics, or synbiotics supplementation in older adults or in animal models of aging musculoskeletal disorders. A comprehensive search was conducted on electronic databases, including PubMed/Medline, Cochrane, and Web of Science until April 2024. The quality assessment of clinical trials was conducted using the Cochrane Collaboration tool and for animal studies, the SYRCLE's tool was used. Our literature search resulted in 652 studies. After removing duplicates and screening the articles based on their titles and abstracts, we assessed the full text of 112 articles, which yielded 20 clinical trials and 30 animal studies in our systematic review. Most of human and animal studies reported an improvement in physical performance, a decrease in frailty index, and a lower reduction in bone mineral density in the intervention groups. Body composition tends to increase in muscle ratio, muscle mass, and reduce in appendicular lean mass and muscle atrophy. Also, the intervention induced bone turnover and mineral absorption, significantly increasing Ca, P, and Mg absorption and short-chain fatty acid concentration. Additionally, levels of inflammatory markers such as IL1, IL6, IL17, T helper 17, and TNF-α exhibited a decreasing trend, while an increase in IL10 and IFN-γ was observed. Prebiotics, probiotics, or synbiotics supplementations could effectively improve the physical performance and muscle strength and reduce the risk of bone loss and frailty in the elderly.
PubMed: 38907826
DOI: 10.1007/s12602-024-10306-3 -
Women and Birth : Journal of the... Jun 2024Australian Aboriginal and Torres Strait Islander (referred to hereafter as Aboriginal) women breastfeed at lower rates than non-Aboriginal women, and rates vary across...
BACKGROUND
Australian Aboriginal and Torres Strait Islander (referred to hereafter as Aboriginal) women breastfeed at lower rates than non-Aboriginal women, and rates vary across and within Aboriginal populations.
AIM
To determine rates of breastfeeding initiation and maintenance and compare individually collected survey data with existing routinely collected state and national breastfeeding data for Aboriginal women.
METHODS
CINAHL, Medline, EMBASE, SCOPUS, PsycINFO, and the Cochrane library were searched for peer-reviewed literature published between 1995 and 2021. Quantitative studies written in English and reporting breastfeeding for Aboriginal women or women having an Aboriginal infant were included. Screening and quality assessment included co-screening 10 % of papers. Two reviewers completed data extraction. A proportional meta-analysis was undertaken for breastfeeding initiation and narrative data synthesis used to summarise breastfeeding maintenance.
FINDINGS
The initial search identified 12,091 records, with 31 full text studies retrieved, and 27 reports from 22 studies met inclusion criteria. Breastfeeding initiation was 79 % (95 % CI 0.73, 0.85), however, rates were lower than non-Aboriginal women. Maintenance ranged between one week and five years. Rates and definitions varied significantly between studies, with inconsistencies in government collection and reporting of breastfeeding.
CONCLUSION
Significant variation in definitions and reporting make comparisons difficult. Breastfeeding rates were below recommended targets. Future pattern and trend analyses require standardised measures and definitions. Current collection and reporting of breastfeeding data, particularly routinely collected state-based data, is inadequate to present an accurate picture of current breastfeeding in Australia for Aboriginal women and infants, and to effectively inform interventions and policies.
PubMed: 38906086
DOI: 10.1016/j.wombi.2024.101634