Association of diabetes and obesity with sperm parameters and testosterone levels: a meta-analysis

Abstract Background The present study performed two distinct meta-analyses with common outcomes (sperm parameters); one was performed in obese individuals (and non-obese controls) and the other in diabetic individuals (and non-diabetic controls). Methods PubMed, Embase, The Cochrane library, Web of Science, Scopus databases were searched to collect clinical studies related to the effects of obesity and diabetes on male sperm from inception to on 1st February 2021. Statistical meta-analyses were performed using the RevMan 5.4 software. Stata16 software was used to detect publication bias. The methodological quality of the included studies was assessed with the Ottawa–Newcastle scale using a star-based system. Results A total of 44 studies were finally included in the present study, which enrolled 20,367 obese patients and 1386 patients with diabetes. The meta-analysis results showed that both obesity and diabetes were associated with reduced semen volume (obese versus non-obese controls: mean difference (MD) = − 0.25, 95% CI = (− 0.33, − 0.16), p < 0.001; diabetes versus non-diabetic controls: MD = − 0.45, 95% CI = (− 0.63, − 0.27), p < 0.001), reduced sperm count (obese versus non-obese controls: MD = − 23.84, 95% CI = (− 30.36, − 17.33), p < 0.001; diabetes versus non-diabetic controls: MD = − 13.12, 95% CI = (− 18.43, − 7.82), p < 0.001), reduced sperm concentration (obese versus non-obese controls: MD = − 7.26, 95% CI = (− 10.07, − 4.46), p < 0.001; diabetes versus non-diabetic controls: MD = − 11.73, 95% CI = (− 21.44, − 2.01), p = 0.02), reduced progressive motility (obese versus non-obese controls: MD = − 5.68, 95% CI = (− 8.79, − 2.56), p < 0.001; diabetes versus non-diabetic controls: MD = − 14.37, 95% CI = (− 21.79, − 6.96), p = 0.001), and decreased testosterone levels (obese versus non-obese controls: MD = − 1.11, 95% CI = (− 1.92, − 0.30), p = 0.007; diabetes versus non-diabetic controls: MD = − 0.37, 95% CI = (− 0.63, − 0.12), p = 0.004). Conclusions Current evidence suggests that obesity and diabetes negatively affect sperm parameters in men and are associated with low testosterone levels. Due to the limitation of the number and quality of included studies, the above conclusions need to be verified by more high-quality studies.

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Effectiveness of e-cigarettes in smoking cessation: a systematic review and meta-analysis

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1226 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

M Oberndorfer ◽

I Grabovac ◽

S Haider ◽

T E Dorner

Keyword(s):

Systematic Review ◽

Smoking Cessation ◽

Meta Analysis ◽

Current Evidence ◽

Promising Alternative ◽

Quality Of Evidence ◽

Different Populations ◽

Meta Analyses

Abstract Background Reports of the effectiveness of e-cigarettes (ECs) for smoking cessation vary across different studies making implementation recommendations hard to attain. We performed a systematic review and meta-analysis to synthesise the current evidence regarding the effectiveness of ECs for smoking cessation. Methods PubMed, PsycInfo and Embase databases were searched for randomized controlled trials comparing nicotine ECs with non-nicotine ECs or with established smoking cessation interventions (nicotine replacement therapy (NRT) and or counselling) published between 01/01/2014 and 01/05/2019. Data from eligible studies were extracted and used for random-effects meta-analyses. Results Our literature review yielded 13190 publications with 10 studies being identified as eligible for systematic review, covering 8362 participants, and 8 for meta-analyses (n = 30 - 6006). Using the last follow-up of eligible studies, the proportion of smokers achieving abstinence was 1.67 [95CI:0.99 - 2.81] times higher in nicotine EC users compared to non-nicotine EC users. The proportion of abstinent smokers was 1.69 [95CI:1.25 - 2.27] times higher in EC users compared to participants receiving NRT. EC users showed a 2.70 [95CI:1.15 - 6.30] times higher proportion of abstinent smokers in comparison to participants solely receiving counselling. Conclusions Our analysis showed modest effects of nicotine-ECs compared to non-nicotine ECs. When compared to NRT or counselling, results suggest that nicotine EC may be more effective for smoking cessation. As ECs also help maintaining routinized behaviour and social aspects of smoking, we hypothesise that this may explain their advantage as a tool for smoking cessation. However, given the small number of included studies, different populations, heterogeneous designs, and the overall moderate to low quality of evidence, it is not possible to offer clear recommendations. More comparable data is needed to strengthen confidence in the quality of evidence. Key messages The number of previous studies assessing the effectiveness of ECs for smoking cessation is limited. Further, comparability of these studies is restricted, weakening the quality of evidence. Although current evidence on the effectiveness of ECs for smoking cessation is inconclusive, our meta-analyses suggest that ECs could be a promising alternative tool in attempts to achieve abstinence.

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The Effectiveness of Acupuncture in Management of Functional Constipation: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2020/6137450 ◽

2020 ◽

Vol 2020 ◽

pp. 1-17

Author(s):

Lu Wang ◽

Mingmin Xu ◽

Qianhua Zheng ◽

Wei Zhang ◽

Ying Li

Keyword(s):

Quality Of Life ◽

Meta Analysis ◽

Safety Evaluation ◽

Functional Constipation ◽

Responder Rate ◽

Current Evidence ◽

Cochrane Library ◽

China National Knowledge Infrastructure ◽

Increased Risk

Objective. The purpose of this study was to assess the effectiveness and safety of acupuncture for functional constipation (FC). Methods. A rigorous literature search was performed in English (PubMed, Web of Science, the Cochrane Library, and EMBASE) and Chinese (China National Knowledge Infrastructure (CNKI), Chinese Biological Medical (CBM), Wanfang database, and China Science and Technology Journal (VIP)) electronic databases from their inception to October 2019. Included randomized controlled trials (RCTs) compared acupuncture therapy with sham acupuncture or pharmacological therapies. The outcome measures were evaluated, including the primary outcome of complete spontaneous bowel movement (CSBM) and secondary outcomes of Bristol Stool Form Scale (BSFS), constipation symptoms scores (CSS), responder rate, the Patient Assessment of Constipation Quality of Life (PAC-QOL) questionnaire, and safety evaluation. Meta-analysis was performed by using RevMan5.3. Results. The merged data of 28 RCTs with 3525 participants indicated that acupuncture may be efficient for FC by increasing CSBMs (p<0.00001; MD = 0.84 [95% CI, 0.65 to 1.03]; I2 = 0%) and improving constipation symptoms (p=0.03; SMD = −0.4 [95% CI, −0.78 to −0.03]; I2 = 74%), stool formation (p<0.00001; MD = 0.24 [95% CI, 0.15 to 0.34]; I2 = 0%), quality of life (p<0.00001; N = 1, MD = −0.33 [95% CI, −0.45 to −0.21]), and responder rates (p=0.02; RR = 2.16; [95% CI, 1.1 to 4.24]; I2 = 69%) compared with the effects of sham treatment. No increased risk of adverse events was observed (p=0.44; RR = 1.18; [95% CI, 0.77 to 1.81]; I2 = 0%). With regard to medication comparisons, the pooled data indicated that acupuncture was more effective in increasing CSBMs (p=0.004; MD = 0.53 [95% CI, 0.17 to 0.88]; I2 = 88%) and improving patients’ quality of life (p<0.00001; SMD = −0.73 [95% CI, −1.02 to −0.44]; I2 = 64%), with high heterogeneity. However, there were no significant differences in responder rate (p=0.12; RR = 1.31; [95% CI, 0.94 to 1.82]; I2 = 53%), BSFS (p=0.5; MD = 0.17 [95% CI, −0.33 to 0.68]; I2 = 93%), or CSS (p=0.05; SMD = −0.62 [95% CI, −1.23 to −0.01]; I2 = 89%). Regarding safety evaluation, acupuncture was safer than medications (p<0.0001; RR = 0.3; [95% CI, 0.18 to 0.52]; I2 = 30%). Conclusions. Current evidence suggests that acupuncture is an efficient and safe treatment for FC. Acupuncture increased stool frequency, improved stool formation, alleviated constipation symptoms, and improved quality of life. However, the evidence quality was relatively low and the relationship between acupuncture and drugs is not clear. More high-quality trials are recommended in the future. PROSPERO registration number: CRD42019143347.

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Comparative efficacy and safety of oral or transdermal opioids in the treatment of knee or hip osteoarthritis: a systematic review and Bayesian network meta-analysis protocol

BMJ Open ◽

10.1136/bmjopen-2018-022142 ◽

2018 ◽

Vol 8 (10) ◽

pp. e022142

Author(s):

Jun Wang ◽

Yin Wang ◽

Hui Zhang ◽

Ming Lu ◽

Weilu Gao ◽

...

Keyword(s):

Bayesian Network ◽

Meta Analysis ◽

Hip Osteoarthritis ◽

Sensitivity Analyses ◽

Cochrane Library ◽

Efficacy And Safety ◽

Meta Analyses ◽

Transdermal Opioids ◽

And Function

IntroductionOsteoarthritis is a common degenerative joint disease that eventually leads to disability and poor quality of life. The main symptoms are joint pain and mobility disorders. If the patient has severe pain or other analgesics are contraindicated, opioids may be a viable treatment option. To evaluate and compare the efficacy and safety of opioids in the treatment of knee or hip osteoarthritis, we will integrate direct and indirect evidence using a Bayesian network meta-analysis to establish hierarchies of these drugs.Methods and analysisWe will search the Medical Literature Analysis and Retrieval System Online, Excerpta Medica database, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Web of Science and PsycINFO databases as well as published and unpublished research in international registries and regulatory agency websites for osteoarthritis reports published prior to 5 January 2018. There will be no restrictions on the language. Randomised clinical trials that compare oral or transdermal opioids with other various opioids, placebo or no treatment for patients with knee or hip osteoarthritis will be included. The primary outcomes of efficacy will be pain and function. We will use pain and function scales to evaluate the main outcomes. The secondary outcomes of safety will be defined as the proportion of patients who have stopped treatment due to side effects. Pairwise meta-analyses and Bayesian network meta-analyses will be performed for all related outcome measures. We will conduct subgroup analyses and sensitivity analyses to assess the robustness of our findings. The Grading of Recommendations, Assessment, Development and Evaluations framework will be used to assess the quality of the evidence contributing to each network assessment.Ethics and disseminationThis study does not require formal ethical approval because individual patient data will not be included. The findings will be disseminated through peer-reviewed publications or conference presentations.PROSPERO registration numberCRD42018085503.

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A Prospective Clinical Study of a Prosexual Nutrient: Nano Leo for Evaluation of Libido, Erection, and Orgasm in Indian Men with Erectile Dysfunction

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2020/4598217 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

S. N. Shankhwar ◽

A. A. Mahdi ◽

A. V. Sharma ◽

Kishan Pv

Keyword(s):

Erectile Dysfunction ◽

Erectile Function ◽

Sperm Count ◽

Sperm Concentration ◽

Prospective Clinical Study ◽

Testosterone Levels ◽

Seminal Parameters ◽

Secondary Endpoints ◽

Indian Men

Aim. The present study aimed to assess the effects of Nano Leo, a prosexual nutrient formulation, on libido, erection, and orgasm in patients with erectile dysfunction (ED). Methods. This was a prospective, single-center, phase IV efficacy study. Patients received two capsules for 7 days and thereafter one capsule through 90 days. Main outcome measures: primary endpoint was change in erectile function assessed using the International Index of Erectile Function (IIEF) questionnaire. Secondary endpoints included improvement in testosterone levels, FSH, LH, and prolactin levels; seminal parameters; and overall quality of life (QoL). Results. Our study included 99 men (mean age 32.2 ± 4.71 years). Mean erectile function domain score increased from 18.9 ± 5.67 at baseline to 23.7 ± 4.01 on day 90 (P<0.001). Similar improvements were observed in orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction domains of IIEF score which was seen as early as day 30. Improved IIEF corroborated with improvement in all QoL domains. From baseline to day 90, treatment with Nano Leo increased testosterone levels (5.04 ± 2.22 vs. 5.57 ± 1.53 ng/mL, P<0.001). Seminal parameters like sperm concentration (44.07 ± 48.28 vs. 56.21 ± 50.45 million/mL) and total sperm count per ejaculate (130.40 ± 156.05 vs. 142.5 ± 161.23 million/mL) significantly increased on day 90 compared to baseline. No changes were observed in hepatic and renal function parameters, and no adverse events were reported which promise the safety of the product, Nano Leo. Conclusion. Nano Leo showed improved libido, erection, and orgasm as evaluated by IIEF and QoL and was well tolerated. Therefore, Nano Leo could be an effective and safe pronutrient supplement in managing ED.

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Simultaneous compared to interval administration of mifepristone and misoprostol for medical abortion up to 10+0 weeks' gestation: a systematic review with meta-analyses

BMJ Sexual & Reproductive Health ◽

10.1136/bmjsrh-2019-200448 ◽

2020 ◽

pp. bmjsrh-2019-200448

Author(s):

Mia Schmidt-Hansen ◽

Jonathan Lord ◽

Elise Hasler ◽

Sharon Cameron

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Cochrane Collaboration ◽

Medical Abortion ◽

Cochrane Library ◽

Published Data ◽

Study Results ◽

Randomised Controlled ◽

Meta Analyses

BackgroundMedical abortion with mifepristone and misoprostol usually involves an interval of 36–48 hours between administering these drugs; however, it is possible that the clinical efficacy at early gestations may be maintained when the drugs are taken simultaneously. The objective of this systematic review was to determine the safety and effectiveness of simultaneous compared with interval administration of mifepristone and misoprostol for abortion up to 10+0 weeks’ gestation.MethodsWe searched Embase Classic, Embase; Ovid MEDLINE(R) including Daily, and Epub Ahead-of-Print, In-Process & Other Non-Indexed Citations; and Cochrane Library on 11 December 2019. We included randomised controlled trials (RCTs), published in English from 1985, comparing simultaneous to interval administration of mifepristone and misoprostol for early abortion. Risk of bias was assessed using the Cochrane Collaboration checklist for RCTs. Meta-analysis of risk ratios (RRs) using the Mantel-Haenszel method were performed. The quality of the evidence was assessed using GRADE.ResultsMeta-analyses of three RCTs (n=1280) showed no differences in ‘ongoing pregnancy’ (RR 1.78, 95% CI 0.38 to 8.36), ‘haemorrhage requiring transfusion or ≥500 mL blood loss’ (RR 0.11, 95% CI 0.01 to 2.03) and ‘incomplete abortion with the need for surgical intervention’ (RR 1.30, 95% CI 0.76 to 2.25) between the interventions. Individual study results showed no difference in patient satisfaction, or ‘need for repeat misoprostol’, although ‘time to onset of bleeding or cramping’ was longer after simultaneous than interval administration. The quality of evidence was very low to moderate.ConclusionThe published data support the use of simultaneous mifepristone and misoprostol for medical abortion up to 9+0 weeks in women who prefer this method of administration.

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Management of haemorrhoids: protocol of an umbrella review of systematic reviews and meta-analyses

BMJ Open ◽

10.1136/bmjopen-2019-035287 ◽

2020 ◽

Vol 10 (3) ◽

pp. e035287

Author(s):

Min Chen ◽

Tai-Chun Tang ◽

Tao-Hong He ◽

Yong-Jun Du ◽

Di Qin ◽

...

Keyword(s):

Systematic Reviews ◽

Meta Analysis ◽

Random Effect Model ◽

Current Evidence ◽

Cochrane Library ◽

Final Report ◽

Umbrella Review ◽

Effect Model ◽

Meta Analyses ◽

The Impact

IntroductionThe prevalence of haemorrhoidal diseases was high in general population, and many treatments are proposed for the management of haemorrhoids. The treatments include conservative and surgical interventions; the credibility and strength of current evidence of their effectiveness are not comprehensively evaluated. We aim to evaluate the credibility of systematic reviews and meta-analyses that assess the effectiveness of the treatments for haemorrhoidal diseases through an umbrella review.Methods and analysisWe will search Ovid Medline, Embase, Cochrane library and Web of Science from inception to March 2020 without any language restriction. We will include meta-analyses that examine the effectiveness of treatments in the management of haemorrhoids. Two reviewers will independently screen the titles and abstracts of retrieved articles, and they will extract data from the included meta-analyses. For each meta-analysis, we will estimate the effect size of a treatment through the random-effect model and the fixed-effect model, and we will evaluate between-study heterogeneity (Cochrane’s Q and I2statistics) and small-study effect (Egger’s test); we will also estimate the evidence of excess significance bias. Evidence of each treatment will be graded according to prespecified criteria. Methodological quality of each meta-analysis will be evaluated by using Assessment of Multiple Systematic Reviews 2. The corrected cover area method will be used to assess the impact of overlap in reviews on the findings of the umbrella review.Ethics and disseminationWe will present the results of the umbrella review at conferences and publish the final report in a peer-reviewed journal. The umbrella review does not require ethical approval.PROSPERO registration numberCRD42019140702.

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Effectiveness of Electronic Cigarettes in Smoking Cessation: A Systematic Review and Meta-analysis

Nicotine & Tobacco Research ◽

10.1093/ntr/ntaa181 ◽

2020 ◽

Cited By ~ 4

Author(s):

Igor Grabovac ◽

Moritz Oberndorfer ◽

Jismy Fischer ◽

Winfried Wiesinger ◽

Sandra Haider ◽

...

Keyword(s):

Systematic Review ◽

Smoking Cessation ◽

Random Effects ◽

Electronic Cigarettes ◽

Meta Analysis ◽

Current Evidence ◽

Quality Of Evidence ◽

Registration Number ◽

Meta Analyses

Abstract Introduction Reports of the effectiveness of e-cigarettes (ECs) for smoking cessation vary across different studies making implementation recommendations hard to attain. We performed a systematic review and meta-analysis to assess the current evidence regarding effectiveness of ECs for smoking cessation. Methods PubMed, PsycInfo, and Embase databases were searched for randomized controlled trials comparing nicotine ECs with non-nicotine ECs or with established smoking cessation interventions (nicotine replacement therapy [NRT] and or counseling) published between 1 January 2014 and 27 June 2020. Data from eligible studies were extracted and used for random-effects meta-analyses (PROSPERO registration number: CRD42019141414). Results The search yielded 13 950 publications with 12 studies being identified as eligible for systematic review (N = 8362) and 9 studies for random-effects meta-analyses (range: 30–6006 participants). The proportion of smokers achieving abstinence was 1.71 (95 CI: 1.02–2.84) times higher in nicotine EC users compared with non-nicotine EC users. The proportion of abstinent smokers was 1.69 (95 CI: 1.25–2.27) times higher in EC users compared with participants receiving NRT. EC users showed a 2.04 (95 CI: 0.90–4.64) times higher proportion of abstinent smokers in comparison with participants solely receiving counseling. Conclusions Our results suggest that nicotine ECs may be more effective in smoking cessation when compared with placebo ECs or NRT. When compared with counseling alone, nicotine ECs are more effective short term, but its effectiveness appears to diminish with later follow-ups. Given the small number of studies, heterogeneous design, and the overall moderate to low quality of evidence, it is not possible to offer clear recommendations. Implications The results of this study do not allow for a conclusive argument. However, pooling current evidence points toward a potential for ECs as a smoking cessation tool. Though, given the overall quality of evidence, future studies should aim for more clarity in terms of interventions and larger study populations.

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The Effectiveness of Laid-back Position on Lactation Related Nipple problems and comfort: A meta-analysis

10.21203/rs.3.rs-40847/v1 ◽

2020 ◽

Author(s):

Zhi WANG ◽

Qiuyue LIU ◽

Lihua MIN ◽

Xiaorong MAO

Keyword(s):

Meta Analysis ◽

Current Evidence ◽

Cochrane Library ◽

Control Group ◽

International Consensus ◽

Factors Affecting ◽

Key Words Breast ◽

Knowledge Infrastructure ◽

Chinese National Knowledge Infrastructure

Abstract Background The importance of breastfeeding for maternal and child health has become an international consensus. However, it has been found that lactation-related nipple problems are common and there are some important factors affecting the effectiveness of breastfeeding. Multiple studies recommended the laid-back breastfeeding, but the researches are on various levels of quality and the results are controversial.Methods We systematically searched the following twelve databases: Cochrane Library, EMBASE, Medline, Ovid, PubMed, Web of Science, CINAHL, Scopus, SinoMed, Chinese National Knowledge Infrastructure (CNKI), WanFang, and VIP from inception to January 28,2020. All studies reporting the laid-back breastfeeding or biological nurturing were considered, regardless of they are randomized controlled trials. Two trained investigators independently evaluated the quality of the included the articles and screened the data. All the data were analyzed separately using Review Manager Version 5.3 and STATA/SE Version 15.1. Results A total of 12 studies involving 1,936 groups of postpartum women and their newborns were included. The results of meta-analysis showed that nipple trauma (RR = 0.47; 95% CI 0.29,0.75; p < 0.002), nipple pain (RR = 0.25; 95% CI 0.20,0.32; p < 0.00001), the correct posture of latching (RR = 1.22; 95% CI 1.11,1.33; p < 0.00001)and position comfort (ES = 0.01; 95%CI -0.28,0.30; p = 0.006) of experimental group were all better than control group, and the differences were statistically significant ( p < 0.05), which indicates that the laid-back position has a positive effect on maternal breastfeeding. Conclusion Laid-back position has significant advantages in decreasing the incidence of nipple trauma and nipple pain compared with traditional breastfeeding postures, and it appears that laid-back position is conducive to the correct posture of latching. However, current evidence does not show different breastfeeding outcomes in the two groups of position comfort. Laid-back position is helpful to solve lactation-related nipple problems and it can be used as a recommended position for breastfeeding. Key words: Breast-feeding, Biological Nurturing, Laid-back Breastfeeding, Meta-Analysis

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The Effectiveness of Laid-back Position on Lactation Related Nipple problems and comfort: A meta-analysis

10.21203/rs.3.rs-40847/v2 ◽

2020 ◽

Author(s):

Zhi WANG ◽

Qiuyue LIU ◽

Lihua MIN ◽

Xiaorong MAO

Keyword(s):

Meta Analysis ◽

Current Evidence ◽

Cochrane Library ◽

Correct Position ◽

International Consensus ◽

Factors Affecting ◽

Knowledge Infrastructure ◽

Chinese National Knowledge Infrastructure ◽

Positive Effect

Abstract Background The importance of breastfeeding for maternal and child health has become an international consensus. However, it has been found that lactation-related nipple problems are common and there are some important factors affecting the breastfeeding. Multiple studies recommended the laid-back breastfeeding, but they are on various levels of quality and the results are inconclusive. Methods We systematically searched the following twelve databases: Cochrane Library, EMBASE, Medline, Ovid, PubMed, Web of Science, CINAHL, Scopus, SinoMed, Chinese National Knowledge Infrastructure (CNKI), WanFang, and VIP from inception to January 28,2020. All studies regarding the laid-back breastfeeding or biological nurturing were considered, regardless of whether they are randomized controlled trials or not. Two trained investigators independently evaluated the quality of the selected articles and screened the data. All the data were analyzed separately using Review Manager Version 5.3 and STATA/SE Version 15.1.Results A total of 12 studies involving 1,936 groups of postpartum women and their newborns were included. The results of meta-analysis showed that nipple pain (RR = 0.24; 95% CI 0.14,0.40; p < 0.00001), nipple trauma (RR = 0.47; 95% CI 0.29,0.75; p = 0.002), the correct position of latching (RR = 1.22; 95% CI 1.11,1.33; p < 0.00001) and position comfort (ES = 0.09; 95% CI -0.63,0.81; p = 0.000) of experimental groups were all better than that of the control groups, and the differences were statistically significant (p < 0.05), which indicate that the laid-back position has a positive effect on maternal breastfeeding.Conclusion Laid-back position has been proved to related with decreasing the incidence of nipple trauma and nipple pain compared with traditional breastfeeding positions, and it appears that laid-back position is conducive to the correct position of latching. However, current evidence does not show different breastfeeding outcomes in the two groups of position comfort. Laid-back position is helpful to solve lactation-related nipple problems and it can be used as a recommended position for breastfeeding.

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Association of Consumption of Sugar-Sweetened Beverages or Artificially Sweetened Beverages with Mortality: A Systematic Review and Dose–Response Meta-Analysis of Prospective Cohort Studies

Advances in Nutrition ◽

10.1093/advances/nmaa110 ◽

2020 ◽

Author(s):

Yan-Bo Zhang ◽

Yi-Wen Jiang ◽

Jun-Xiang Chen ◽

Peng-Fei Xia ◽

An Pan

Keyword(s):

Meta Analysis ◽

Cochrane Library ◽

Sugar Sweetened Beverage ◽

Quality Of Evidence ◽

Sweetened Beverage ◽

Sweetened Beverages ◽

All Cause Mortality ◽

Meta Analyses ◽

Cvd Mortality

ABSTRACT Sugar-sweetened beverage (SSB) and artificially sweetened beverage (ASB) intakes have been reported to be associated with mortality; however, conclusions have been inconsistent. This review synthesized the evidence on the associations of SSB and ASB intakes with mortality from all causes, cardiovascular disease (CVD), and cancer among all populations (including general, diseased, or occupational populations, etc.). PubMed, EMBASE, Web of Science, Cochrane Library, ProQuest, ClinicalTrials.gov, and the International Clinical Trials Registry Platform were searched up to March 2020. Fifteen studies including 17 cohorts were included in meta-analyses. Each serving (12 fluid ounces or 355 mL) increase in daily SSB consumption was associated with higher risks of all-cause (HR: 1.08; 95% CI: 1.04, 1.12; 11 cohorts with 965,851 participants) and CVD (HR: 1.08; 95% CI: 1.04, 1.12; 13 cohorts with 898,005 participants) mortality. The associations of ASB intakes with all-cause and CVD mortality were J-shaped, and HRs (95% CI) across different doses (0, 1, 1.5, 2, and 2.5 servings/d) were 1.00, 1.01 (0.99, 1.03), 1.04 (1.02, 1.07), 1.08 (1.05, 1.11), and 1.13 (1.09, 1.18) for all-cause mortality and 1.00, 1.01 (0.96, 1.07), 1.07 (1.01, 1.13), 1.15 (1.08, 1.23), and 1.25 (1.14, 1.37) for CVD mortality. No significant association was found for cancer mortality. According to the NutriGrade scoring system, the quality of evidence on the associations of SSB intakes with all-cause and CVD mortality was high, and the quality of evidence on other associations was low to moderate. In summary, higher SSB and ASB intakes were associated with higher risks of all-cause mortality and CVD mortality. Given the limited evidence, future studies should further investigate the association between ASB intakes and cause-specific mortality.

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