scholarly journals The Effect of the Mediterranean Diet on Metabolic Health: A Systematic Review and Meta-Analysis of Controlled Trials in Adults

Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3342 ◽  
Author(s):  
Angeliki Papadaki ◽  
Eric Nolen-Doerr ◽  
Christos S. Mantzoros
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Cardiovascular Disease ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Metabolic Health ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Meta Analyses ◽  
Consistent Direction

The Mediterranean diet (MD) may provide metabolic benefits but no systematic review to date has examined its effect on a multitude of outcomes related to metabolic health. This systematic review with meta-analysis (International Prospective Register of Systematic Reviews, PROSPERO; number CRD42019141459) aimed to examine the MD’s effect on metabolic syndrome (MetSyn) incidence, components and risk factors (primary outcomes), and incidence and/or mortality from MetSyn-related comorbidities and receipt of pharmacologic treatment for MetSyn components and comorbidities (secondary outcomes). We searched Pubmed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science for controlled trials published until June 2019, comparing the MD with no treatment, usual care, or different diets in adults. Studies not published in English and not promoting the whole MD were excluded. Two authors independently extracted data and assessed risk of bias using the Cochrane Collaboration’s and Risk of Bias in non-randomised studies (ROBINS-I) tools. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Random-effects meta-analyses, subgroup analyses and meta-regressions were performed, and heterogeneity was quantified using the I2 statistic. We identified 2654 reports and included 84 articles reporting 57 trials (n = 36,983). In random effects meta-analyses, the MD resulted in greater beneficial changes in 18 of 28 MetSyn components and risk factors (body weight, body mass index, waist circumference, systolic and diastolic blood pressure, glucose, insulin, homeostatic model assessment of insulin resistance (HOMA-IR) index, total-, low-density lipoprotein (LDL)- and high-density lipoprotein (HDL)-cholesterol, triglycerides, alanine transaminase, hepatic fat mass, C-reactive protein, interleukin-6, tumour necrosis factor-a, and flow-mediated dilatation) and lower risk of cardiovascular disease incidence (risk ratio (RR) = 0.61, 95% confidence intervals (CI) 0.42–0.80; I2 = 0%), and stroke (RR = 0.67, 95% CI 0.35–0.98; I2 = 0%). Only six studies reported effects on pharmacotherapy use, and pooled analysis indicated no differences between diet groups. Lack of consistency in comparator groups and other study characteristics across studies resulted in high heterogeneity for some outcomes, which could not be considerably explained by meta-regressions. However, a consistent direction of beneficial effect of the MD was observed for the vast majority of outcomes examined. Findings support MD’s beneficial effect on all components and most risk factors of the MetSyn, in addition to cardiovascular disease and stroke incidence. More studies are needed to establish effects on other clinical outcomes and use of pharmacotherapy for MetSyn components and comorbidities. Despite the high levels of heterogeneity for some outcomes, this meta-analysis enabled the comparison of findings across studies and the examination of consistency of effects. The consistent direction of effect, suggesting the MD’s benefits on metabolic health, supports the need to promote this dietary pattern to adult populations.

scholarly journals Almond Consumption and Risk Factors for Cardiovascular Disease: A Systematic Review and Meta-analysis of Randomized Controlled Trials

2019 ◽  
Vol 10 (6) ◽  
pp. 1076-1088 ◽  
Author(s):  
Michelle A Lee-Bravatti ◽  
Jifan Wang ◽  
Esther E Avendano ◽  
Ligaya King ◽  
Elizabeth J Johnson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Body Weight ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Meta Analyses

ABSTRACT Evidence suggests that eating nuts may reduce the risk of cardiovascular disease (CVD). We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating almond consumption and risk factors for CVD. MEDLINE, Cochrane Central, Commonwealth Agricultural Bureau, and previous systematic reviews were searched from 1990 through June 2017 for RCTs of ≥3 wk duration that evaluated almond compared with no almond consumption in adults who were either healthy or at risk for CVD. The most appropriate stratum was selected with an almond dose closer to 42.5 g, with a control most closely matched for macronutrient composition, energy intake, and similar intervention duration. The outcomes included risk factors for CVD. Random-effects model meta-analyses and subgroup meta-analyses were performed. Fifteen eligible trials analyzed a total of 534 subjects. Almond intervention significantly decreased total cholesterol (summary net change: −10.69 mg/dL; 95% CI: −16.75, −4.63 mg/dL), LDL cholesterol (summary net change: −5.83 mg/dL; 95% CI: −9.91, −1.75 mg/dL); body weight (summary net change: −1.39 kg; 95% CI: −2.49, −0.30 kg), HDL cholesterol (summary net change: −1.26 mg/dL; 95% CI: −2.47, −0.05 mg/dL), and apolipoprotein B (apoB) (summary net change: −6.67 mg/dL; 95% CI: −12.63, −0.72 mg/dL). Triglycerides, systolic blood pressure, apolipoprotein A1, high-sensitivity C-reactive protein, and lipoprotein (a) showed no difference between almond and control in the main and subgroup analyses. Fasting blood glucose, diastolic blood pressure, and body mass index significantly decreased with almond consumption of >42.5 g compared with ≤42.5 g. Almond consumption may reduce the risk of CVD by improving blood lipids and by decreasing body weight and apoB. Substantial heterogeneity in eligible studies regarding almond interventions and dosages precludes firmer conclusions.

scholarly journals Comparative efficacy and safety of interventions for treating head lice: a protocol for systematic review and network meta-analysis

2021 ◽  
Vol 5 (1) ◽  
pp. e001129
Author(s):  
Bill Stevenson ◽  
Wubshet Tesfaye ◽  
Julia Christenson ◽  
Cynthia Mathew ◽  
Solomon Abrha ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Grey Literature ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Head Lice ◽  
Efficacy And Safety ◽  
Randomised Controlled ◽  
Meta Analyses

BackgroundHead lice infestation is a major public health problem around the globe. Its treatment is challenging due to product failures resulting from rapidly emerging resistance to existing treatments, incorrect treatment applications and misdiagnosis. Various head lice treatments with different mechanism of action have been developed and explored over the years, with limited report on systematic assessments of their efficacy and safety. This work aims to present a robust evidence summarising the interventions used in head lice.MethodThis is a systematic review and network meta-analysis which will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement for network meta-analyses. Selected databases, including PubMed, Embase, MEDLINE, Web of Science, CINAHL and Cochrane Central Register of Controlled Trials will be systematically searched for randomised controlled trials exploring head lice treatments. Searches will be limited to trials published in English from database inception till 2021. Grey literature will be identified through Open Grey, AHRQ, Grey Literature Report, Grey Matters, ClinicalTrials.gov, WHO International Clinical Trials Registry and International Standard Randomised Controlled Trials Number registry. Additional studies will be sought from reference lists of included studies. Study screening, selection, data extraction and assessment of methodological quality will be undertaken by two independent reviewers, with disagreements resolved via a third reviewer. The primary outcome measure is the relative risk of cure at 7 and 14 days postinitial treatment. Secondary outcome measures may include adverse drug events, ovicidal activity, treatment compliance and acceptability, and reinfestation. Information from direct and indirect evidence will be used to generate the effect sizes (relative risk) to compare the efficacy and safety of individual head lice treatments against a common comparator (placebo and/or permethrin). Risk of bias assessment will be undertaken by two independent reviewers using the Cochrane Risk of Bias tool and the certainty of evidence assessed using the Grading of Recommendations, Assessment, Development and Evaluations guideline for network meta-analysis. All quantitative analyses will be conducted using STATA V.16.DiscussionThe evidence generated from this systematic review and meta-analysis is intended for use in evidence-driven treatment of head lice infestations and will be instrumental in informing health professionals, public health practitioners and policy-makers.PROSPERO registration numberCRD42017073375.

scholarly journals Polyphenol in reducing cardiovascular outcomes in adult: A Rapid Review and Meta Analysis

2021 ◽  
Vol 7 (1) ◽  
pp. 36-47
Author(s):  
Arditya Damar Kusuma ◽  
Anggoro Budi Hartopo
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Diastolic Blood Pressure ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Risk Of Bias ◽  
Surrogate Endpoints ◽  
Men And Women

Abstract Objectives This review has an objective to determine the effectiveness of polyphenol intervention for the primary prevention of cardiovascular disease events and others surrogate endpoint which may correlate with cardiovascular disease events Data Sources These electronic databases were used to search the appropriate trials: MEDLINE (OvidSP, 1946 to March week 2 2020); The Cochrane Central Register of Controlled Trials (CENTRAL,week 2 March 2020). We only used English language trials that were available on these two databases. Review Methods We chose randomized controlled trials both in healthy or having high risk of cardiovascular diseases. Polyphenol as intervention was described as any food or drink that has polyphenol or its derived substance as main content. Placebo or no intervention is the comparison group. Cardiovascular clinical events and surrogate endpoints or cardiovascular disease risk factors are included in the outcome. Revman 5.5 software was used to analyze all the trials and to assess the risk of bias each trial. We selected random or fixed effects depend on the heterogeneity between trials in the meta analysis. Results Seven trials were included with 49200 participants randomized. Heterogeneity was shown between trials regarding the characteristic of participants, types of polyphenol intervention, and follow up periods. Cardiovascular event outcomes are only available in one trial (Howard et al 2006), with the intervention not clearly defined as polyphenol but increasing fruit and grain consumption. This trial shows no evidence was shown on fatal and non-fatal cardiovascular outcome by consuming more fruit and grain with 8 years mean of follow up. By analyzing remaining trials, which provide surrogate endpoints or cardiovascular risk factors, there is no evidence that polyphenol intervention reduce systolic and diastolic blood pressure, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol level, and triglyceride level. However, reduction total cholesterol level was shown from the baseline (MD -5.41 mg/dl, 95% CI -8.21 to -2.62, P=0.0001). Subgroup analyses were done with dividing the trials that involve women only and both men and women. This analysis shows the reduction of both systolic (MD -2.78 mmHg, 95% CI -5.47 to -0.08, P=0.04) and diastolic blood pressure (MD -2.59 mmHg, 95% CI -4.84 to -0.34, P=0.02) in trials involving both men and women. A sensitivity analysis was done by excluding the trials with risk of bias with no different results effect. Moreover, not any trials reported adverse events of polyphenol. Author’s Conclusion Due to the limitation evidence or trial available, we could not obtain meta analysis on the primary outcome. Nevertheless, this review suggests that polyphenol intervention does show favorable effect on surrogate endpoints which was total cholesterol levels. Besides, systolic blood pressure and diastolic blood pressure in trials which involves both men and women also shown an improvement. The high heterogeneity in this review also suggests that more evidence are needed to assess the effectiveness of polyphenol intervention in reducing cardiovascular event outcomes and risk factors in the future.

scholarly journals Incidence, risk factors and outcomes of early postoperative hyperglycemia in surgical patients: a protocol for a systematic review and meta-analysis

2020 ◽  
Author(s):  
Paddy Ssentongo ◽  
Joseph A. Lewcun ◽  
Anna E. Ssentongo ◽  
David I. Soybel
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Clinical Outcomes ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Postoperative Outcomes ◽  
Cochrane Library ◽  
Logit Transformation ◽  
Incidence Risk ◽  
Meta Analyses

Abstract Background Early postoperative hyperglycemia is common and associated with poor postoperative outcomes. We aimed to estimate the pooled incidence, risk factors and clinical outcomes of early postoperative hyperglycemia in men and women globally. Method and analysis We will conduct a systematic review and meta-analysis of cohort studies published before January 1, 2020, reporting the incidence of postoperative hyperglycemia. We will search the following databases: PubMed (MEDLINE), Scopus, EMBASE, Cochrane Library, OVID (HEALTH STAR), OVID (MEDLINE), Joana Briggs Institute EBF Database and Web of Science. No age, geographical location, study-design or language limits will be applied. This protocol was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. Two reviewers (JAL, AES) will independently screen citations, abstracts and will identify full-text articles for inclusion, extract data and evaluate the quality and bias of included studies. Discrepancies will be resolved by consensus or consultation with a third researcher (PS). The risk of bias of included studies will be evaluated by the appropriate Cochrane risk of bias tool. The primary outcome will be the overall incident rate of postoperative hyperglycemia. Secondary outcomes are the risk factors and clinical outcomes of postoperative hyperglycemia. We will use the random-effects model with a logit transformation of proportions for the pooling of studies. We will assess the between-study heterogeneity using the I 2 statistic, and Cochrane’s Q statistic (significance level < 0.05). We will perform subgroup meta-analyses to look at geographical differences in the incidence of postoperative hyperglycemia and conduct a meta-regression analysis, using study level median age, year of publication, study level gender proportions, the proportion of type 2 diabetes, mean body mass index, American Society of Anesthesiologists and type of surgical procedure. We will report the probability of postoperative hyperglycemia as a measure of incidence rate, relative risk ratios (RR) and 95% confidence intervals to report the effects of the risk factors and postoperative outcomes. The Egger’s test and funnel plots will be used to assess publication bias.

Carnosine and histidine-containing dipeptides improve dyslipidemia: a systematic review and meta-analysis of randomized controlled trials

2020 ◽  
Vol 78 (11) ◽  
pp. 939-951
Author(s):  
Kirthi Menon ◽  
Clara Marquina ◽  
Pernille Hoj ◽  
Danny Liew ◽  
Aya Mousa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Cardiovascular Risk ◽  
Randomized Controlled Trials ◽  
Total Cholesterol ◽  
Burden Of Disease ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Controlled Trials ◽  
Randomized Controlled

Abstract Context Cardiovascular disease is a major public health problem and represents a significant burden of disease globally. Lifestyle interventions have their limitations and an intervention that will effectively address cardiovascular risk factors to help reduce this growing burden of disease is required. Objective Carnosine and other histidine-containing dipeptides (HCDs) have exerted positive effects on cardiovascular risk factors and diseases in animal and human studies. The authors conducted a systematic review and meta-analysis examining the effects of HCDs on cardiovascular outcomes in line with the PRISMA guidelines. Data Sources The Medline, Medline in process, Embase, Cumulative Index of Nursing and Allied Health, and All EBM databases were searched from inception until January 25, 2019, for randomized controlled trials (RCTs) examining the effects of HCDs on cardiovascular outcomes, compared with placebo or controls. Data Extraction Basic characteristics of the study and populations, interventions, and study results were extracted. The grading of recommendations assessment, development, and evaluation approach was used to assess the quality of evidence for each outcome. Data Analysis A total of 21 studies were included. Of these, 18 were pooled for meta-analysis (n = 913). In low risk of bias studies, HCD-supplemented groups had lower total cholesterol (n = 6 RCTs; n = 401; weighted mean difference [WMD], −0.32 mmol/L [95%CI, −0.57 to −0.07], P = 0.01) and triglyceride levels (n = 6 RCTs; n = 401; WMD, −0.14 mmol/L [95%CI, −0.20 to −0.08], P &lt; 0.001) compared with controls. In studies using carnosine, triglycerides levels were also lower in the intervention group vs controls (n = 5 RCTS; n = 309; P &lt; 0.001). There were no significant differences in blood pressure, heart rate, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C) or the total cholesterol to HDL-C ratio between groups. Conclusions Carnosine and other HCDs may have a role in improving lipid profiles. Larger studies with sufficient follow-up are necessary to confirm these findings and explore the use of HCDs in the prevention of cardiovascular diseases. Systemic Review Registration PROSPERO registration no.: CRD42017075354

Incorporating healthy dietary changes in addition to an increase in fruit and vegetable intake further improves the status of cardiovascular disease risk factors: A systematic review, meta-regression, and meta-analysis of randomized controlled trials

2019 ◽  
Vol 78 (7) ◽  
pp. 532-545 ◽  
Author(s):  
Darel Wee Kiat Toh ◽  
Evangelyn Sihui Koh ◽  
Jung Eun Kim
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Controlled Trials ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Dietary Changes ◽  
Randomized Controlled ◽  
Meta Regression

Abstract Context Fruit and vegetable (FV) intake has been associated with a reduced risk of cardiovascular disease (CVD). Beyond increasing FV intake, the incorporation of other healthy dietary changes may help to further attenuate CVD risk. Objective A systematic review and meta-analysis was conducted to determine the effect of increasing FV intake to &gt; 3 servings daily as well as incorporating other healthy dietary changes on classical CVD risk factors through a systematic review, meta-regression, and meta-analysis of randomized controlled trials. Data Sources The following databases were searched: PubMed, CINAHL Plus with Full Text, Medline (ProQuest), and Cochrane Library. Data Extraction 82, 24, and 10 articles were selected for the systematic review, meta-regression, and meta-analysis, respectively. Data Analysis Meta-regression analysis showed a dose-dependent response between the number of FV servings consumed in each intervention group and the blood triglyceride change value. Pooled weighted mean differences from the meta-analysis suggested that increasing FV intake to &gt; 3 servings daily contributes to significant decreases in triglyceride (−0.10 mmol/L; 95%CI, −0.18 to −0.01) and diastolic blood pressure (−1.99 mmHg; 95%CI, −2.28 to −1.70) as well as marginal decreases in total cholesterol and low-density lipoprotein cholesterol. While improvements were observed in the triglyceride and high-density lipoprotein cholesterol response following the incorporation of other healthy dietary changes, no additional cardiovascular benefits were observed when FV intake was increased from &gt; 3 to &gt; 5 servings daily. Conclusion Increasing FV intake to &gt; 3 servings daily improves CVD risk factors, most distinctly triglyceride, especially when complemented with other healthy dietary changes.

Association between berries intake and cardiovascular diseases risk factors: a systematic review with meta-analysis and trial sequential analysis of randomized controlled trials

2018 ◽  
Vol 9 (2) ◽  
pp. 740-757 ◽  
Author(s):  
Ângelo Luís ◽  
Fernanda Domingues ◽  
Luísa Pereira
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Cardiovascular Disease ◽  
Sequential Analysis ◽  
Meta Analysis ◽  
Trial Sequential Analysis ◽  
Controlled Trials ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Randomized Controlled

The main goal of this work was to clarify the effects of the consumption of berries on cardiovascular disease (CVD) risk factors by performing a systematic review followed by a meta-analysis and a trial sequential analysis (TSA).

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