The Role of Iron and Zinc in the Treatment of ADHD among Children and Adolescents: A Systematic Review of Randomized Clinical Trials

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder common from childhood to adulthood, affecting 5% to 12% among the general population in developed countries. Potential etiological factors have been identified, including genetic causes, environmental elements and epigenetic components. Nutrition is currently considered an influencing factor, and several studies have explored the contribution of restriction and dietary supplements in ADHD treatments. Iron is an essential cofactor required for a number of functions, such as transport of oxygen, immune function, cellular respiration, neurotransmitter metabolism (dopamine production), and DNA synthesis. Zinc is also an essential trace element, required for cellular functions related to the metabolism of neurotransmitters, melatonin, and prostaglandins. Epidemiological studies have found that iron and zinc deficiencies are common nutritional deficits worldwide, with important roles on neurologic functions (poor memory, inattentiveness, and impulsiveness), finicky appetite, and mood changes (sadness and irritability). Altered levels of iron and zinc have been related with the aggravation and progression of ADHD. Objective: This is a systematic review focused on the contribution of iron and zinc in the progression of ADHD among children and adolescents, and how therapies including these elements are tolerated along with its effectiveness (according to PRISMA guidelines). Method: The scientific literature was screened for randomized controlled trials published between January 2000 to July 2021. The databases consulted were Medline, PsycINFO, Web of Science, and Google Scholar. Two independent reviewers screened studies, extracted data, and assessed quality and risk of bias (CONSORT, NICE, and Cochrane checklists used). Conclusion: Nine studies met the eligibility criteria and were selected. Evidence was obtained regarding the contribution of iron-zinc supplementation in the treatment of ADHD among young individuals. The discussion was focused on how the deficits of these elements contribute to affectation on multiple ADHD correlates, and potential mechanisms explaining the mediational pathways. Evidence also suggested that treating ADHD with diet interventions might be particularly useful for specific subgroups of children and adolescents, but further investigations of the effects of these diet interventions are needed.

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How does academic achievement relate to cardiorespiratory fitness, self-reported physical activity and objectively reported physical activity: a systematic review in children and adolescents aged 6–18 years

British Journal of Sports Medicine ◽

10.1136/bjsports-2016-097361 ◽

2017 ◽

Vol 52 (16) ◽

pp. 1039-1039 ◽

Cited By ~ 48

Author(s):

Adilson Marques ◽

Diana A Santos ◽

Charles H Hillman ◽

Luís B Sardinha

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Academic Achievement ◽

Children And Adolescents ◽

Cardiorespiratory Fitness ◽

Inclusion Criteria ◽

Eligibility Criteria ◽

Cross Sectional ◽

Explanatory Variables ◽

The Relationship

ObjectiveThis report aimed to systematically review the evidence for a differential association between objective and self-reported physical activity and cardiorespiratory fitness on academic achievement.DesignSystematic review.Data sourcesStudies were identified from searches in Embase, Education Resources Information Center, PubMed, PsycINFO, SPORTdiscus and Web of Science databases from January 2000 to December 2016.Eligibility criteria for selecting studiesEligibility criteria included cross-sectional, longitudinal and interventional study designs. Outcomes included students’ school grade or a standardised test or measure of academic achievement. Explanatory variables were cardiorespiratory fitness and objective and self-reported physical activity. Inclusion criteria included school-aged children and adolescents aged–18 years (or students from primary to secondary school when student’s participants age was not described) and articles published in English, Portuguese or Spanish.ResultsA total of 51 articles met inclusion criteria: 41 cross-sectional, 2 intervention and 8 longitudinal studies. Results from 11 studies were inconsistent regarding the relationship between objectively measured physical activity and academic achievement. Ten of the 16 articles reported positive associations between self-reported physical activity and academic achievement. From the 22 studies that analysed the relationship between cardiorespiratory fitness and academic achievement, it was verified that they all generally support the beneficial effect of cardiorespiratory fitness on students’ academic achievement.ConclusionHigher cardiorespiratory fitness may be important to enhance children and adolescents’ health and, additionally, academic achievement. Due to a lack of consensus across studies, methodological issues associated with the assessment of physical activity should be considered when investigating physical activity and academic achievement.

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Neighbourhood socioeconomic status and overweight/obesity: a systematic review and meta-analysis of epidemiological studies

BMJ Open ◽

10.1136/bmjopen-2018-028238 ◽

2019 ◽

Vol 9 (11) ◽

pp. e028238 ◽

Cited By ~ 7

Author(s):

Shimels Hussien Mohammed ◽

Tesfa Dejenie Habtewold ◽

Mulugeta Molla Birhanu ◽

Tesfamichael Awoke Sissay ◽

Balewgizie Sileshi Tegegne ◽

...

Keyword(s):

Systematic Review ◽

Socioeconomic Status ◽

Observational Studies ◽

Data Extraction ◽

Meta Analysis ◽

Epidemiological Studies ◽

Cochrane Library ◽

Eligibility Criteria ◽

Cross Sectional ◽

Neighbourhood Socioeconomic Status

ObjectiveLow neighbourhood socioeconomic status (NSES) has been linked to a higher risk of overweight/obesity, irrespective of the individual’s own socioeconomic status. No meta-analysis study has been done on the association. Thus, this study was done to synthesise the existing evidence on the association of NSES with overweight, obesity and body mass index (BMI).DesignSystematic review and meta-analysis.Data sourcesPubMed, Embase, Scopus, Cochrane Library, Web of Sciences and Google Scholar databases were searched for articles published until 25 September 2019.Eligibility criteriaEpidemiological studies, both longitudinal and cross-sectional ones, which examined the link of NSES to overweight, obesity or BMI, were included.Data extraction and synthesisData extraction was done by two reviewers, working independently. The methodological quality of included studies was assessed using the Newcastle-Ottawa Scale for the observational studies. The summary estimates of the relationships of NSES with overweight, obesity and BMI statuses were calculated with random-effects meta-analysis models. Heterogeneity was assessed by Cochran’s Q and I2 statistics. Subgroup analyses were done by age categories, continents, study designs and NSES measures. Publication bias was assessed by visual inspection of funnel plots and Egger’s regression test.ResultA total of 21 observational studies, covering 1 244 438 individuals, were included in this meta-analysis. Low NSES, compared with high NSES, was found to be associated with a 31% higher odds of overweight (pooled OR 1.31, 95% CI 1.16 to 1.47, p<0.001), a 45% higher odds of obesity (pooled OR 1.45, 95% CI 1.21 to 1.74, p<0.001) and a 1.09 kg/m2 increase in mean BMI (pooled beta=1.09, 95% CI 0.67 to 1.50, p<0.001).ConclusionNSES disparity might be contributing to the burden of overweight/obesity. Further studies are warranted, including whether addressing NSES disparity could reduce the risk of overweight/obesity.PROSPERO registration numberCRD42017063889

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The epidemiology of multiple sclerosis in Latin America and the Caribbean: a systematic review

Multiple Sclerosis Journal ◽

10.1177/1352458512462918 ◽

2012 ◽

Vol 19 (7) ◽

pp. 844-854 ◽

Cited By ~ 39

Author(s):

E Cristiano ◽

JI Rojas ◽

M Romano ◽

N Frider ◽

G Machnicki ◽

...

Keyword(s):

Multiple Sclerosis ◽

Systematic Review ◽

Latin America ◽

Low Frequency ◽

Epidemiological Data ◽

Developed Countries ◽

Epidemiological Studies ◽

Incidence Data ◽

Full Text Review ◽

The Caribbean

The incidence and prevalence of multiple sclerosis (MS) varies geographically as shown through extensive epidemiological studies performed mainly in developed countries. Nonetheless, scant data is available in Latin America and the Caribbean (LAC). The objective of this review is to assess epidemiological data of MS in LAC. We conducted a systematic review of published articles and gray literature from January 1995 to May 2011. Twenty-two studies met the inclusion criteria after full-text review. Incidence data were found in only three studies and ranged from 0.3 to 1.9 annual cases per 100,000 person-years. Prevalence was reported in 10 studies and ranged from 0.83 to 21.5 cases per 100,000 inhabitants. The most prevalent subtype of MS was the relapsing–remitting form (48% to 91% of the series). No data about mortality were found. This study showed low frequency for MS in LAC compared with North American and European countries. The role of environmental and genetic factors should be well studied, providing new insights about its etiology.

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Barriers and determinants of asthma control in children and adolescents in Africa: a systematic review

BMJ Open ◽

10.1136/bmjopen-2021-053100 ◽

2021 ◽

Vol 11 (10) ◽

pp. e053100

Author(s):

Reratilwe Ephenia Mphahlele ◽

Omolemo Kitchin ◽

R Masekela

Keyword(s):

Systematic Review ◽

Children And Adolescents ◽

Asthma Control ◽

Inhaled Corticosteroids ◽

Control Test ◽

Asthma Diagnosis ◽

Asthma Control Test ◽

Eligibility Criteria ◽

Asthma Control Questionnaire ◽

African Children

ObjectiveTo identify reasons for poor asthma control in African children and adolescents.DesignSystematic reviewData sourcesPubMed, Scopus, CINHAL, PsycINFO, MEDLINE and Web of Science databases were systematically searched up to 31 May 2020. Hand searching was done on Sabinet, African Journal online and Google Scholar.Eligibility criteriaStudies identifying barriers to asthma control, where asthma control was assessed by the validated Asthma Control Test/Child Asthma Control Test and/or Asthma Control Questionnaire were included.Data extraction and synthesisTwo reviewers independently selected studies for inclusion with disagreements resolved by a research team discussion, including a third reviewer. Data were extracted using the Cochrane Effective Practice and Organization of Care data collection form. The quality of the included studies was assessed using the modified Newcastle-Ottawa quality assessment scale. Identified barriers were reported in a thematic narrative synthesis.Primary outcomesPoorly controlled asthma and associated factors.ResultsFrom 914 records, three studies conducted between 2014 and 2019 in Nigeria, Uganda and South Africa met the inclusion criteria. A total of 883 children aged 4–19 years were analysed. Older age, concurrent allergy and city-dwelling significantly impacted asthma control. Few children with asthma symptoms in the community had ever used inhaled corticosteroids (6.7%) and identified reasons included lack of asthma diagnosis (38.8%) and no prescribed treatment (47.6%).ConclusionAsthma control in African children is impacted by age, allergy, urbanisation and lack of access to asthma diagnosis and treatment. More studies focusing on identifying barriers to asthma control in Africa are needed.PROSPERORegistration no: CRD42020196755)

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The therapeutic use of essential oils in the care of cancer patients in chemotherapy: A systematic review

Brazilian Journal of Health and Biomedical Sciences ◽

10.12957/bjhbs.2021.59744 ◽

2021 ◽

Vol 20 (1) ◽

pp. 36-45

Author(s):

Bruno B. Monteiro-Oliveira ◽

Ana Carolina Coelho-Oliveira ◽

Tatiane S. A. David ◽

Adriana T. Brito ◽

Ana Carla A. Cruz ◽

...

Keyword(s):

Systematic Review ◽

Adverse Effects ◽

Essential Oils ◽

Methodological Quality ◽

Randomized Clinical Trials ◽

Database Search ◽

Quality Of Sleep ◽

Effective Technique ◽

Eligibility Criteria

Introducton: Chemotherapy is an important therapy in the treatment of cancer. Nausea, vomiting and worsening quality are some adverse effects of chemotherapy. Aromatherapy is an ancient technique that uses essential oils for physical and psychological/emotional improvement and is able to reduce the symptoms of chemotherapy and can be an excellent complementary technique.Objective: The aim of this systematic review was to determine the effects of aromatherapy on the adverse effects of chemotherapy in patients diagnosed with cancer. Methods: A search in three database PubMed, EMBASE and SCOPUS. Five studies that analyzed the use of aromatherapy to evaluate the reduction of the adverse effects of chemotherapy in a cancer patient, published only in English were included. Two reviewers, which independently examined titles and abstracts, identified records through database search and reference screening and irrelevant studies were excluded based in eligibility criteria. Relevant full texts were analyzed for eligibility, and all selected studies were included in this systematic review. Results: Five studies were included in this systematic review. This review suggests that aromatherapy reduces nausea, frequency of vomiting and improves quality of sleep. Conclusion: Aromatherapy is an effective technique to reduce nausea, the frequency of vomiting and improves the quality of sleep of patients diagnosed with cancer and undergoing chemotherapy. However, more randomized clinical trials with a good methodological quality are necessary to confirm the preliminary findings of this systematic review.

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Is mindfulness research methodology improving over time? A systematic review

10.31231/osf.io/nm7a8 ◽

2018 ◽

Author(s):

Simon Goldberg ◽

Raymond P. Tucker ◽

Preston A. Greene ◽

Tracy L. Simpson ◽

David Kearney ◽

...

Keyword(s):

Systematic Review ◽

Randomized Clinical Trials ◽

Scientific Evidence ◽

Treatment Fidelity ◽

The Body ◽

Synthesis Methods ◽

Eligibility Criteria ◽

Clinical Disorder ◽

Fidelity Assessment ◽

Methodological Improvement

Background: Despite an exponential growth in research on mindfulness-based interventions, the body of scientific evidence supporting these treatments has been criticized for being of poor methodological quality. Objectives: The current systematic review examined the extent to which mindfulness research demonstrated increased rigor over the past 16 years regarding six methodological features that have been highlighted as areas for improvement. These feature included using active control conditions, larger sample sizes, longer follow-up assessment, treatment fidelity assessment, and reporting of instructor training and intent-to-treat (ITT) analyses. Data sources: We searched PubMed, PsychInfo, Scopus, and Web of Science in addition to a publically available repository of mindfulness studies. Study eligibility criteria: Randomized clinical trials of mindfulness-based interventions for samples with a clinical disorder or elevated symptoms of a clinical disorder listed on the American Psychological Association’s list of disorders with recognized evidence-based treatment. Study appraisal and synthesis methods: Independent raters screened 9,067 titles and abstracts, with 303 full text reviews. Of these, 171 were included, representing 142 non-overlapping samples. Results: Across the 142 studies published between 2000 and 2016, there was no evidence for increases in any study quality indicator, although changes were generally in the direction of improved quality. When restricting the sample to those conducted in Europe and North America (continents with the longest history of scientific research in this area), an increase in reporting of ITT analyses was found. When excluding an early, high-quality study, improvements were seen in sample size, treatment fidelity assessment, and reporting of ITT analyses. Conclusions and implications of key findings: Taken together, the findings suggest modest adoption of the recommendations for methodological improvement voiced repeatedly in the literature. Possible explanations for this and implications for interpreting this body of research and conducting future studies are discussed.

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Effectiveness of complementary therapies for the management of symptom clusters in palliative care in pediatric oncology: a systematic review

Revista da Escola de Enfermagem da USP ◽

10.1590/s1980-220x2020025103709 ◽

2021 ◽

Vol 55 ◽

Author(s):

Luís Carlos Lopes-Júnior ◽

Isadora Rangel Urbano ◽

Sara Isabel Pimentel de Carvalho Schuab ◽

Raphael Manhães Pessanha ◽

Gabriela Sylvestre Rosa ◽

...

Keyword(s):

Systematic Review ◽

Palliative Care ◽

Children And Adolescents ◽

Complementary Therapies ◽

Cannabis Sativa ◽

Meta Analysis ◽

Symptom Clusters ◽

Eligibility Criteria ◽

Pain Anxiety ◽

Therapeutic Massage

ABSTRACT Objective: To evaluate the effectiveness of complementary therapies in the management of symptom clusters in children and adolescents with cancer undergoing palliative care. Method: Systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, resorting to the databases MEDLINE, Web of Science, Central Cochrane, and PsycINFO. The identification, selection, inclusion, extraction, and methodological assessment were conducted by two independent reviewers. Results: Five quasi-experiments met the eligibility criteria. The heterogeneous characteristics of the studies made meta-analysis impossible. Two studies used therapeutic massage, one used Reiki, one used boswellic acid, and one used Cannabis sativa; three of them (therapeutic massage and Reiki) presented statistically significant results for the management of the cluster pain-anxiety-worry-dyspnea. Most studies presented a moderate risk of bias as per ROBINS-I tool. Conclusion: Therapeutic massage and Reiki may be effective for the symptom clusters management, especially the pain-anxiety-worry-dyspnea cluster in children and adolescents undergoing palliative care.

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Latin American interventions in children and adolescents’ sedentary behavior: a systematic review

Revista de Saúde Pública ◽

10.11606/s1518-8787.2020054001977 ◽

2020 ◽

Vol 54 ◽

pp. 59

Author(s):

Evelyn Helena Corgosinho Ribeiro ◽

Paulo Henrique Guerra ◽

Ana Carolina De Oliveira ◽

Kelly Samara da Silva ◽

Priscila Santos ◽

...

Keyword(s):

Systematic Review ◽

Children And Adolescents ◽

Sedentary Behavior ◽

Latin American ◽

Screen Time ◽

Sitting Time ◽

Community Based Interventions ◽

Community Based ◽

Eligibility Criteria ◽

American Children

OBJECTIVE: To identify and evaluate the effects of community-based interventions on the sedentary behavior (SB) of Latin American children and adolescents. METHODS: A systematic review on community-based trials to reduce and/or control SB in Latin American countries (Prospero: CRD42017072157). Five databases (PubMed, Web of Science, Scopus, SciELO and Lilacs) and a reference lists were searched. RESULTS: Ten intervention studies met the eligibility criteria and composed the descriptive synthesis. These studies were conducted in Brazil (n=5), Mexico (n=3), Ecuador (n=1) and Colombia (n=1). Most interventions were implemented in schools (n=8) by educational components, such as meetings, lessons, and seminars, on health-related subjects (n=6). Only two studies adopted specific strategies to reduce/control SB; others focused on increasing physical activity and/or improving diet. Only one study used an accelerometer to measure SB. Seven studies investigated recreational screen time. Eight studies showed statistically significant effects on SB reduction (80%). CONCLUSIONS: Latin America community-based interventions reduced children and adolescents’ SB. Further studies should: define SB as a primary outcome and implement strategies to reduce such behaviour; focus in different SBs and settings, other than recreational screen time or at-home sitting time; and use objective tools together with questionnaires to measure sedentary behaviour in.

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Efficacy of Dental Bleaching with Whitening Dentifrices: A Systematic Review

International Journal of Dentistry ◽

10.1155/2018/7868531 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Bruno G. S. Casado ◽

Sandra L. D. Moraes ◽

Gleicy F. M. Souza ◽

Catia M. F. Guerra ◽

Juliana R. Souto-Maior ◽

...

Keyword(s):

Systematic Review ◽

Randomized Clinical Trials ◽

Color Change ◽

Tooth Surface ◽

Cochrane Library ◽

Tooth Whitening ◽

Eligibility Criteria ◽

Tooth Color ◽

Color Changes ◽

Meta Analyses

A systematic review was performed to evaluate whether whitening toothpastes promote tooth whitening when compared to the use of conventional (nonbleaching) dentifrices. This review was registered at PROSPERO (CRD42017065132) and is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Electronic systematic searches of PubMed/MEDLINE, Scopus, and the Cochrane Library were conducted for published articles. Only randomized clinical trials in adults that compared the use of so-called whitening dentifrices to the use of nonwhitening dentifrices were selected. The outcome was tooth color change. Twenty-two articles from 703 data sources met the eligibility criteria. After title and abstract screening, 16 studies remained, after which a further five studies were excluded. In total, nine studies were qualitatively analyzed. Significant differences in tooth color change were found between the groups using whitening dentifrices and those using nonwhitening dentifrices. Within the limitations of this study, the evidence from this systematic review suggests that bleaching dentifrices have potential in tooth whitening. However, although many whitening dentifrices have been introduced into the dental market for bleaching treatments, it is important to analyze tooth surface and color changes when performing home bleaching.

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Vitamin D Food Fortification and Nutritional Status in Children: A Systematic Review of Randomized Controlled Trials

Nutrients ◽

10.3390/nu11112766 ◽

2019 ◽

Vol 11 (11) ◽

pp. 2766 ◽

Cited By ~ 2

Author(s):

Paula Nascimento Brandão-Lima ◽

Beatriz da Cruz Santos ◽

Concepción Maria Aguilera ◽

Analícia Rocha Santos Freire ◽

Paulo Ricardo Saquete Martins-Filho ◽

...

Keyword(s):

Systematic Review ◽

Vitamin D ◽

Clinical Trials ◽

Nutritional Status ◽

Systematic Reviews ◽

Randomized Clinical Trials ◽

Hypovitaminosis D ◽

Food Fortification ◽

Fortified Foods ◽

Eligibility Criteria

Children are in the risk group for developing hypovitaminosis D. Several strategies are used to reduce this risk. Among these, fortification of foods with vitamin D (25(OH)D) has contributed to the achievement of nutritional needs. This systematic review aims to discuss food fortification as a strategy for maintenance or recovery of nutritional status related to vitamin D in children. The work was developed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and registered in the International prospective register of systematic reviews (PROSPERO) database (CRD42018052974). Randomized clinical trials with children up to 11 years old, who were offered vitamin D-fortified foods, and who presented 25(OH)D concentrations were used as eligibility criteria. After the selection stages, five studies were included, totaling 792 children of both sexes and aged between two and 11 years. Interventions offered 300–880 IU of vitamin D per day, for a period of 1.6–9 months, using fortified dairy products. In four of the five studies, there was an increase in the serum concentrations of 25(OH)D with the consumption of these foods; additionally, most children reached or maintained sufficiency status. Moreover, the consumption of vitamin D-fortified foods proved to be safe, with no concentrations of 25(OH)D > 250 nmol/L. Based on the above, the fortification of foods with vitamin D can help maintain or recover the nutritional status of this vitamin in children aged 2–11 years. However, it is necessary to perform additional randomized clinical trials in order to establish optimal doses of fortification, according to the peculiarities of each region.

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