Nutrition reviews最新文献

Context: Food insecurity remains a persistent public health challenge in the United States, affecting greater than 10% of households for the past 20 years. Although a variety of interventions have been implemented to address food insecurity, no prior review appears to have synthesized evidence exclusively from randomized controlled trials (RCTs).

Objectives: The effectiveness of food insecurity interventions in the United States, focusing exclusively on evidence from RCTs, was examined in this systematic review. The strengths and limitations of the existing evidence were assessed, and recommendations are provided for future research, practice, and policy.

Data sources: A comprehensive search was conducted across the PubMed, Embase, Web of Science, and ProQuest Central databases. Randomized controlled trials conducted in the United States that evaluated food security outcomes were included. Twenty-five studies met inclusion criteria.

Data extraction: Two reviewers independently screened abstracts and full texts. Data were extracted by a primary reviewer and verified by a second reviewer. Study quality was assessed using the Cochrane Risk of Bias tool.

Data analysis: The reviewed studies used a wide range of interventions across diverse settings. Findings were mixed, with 44% of included studies (n = 11) reporting significant improvements in food security compared with control groups.

Conclusion: The evidence does not support any single intervention as consistently effective and reveals significant gaps in geographic and population coverage. Key limitations across studies included short intervention and follow-up periods and limited assessment of intervention utilization. Future RCTs should prioritize long-term follow-up, inclusion of underserved regions and populations, and more rigorous evaluation of intervention uptake.

Systematic review registration: OSF registration no. 49jcs.

Context: Zinc deficiency is prevalent in people with chronic kidney disease (CKD) and has significant clinical implications. Previous systematic reviews have only evaluated the impact of zinc supplementation on a limited range of biochemical outcomes in people receiving hemodialysis.

Objective: In this analysis we sought to evaluate the impact of zinc supplementation on all outcomes in adults with CKD, including kidney replacement therapies.

Data sources: We conducted a systematic search across Cochrane, MEDLINE, CINAHL, PubMed, Scopus, and Google Scholar to identify randomized controlled trials assessing any outcomes in adults with CKD.

Data extraction: Three authors independently assessed trial eligibility, extracted data, and assessed the risk of bias using the Cochrane Risk of Bias Tool and the quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology.

Data analyses: We identified 41 studies, with 23 included in meta-analyses. In total, 176 outcomes were reported, of which 11 were meta-analyzed. Zinc supplementation resulted in a significant increase in body weight (weighted mean difference [WMD], 2.52 kg; 95% CI, 1.58-3.45; P < .00001), serum zinc (WMD, 24.96 µg/dL; 95% CI, 20.43-29.50; P < .00001), high density lipoprotein cholesterol (HDL-C; WMD, 8.05 mg/dL; 95% CI, 0.22-15.88; P = .04), albumin (WMD, 0.38 g/dL; 95% CI, 0.07-0.69; P = .02), and dietary energy intake (WMD, 271.80 kcal; 95% CI, 172.70-370.90; P < .00001). No significant difference was observed in body mass index, total cholesterol, triglycerides, creatinine, and dietary protein and zinc intakes. Qualitative synthesis suggests that zinc supplementation may improve gastrointestinal symptoms, intensity of pruritus, quality of life, and quality of sleep.

Conclusions: In patients with CKD, znc supplementation is associated with increases in body weight, serum zinc, high-density lipoprotein-cholesterol (HDL-C), albumin, and dietary energy intake. The current body of evidence is of low quality, highlighting the need for further high-quality research to substantiate these findings and for the translation of findings into clinical practice.

Systematic review registration: PROSPERO registration no. CRD42024574253.

The initial 1000 days of an infant's life represent a critical period for determining their long-term health outcomes. During this time, breast milk serves as the most distinctive and essential source of nutrition for newborns, providing not only the necessary micronutrients and macronutrients but also a range of bioactive components that greatly influence growth and development. Of particular interest are the microRNAs (miRNAs or miRs) present in significant quantities within breast milk. These small noncoding RNAs, ranging from 19 to 24 nucleotides in length, have been shown to play pivotal roles in the regulation of gene expression through intricate cell signaling networks. Key miRNAs frequently detected in breast milk include miR-148a-3p, miR-30a/d-5p, miR-22-3p, miR-146b-5p, miR-200a/c-3p, and let-7-5p, which are implicated in critical processes such as metabolism, immunity, cellular growth, and differentiation. The composition of these molecules in breast milk is influenced by various factors, including maternal diet, genetic predisposition, and environmental exposures. Maternal nutritional habits and body composition before and during pregnancy are particularly important, as they can affect infant health and susceptibility to cardiometabolic diseases. For instance, exposure to an obesogenic environment may alter the phenotype and genotype of offspring, thereby increasing the risk of such diseases. The growing recognition of the importance of the content of miRNAs in breast milk in the context of fetal programming is underscored by mounting evidence that points to the capacity of maternal dietary patterns and body composition to modulate levels of miRNAs and their functional impacts. This review aims to provide a comprehensive summary of the fundamental roles of miRNAs in breast milk and to explore the potential influence of maternal dietary patterns and body composition on their composition and functionality, drawing upon the extant literature in the field.

Context: Beneficial effects of mindful eating-based interventions during pregnancy have been reported.

Objective: This study aimed to synthesize the available evidence on the effects of mindfulness-based interventions during pregnancy that incorporate a mindful eating (ME) protocol on the health and well-being of pregnant women, including mental health, body metabolism (weight gain and/or blood glucose levels), eating behavior, and physical activity levels.

Data sources: The search was conducted in the Medline, Web of Science, PsycArticles, Embase, Scopus, Food Science Source, CINAHL, and Google Scholar databases.

Data extraction: Studies that describe ME-based interventions in pregnant women were identified. Risk of bias was determined using the Joanna Briggs Institute (JBI) critical appraisal tool, and the level of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.

Data analysis: Of the 489 articles identified, only 4 non-randomized intervention studies met the inclusion criteria. All selected studies used the "Mindful Motherhood Training" protocol and employed validated methods for measuring outcomes. The studies assessed the impact of the intervention on mental health and revealed significant reductions in stress and depressive symptoms, and significant increases in physical activity, among other outcomes.

Conclusion: Although they showed that there are potentially benefits from ME interventions, particularly in contributing to mental health (reduction in depressive symptoms) and increasing physical activity levels, the included studies were assessed as being exploratory in nature, of low methodological quality, having inconsistent results, and having aspects of serious concern regarding the certainty domain. Improvements in the quality of the ME interventions during pregnancy are necessary.

Systematic review registration: PROSPERO registration No. CRD42024496025.

Context: Dysregulated blood glucose levels and insulin resistance are key contributors to various metabolic complications and increased mortality. Among lifestyle interventions, dietary modification is a crucial strategy for improving glucose tolerance. Barley, rich in fiber and β-glucan, may offer a promising dietary approach for glycemic control.

Objective: To evaluate the impact of barley intake on short- and long-term glycemic and insulin responses through a systematic review and meta-analysis.

Data sources: Through comprehensive searches in major scientific databases, 31 controlled trials with 34 intervention arms were identified, including a total of 660 case patients and 665 control participants.

Data extraction: Two reviewers independently extracted data, and a random-effects model was used to calculate pooled estimates of outcomes.

Results: Barley supplementation significantly reduced postprandial glucose levels at 30 (-10.48 mg dL-1), 60 (-12.38 mg dL-1), and 120 (-6.95 mg dL-1) minutes; however, no significant effects were observed at 180 minutes. Barley supplementation significantly reduced postprandial insulin levels at 30 (-6.02 pmol L-1), 60 (-12.83 pmol L-1), and 180 (-5.89 mg dL-1) minutes; however, no significant effects were observed at 120 minutes. No significant changes in insulin levels were observed beyond the early postprandial period. In the long term, barley intake did not significantly affect fasting glucose or hemoglobin A1c levels.

Conclusions: This meta-analysis supports the short-term benefits of barley consumption in improving early postprandial glucose and insulin responses. No significant impact was found on later or long-term glycemic markers. More high-quality trials are needed to confirm these outcomes.

Systematic review registration: PROSPERO registration No. CRD42022368122.

Context: Overweight and obesity among children and adolescents are increasing globally, requiring effective treatment strategies to mitigate future health risks.

Objective: This systematic review and meta-analysis with meta-regressions evaluated the impact of Mediterranean diet (MD)-based dietary interventions, with or without physical activity (PA), on anthropometric parameters and adherence to the MD in children and adolescents with overweight or obesity.

Data sources: Scopus, PubMed/Medline, ISI/Web of Science, Embase, and Cochrane Central Register of Controlled Trials were searched as data sources for intervention studies, either designed as randomized controlled trials (RCTs) or non-RCTs. Primary outcomes were changes in body weight and body mass index (BMI); secondary outcomes included body fat, waist circumference, and adherence to the MD.

Data extraction: Eighteen studies involving 1539 participants aged 2-18 years were analyzed. Nine and 2 of the included studies were RCTs and randomized trials without a control group, respectively, whereas the others were non-RCT studies without a control group. Four exclusively presented an MD-based dietary intervention without a PA addition.

Data analysis: Mediterranean diet-based interventions improved BMI (effect size [ES] = 0.34; 95% CI, 0.13-0.56) and body fat (ES = 0.64; 95% CI, 0.19-1.08). Waist circumference changes were smaller but significant (ES = 0.22; 95% CI, 0.06-0.38). Changes in body weight (ES = 0.22; 95% CI, -0.04 to 0.48) were not significant. Combining these outcomes, the overall ES was computed at 0.42 (95% CI, 0.14-0.70). Adherence to the MD significantly increased in all studies reporting it. Interventions combining an MD and PA showed stronger effects compared with an MD alone.

Conclusion: Mediterranean diet-based interventions, particularly with PA, significantly improve BMI and body fat in children and adolescents with obesity, offering a promising strategy for early-life obesity management. However, high study heterogeneity and nonsignificant results in some outcomes underscore the need for more robust research.

Systematic review registration: PROSPERO registration no. CRD42020179868.

Context: Breast cancer, the most common malignancy in women, often leads to nutritional challenges exacerbated by treatments such as mastectomy. Perioperative nutrition interventions show promise in improving outcomes, but their effectiveness is limited by the lack of reliable biomarkers. Bioimpedance phase angle (PhA), a measure of cellular integrity and nutritional status, offers potential as a biomarker. However, research on its relationship with perioperative nutrition in patients with breast cancer remains scarce.

Objective: This systematic review aims to synthesize existing evidence, evaluate the role of PhA, and guide personalized nutrition strategies to enhance recovery and outcomes.

Data sources: A systematic review on the impact of perioperative nutrition intervention on bioimpedance PhA in patients with breast cancer was carried out based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The risk of bias was assessed using the modified Newcastle-Ottawa scale for observational studies, whereas the revised Cochrane risk-of-bias tool for randomized trials (RoB2) was used to evaluate randomized studies.

Data extraction: A database search was performed in PubMed and Karger for studies published between January 1, 2005, and December 31, 2024.

Data analysis: Of 689 articles identified in the literature search, 8 prospective studies, 4 reviews, and 3 randomized trials describing breast cancer, nutrition, and PhA were included in the review. A total of 42 301 participants were involved. Five of the total observational studies had a Newcastle-Ottawa scale score of 5 and above. In addition, 2 randomized trials recorded a low overall bias.

Conclusion: Perioperative nutrition interventions may positively influence PhA, reflecting changes in nutritional status and recovery. However, further higher-quality studies are needed to establish PhA as a standardized biomarker for nutritional assessment and prognosis in patients with breast cancer.

Systematic review registration: PROSPERO registration no. CRD42024625703.

Dietary diversity (DD) is an established pillar of healthy eating in dietary guidelines, but definitions, measurement, and meanings vary across settings. This scoping review aimed to clarify how DD has been conceptualized, operationalized, and measured as a healthy eating indicator, and to examine the methods and areas of improvement for research on this topic. A systematic search of peer-reviewed and gray literature was conducted using 5 bibliographic databases, organizational websites, and hand-searches addressing food variety, DD, and balanced or mixed diet in the general population in developed settings. Publications in English, French, Persian/Farsi, and Chinese were included. Extracted data were synthesized by quantitative content analysis. We identified 941 publications eligible for inclusion and randomly sampled 20% for data extraction (n = 190). Literature on DD, published since 1985, came from Asian (n = 88, 46%) and Anglo-European (n = 47, 25%) countries, mostly used food-frequency questionnaires (54%), and reported a total of 322 measures (208 assessed whole-diet diversity; 114 measured within-group diversity) and were less commonly validated (14%). Three-quarters of all measures used simple counting (n = 247) and others also weighted (n = 11) or categorized (n = 37) the counts; 25 measures calculated DD as a relative proportion. Across measures, the mean total DD score was 21.99 items or 'groups' (median, 10; range, 1-248). The 208 whole-diet DD measures were widely named and operationalized as 5-6 major food groups alone (n = 23) or in combination with subgroups or items (n = 131). Measurement of within-group diversity has grown since 2010. Over half of 114 within-group diversity measures assessed fruit and/or vegetable diversity, 25% assessed meat/alternatives diversity, 10% assessed grain diversity, and 8% assessed dairy diversity. There is wide variation in the definitions, measures, scoring methods, and foods included in nutrition literature regarding DD. To our knowledge, this is the first comprehensive, international overview of the topic, demonstrating the urgent need for standardization of DD as a research agenda to advance nutrition and food science.

Immunoglobulin G (IgG) antibody hypersensitivity is increasingly suggested as a potential trigger of irritable bowel syndrome (IBS) symptoms. Although the underlying mechanism remains unclear, it has been proposed that immunocomplex formation may induce inflammatory responses, exacerbating IBS symptoms. The available evidence on IgG-based elimination diets in adults with IBS was mapped and synthesized in this systematic scoping review, with a focus on gastrointestinal (GI) and extraintestinal symptoms, as well as quality of life (QoL). A systematic search was conducted in 4 databases (PubMed, SCOPUS, Web of Science, and Cochrane Controlled Register of Trials) until the end of January 2025. Three independent reviewers screened titles, abstracts, and full texts. The following data were extracted: study design, participants, IBS subtype, intervention and comparators, outcomes, and results. A qualitative synthesis was performed to summarize study characteristics and reported outcomes. Intervention studies investigating the effects of IgG-based elimination diets in adults diagnosed with IBS (Rome Criteria) in any setting were included. Thirteen studies involving 935 patients with IBS met eligibility criteria. Overall, IgG-based elimination diets were associated with improvements in GI symptoms, including abdominal pain, distention, bowel habits, and stool consistency, as well as QoL. Some studies also noted improvements in extraintestinal symptoms such as anxiety, migraines, and fatigue. There was substantial heterogeneity in study designs, risk of bias, and limitations in blinding and data collection methods. Additionally, concerns were raised regarding the risks associated with excluding multiple foods, which may lead to altered eating habits and increased malnutrition risk. IgG-based elimination diets demonstrate improvements in IBS symptoms and patient QoL. Nonetheless, there are significant methodological limitations in the available evidence, and more well-designed trials are needed to determine the true effectiveness and applicability of these interventions. Systematic Review  Registration Open Science Framework (https://doi.org/10.17605/OSF.IO/B52TM).