Nutrition reviews最新文献

In this review we sought to map the body of published literature on the role of oral probiotics, prebiotics, and synbiotics in maintaining and optimizing skin health and function and preventing and managing skin conditions throughout the life course. Globally, the burden of skin diseases is considerable. Diet is a modifiable risk factor for many dermatological conditions, and one mechanism by which nutrition influences skin health is through the gut microbiome. Oral probiotics, prebiotics, and synbiotics have the potential to improve skin health, delay skin aging, and successfully treat dermatological diseases. We developed a scoping review protocol in accordance with the Johanna Briggs Institute methodology. Six online databases were systematically searched for peer-reviewed literature, and non-peer-reviewed sources were also considered. All records were screened independently by 2 reviewers using predefined eligibility criteria. A total of 516 studies were included in the scoping review, comprising 73 systematic reviews. Most studies investigated probiotics (n = 401). Infants (0-12 months old) and adults (18-60 years old) were the age groups most frequently receiving supplementation with probiotics (42% [n = 114] and 41% [n = 112] of human studies, respectively), whereas only 15% of studies (n = 41) comprised adults participants older than 60 years. Of the skin diseases investigated, atopic dermatitis was the most extensively researched (n = 330 studies), followed by psoriasis (n = 24), and acne (n = 23). Skin health and function in healthy populations is a growing area of research; outcomes related to wrinkling, elasticity, aging, or UV irradiation response accounted for 54 studies. Consistencies in the evidence base found in our investigation underscore the need for an umbrella review on oral probiotics, prebiotics, and synbiotics and atopic dermatitis, as well as a systematic review on skin aging. Preliminary evidence for roles in managing rosacea, alopecia, and melasma suggests additional research avenues. Future studies should consider participant diets, probiotic strain and dose reporting, and inclusivity of populations and languages.

Lipedema, a chronic condition primarily affecting women, is characterized by abnormal subcutaneous fat accumulation and swelling in the extremities (while sparing the hands, feet, and trunk). This disease is associated with genetic predisposition, hormonal imbalances, impaired lymphatic function, and vascular dysfunction. Lipedema does not directly cause weight gain, but excess weight can worsen symptoms and accelerate disease progression. Bariatric surgery is considered a treatment option for body weight management and reduction of subcutaneous fat; however, reported studies have indicated that this treatment cannot reduce localized fat accumulation or fat cell hypertrophy or alleviate pain symptoms. Although no proven dietary treatment currently exists, nutrition plays a key role in managing lipedema. Certain dietary approaches such as ketogenic, low-carbohydrate, and modified Mediterranean diets have been explored for weight management and inflammation reduction in lipedema, with studies showing positive effects on body composition and pain. However, according to the current literature no evidence-based nutritional treatments or nutritional supplements are effective in this patient group. Nutritional therapy in lipedema is complicated by frequent comorbidities; therefore, precision nutritional therapy should be planned by evaluating the causes and consequences of the disease. In this review, we evaluated reported studies of current evidence-based clinical nutritional approaches to lipedema treatment.

Malnutrition and helminth infections are known to be associated conditions. Malnutrition, which refers to excesses, deficiencies, or imbalances in intake of energy and/or nutrients, affects millions of people worldwide and is the most common cause of immunodeficiency in the world. In helminth-infected individuals, malnutrition has been associated with an augmented morbidity rate, a higher parasitic load, and prolonged infections, and may also contribute to increased mortality. Helminth infections affect millions of people worldwide, particularly in non-industrialized countries, leading to chronic infections. This review focuses on the bidirectional relationships between macronutrient malnutrition and helminth infections. Relevant scientific articles published until May 2024 were retrieved from PubMed and Google Scholar. The data extracted were parameters of immunology, hematology, parasitology, disease, and nutrition. Malnutrition leads to alterations in the immune responses to helminth infections, including innate responses (Heligmosomoides polygyrus, hookworms, Trichinella spp., Trichuris spp.), T-cell-mediated responses (Ascaris spp., H. polygyrus, Trichuris spp.), and antibody responses (Ascaris spp., H. polygyrus, Schistosoma spp., Trichinella spp., Trichuris spp.), frequently resulting in increased parasite load and worm fecundity. However, in some cases malnutrition may have negative effects on the life cycle of helminths, including reductions in worm weight, egg production, worm size, and parasite fecundity. Malnutrition has a notorious influence on both host and parasite. The consequences for the host would be related to the severity and type of malnutrition condition, and the helminth involved.

Folate compounds are crucial for DNA and RNA synthesis, homocysteine regulation, and epigenetic methylation. However, significant differences exist between 5-methyltetrahydrofolate (5-MTHF) and folinic acid (CHO-THF) -and synthetic folic acid (sFA). Understanding their absorption, bioavailability, and clinical effects is essential, especially for women planning pregnancy, pregnant women, and patients with MTHFR or DHFR polymorphisms, autism spectrum disorders, or other folate-related conditions. A comparative analysis of clinical and biochemical studies was conducted to evaluate the efficacy, safety, and optimal dosing of these folate forms. 5-MTHF and CHO-THF demonstrated key advantages over sFA, including avoidance of unmetabolized folic acid accumulation, reduced risk of masking vitamin B12 deficiency, and improved metabolic support in individuals with genetic variants or folate receptor dysfunction. Both forms also show enhanced activity in high-dose therapies for patients with autoantibodies to folate receptors or transport defects. 5-MTHF efficiently crosses the blood-brain barrier, supports fetal and neonatal brain development, and has shown potential in improving cognitive function and depressive symptoms. CHO-THF exhibits promise in managing autism spectrum disorders by modulating neurotransmission and neurometabolic pathways. Despite these advantages, sFA remains the only folate form with proven efficacy in large randomized clinical trials for preventing neural tube defects (NTDs) and continues to play a key role in public health strategies. Use of sFA at doses above 1000 µg/day requires monitoring to avoid masking B12 deficiency. For personalized or high-risk cases, 5-MTHF and CHO-THF should be the preferred options, ideally combined with vitamin B12 supplementation.

Context: Excessive salt intake is a well-established, modifiable risk factor for hypertension and cardiovascular disease. Although reducing salt consumption lowers blood pressure (BP), the quantitative association across intake levels, subgroup differences, and the influence of salt-intake assessment methods remain uncertain.

Objective: To evaluate the association between salt-intake levels and BP across randomized controlled trials using predefined intake categories and to explore study-level continuous trends.

Data sources: The PubMed, Embase, Cochrane Library, Web of Science, CINAHL, China Knowledge Network, Wanfang, China Science and Technology Journal Database (VIP), and Sinomed databases were searched from inception to December 2024, without language restrictions.

Data extraction: Two reviewers independently screened records using prespecified PICOS criteria, extracted study characteristics and outcomes (systolic and diastolic BPs), and assessed risk of bias with the RoB2 tool. Discrepancies were resolved by discussion or third-reviewer adjudication. Salt was used as the primary exposure metric (measured in grams per day; conversion: 1 g sodium = 2.54 g salt).

Data analysis: Random-effects meta-analyses compared standardized intake categories (high >15 g d-1; moderate 5-15 g d-1; low <5 g d-1). Prespecified study-level meta-regression was conducted as an exploratory assessment of continuous trends. Subgroup and sensitivity analyses considered salt sensitivity, age, intervention duration, comorbid conditions, geographic region, publication year, and potassium handling. Publication bias diagnostics were performed where applicable.

Conclusions: Across 43 randomized controlled trials (1983-2024), higher amounts of salt intake were associated with higher BP, whereas lower intake was associated with larger BP reductions, demonstrating a graded association across intake categories. Exploratory study-level continuous trends were not statistically significant, consistent with residual heterogeneity, exposure measurement error, and adherence variation. These findings support individualized salt-reduction strategies and robust public-health measures, including food reformulation and national salt-reduction programs, to reduce the burden of hypertension and cardiovascular disease.

Systematic review registration: PROSPERO registration No. CRD42024617388.

Context: Dipeptidyl peptidase-4 inhibitors (DPP-4i) serve as an incretin-based hypoglycemic class for the treatment of type 2 diabetes (T2D). DPP-4i have been reported to produce a pleiotropic effect on lipid profiles in addition to regulation of glucose homeostasis.

Objective: The aim of this systematic review and meta-analysis was to quantitatively evaluate the impact of DPP-4i on lipid parameters in patients with T2D.

Data sources: PubMed, Embase, and The Cochrane Library were systematically searched for randomized controlled trials.

Data extraction: Trials were identified if changes in lipid parameters, including low-density-lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglycerides (TG), high-density-lipoprotein cholesterol (HDL-C), non-HDL-C, and apolipoprotein B (ApoB) were reported.

Data analysis: A total of 95 publications were identified. DPP-4i significantly reduced levels of LDL-C (-3.48 mg/dL; 95% CI, -4.77 to -2.20; I2 = 70%, P < .00001), TC (-2.59 mg/dL; 95% CI, -3.88 to -1.29; I2 = 73%, P < .0001), TG (-5.39 mg/dL; 95% CI, -8.04 to -2.75; I2 = 77%, P < .0001), and non-HDL-C (-6.27 mg/dL; 95% CI, -10.94 to -1.60; I2 = 53%, P = .008). No significant effect was found on HDL-C (-0.32 mg/dL; 95% CI, -1.19 to 0.55; I2 = 97%, P = .47) and ApoB (-0.88 mg/dL; 95% CI, -3.36 to 1.60; I2 = 36%, P = .49) during DPP-4i treatment.

Conclusion: DDP-4i significantly improved lipid parameters including LDL-C, TC, TG, and non-HDL-C in patients with T2D. This underscores the potential cardiovascular benefits of DPP-4i and their role in improving diabetes-related outcomes.

Systematic review registration: PROSPERO registration no. CRD42020175999.

Introduction: Hip fracture is an important cause of hospitalization, with high morbidity and mortality. Evidence suggests that vegetarians and vegans have lower bone mineral density, and plant-based diets are gaining popularity. However, the impact of these diets on the occurrence of hip fracture risk remains unclear.

Objective: This systematic review aimed to assess the impact of vegetarian and vegan diets on the risk of hip fracture in adults.

Methods: We conducted a systematic review of studies comparing vegetarians and vegans with meat-eaters. We searched Medline, EMBASE, LILACS, CINAHL, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL). Two reviewers independently and in duplicate performed study selection, risk-of-bias assessment, and data extraction. Hazard ratios (HRs) with 95% CIs were calculated as an estimate of the effect of vegetarian and vegan diets. The quality of evidence was determined according to the Grading of Recommendations Assessment, Development, and Evaluation.

Results: Four cohort studies with 529 672 participants were included. Both vegetarian and vegan diets were associated with a higher risk of hip fracture after adjusting for confounders. Vegetarians had a 25% higher risk than meat-eaters (HR, 1.25; 95% CI, 1.11-1.39; 38 433 vegetarians; I2 = 0%; low certainty of evidence). Vegans had a 75% higher risk (HR, 1.75; 95% CI, 1.17-2.63; 5344 vegans; I2 =64%; very low certainty of evidence).

Conclusion: These findings emphasize the importance of incorporating dietary patterns into strategies for promoting bone health, especially among individuals following plant-based diets. Healthcare providers should offer guidance to individuals adopting vegetarian or vegan diets to ensure adequate nutrient intake and support bone health.

Systematic review registration: PROSPERO no. CRD 42024592448.

Context: Taurine, a sulfur-containing amino acid vital for cardiovascular health, is suggested as a promising intervention for reducing cardiometabolic disease risk.

Objective: In this meta-analysis of randomized controlled trials (RCTs) we sought to evaluate the effects of taurine on cardiometabolic risk factors.

Data sources: We systematically searched PubMed/MEDLINE, Web of Science, EMBASE, Cochrane Library, and Google Scholar for articles reporting RCTs that investigated the effects of taurine on cardiometabolic risk factors.

Data extraction: Data extraction was performed in accordance with the Cochrane and PRISMA guidelines. A random-effects model or a common-effect model was used to calculate mean differences (MDs) or standardized mean differences (SMDs).

Data analyses: Thirty-four eligible RCTs were analyzed. Taurine supplementation resulted in significant reductions in fasting blood glucose (MD, -5.90 mg/dL; 95% CI, -9.65 to -2.15), glycated hemoglobin A1c (MD, -0.21%; 95% CI, -0.37 to -0.05), fasting insulin (SMD, -0.55; 95% CI, -0.78 to -0.32), homeostatic model assessment for insulin resistance index (MD, -0.57; 95% CI, -0.74 to -0.40), triglycerides (MD, -14.42 mg/dL; 95% CI, -23.60 to -5.25), total cholesterol (MD, -12.41 mg/dL; 95% CI, -19.10 to -5.71), low-density lipoprotein cholesterol (MD, -5.08 mg/dL; 95% CI, -8.35 to -1.81), systolic blood pressure (MD, -4.38 mmHg; 95% CI, -7.26 to -1.50), diastolic blood pressure (MD, -2.54 mmHg; 95% CI, -3.97 to -1.11), aspartate aminotransferase (MD, -9.65 U/L; 95% CI, -17.39 to -1.90), alanine aminotransferase (MD, -8.26 U/L; 95% CI, -14.81 to -1.70), C-reactive protein (SMD, -1.26; 95% CI, -2.01 to -0.52), tumor necrosis factor-α (MD, -0.35 pg/mL; 95% CI, -0.56 to -0.14), and malondialdehyde (SMD, -1.16; 95% CI, -1.81 to -0.52). Subgroup and dose-response analyses indicated that a daily taurine dose of 1.5-3.0 g was more effective in improving these cardiometabolic risk factors. Specifically, taurine intervention for ≥8 weeks yielded greater improvements in glucose and lipid metabolism, while durations <8 weeks were optimal for managing blood pressure and inflammation.

Conclusion: Taurine supplementation may effectively improve cardiometabolic risk factors in adults, underscoring its potential to reduce the incidence of cardiometabolic diseases.

Systematic review registration: PROSPERO registration No. CRD42024577852.

Context: Chronic kidney disease (CKD) is a major clinical kidney disease associated with numerous adverse events, such as heart failure and premature mortality. Dietary modifications are prioritized in the management of CKD due to the long-term effects of this disease.

Objective: In this review we sought to consolidate evidence from published systematic reviews and meta-analyses performed to investigate the associations between different dietary patterns and kidney health.

Data sources: We searched related systematic reviews and meta-analyses in PubMed, Embase, Ovid, and the Cochrane Database of Systematic Reviews.

Data extraction: Two independent reviewers undertook screening, data extraction, and quality assessment. The corrected covered area was used to identify the degree of overlap between reviews. Exposures included the amount of protein/salt intake, types of dietary protein, ketoanalogue (KA) supplementation, the Mediterranean diet, and the Dietary Approaches to Stop Hypertension (DASH) diet.

Data analysis: In total, 28 reviews evaluating the associations between multiple dietary patterns and kidney health were included. According to reported review findings, a low-protein diet (LPD) reduced proteinuria in CKD patients. A very low-protein diet (VLPD) was shown to decrease the occurrence of end-stage renal disease. Supplementation with KA based on the LPD/VLPD further reduced levels of proteinuria, blood urea nitrogen, and serum creatinine and preserved the estimated glomerular filtration rate (eGFR) in CKD patients. Lower sodium intake effectively decreased urinary sodium and protein excretion and produced a significant reduction in the incidence of composite endpoints in CKD patients. Both the Mediterranean and the DASH diet mitigated the risk of CKD, while the latter also showed benefits in reducing proteinuria and rate of eGFR decline.

Conclusions: Although the aforementioned dietary interventions did not directly improve patient mortality, they showed protective effects in lowering proteinuria, preserving renal function in CKD patients and reducing the risk of CKD in the non-CKD population. Clinicians should acknowledge the impact of various dietary patterns on kidney health to achieve better prevention and management of kidney diseases.

Systematic review registration: PROSPERO registration No. [CRD42022313262].

Context: The prevalence of metabolic dysfunction-associated fatty liver disease (MAFLD) has increased, and it is emerging as a global health problem. Exercise is the primary treatment, but the ideal prescription remains unclear.

Objective: The objective of this study was to synthesize the evidence for exercise prescription for MAFLD, encompassing frequency, intensity, duration, type, and outcomes, and to evaluate the methodological rigor and evidence quality.

Data sources: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 6 electronic databases, namely, PubMed, Embase, CINAHL, the Cochrane Library, the Web of Science, and the Joanna Briggs Institute (JBI), were searched for systematic reviews and meta-analyses in April 2024. Backward citation tracking was performed.

Data extraction: Data were extracted from exercise prescription data reviews, and the relationships between prescription variables and outcomes were analyzed. AMSTAR-2 and GRADE were used to assess the methodological quality and evidence level.

Data analysis: Among the 506 identified studies, 23 systematic reviews were included after excluding irrelevant studies that did not meet the inclusion criteria. Five systematic reviews identified an effective exercise frequency range of 2-5 sessions per week, with the most consistent improvements in total cholesterol observed at 4-5 sessions. Nine reviews addressed moderate to high exercise intensities, while 5 emphasized exercise durations within the 30-60 minute range. Two articles recommended prioritizing a combination of aerobic exercise and resistance training in cases without contraindications. Regarding the literature quality, 82% of the studies were rated as being of low to critically low quality. GRADE assessment indicated that the overall quality of the evidence was low to moderate.

Conclusion: MAFLD patients may benefit most from exercising 4-5 times per week at moderate to high intensity, particularly through improving lipid profiles. Prioritizing a blend of aerobic and resistance exercises is advisable if there are no contraindications. Optimal session duration falls within the 30-60-minute range, with longer adherence yielding better outcomes. However, more high-quality studies exploring exercise prescription variables and dose-response meta-analyses are needed.

Systematic review registration: PROSPERO registration No. CRD42022344662.