Nutrition reviews最新文献

Context: Several effects of non-sugar-sweetened beverage (NSSBs) intake on health outcomes have been reported; however, the evidence on the association between NSSBs intake and chronic diseases and mortality risk is still inconclusive.

Objective: This umbrella review aimed to summarize the evidence on the association between NSSBs intake and the risk of chronic diseases and mortality.

Data sources: Embase, ISI Web of Science, Cochrane Central, and PubMed were searched up to September 2023 for relevant meta-analyses of observational prospective cohort studies.

Data extraction: Two groups of researchers independently extracted study data and assessed the risk of bias for meta-analyses and primary studies.

Data analysis: Six meta-analyses, reporting 74 summary hazard ratios (HRs) for different outcomes obtained from 50 primary studies, were included. The summary HRs, 95% CIs, and certainty of evidence on the association of NSSBs intake with risk of chronic diseases and mortality were as follows: all-cause mortality (per 355 mL/d: 1.06 [1.01 to 1.10]; moderate certainty); stroke (per 250 mL/d: 1.09 [1.04 to 1.13]; high certainty); coronary heart disease (CHD) (per 250 mL/d: 1.06 [1.02 to 1.11]; high certainty); hypertension (HTN) (high vs low intake: 1.14 [1.09 to 1.18]; moderate certainty); type 2 diabetes (T2D) (high vs low intake: 1.16 [1.08 to 1.26]; low certainty); metabolic syndrome (MetS) (high vs low intake: 1.32 [1.22 to 1.43]; low certainty); colorectal cancer (high vs low intake: 0.78 [0.62 to 0.99]; moderate certainty); and leukemia (high vs low intake: 1.35 [1.03 to 1.77]; moderate certainty). For other outcomes, including the risk of cardiovascular and cancer mortality, chronic kidney diseases, breast cancer, prostate cancer, endometrial cancer, pancreatic cancer, multiple myeloma, and non-Hodgkin lymphoma, no association was found.

Conclusion: This study provides further evidence that NSSBs are associated with increased risk of all-cause mortality, stroke, CHD, HTN, T2D, MetS, and leukemia. Moreover, a higher intake of NSSBs was associated with a lower risk of colorectal cancer. However, it should be noted that the magnitudes of the associations are not large. Further studies are needed to clarify the long-term effects of different NSSBs intakes on health.

Systematic review registration: PROSPERO no. CRD42023429981.

Context: Today, there are many discussions about the best way to maintain weight and prevent weight regain after a period of weight loss.

Objectives: The aim of this study was to summarize, based on data from randomized clinical trials (RCTs), the impact of nonsurgical interventions for adults' weight loss maintenance.

Data sources: The Medline (PubMed), Scopus, and Web of Science databases were reviewed during June 2023.

Data extraction: Meta-analyses assessing the impacts of nonsurgical interventions for weight loss maintenance were conducted. Effect sizes of nutritional interventions were recalculated by applying a random-effects model. The Grading of Recommendations, Assessment, Development, and Evaluation framework was implemented to determine evidence certainty.

Results: Meta-analysis of data from a total of 56 RCTs (n = 13 270 participants) represented a significant weight reduction after behavior and lifestyle interventions (mean difference [MD], -0.64 kg [95% CI, -1.18 to -0.09]; I2 = 89.5%; P < .001 for heterogeneity). Pharmacological interventions had also a significant effect on weight change during the weight maintenance phase (MD, -2.57 kg [95% CI, -3.12 to -2.02]; I2 = 91.6%; P < .001 for heterogeneity). The weight loss reduction from pharmacological interventions was greater with sibutramine (MD, -2.57; 95% CI: -3.12 to -2.02). Additionally, diet intervention and dietary and physical activity strategies were associated with a negligible trending decrease in weigh regain (respectively: MD, -0.91 kg [95% CI, -2.18 to 0.36], I2 = 55.7%, P = .016 for heterogeneity; and MD, -0.3 kg [95% CI, -4.13 to 3.52], I2 =  94.1%, P < .001).

Conclusion: The findings of this review indicate there is a favorable impact of behavior-based interventions and antiobesity medications on weight maintenance.

Systematic review registration: PROSPERO registration no CRD42023468056.

Context: The price and affordability of food are priorities for public health and health equity; however, Australia lacks a consistent method to evaluate healthy versus unhealthy diets, creating a gap in routine food price reporting.

Objective: This review aimed to identify and summarize recent methods used to assess and monitor the price and/or affordability of food and beverages in Australia using a health lens.

Data sources: Four academic databases (MEDLINE Complete, Global Health, CINAHL Complete, and Business Source Complete) were searched in English from 2016 to 2022. Relevant gray literature was searched through Google Scholar and government websites.

Data extraction: Five reviewers screened titles and abstracts, and full-text screening was conducted by 1 reviewer, with eligibility confirmed by a second reviewer. The quality of studies was assessed using the Joanna Briggs Institute "Checklist for Analytical Cross-Sectional Studies."

Data analysis: Twenty-five eligible studies were identified. Eleven studies used a version of the Healthy Diets Australian Standardized Affordability and Pricing protocol to collect prices for a "healthy" diet modelled on dietary guidelines and an "unhealthy" diet based on a habitual Australian diet. These studies consistently found unhealthy diets to be more expensive than healthy diets. Other identified methods included assessing the price of household diets across healthy baskets (n = 6), store types (n = 5), a planetary health diet (n = 1), packaged foods according to their Health Star Rating (n = 1), a fruit and vegetable basket (n = 1), school canteen foods against a traffic light system (n = 1), and weekly healthy meal plans (n = 1). Healthy diets tended to be less costly than less healthy diets, but both diets were often unaffordable in regional areas, for people on low incomes, and for First Nations peoples.

Conclusion: Consistent country-wide application of methods for monitoring the price and affordability of foods and diets in Australia is needed-including tailored approaches for priority groups.

Systematic review registration: PROSPERO registration no. CRD42022333531.

Context: Dietary interventions providing different amounts of carbohydrates have been proposed as a means of achieving glycemic control and weight loss in type 2 diabetes mellitus (T2DM); however, the supporting evidence is heterogeneous, making this recommendation difficult to apply in nutritional clinical practice.

Objective: The aim was to assess the quality of evidence from meta-analyses on low-carbohydrate (LC) dietary interventions for glycemic control, weight loss, and lipid profile in individuals with T2DM.

Data sources: The MEDLINE, Web of Science, and Scopus databases were searched until September 2023.

Data extraction: A systematic review was conducted. Systematic reviews with meta-analysis of randomized clinical trials designed to assess glycated hemoglobin (HbA1c) reductions in individuals with T2DM were eligible. The AMSTAR-2 critical appraisal tool was used to evaluate the methodological aspects of all included studies. The GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach was used to assess the certainty of the evidence.

Data analysis: The LC interventions were associated with a reduction in HbA1c (%) of -0.42 (-1.45 to -0.09; high certainty of evidence) without considering follow-up time; at up to 3 months of follow-up of -0.28 (-0.13 to -0.43); at up to 6 months of follow-up of -0.40 (-0.61 to -0.09); at 6 to 12 months of follow-up of -0.32 (-0.49 to 0.11); and at >12 months of follow-up time of -0.31 (-0.14 to -0.65) compared with control diets.

Conclusion: LC diets can help reduce HbA1c in individuals with T2DM in the short term (up to 3 months). However, dietary recommendations must always be individualized, as the studies reviewed herein analyzed different populations and used different definitions of what constitutes an LC diet.

Systematic review registration: PROSPERO no. CRD42023404197.

Context: Recent data from the South Asian subregion have raised concern about the dramatic increase in the prevalence of metabolic diseases, which are influenced by genetic and lifestyle factors.

Objective: The aim of this systematic review was to summarize the contemporary evidence for the effect of gene-lifestyle interactions on metabolic outcomes in this population.

Data sources: PubMed, Web of Science, and SCOPUS databases were searched up until March 2023 for observational and intervention studies investigating the interaction between genetic variants and lifestyle factors such as diet and physical activity on obesity and type 2 diabetes traits.

Data extraction: Of the 14 783 publications extracted, 15 were deemed eligible for inclusion in this study. Data extraction was carried out independently by 3 investigators. The quality of the included studies was assessed using the Appraisal Tool for Cross-Sectional Studies (AXIS), the Risk Of Bias In Non-randomized Studies-of Interventions (ROBINS-I), and the methodological quality score for nutrigenetics studies.

Data analysis: Using a narrative synthesis approach, the findings were presented in textual and tabular format. Together, studies from India (n = 8), Pakistan (n = 3), Sri Lanka (n = 1), and the South Asian diaspora in Singapore and Canada (n = 3) reported 543 gene-lifestyle interactions, of which 132 (∼24%) were statistically significant. These results were related to the effects of the interaction of genetic factors with physical inactivity, poor sleep habits, smoking, and dietary intake of carbohydrates, protein, and fat on the risk of metabolic disease in this population.

Conclusions: The findings of this systematic review provide evidence of gene-lifestyle interactions impacting metabolic traits within the South Asian population. However, the lack of replication and correction for multiple testing and the small sample size of the included studies may limit the conclusiveness of the evidence. Note, this paper is part of the Nutrition Reviews Special Collection on Precision Nutrition.

Systematic review registration: PROSPERO registration No. CRD42023402408.

The leading causes of cancer include gradual changes in regulatory proteins, dysregulated cell-signaling pathways, dysfunction of apoptosis, and oxidative stress. Consuming polyphenols from food sources has been proven to have strong connections with ameliorating specific physiological biomarkers along with other elements concerning cancer. Recent studies have focused on polyphenols' molecular mechanisms of action and anticancer and chemopreventive properties and effects in the treatment of different types of cancer. Polyphenols participate in the regulation of numerous cellular mechanisms alongside signaling pathways through their effects on inflammation, cellular proliferation, apoptosis, and partially via epigenetic alterations in cervical cancer. A number of animal models and cell and human studies have indicated the use of polyphenols to be safe and tolerable. Thus, it would be fair to state that, with their advantages vis-à-vis lack of toxicity, cost, and access, and with the positive clinical results, polyphenols have a potential to make a difference in cancer treatment. The present review examined the chemical and physical properties, analogs, metabolites, and mechanisms of physiological activities of various polyphenols and how they may affect the incidence rate and management of cervical cancer. Therefore, this review constitutes a starting point to examine the potential applications for cervical cancer.

Objectives: The aim of this study was to analyze the modeling methodologies of fiscal policies on food with health or environmental outcomes.

Background: Evidence suggests that fiscal policies on food can contribute to addressing the growing burden of noncommunicable diseases and climate change. These policies should be modeled in advance to see the implications for the environment and health.

Methods: A systematic review was conducted of studies that modeled fiscal policies on the food groups targeted by the EAT-Lancet Commission and examined their health or environmental outcomes. The Scopus and PubMed databases were searched on November 30, 2021. The records were double-screened and data on modeling methods were extracted from the included studies.

Results: A total of 55 studies were included in the review. The most frequently modeled interventions were fruit and vegetable subsidies (n = 19) and carbon taxes on food (n = 17). One study also included a consumer education campaign to enhance the effect of fiscal policy. The outcomes are highly sensitive to consumption change and price elasticities. None of the studies modeled the health effects of environmental outcomes.

Conclusions: A model that covered all the relevant aspects of the issue was not found. Some parts were missing from all the included models. It is advisable to model the stability of the amount of diet consumed, either by keeping the amount of food in the diet stable or by taking a more conservative approach and keeping the consumed calories stable. It is preferable to keep the included diseases and environmental boundaries broad to have more valid outcome estimates on this complex issue. A more comprehensive understanding of fiscal policies would allow us to better anticipate the impact of our actions and inactions and thus could lead to more sophisticated measures taken by policymakers.

Systematic review registration: PROSPERO registration no. 2022 CRD42022291945/.