Nutrition reviews最新文献

Context: Polycystic ovary syndrome (PCOS) is a prevalent hormonal imbalance that predominantly affects women in their reproductive years. Previous studies have yielded conflicting conclusions.

Objective: This is an updated meta-analysis aiming to explore the connection between flavonoid supplementation and PCOS.

Data sources: Seven databases were searched: Cochrane Library, PubMed, Web of Science, Embase, Wanfang, China Science and Technology Journal, and China National Knowledge Infrastructure, spanning from their inception to April 15, 2024.

Data extraction: Two authors independently searched the databases using the search terms.

Data analysis: Following strict inclusion criteria, 8 papers were ultimately included. This updated meta-analysis suggests that flavonoid supplementation could enhance follicular development, promote the proliferation and differentiation of follicular granulosa cells, elevate estradiol levels, and mitigate testosterone, C-reactive protein, and ovarian index levels.

Conclusion: This analysis suggests that dietary flavonoids could potentially alleviate symptoms associated with PCOS.

Systematic review registration: PROSPERO registration no. CRD42022382912.

Context: Hesperidin is a naturally occurring bioactive compound that may influence cardiometabolic markers, but the existing evidence is inconclusive.

Objective: This study aims to further investigate the effects of hesperidin supplementation on cardiometabolic markers in adults.

Data sources: A comprehensive search was conducted up to August 2023, utilizing relevant key words in databases such as PubMed, Scopus, Embase, and the Cochrane Central Register of Controlled Trials, focusing on randomized controlled trials (RCTs).

Data extraction: RCTs that examined the impact of hesperidin on fasting blood sugar (FBS), insulin, quantitative insulin-sensitivity check index (QUICKI), homeostatic model assessment of insulin resistance (HOMA-IR), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), systolic blood pressure (SBP), diastolic blood pressure (DBP), tumor necrosis factor-alpha (TNF-α), and high-sensitivity C-reactive protein (hs-CRP) were selected independently by 2 authors. The GRADE assessment was used to ascertain the certainty of the evidence. Results were pooled using a random-effects model as weighted mean differences and 95% CIs.

Data analysis: The results of this study demonstrate that hesperidin supplementation had a significant impact on reducing FBS, TG, TC, LDL-C, SBP, and TNF-α. However, there was no significant effect observed on insulin, HOMA-IR, QUICKI, HDL-C, DBP, and hs-CRP. The study's subgroup analyses also revealed that interventions lasting more than 12 weeks were effective in reducing FBS, TG, TC, and LDL-C. Moreover, hesperidin dosage exceeding 500 mg/day showed significance in reducing FBS, TC, and LDL-C levels.

Conclusion: In conclusion, this research suggests that hesperidin can be consumed as an effective dietary approach to enhance cardiometabolic markers.

Systematic review registration: PROSPERO registration no. CRD42022325775.

The gut and brain communicate through bidirectional neural, endocrine, and immune signals to coordinate central nervous system activity with gastrointestinal function. Dysregulated inflammation can promote immune cell activation and increase entero-endocrine signaling and intestinal permeability; hence, a functional gut-brain axis is necessary for a healthy digestive system. The consumption of milk products can lead to gut discomfort via effects on gastrointestinal tract function and the inflammatory state, which, in turn, affect the brain. A1 β-casein and A2 β-casein are major components of bovine-milk protein, and their digestion may result in different physiological effects following the consumption of milk products. Peptides derived from A1 β-casein, such as β-casomorphins, may increase gut dysfunction and inflammation, thereby modulating the availability of bioactive metabolites in the bloodstream and contribute to changes in cognitive function. This narrative review examines the functional interrelationships between the consumption of cow-milk-derived β-caseins and their effect on the brain, immune system, and the gut, which together comprise the gut-brain axis.

Context: Several studies have demonstrated that dietary patterns identified by a posteriori and hybrid methods are associated with gastrointestinal (GI) cancer risk and mortality. These studies applied different methods for analyzing dietary data and reported inconsistent findings.

Objective: This systematic review and meta-analysis were aimed to determine the association between dietary patterns, derived using principal component analysis (PCA) and reduced rank regression (RRR), and GI cancer risk and GI cancer-caused mortality.

Data source: Articles published up to June 2023 in English were eligible for inclusion. The Medline, SCOPUS, Cochrane Library, CINHAL, PsycINFO, ProQuest, and Web of Sciences databases were used to identify prospective studies. The Preferred Reporting Item for Systematic Review and Meta-analysis Protocol 2020 was used to report results.

Data extraction: A total of 28 studies were eligible for inclusion. Varied approaches to deriving dietary patterns were used, including PCA (n = 22), RRR (n = 2), combined PCA and RRR (n = 1), cluster analysis (CA; n = 2) and combined PCA and CA (n = 1).

Data analysis: Two dietary patterns, "healthy" and "unhealthy," were derived using PCA and RRR. The healthy dietary pattern was characterized by a higher intake of fruits, whole grains, legumes, vegetables, milk, and other dairy products, whereas the unhealthy dietary pattern was characterized by a higher intake of red and processed meat, alcohol, and both refined and sugar-sweetened beverages. The findings indicated that the PCA-derived healthy dietary pattern was associated with an 8% reduced risk (relative risk [RR], 0.92; 95% CI, 0.87-0.98), and the unhealthy dietary pattern was associated with a 14% increased risk (RR, 1.14; 95% CI, 1.07-1.22) of GI cancers. Similarly, the RRR-derived healthy dietary pattern (RR, 0.83; 95% CI, 0.61-1.12) may be associated with reduced risk of GI cancers. In contrast, the RRR-derived unhealthy dietary pattern (RR, 0.93; 95% CI, 0.57-1.52) had no association with a reduced risk of GI cancers. Similarly, evidence suggested that PCA-derived healthy dietary patterns may reduce the risk of death from GI cancers, whereas PCA-derived unhealthy dietary patterns may increase the risk.

Conclusion: Findings from prospective studies on the association of PCA-derived dietary patterns and the risk of GI cancers support the evidence of healthy and unhealthy dietary patterns as either protective or risk-increasing factors for GI cancers and for survivorship, respectively. The findings also suggest that the RRR-derived healthy dietary pattern reduces the risk of GI cancers (albeit with low precision), but no association was found for the RRR-derived unhealthy dietary pattern. Prospective studies are required to further clarify disparities in the association between PCA- and RRR-derived

Context: Global Leadership Initiative on Malnutrition (GLIM) and Patient-Generated Subjective Global Assessment (PG-SGA) are commonly used nutrition assessment tools, whose performance does not reach a consensus due to different and imperfect reference standards.

Objective: This study aimed to evaluate and compare the diagnostic accuracy of GLIM and PG-SGA, using a hierarchical Bayesian latent class model, in the absence of a gold standard.

Data sources: A systematic search was undertaken in PubMed, Embase, and Web of Science from inception to October 2022. Diagnostic test studies comparing (1) the GLIM and/or (2) PG-SGA with "semi-gold" standard assessment tools for malnutrition were included.

Data extraction: Two authors independently extracted data on sensitivity, specificity, and other key characteristics. The methodological quality of each included study was appraised according to the criteria in the Quality Assessment of Diagnostic Accuracy Studies-2.

Data analysis: A total of 45 studies, comprising 20 876 individuals evaluated for GLIM and 11 575 for PG-SGA, were included. The pooled sensitivity was 0.833 (95% CI 0.744 to 0.896) for GLIM and 0.874 (0.797 to 0.925) for PG-SGA, while the pooled specificity was 0.837 (0.780 to 0.882) for GLIM and 0.778 (0.707 to 0.836) for PG-SGA. GLIM showed slightly better performance than PG-SGA, with a higher diagnostic odds ratio (25.791 vs 24.396). The diagnostic performance of GLIM was most effective in non-cancer patients with an average body mass index (BMI) of <24 kg/m2, followed by non-cancer patients with an average age of ≥60 years. PG-SGA was most powerful in cancer patients with an average age of <60 years, followed by cancer patients with an average BMI of <24 kg/m2.

Conclusion: Both GLIM and PG-SGA had moderately high diagnostic capabilities. GLIM was most effective in non-cancer patients with a low BMI, while PG-SGA was more applicable in cancer patients.

Systematic review registration: PROSPERO registration No. CRD42022380409.

Context: Higher protein diets (HPDs) have shown favorable outcomes on weight maintenance and body-composition management; however, their protective effects against cardiovascular diseases (CVDs) remain uncertain and contentious. Furthermore, it is important to consider the influence of other macronutrients in the diet and type of dietary protein when studying HPDs, because this aspect has been overlooked in previous studies.

Objective: We assessed the impacts of quantity and type of dietary protein on CVD risk factors.

Data sources: A database search was conducted in PubMed, Embase, CINAHL, Web of Science, and Cochrane Library and a total of 100 articles met the eligibility criteria.

Data extraction: Extracted data from 100 articles were analyzed using standard meta-analysis, and 41 articles were also analyzed using network meta-analysis.

Data analysis: In the standard meta-analysis, an HPD had significant favorable effects on systolic blood pressure (SBP) (mean difference [MD] = -1.51 mmHg; 95% CI: -2.77, -0.25), diastolic blood pressure (DBP) (MD = -1.08 mmHg; 95% CI: -1.81, -0.35), and flow-mediated dilation (MD = 0.78%; 95% CI: 0.09, 1.47) compared with lower protein diets. The further network meta-analysis supported that the high-protein, high-carbohydrate, low-fat diet was the most recommended diet to ensure a maximum decrease in SBP, DBP, total cholesterol (TC), and low-density-lipoprotein cholesterol (LDL-C). In comparison to animal-protein-rich diets, plant-protein-rich diets (PPRs) exhibited a significant favorable effects on improving TC (MD = -0.12 mmol/L; 95% CI: -0.19, -0.05), triglyceride (MD = -0.05 mmol/L; 95% CI: -0.09, -0.01), LDL-C (MD = -0.11 mmol/L; 95% CI: -0.18, -0.04), and high-density-lipoprotein cholesterol (MD = 0.03 mmol/L; 95% CI: 0.02, 0.04) levels.

Conclusion: Consumption of HPDs and PPRs supports improvements in vascular health and lipid-lipoprotein profiles, respectively. Furthermore, macronutrient composition should be carefully designed in the dietary approach to maximize the effectiveness of HPDs in improving CVD risk factors.

Systematic review registration: PROSPERO registration no. CRD42022369931.

Context: Energy intake may differ across the menstrual cycle, with some studies identifying greater energy intake in the luteal phase (LP) compared with the follicular phase (FP) and others finding no clear differences. To date, no study has systematically synthesized the available data to draw more definite conclusions while considering any methodological inconsistencies between studies.

Objective: The aim was to conduct a systematic review/meta-analysis in an effort to determine if there are differences in energy intake between the FP and LP.

Data sources: A systematic search strategy was developed and the search was conducted in 5 databases for studies that investigated any changes in energy intake across menstrual phases.

Data extraction: Using Covidence, studies were identified and included if they contained individuals between the ages of 18 and 45 years, maintained an average body mass index (BMI) of 18.5-25 kg/m2, had no history of disordered eating, and included energy intake and menstrual cycle measurements in the FP and LP.

Data analysis: Effect sizes were calculated for each study and a random-effects model was used to pool the results of each study.

Results: Fifteen datasets were included consisting of 330 female participants with a mean age of 26 ± 4 years and mean BMI of 22.4 ± 2.3 kg/m2. Overall, there was a statistically significant difference (standardized mean difference = 0.69; P = .039) with increased energy intake in the LP compared with the FP (crude 168 kcal⋅d-1 average difference between phases).

Conclusion: Energy intake was found to be greater in the LP compared with the FP, providing insight into the effect of the menstrual cycle on energy intake. However, there were repeated methodological inconsistencies and future work should strive to utilize best practices for both energy intake measurement and menstrual phase specification.

Context: Olive oil is a vegetable oil that provides health benefits, including a reduction in free radicals and total cholesterol and prevention of chronic diseases. The escalating incidence of chronic diseases presents a substantial challenge to public health, prompting numerous studies to assess these health-related effects. Despite several systematic reviews and meta-analyses summarizing the association between olive oil consumption and specific health outcomes, there is no summary of the accumulated evidence from these reviews.

Objective: This umbrella review summarizes the evidence on olive oil consumption or intervention in adults and its association with multiple risk factors and diseases.

Data sources: We retrieved systematic reviews of randomized trials or observational studies on oral interventions or the consumption of olive oil. The systematic search encompassed databases including MEDLINE, Embase, Scopus, Web of Science, LILACS, and CENTRAL from inception to February 6, 2023.

Data extraction: Two independent reviewers conducted data extraction and assessed methodological quality using the Joanna Briggs Institute tool.

Data analysis: Overall, 17 systematic reviews of randomized trials and observational studies, covering outcomes such as cardiovascular diseases, cancer, type 2 diabetes, glucose metabolism, inflammatory and oxidative markers, and all-cause mortality, were included. The evidence suggests a beneficial association between olive oil consumption and cardiovascular diseases, cancer, type 2 diabetes, and all-cause mortality. However, the evidence was less definitive for inflammatory markers, oxidative stress, glucose metabolism, and blood lipid outcomes. Several meta-analyses revealed high heterogeneity and wide confidence intervals, along with a limited number of randomized clinical trials.

Conclusion: Given the high heterogeneity and low quality of evidence, further studies involving randomized trials are imperative. Prioritizing an in-depth analysis of specific olive oil components and using a control group with distinct characteristics and different effects is strongly recommended.

Systematic review registration: PROSPERO registration no. CRD42022357290.

Context: Cachexia is associated with poor survival rates. In the clinical setting, the diagnosis of cancer cachexia is challenging. The cachexia index (CXI), a new index for predicting survival time, is a promising tool for diagnosing cancer cachexia; however, its efficacy in predicting patient survival has not been validated.

Objective: This meta-analysis and systematic review aimed to explore the CXI's prognostic value in patients with cancer.

Data sources: The PubMed, Embase, MEDLINE, and Cochrane Library databases were searched for relevant studies to determine the association between CXI findings and prognosis.

Data extraction: The outcomes were overall survival (OS), progression-, disease-, and recurrence-free survival (PFS/DFS/RFS) rates, and the rate of complete response.

Data analysis: The QUality In Prognostic Studies (QUIPS) tool was used to evaluate the quality of the included trials. This meta-analysis comprised 14 studies involving 2777 patients. A low CXI was associated with decreased OS (hazard ratio [HR] 2.34, 95% confidence interval [CI] 2.01-2.72; P < .001), PFS/DFS/RFS (HR 1.93, 95% CI 1.68-2.22; P < .001), and complete response (odds ratio [OR] 0.49, 95% CI 0.36-0.66; P < .001). Patients with a low CXI had a lower body mass index (mean difference [MD] -0.75, 95% CI -1.00 to 0.50; P < .001), skeletal muscle index (standardized MD -0.80, 95% CI -0.98 to -0.61; P < .001), and serum albumin level (MD -0.23, 95% CI -0.26 to -0.20; P < .001); and a higher neutrophil-lymphocyte ratio (MD 1.88, 95% CI 1.29-2.47; P < .001) and more advanced disease stages (OR 0.80, 95% CI 0.71-0.91; P = .001).

Conclusion: A low CXI was found to be associated with poor survival in patients with cancer. While the CXI is a promising marker for predicting cancer cachexia, further studies are required to verify its usefulness.

Context: Despite the progress toward gender equality in events like the Olympic Games and other institutionalized competitions, and the rising number of women engaging in physical exercise programs, scientific studies focused on establishing specific nutritional recommendations for female athletes and other physically active women are scarce.

Objective: This systematic review aimed to compile the scientific evidence available for addressing the question "What dietary strategies, including dietary and supplementation approaches, can improve sports performance, recovery, and health status in female athletes and other physically active women?"

Data sources: The Pubmed, Web of Science, and Scopus databases were searched.

Data extraction: The review process involved a comprehensive search strategy using keywords connected by Boolean connectors. Data extracted from the selected studies included information on the number of participants and their characteristics related to sport practice, age, and menstrual function.

Data analysis: A total of 71 studies were included in this review: 17 focused on the analysis of dietary manipulation, and 54 focused on the effects of dietary supplementation. The total sample size was 1654 participants (32.5% categorized as competitive athletes, 30.7% as highly/moderately trained, and 37.2% as physically active/recreational athletes). The risk of bias was considered moderate, mainly for reasons such as a lack of access to the study protocol, insufficient description of how the hormonal phase during the menstrual cycle was controlled for, inadequate dietary control during the intervention, or a lack of blinding of the researchers.

Conclusion: Diets with high carbohydrate (CHO) content enhance performance in activities that induce muscle glycogen depletion. In addition, pre-exercise meals with a high glycemic index or rich in CHOs increase CHO metabolism. Ingestion of 5-6 protein meals interspersed throughout the day, with each intake exceeding 25 g of protein favors anabolism of muscle proteins. Dietary supplements taken to enhance performance, such as caffeine, nitric oxide precursors, β-alanine, and certain sport foods supplements (such as CHOs, proteins, or their combination, and micronutrients in cases of nutritional deficiencies), may positively influence sports performance and/or the health status of female athletes and other physically active women.

Systematic review registration: PROSPERO registration no. CRD480674.