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Health-Promoting Components in Fermented Foods: An Up-to-Date Systematic Review.
Melini, F, Melini, V, Luziatelli, F, Ficca, AG, Ruzzi, M
Nutrients. 2019;11(5)
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While fermented foods have long been produced, a renewed interest has been observed in Western countries. Several reviews have investigated the health benefits of fermented foods, however none of them have discussed the components that form upon fermentation and their possible effect on health. The purpose of this study was to provide a comprehensive review of the health-promoting components of fermentation in order to better understand their role in healthy diets. This systematic review found fermentation increased antioxidant activity of milks, cereals, fruit, vegetables, meat and fish based on 125 analysed articles. Fermentation of different food categories led to varying health benefits including vitamin content, probiotic activity and anti-hypertensive properties. Based on the existing literature, the authors conclude fermented foods should be consumed regularly and recommend they be included in worldwide dietary guidelines.
Abstract
Fermented foods have long been produced according to knowledge passed down from generation to generation and with no understanding of the potential role of the microorganism(s) involved in the process. However, the scientific and technological revolution in Western countries made fermentation turn from a household to a controlled process suitable for industrial scale production systems intended for the mass marketplace. The aim of this paper is to provide an up-to-date review of the latest studies which investigated the health-promoting components forming upon fermentation of the main food matrices, in order to contribute to understanding their important role in healthy diets and relevance in national dietary recommendations worldwide. Formation of antioxidant, bioactive, anti-hypertensive, anti-diabetic, and FODMAP-reducing components in fermented foods are mainly presented and discussed. Fermentation was found to increase antioxidant activity of milks, cereals, fruit and vegetables, meat and fish. Anti-hypertensive peptides are detected in fermented milk and cereals. Changes in vitamin content are mainly observed in fermented milk and fruits. Fermented milk and fruit juice were found to have probiotic activity. Other effects such as anti-diabetic properties, FODMAP reduction, and changes in fatty acid profile are peculiar of specific food categories.
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Comparison of the Effectiveness of Lifestyle Modification with Other Treatments on the Incidence of Type 2 Diabetes in People at High Risk: A Network Meta-Analysis.
Yamaoka, K, Nemoto, A, Tango, T
Nutrients. 2019;11(6)
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The prevalence of diabetes has been increasing worldwide. The accompanying increase in the prevalence of diabetes-related complications and the occurrence of diabetes are likely to have a substantial impact on healthcare costs. The aim of the study was to compare the effectiveness of lifestyle modifications to other treatments for patients at high risk of type 2 diabetes. The study design is a systemic review of published literature and a network meta-analysis of data from each selected study. Forty-seven interventions were used for the analyses. The results of the meta-analysis highlight the efficacy of lifestyle modification in preventing the onset of type 2 diabetes in high-risk patients in comparison with standard treatment or placebo as well as other treatments. The proportion of patients with onset of type 2 diabetes in the intervention (lifestyle modification) group was approximately twice as low as compared to the control (standard intervention) group. Authors conclude that lifestyle modification is the superior treatment intervention among 12 treatments for the prevention of type 2 diabetes in high-risk individuals.
Abstract
BACKGROUND Many clinical trials have been conducted to verify the effects of interventions for prevention of type 2 diabetes (T2D) using different treatments and outcomes. The aim of this study was to compare the effectiveness of lifestyle modifications (LM) with other treatments in persons at high risk of T2D by a network meta-analysis (NMA). METHODS Searches were performed of PUBMED up to January 2018 to identify randomized controlled trials. The odds ratio (OR) with onset of T2D at 1 year in the intervention group (LM, dietary, exercise, or medication) versus a control group (standard treatments or placebo) were the effect sizes. Frequentist and Bayesian NMAs were conducted. RESULTS Forty-seven interventions and 12 treatments (20,113 participants) were used for the analyses. The OR in the LM was approximately 0.46 (95% CI: 0.33 to 0.61) times lower compared to the standard intervention by the Bayesian approach. The effects of LM compared to other treatments by indirect comparisons were not significant. CONCLUSIONS This meta-analysis further strengthened the evidence that LM reduces the onset of T2D compared to standard and placebo interventions and appears to be at least as effective as nine other treatments in preventing T2D.
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Headache Associated with Coeliac Disease: A Systematic Review and Meta-Analysis.
Zis, P, Julian, T, Hadjivassiliou, M
Nutrients. 2018;10(10)
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Coeliac disease (CD) is the best-recognised gluten-related disorder (GRD), and it is characterized by a small bowel enteropathy occurring in genetically susceptible individuals whilst exposed to the protein gliadin. The aim of this study was to systematically review the current literature in order to establish the relationship between headache and CD. This study is a systematic review of 40 articles, studying a total of 42,388 individuals with either headache or GRD. Results show that: - There is an increased prevalence of headache amongst patients with CD. - There is an increased prevalence of CD amongst patients with idiopathic headache. - Headaches associated with CD are mainly migraines. - Gluten-free diet is a very effective treatment for headaches associated with CD. Authors conclude that further studies on the prevalence of gluten sensitivity in patients with idiopathic headache are needed, including further research on the pathogenetic mechanisms.
Abstract
OBJECTIVE The aim of this systematic review was to explore the relationship between coeliac disease (CD) and headache. The objectives were to establish the prevalence of each entity amongst the other, to explore the role of gluten free diet (GFD), and to describe the imaging findings in those affected by headaches associated with CD. METHODOLOGY A systematic computer-based literature search was conducted on the PubMed database. Information regarding study type, population size, the age group included, prevalence of CD amongst those with headache and vice versa, imaging results, the nature of headache, and response to GFD. RESULTS In total, 40 articles published between 1987 and 2017 qualified for inclusion in this review. The mean pooled prevalence of headache amongst those with CD was 26% (95% CI 19.5⁻33.9%) in adult populations and 18.3% (95% CI 10.4⁻30.2%) in paediatric populations. The headaches are most often migraine-like. In children with idiopathic headache, the prevalence of CD is 2.4% (95% CI 1.5⁻3.7%), whereas data for adult populations is presently unavailable. Brain imaging can be normal, although, cerebral calcifications on CT, white matter abnormalities on MRI and deranged regional cerebral blood flow on SPECT can be present. GFD appears to be an effective management for headache in the context of CD, leading to total resolution of headaches in up to 75% of patients. CONCLUSIONS There is an increased prevalence of CD amongst idiopathic headache and vice versa. Therefore, patients with headache of unknown origin should be screened for CD, as such patients may symptomatically benefit from a GFD.
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Systematic review of palm oil consumption and the risk of cardiovascular disease.
Ismail, SR, Maarof, SK, Siedar Ali, S, Ali, A
PloS one. 2018;13(2):e0193533
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Palm oil, the most widely consumed vegetable oil in the world, derives from the palm tree fruit with a balanced ratio of unsaturated and saturated fatty acids. Studies have shown an association between high contents of saturated fats in palm oil with the detrimental atherogenic profile. The review aims at synthesising the available evidence reporting the association of palm oil consumption with cardiovascular disease risk and cardiovascular disease-specific mortality, including specifically Coronary Heart Disease (CHD) and stroke. The authors systematically searched three databases up to June 2017 without restriction on setting or language. Published interventional and observational studies that evaluated palm oil consumption with coronary heart disease or stroke in adults were searched. Separate searches were performed depending on the outcome. The study did not find a clear association between palm oil consumption and risk or mortality of cardiovascular disease, namely coronary heart disease and stroke. The health effects found between association of palm oil consumption and risk of coronary heart disease were not unique to just palm oil consumption as other food items were also included in the analysis. The review could not establish strong evidence for or against palm oil consumption relating to cardiovascular disease risk and cardiovascular disease-specific mortality. A healthy overall diet is suggested for good cardiometabolic health.
Abstract
BACKGROUND The high amount of saturated fatty acids (SFA) coupled with the rising availability and consumption of palm oil have lead to the assumption that palm oil contributes to the increased prevalence of cardiovascular diseases worldwide. We aimed at systematically synthesising the association of palm oil consumption with cardiovascular disease risk and cardiovascular disease-specific mortality. METHODS We systematically searched Central, Medline and Embase databases up to June 2017 without restriction on setting or language. We performed separate searches based on the outcomes: coronary heart disease and stroke, using keywords related to these outcomes and palm oil. We searched for published interventional and observational studies in adults (Age: >18 years old). Two investigators extracted data and a consensus was reached with involvement of a third. Only narrative synthesis was performed for all of the studies, as the data could not be pooled. RESULTS Our search retrieved 2,738 citations for stroke with one included study and 1,777 citations for coronary heart disease (CHD) with four included studies. Palmitic acid was reported to be associated with risk of myocardial infarction (MI) (OR 2.76; 95%CI = 1.39-5.47). Total SFA intake was reported to be not significant for risk of MI. Varying intake of fried foods, highest contributor to total SFA with 36% of households using palm oil for frying, showed no significant associations to risk of MI. Odds of developing first non-fatal acute MI was higher in palm oil compared to soybean oil with 5% trans-fat (OR = 1.33; 95%CI = 1.09-1.62) than palm oil compared to soybean oil with 22% trans-fat (OR = 1.16; 95%CI = 0.86-1.56). Nevertheless, these risk estimates were non-significant and imprecise. The trend amongst those taking staple pattern diet (characterised by higher palm oil, red meat and added sugar consumption) was inconsistent across the factor score quintiles. During the years of 1980 and 1997, for every additional kilogram of palm oil consumed per-capita annually, CHD mortality risk was 68 deaths per 100,000 (95% CI = 21-115) in developing countries and 17 deaths per 100,000 (95%CI = 5.3-29) in high-income countries, whereas stroke was associated with 19 deaths per 100,000 (95%CI = -12-49) and 5.1 deaths per 100,000 (95% CI: -1.2-11) respectively. The evidence for the outcomes of this review were all graded as very low. The findings of this review should be interpreted with some caution, owing to the lack of a pooled effect estimate of the association, significant bias in selection criteria and confounding factors, inclusion of other food items together with palm oil, and the possible out-dated trend in the ecological study. CONCLUSION In view of the abundance of palm oil in the market, quantifying its true association with CVD outcomes is challenging. The present review could not establish strong evidence for or against palm oil consumption relating to cardiovascular disease risk and cardiovascular disease-specific mortality. Further studies are needed to establish the association of palm oil with CVD. A healthy overall diet should still be prioritised for good cardiometabolic health.
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The Effects of Magnesium Supplementation on Subjective Anxiety and Stress-A Systematic Review.
Boyle, NB, Lawton, C, Dye, L
Nutrients. 2017;9(5)
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15% of the population experience anxiety-related conditions at some point in their lives. Several studies have found a relationship between low magnesium (Mg) and an increased likelihood of stress and anxiety. This systematic review examined the available evidence for the effectiveness of Mg supplementation in reducing anxiety and stress. 18 studies were included in the review. Of the eight studies looking at Mg supplementation and anxiety, four reported positive results. Four of seven studies on premenstrual syndrome and one of two studies in people with high blood pressure reported positive effects of Mg on anxiety. Mg had no effect on postpartum anxiety in the study reviewed. The authors concluded that existing evidence is suggestive of a beneficial effect of Mg on anxiety. However, the quality of the existing evidence is poor. Well-designed randomised controlled trials are required to further confirm the effect of Mg supplementation on anxiety and stress.
Abstract
BACKGROUND Anxiety related conditions are the most common affective disorders present in the general population with a lifetime prevalence of over 15%. Magnesium (Mg) status is associated with subjective anxiety, leading to the proposition that Mg supplementation may attenuate anxiety symptoms. This systematic review examines the available evidence for the efficacy of Mg supplementation in the alleviation of subjective measures of anxiety and stress. METHODS A systematic search of interventions with Mg alone or in combination (up to 5 additional ingredients) was performed in May 2016. Ovid Medline, PsychInfo, Embase, CINAHL and Cochrane databases were searched using equivalent search terms. A grey literature review of relevant sources was also undertaken. RESULTS 18 studies were included in the review. All reviewed studies recruited samples based upon an existing vulnerability to anxiety: mildly anxious, premenstrual syndrome (PMS), postpartum status, and hypertension. Four/eight studies in anxious samples, four/seven studies in PMS samples, and one/two studies in hypertensive samples reported positive effects of Mg on subjective anxiety outcomes. Mg had no effect on postpartum anxiety. No study administered a validated measure of subjective stress as an outcome. CONCLUSIONS Existing evidence is suggestive of a beneficial effect of Mg on subjective anxiety in anxiety vulnerable samples. However, the quality of the existing evidence is poor. Well-designed randomised controlled trials are required to further confirm the efficacy of Mg supplementation.
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Nonnutritive sweeteners and cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials and prospective cohort studies.
Azad, MB, Abou-Setta, AM, Chauhan, BF, Rabbani, R, Lys, J, Copstein, L, Mann, A, Jeyaraman, MM, Reid, AE, Fiander, M, et al
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne. 2017;189(28):E929-E939
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Obesity is a major public health challenge that contributes to type 2 diabetes and cardiovascular disease. Evidence that sugar consumption is fuelling this epidemic has stimulated the increasing popularity of non-nutritive sweeteners including aspartame, sucralose and stevioside. The aim of this study was to synthesize evidence of whether routine consumption of non-nutritive sweeteners by adults and adolescents is associated with adverse long-term cardiometabolic effects. This study is a systemic review and meta-analysis of randomised controlled trials and prospective cohort studies. It includes 37 studies involving a total of 406910 individuals. The study shows that small RCTs with short follow-up (median 6 months) suggest that consumption of non-nutritive sweeteners is not consistently associated with decreases in body weight, BMI or waist circumference. However, in larger prospective cohort studies with longer follow-up periods (median 10 years), intake of non-nutritive sweeteners is significantly associated with modest long-term increases in each of these measures. Authors conclude that caution in the use of non-nutritive sweeteners is warranted until the long-term risks and benefits of these products are fully characterised.
Abstract
BACKGROUND Nonnutritive sweeteners, such as aspartame, sucralose and stevioside, are widely consumed, yet their long-term health impact is uncertain. We synthesized evidence from prospective studies to determine whether routine consumption of non-nutritive sweeteners was associated with long-term adverse cardiometabolic effects. METHODS We searched MEDLINE, Embase and Cochrane Library (inception to January 2016) for randomized controlled trials (RCTs) that evaluated interventions for nonnutritive sweeteners and prospective cohort studies that reported on consumption of non-nutritive sweeteners among adults and adolescents. The primary outcome was body mass index (BMI). Secondary outcomes included weight, obesity and other cardiometabolic end points. RESULTS From 11 774 citations, we included 7 trials (1003 participants; median follow-up 6 mo) and 30 cohort studies (405 907 participants; median follow-up 10 yr). In the included RCTs, nonnutritive sweeteners had no significant effect on BMI (mean difference -0.37 kg/m2; 95% confidence interval [CI] -1.10 to 0.36; I2 9%; 242 participants). In the included cohort studies, consumption of nonnutritive sweeteners was associated with a modest increase in BMI (mean correlation 0.05, 95% CI 0.03 to 0.06; I2 0%; 21 256 participants). Data from RCTs showed no consistent effects of nonnutritive sweeteners on other measures of body composition and reported no further secondary outcomes. In the cohort studies, consumption of nonnutritive sweeteners was associated with increases in weight and waist circumference, and higher incidence of obesity, hypertension, metabolic syndrome, type 2 diabetes and cardiovascular events. Publication bias was indicated for studies with diabetes as an outcome. INTERPRETATION Evidence from RCTs does not clearly support the intended benefits of nonnutritive sweeteners for weight management, and observational data suggest that routine intake of nonnutritive sweeteners may be associated with increased BMI and cardiometabolic risk. Further research is needed to fully characterize the long-term risks and benefits of nonnutritive sweeteners. Protocol registration: PROSPERO-CRD42015019749.
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Associations between Yogurt Consumption and Weight Gain and Risk of Obesity and Metabolic Syndrome: A Systematic Review.
Sayon-Orea, C, Martínez-González, MA, Ruiz-Canela, M, Bes-Rastrollo, M
Advances in nutrition (Bethesda, Md.). 2017;8(1):146S-154S
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According to the WHO, overweight and obesity is defined as an excessive or abnormal fat accumulation that may affect human health. The prevalence of metabolic syndrome is growing which is mainly due to sedentary lifestyles, as well as the increasing prevalence of obesity. The aim of the study was to analyse the relation between yoghurt consumption and changes in weight or waist circumference and the risk of becoming overweight, obese or develop metabolic syndrome. This study is a systemic review based on 10 cohort studies, 1 of which included the results of 3 cohort studies. Results demonstrate that there was no detrimental affect of yoghurt consumption on weight status or on the risk of developing metabolic syndrome. The study also showed that high consumption of yoghurt in tandem with high consumption of fruit may be inversely associated with the development of metabolic syndrome. Authors conclude that further prospective studies and high-quality randomised control trials are required in order to confirm that yoghurt consumption may contribute to a reduction in adiposity indexes and the risk of metabolic syndrome.
Abstract
The role of yogurt consumption in the risk of developing overweight, obesity, or metabolic syndrome has been the subject of epidemiologic studies over the last 10 y. A comprehensive literature search on MEDLINE and ISI Web of Knowledge from 1966 through June 2016 was conducted to examine the relation between yogurt consumption and weight gain, as well as the risk of overweight, obesity, or metabolic syndrome, in prospective cohort studies. Ten articles met all the inclusion criteria and were included in our systematic review. Of the 10 cohort studies, 3 analyzed the relation between yogurt consumption and the risk of overweight or obesity, 8 analyzed changes in waist circumference or weight changes, 3 studied the association with the risk of developing metabolic syndrome, and 1 studied the probability of abdominal obesity reversion. Although an inverse association between yogurt consumption and the risk of developing overweight or obesity was not fully consistent or always statistically significant, all studies but one showed in their point estimates inverse associations between yogurt consumption and changes in waist circumference, changes in weight, risk of overweight or obesity, and risk of metabolic syndrome during follow-up, although not all estimates were statistically significant (2 studies). Prospective cohort studies consistently suggested that yogurt consumption may contribute to a reduction in adiposity indexes and the risk of metabolic syndrome. Therefore, there is a need for more prospective studies and high-quality randomized clinical trials to confirm this apparent inverse association.