Breastfeeding and the Longitudinal Changes of Body Mass Index in Childhood and Adulthood: A Systematic Review.

Mounting evidence supports the beneficial role of breastfeeding in lowering obesity risk, but the enduring impact of breastfeeding on longitudinal changes in body mass index (BMI) (i.e., BMI trajectories) remains unclear. This systematic review summarized evidence on how breastfeeding influenced the longitudinal trajectories of BMI later in life. Literature searches were conducted in Medline, Embase, Web of Science, and ScienceDirect to identify studies that assessed how breastfeeding (versus other feeding types or duration) was associated with longitudinal trajectories of BMI or BMI z-score. Three randomized controlled trials (RCTs) and 24 longitudinal cohort studies were included. Two-thirds (18/27) of studies were rated as acceptable or high quality. Most cohort studies (9/11) showed that children who continued to breastfeed at 3 to 12 mo of age had a lower BMI trajectory or lower odds of following a high BMI trajectory than those who were formula-fed or mixed-fed. The BMI differences between breastfeeding and other feeding groups were evident from age 7 mo and remained up to 8 y, and the magnitude of between-group BMI differences increased with age. For breastfeeding duration, 12 out of 15 cohort studies found that longer breastfeeding duration was associated with lower BMI trajectories up to age 18 y. Moreover, beneficial associations were observed for both exclusive and any breastfeeding with BMI trajectory. In contrast, mixed findings were reported from 3 RCTs that compared BMI trajectories from birth to ages 12 to 24 mo between breastfeeding promotion versus control or breastfeeding versus formula-feeding groups. The current review provides further longitudinal evidence from cohort studies that breastfeeding versus formula/mixed feeding or longer breastfeeding duration was associated with lower BMI trajectories. Such associations initiated in early childhood became more apparent with age and were sustained into early adulthood. The existing evidence substantiates the importance of breastfeeding promotion and continuation to support obesity prevention.

The effect of sodium-glucose co-transporter-2 (SGLT2) inhibitors on blood interleukin-6 concentration: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: The low-grade chronic inflammation in diabetes plays an important role in development of cardiovascular and renal complications. Sodium-glucose co-transporter-2 (SGLT2) inhibitors are recognized as protective agents for cardio-renal complications. Interleukin-6 (IL-6) is positively associated with the pathophysiology of metabolic-related pathologies. The aim of this meta-analysis is to investigate the effect of SGLT2 inhibitors on blood IL-6 concentration in randomized controlled trials (RCTs). METHODS: Embase, PubMed, and Scopus were systematically searched up to 1st of November 2023. The eligible studies were RCTs with adult population that had provided blood IL-6 for both control and intervention groups. Cochrane risk-of-bias tool were for study quality assessment. Data were analyzed using random effect model via Stata statistical software. RESULTS: Eighteen studies with a total of 5311 patients were included. Of which 3222 and 2052 patients were in intervention and control arm, respectively. Of the total population, 49.7% were men. The study durations ranged from 8 to 52 weeks. The pooled analysis showed a significant association between the use of SGLT2 inhibitors and lower IL-6 levels (standardized mean difference (SMD) = -1.04, Confidence Interval (CI): -1.48; -0.60, I2 = 96.93%). Dapagliflozin was observed to have a higher IL-6-lowering effect (SMD = -1.30, CI: -1.89; -0.71, I2 = 92.52) than empagliflozin or canagliflozin. Sub-group analysis of control groups (SMD = -0.58 (-1.01, -0.15) and -1.35 (-2.00, -0.70 for the placebo and active control sub-groups, respectively) and duration of interventions (SMD = -0.78 (-1.28, -0.28) and -1.20 (-1.86, -0.55) for study duration of ≤ 12 and > 12 weeks, respectively) did not change the results. Meta-regression analysis showed a significant correlation between the level of HbA1c and IL-6-lowering efficacy of SGLT2 inhibitors. CONCLUSION: IL-6 levels are significantly reduced with the use of SGLT2 inhibitors with HbA1c as the only marker influencing such reductions, and dapagliflozin had the highest potency. The anti-inflammatory effect of SGLT2 inhibitors supports their broader use to address diabetic complications related to inflammatory responses.

The effects of macro-algae supplementation on serum lipid, glycaemic control and anthropometric indices: A systematic review and meta-analysis of clinical trials.

INTRODUCTION: Macro-algae products have been shown to ameliorate the metabolic disorders state. Thus, highlighting their function as supplementary therapeutic agents can be a novel strategy for clinical therapies. This systematic review and meta-analysis of clinical trials aimed to summarize the effect of macro-algae consumption on serum lipid profile, glycaemic control and anthropometric factors. METHODS: In this systematic review and meta-analysis, a comprehensive search was performed for relevant studies published up to May 2023. The Cochran's Q test and I-square (I2 ) tests were used to evaluate heterogeneity across the included studies. The meta-analysis was conducted using random-effects model (DerSimonian and Laird), and weighted mean difference (WMD) was considered as the pooled effect size. RESULTS: Out of 8602 papers in the initial screening, eight clinical trials with a total of 438 participants were included into this meta-analysis. The results indicated that macro-algae supplementation significantly decreased serum levels of total cholesterol (TC) (WMD = -6.7 mg/dL; 95% CI: -12.59, -0.80; item = 0.026) and low-density lipoprotein cholesterol (LDL-c) (WMD = -8.25 mg/dL; 95% CI: -15.38, -1.12; p-value = .023). There was an increase in level of high-density lipoprotein cholesterol (HDL-c) (WMD = 0.48 mg/dL; 95% CI: -2.05, 3.01; p-value = .71) which was not statistically significant. Macro-algae supplementation reduced body mass index (BMI) (WMD = -0.28 kg/m2 ; 95% CI: -0.96, 0.41; p-value = .426), weight (WMD = -0.39 kg; 95% CI: -3.6, 2.83; p-value = .81), waist circumference (WC) (WMD = -0.52 cm; 95% CI: -2.71, 1.66; p-value = .64), fasting blood sugar (FBS) (WMD = -1.95 mg/dL; 95% CI: -5.19, 1.28; p-value = .24) and HbA1c (WMD = -0.02%; 95% CI: -0.14, 0.09; p-value = .66) in intervention group. CONCLUSIONS: This meta-analysis indicated that macro-algae supplementation significantly decreased TC and LDL-c level. It can also increase HDL-c level and reduce anthropometric indices and glycaemic control factors.

The effect of dietary approaches to stop hypertension and ketogenic diets intervention on serum uric acid concentration: a systematic review and meta-analysis of randomized controlled trials.

Hyperuricemia as a risk factor for metabolic diseases is proved to be profoundly modified by dietary approaches. This systematic review and meta-analysis of randomized control trials (RCT) was conducted to investigate the effect of two nutritional interventions; dietary approaches to stop hypertension (DASH) diet and ketogenic diet (KD) on serum uric acid (UA) concentrations. Our systematic search was for RCTs in which KD or DASH diet were assigned to adults for at least 2 weeks or more. Until March 2023 in Embase, Web of Science, PubMed, and Scopus databases, 10 eligible RCTs that intervened with DASH diet (n = 4) or KD (n = 6) and had provided laboratory data on serum UA were found. Summary effect was calculated by random-effects model. Results from the meta-analysis of the 4 DASH diet RCTs with a total of 590 participants revealed significant decrease in serum UA after at least 4 weeks of interventions (mean difference (MD) = ‒0.25; 95% CI ‒0.4 to ‒0.1 mg/dL; p < 0.01; I2 = 0%). The pooled meta-analysis of the 6 included RCTs of KD reporting data of 267 participants showed no significant changes in serum UA (MD = 0.26; 95% CI ‒0.47 to 0.98 mg/dL, I2 = 95.32%). However, a non-significant reduction of UA in the subgroup analysis of very low-calorie KD (VLCKD) studies (MD = ‒0.04; 95% CI ‒0.29 to 0.22, I2 = 0%) was obtained. DASH diet has an ameliorating effect on serum UA and may be recommended for hyperuricemia states such as gout. In addition, we have shown that serum UA level following KD remained unchanged. Although, in view of the heterogeneity across the studies, further investigations are needed to determine the effect of KD and VLKD on serum UA concentrations.

Effect of zinc supplementation in the management of type 2 diabetes: A grading of recommendations assessment, development, and evaluation-assessed, dose-response meta-analysis of randomized controlled trials.

The question of whether zinc supplementation may improve cardio-metabolic health in patients with type 2 diabetes mellitus (T2DM) remains controversial and require further evaluation. This study aimed to summarize the effectiveness of oral zinc supplementation in improving cardio-metabolic risk markers in people with T2DM. We searched PubMed, Scopus, and Web of Science from inception to April 2023, for randomized controlled trials (RCTs). RCTs of type 2 diabetic adults (aged ≥18 years) comparing zinc supplementation with placebo were included. We excluded studies if not randomized, involved co-supplementation, and were conducted in children or pregnant women. Glycemic indices, lipid profiles, blood pressure, anthropometric measure, c-reactive protein (CRP), creatinine, and serum zinc were extracted. Certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methods. We used a random-effect model to perform the dose-response analysis. Effect sizes were presented as mean difference (MD) and 95% confidence interval (CI). 22 studies (n = 1442 participants) were included. The certainty of the evidence was rated as moderate to high. Zinc supplementation significantly reduced glycemic indices: including two-hour postprandial glucose (2hpp) (mean difference (MD): -34.34 mg/dl; 95%CI: -51.61∼ -17.07), fast blood sugar (FBS) (MD: -23.32 mg/dl; 95% CI: -33.81∼ -12.83), and hemoglobin A1c (HbA1c) (MD: -0.47; 95% CI: -0.71∼ -0.23). Zinc had a favorable effect on lipid profiles low-density lipoprotein (LDL) (MD: -10.76 mg/dl; CI: -17.79∼-3.73), triglyceride (TG) (MD: -18.23 mg/dl; CI: -32.81∼-3.65), total cholesterol (TC) (MD: -12.74 mg/dl; CI: -21.68∼-3.80), VLDL (MD: -5.39 mg/dl; CI: -7.35∼-3.43) and high-density lipoprotein (HDL) (MD: 4.04 mg/dl; CI: 0.96 ∼ 7.12). Systolic blood pressure (SBP) (MD): -3.64 mmHg; 95% CI: -6.77∼ -0.52), weight (MD: 1.00 kg; 95% CI: 0.34∼1.66), CRP (MD: -3.37 mg/l, 95% CI: -4.05∼ -2.70), and serum zinc (MD: 15.38 µg/dl; 95% CI: 10.74∼ 20.02) changed to a statistically significant extent with zinc supplementation. There was also a linear association between additional 10 mg/d zinc treatment with FBS, HbA1c, HDL, LDL, TG, TC, and serum zinc. A non-linear dose-response gradient was seen for FBS, HDL, and SBP (p < 0.05). Egger's test showed no substantial publication bias. Our findings strongly suggest a potential beneficial effect of zinc supplementation on type 2 diabetic patients. Further high-quality research is needed to determine the optimal form, dosage, and duration of zinc supplementation for this population.

Postmortem Histopathologic Findings and SARS-CoV-2 Detection in Autopsy Kidneys of Patients With COVID-19: A Systematic Review and Meta-Analysis.

OBJECTIVES: This systematic review and meta-analysis aimed to investigate the prevalence of postmortem kidney histopathologic features of patients with coronavirus disease 2019 (COVID-19) in addition to the rate of renal tropism in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: We searched Web of Science, PubMed, Embase, and Scopus up to September 2022 to identify eligible studies. A random-effects model was used to estimate the pooled prevalence. Cochran Q test and Higgins I2 were used to assess evidence of heterogeneity. RESULTS: In total, 39 studies were included in the systematic review. The meta-analysis included 35 studies consisting of a total of 954 patients, with an average age of 67.1 years. The pooled prevalence of acute tubular injury (ATI)-related changes was the predominant finding (85% [95% confidence interval, 71%-95%]), followed by arteriosclerosis (80%), vascular congestion (66%), and glomerulosclerosis (40%). Endotheliitis (7%), fibrin microthrombi (12%), focal segmental glomerulosclerosis (1%), and calcium crystal deposits (1%) were seen in a smaller number of autopsies. The overall average rate of virus detection was 47.79% in the pooled data of 21 studies (272 samples). CONCLUSIONS: The main finding-ATI-correlated to clinical COVID-19-associated acute kidney injury. The presence of SARS-CoV-2 in kidney samples in addition to vascular lesions in kidneys can be linked to direct kidney invasion by the virus.

Effects of whole grain intake on glucagon-like peptide 1 and glucose-dependent insulinotropic peptide: a systematic review and meta-analysis.

CONTEXT: Whole grain intake may control help glycemia and reduce food intake by affecting the secretion of glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP). OBJECTIVE: This systematic review and meta-analysis aimed to assess the postprandial and long-term effects of whole grains on GLP-1 and GIP levels. DATA SOURCES: PubMed, Web of Science, and Scopus online databases were searched systematically to identify relevant randomized clinical trials (RCTs) published up to April 2021. STUDY SELECTION: RCTs that evaluated the effects of whole grains, compared with refined grains, on the postprandial area under the curve (AUC) value, the postprandial serum concentration of incretins from 0 to 180 minutes, or the fasting level of incretins after at least 14 days of intervention were included. RESULTS: Nineteen studies were included in the meta-analysis. The results showed that acute intake of whole grains could not significantly change the AUC value of GLP-1 or GIP. However, the AUC value of GIP was reduced more significantly in (1) unhealthy participants (standard mean difference [SMD] -1.08; 95%CI, -2.07 to -0.10; I2 = 75.9%) compared with healthy participants, and (2) those with a baseline fasting blood glucose of ≥99 mg/dL (SMD -0.71; 95%CI, -1.30 to -0.11; I2 = 74.4%) compared with those with a baseline value of < 99 mg/dL. On the other hand, the results of time-response evaluation during 0 to 180 minutes after the intake of test meals showed that serum concentrations of GIP decreased significantly from 0 to 30 minutes (coefficient = -44.72; P = 0.005), but increased from 60 to 180 minutes (coefficient = 27.03; P = 0.005). However, long-term studies found no significant effects of whole grains on fasting concentrations of GLP-1 or GIP. CONCLUSION: Whole grain intake did not affect postprandial levels of GLP-1 but enhanced postprandial levels of GIP from 60 to 180 minutes. Further high-quality trials are required to assess the long-term effects of whole grain intake on serum levels of incretins. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42021256695.

Effect of Serum Lipid Profile on the Risk of Breast Cancer: Systematic Review and Meta-Analysis of 1,628,871 Women.

Dyslipidemia has been linked to breast cancer incidence. The aim of the present meta-analysis was to further investigate the relationship between the serum lipid profile and breast cancer risk. Databases such as PubMed, EMBASE, and Web of Sciences were searched up to the end of January 2021 using certain MeSH and non-MeSH keywords and combinations to extract related published articles. Twenty-six prospective studies involving 1,628,871 women, of whom 36,590 were diagnosed with breast cancer during the follow-up period met the inclusion criteria. A negative and significant association was found between the HDL-C level and the risk of breast cancer (relative risk (RR): 0.85, 95% CI: 0.72-0.99, I2: 67.6%, p = 0.04). In contrast, TG (RR: 1.02, 95% CI: 0.91-1.13, I2: 54.2%, p = 0.79), total cholesterol (TC) (RR: 0.98, 95% CI: 0.90-1.06, I2: 67.2%, p = 0.57), apolipoprotein A (ApoA) (RR: 0.96, 95% CI: 0.70-1.30, I2: 83.5%, p = 0.78) and LDL-C (RR: 0.93, 95% CI: 0.79-1.09, I2: 0%, p = 0.386) were not associated with breast cancer development. In studies adjusting for hormone use and physical activity, breast cancer risk was positively correlated with TC (RR: 1.05, 95% CI: 1.01-1.10). Similarly, TG was significantly related to breast cancer development after adjustment for baseline lipids (RR: 0.92, 95% CI: 0.85-0.99) and race (any races mentioned in each study) (RR: 1.80, 95% CI: 1.22-2.65). In the present meta-analysis, HDL-C was inversely related to breast cancer risk. Overall, data on the links between lipids and breast cancer are conflicting. However, there is increasing evidence that low HDL-C is related to an increased risk for this type of malignancy.

The effect of calcium supplement intake on lipid profile: a systematic review and meta-analysis of randomized controlled clinical trials.

Despite the potential role of dietary calcium in fat excretion, the favorable effects of calcium supplements on lipid profile remains inconclusive. The current study aimed to review the effect of calcium supplement intake on lipid profile in randomized controlled clinical trials (RCTs). This systematic review and meta-analysis was conducted in PubMed, Scopus, Embase, and Central. RCTs which assessed the effects of calcium supplementation on lipid profile were included. All outcomes were recorded as continuous variables, and the effect size was measured. We classified studies according to dose of supplement, study duration, and dyslipidemia. Calcium supplement intake was associated with a significant reduction in low density lipoprotein cholesterol (LDL-C) level (WMD:-0.08; 95%CI:-0.16,-0.01)(mmol/l), especially with intakes of at least 1000 mg/day (WMD:-0.13; 95%CI:-0.23,-0.03)(mmol/l), with intakes of at least 12 weeks (WMD:-0.08; 95%CI: -0.16,-0.00)(mmol/l), and in individuals without dyslipidemia (WMD:-0.15; 95%CI:-0.26,-0.04)(mmol/l). Also, in another subgroup analysis, consumption of less than 1000 mg/day calcium supplement caused a significant increase in Total Cholesterol (TC) level (WMD: 0.24; 95%CI: 0.05,0.42) (mmol/l). In other blood lipids or study subgroups we observed no significant effect. We concluded that calcium supplements had a favorable effect on LDL-C level, especially in individuals without dyslipidemia, higher calcium intakes, and longer period of consumption.

No adverse effects of dairy products on lipid profile: A systematic review and meta-analysis of randomized controlled clinical trials.

BACKGROUND AND AIMS: The current study aimed to review the effects of dairy foods on lipid profile in randomized controlled clinical trials (RCTs). METHODS: We searched PubMed, Scopus, Embase, and Central. RCTs that assess the effects of dairy foods on lipid profile were included. RESULTS: The overall effects of dairy foods on lipid profile were non-significant. Dairy foods were associated with a non-significant reduction in triacylglycerol level, and a non-significant increase in total cholesterol, low density lipoprotein cholesterol, and high-density lipoprotein cholesterol level. CONCLUSION: We conclude that dairy foods doesn't have any unfavorable effects on lipids.

Comments on "Zinc supplementation is associated with a reduction in serum markers of inflammation and oxidative stress in adults: A systematic review and meta-analysis of randomized controlled trials".

We carefully read the meta-analysis by Hosseini et al. (1) on the effects of Zinc supplementation on inflammation and oxidative stress markers, which was recently published in Cytokine journal. The authors show that Zinc supplementation significantly decreased CRP, TNF, and MDA while having no significant effect on IL-6. Although respecting the authors' efforts, we are concerned about different aspects of the current review: the inadequate search strategy, the methodological flaws, the interpretation of data, and the reporting of the results that might lead to biased results.

Effect of nuts on energy intake, hunger, and fullness, a systematic review and meta-analysis of randomized clinical trials.

Despite high energy content, nut consumption has not been associated with weight gain in epidemiological and clinical investigations. Since a satiety effect a decreased sense of hunger in the following meals has been proposed as the mechanism of nuts against obesity, the present meta-analysis was performed to examine how nut consumption affects "energy intake", "hunger", and "fullness". "Weight" was not included among the search terms but weight data were extracted from the collected articles in order to help interpreting the results. A total of 1048 trials were found, of which 31 passed the eligibility process. Daily energy intake was mostly assessed by 3-day food records, and hunger and fullness were estimated by visual analog scale (VAS). Nut consumption was associated with increased energy intake (mean difference (MD) (nuts - control) = 76.3 kcal; 95% CI: 22.7, 130 kcal; P = 0.005). In contrast, hunger suppressed following nut consumption (MD = -6.54 mm VAS; 95% CI: -12.7, -0.42 mm VAS; P = 0.03). Nuts did not affect sense of fullness and weight in the overall estimate. Subgroup analysis based on participants' BMI revealed that energy intake of overweight/obese individuals was increased following nut consumption while such effect was not observed in normal weight participants. In conclusion, pooled estimates of available clinical trials showed increased energy intake following nut consumption in overweight/obese individuals but not in persons with normal weight. Nut consumption was associated with decreased hunger but no effect was observed on fullness and weight.

Association of Vitamin D Status and Metabolic Syndrome Components in Iranian Children.

BACKGROUND: Recently, it has been found that Vitamin D can affect cardiometabolic risk factors. However, these findings have not been confirmed in younger population. We aimed to assess the associations of serum 25-hydroxyvitamin D (25(OH)D) and metabolic syndrome (MetS) components in Iranian children. METHODS: This cross-sectional study was conducted on 240 children aged 6-9 years old. Anthropometric indices (weight, height, waist circumference, and body fat), biochemical parameters (low-density lipoprotein, high-density lipoprotein, triglyceride [TG], fasting blood sugar, and serum 25(OH)D), systolic blood pressure (SBP) and diastolic blood pressure (DBP) blood pressure, and dietary intake and physical activity were measured. Multivariate linear regression analysis was used to assess the association of MetS components and serum 25(OH)D. RESULTS: Mean age of children was 7.8 ± 1.06 year. Mean serum 25(OH)D concentration was 14.6 ± 10.64 ng/ml, and the prevalence of Vitamin D deficiency (serum 25(OH)D lower than 10 ng/ml) was 41.66%. Dietary intake of Vitamin D was 1.91 ± 1.8 mcg/day. Serum 25(OH)D was inversely associated with TG (ß = -0.16; CI: -0.27, -0.04) after adjusting by age, gender, body mass index, physical activity, and some dietary components. Serum 25(OH)D was negatively associated with SBP (ß = -0.02; CI: (-0.05, -0.004), and DBP (ß = -0.02; CI: -0.05, -0.003); however, it was not significant anymore after adjustment for sodium, potassium, and fiber. CONCLUSIONS: Vitamin D deficiency is alarming among Iranian children. Among the components of MetS, lower serum Vitamin D concentration was only associated with TG that could contribute in onset and progression of cardiometabolic disorders later in life.

Comparison of blood lipid-lowering effects of olive oil and other plant oils: A systematic review and meta-analysis of 27 randomized placebo-controlled clinical trials.

Objective: We aim to report a systematic review and meta-analysis of randomized controlled trials (RCTs) on effects of olive oil consumption compared with other plant oils on blood lipids. Methods: PubMed, web of science, Scopus, ProQuest, and Embase were systematically searched until September 2017, with no age, language and design restrictions. Weighed mean difference (WMD) and 95% confidence interval (CI) were expressed as effect size. Sensitivity analyses and pre specified subgroup was conducted to evaluate potential heterogeneity. Meta-regression analyses were performed to investigate association between blood lipid-lowering effects of olive oil and duration of treatment. Results: Twenty-seven trials, comprising 1089 participants met the eligibility criteria. Results of this study showed that compared to other plant oils, high-density lipoprotein level increased significantly more for OO (1.37 mg/dl: 95% CI: 0.4, 2.36). Also OO consumption reduced total cholesterol (TC) (6.27 mg/dl, 95% CI: 2.8, 10.6), Low-density lipoprotein (LDL-c) (4.2 mg/dl, 95% CI: 1.4, 7.01), and triglyceride (TG) (4.31 mg/dl, 95% CI: 0.5, 8.12) significantly less than other plant oils. There were no significant effects on Apo lipoprotein A1 and Apo lipoprotein B. Conclusion: This meta-analysis suggested that OO consumption decreased serum TC, LDL-c, and TG less but increased HDL-c more than other plant oils.

Effects of Canola Oil Consumption on Lipid Profile: A Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials.

Hyperlipidemia is a well- known risk factor of cardiovascular disease. A healthy diet containing vegetable oils such as canola oil (CO) may help to reduce serum lipids. This study aimed to quantify the effects of CO on lipid parameters using a systematic review and meta-analysis of randomized controlled trials. PubMed, Web of Science, Scopus, ProQuest, and Embase were systematically searched until December 2017, with no time and design restrictions. Also, a manual search was performed to find extra relevant articles. Lipid parameters including total cholesterol (TC), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), triglycerides (TG), apolipoprotein A1 (Apo A1), and apolipoprotein B (Apo B) were entered the meta-analysis. Weighed mean difference (WMD) and 95% confidence interval (CI) were stated as the effect size. Sensitivity analyses and prespecified subgroup were conducted to evaluate potential heterogeneity. Twenty-seven trials, comprising 1359 participants, met the eligibility criteria. Results of this study showed that CO consumption significantly reduced TC (-7.24 mg/dl, 95% CI, -12.1 to -2.7), and LDL (-6.4 mg/dl, 95% CI, -10.8 to -2), although it had no effects on HDL, TG, Apo B, and Apo A1. Effects of CO on TC and LDL significantly decreased after CO consumption in subgroups of >50 years of age participants and >30 intervention duration subgroup. Moreover, CO decreased LDL and TC compared to sunflower oil and saturated fat. This meta-analysis suggested that CO consumption improves serum TC and LDL, which could postpone heart disease progression. Key Teaching Points CO consumption could decrease serum TC and LDL, although it had no effects on other blood lipids. There was an overall significant effect of canola oil on TC and LDL compared to sunflower oil and saturated fats. CO could have beneficial effects on serum TC and LDL just when consumed longer than 30 days. CO consumption improved lipid profiles in participants older than 50 years.

Eating breakfast and snacks while television viewing are associated with some cardio metabolic risk factors among Iranian children.

AIM: We aimed to investigate the association of eating meals while television viewing (TVV) and screen-based behaviors with cardio metabolic risk factors (CRFs) among school-aged children in Shiraz. MATERIALS AND METHODS: This cross-sectional study was done on 409 primary school children (217 boys), aged 6-9 years. Physical activity, time spent on screen-based behaviors and frequency of eating meals while TVV were measured using a questionnaire. Anthropometric indices, fasting blood sugar (FBS), blood lipids, blood pressure (BP), dietary intakes and physical activity were assessed. Association of eating while TVV with CRFs were assessed using linear regression, adjusted for potential confounders. All statistical analysis were conducted using the Stata 13 software. RESULTS: Fully adjusted model showed that TVV time had significant positive association with waist circumferences (WC), and BP (p <0.05). Also, we found an inverse relationship between using Computer and Video games with TG level (ß=-0.3; CI: -0.64, -0.09). Children who ate two or more breakfast meal while TVV had higher WC (ß=2.02; CI: 0.51, 3.53) and FBS (ß=3.58; CI: 0.39, 6.78) compared to who never ate breakfast while TVV. After adjustment for Screen time and BMI, eating snacks while TVV was positively associated with FBS and systolic BP. However, Eating dinner and lunch while TVV were not significantly associated with any of CRFs after adjustment for confounders. CONCLUSIONS: We found that both eating breakfast and snacks while TVV were associated with WC, FBS and BP in children. Also, excessive TVV was associated with WC and BP.

Association between overweight/obesity and eating habits while watching television among primary-school children in the city of Shiraz, Iran.

OBJECTIVE: It has been reported that television (TV) viewing is associated with childhood obesity in Western countries. The present study aimed to investigate the relationship between obesity and eating habits while watching TV among primary-school children in the Middle East. DESIGN: Cross-sectional. SETTING: Children were recruited from primary schools of four educational districts in Shiraz, Iran. Anthropometric indices of mass (kg) and height (m) were measured, and BMI (percentile) was calculated. Demographic characteristics, TV viewing behaviours and physical activity data were collected from parents during face-to-face interviews and a 3d dietary record was completed. Subject Children (n 607) aged 6-10 years. RESULTS: Mean (sd) age of children was 8·16 (1·37) years, of whom 9·1 and 8·4 % were overweight and obese, respectively. Children who spent ≥2 h watching TV on weekdays (OR=1·99; 95 % CI 1·09, 3·60) and weekend days (OR=1·86; 95 % CI 1·01, 3·43) had higher odds of being obese, even after adjusting for physical activity. Children who ate breakfast while watching TV had higher odds of being overweight v. those who did not watch TV while eating breakfast (OR=2·70; 95 % CI 1·02, 7·60). There were no associations between TV viewing during other meals (lunch and dinner) and overweight/obesity. CONCLUSIONS: TV viewing for ≥2 h daily increases the risk of being obese in Iranian children aged 6-10 years, independent of physical activity. Further, breakfast consumption while watching TV may increase the risk of overweight/obesity, independent of total TV viewing time.