The association between dietary patterns and disease severity in patients with ulcerative colitis.

Ulcerative colitis (UC) is a chronic inflammatory disease involving the colon and rectum. One of the most modifiable environmental factors affecting UC severity is the patient's dietary pattern. Although the role of dietary patterns on UC aetiology has been investigated previously, its relationship with disease severity has not yet been elucidated. This study examined the association between UC patients' dietary patterns and disease severity. This cross-sectional study was conducted in 340 UC patients. Using an FFQ, food patterns were assessed. Twenty-five food categories were categorised based on the similarity of the nutrient composition of the food using the factor analysis method. A simple clinical colitis activity index was used to determine disease severity. Three dietary patterns were identified based on the factor analysis: healthy, unhealthy and Western dietary pattern. After adjusting for potential confounding factors, patients who were in the highest tertile of healthy dietary pattern compared with the lowest tertile were 92 % less likely to have severe UC (OR: 0·08; 95 % CI: 0·03, 0·22). Also, those in the highest tertile of the Western dietary pattern were 3·86 times more likely to have severe UC than those in the lowest tertile (OR: 3·86; 95 % CI: 1·86, 8·00). Even after controlling for confounding variables, unhealthy dietary pattern did not increase the risk of severe UC. Our data indicate the beneficial role of healthy dietary pattern in amelioration of disease severity in UC patients. To confirm this association, more studies are needed, especially prospective cohort studies.

Effects of vitamin D supplementation on liver fibrogenic factors, vitamin D receptor and liver fibrogenic microRNAs in metabolic dysfunction-associated steatotic liver disease (MASLD) patients: an exploratory randomized clinical trial.

BACKGROUND AND AIMS: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a global metabolic problem which can lead to irreversible liver fibrosis. It has been shown that vitamin D and its receptors contribute to fibrogenic pathways in the liver. However, the effect of vitamin D supplementation on liver fibrosis related factors have not been examined. This double blinded placebo controlled clinical trial was designed to investigate the effects on vitamin D supplementation on serum levels of VDR, fibrogenic factors and fibrogenic MicroRNAs in MASLD patients. METHODS: Forty six MASLD patients after block matching for sex and BMI were randomly assigned to receive 4000 IU/d vitamin D or placebo for 12 weeks. Weight, height and waist circumference were measured. Serum fibrogenic microRNAs, laminin, collagen type IV, hyaluronic acid, vitamin D, VDR, PTH, blood fasting glucose, serum fasting insulin, lipid profile, ALT and AST were determined at the baseline and at the end of the trial. Insulin resistance and insulin sensitivity were calculated using the HOMA-IR and QUICKI equation. RESULTS: Supplementation with vitamin D for 12 weeks led to the significant increases in serum 25(OH) vitamin D, VDR and HDL-C compared to placebo (P < 0.001, P = 0.008 and P < 0.001). There were significant decreases in ALT, AST, FBS and LDL-C levels in the vitamin D group as compared to the placebo (P < 0.05). Laminin and hyaluronic acid concentrations were significantly decreased in the vitamin D group as compared to the placebo group, by -10.6 and - 28.7 ng/mL, respectively. Supplementation with vitamin D for 12 weeks resulted in a significant lower MiR-21 and MiR-122 gene expressions compared to the placebo group (P = 0.01 and P < 0.001, respectively). DISCUSSION: As the first randomized controlled trial on the effect of vitamin D supplementation on serum levels of VDR, fibrogenic factors and fibrogenic MicroRNAs in MASLD patients, we found a significant reduction in some liver fibrogenic factors, in liver transaminases and corresponding changes in some fibrosis-related MiRs and some metabolic factors. Further clinical trials with larger sample sizes and direct measures of liver fibrosis are needed to confirm these findings. TRIAL REGISTRATION NUMBER: (available at: http://www.irct.ir , identifier: IRCT201405251485N13), Registration date: 14-03-2017.

The association between dietary total antioxidant capacity and hearing loss: results from the Tehran employees Cohort Study.

BACKGROUND: Despite numerous studies that have explored the association between individual antioxidants or specific combinations and the risk of hearing loss, there is lack of information regarding the relationship between dietary total antioxidant capacity (dTAC) and hearing loss. The conflicting results on this association further highlight the need for more research in this area. This study aims to investigate the association between overall dietary antioxidant intake and the risk of hearing loss among Iranian adults. METHODS: This cross-sectional study recruited 3443 adult participants aged between 19 and 67 years (with an average age of 41.4 years ± 8.8) who were employed at Tehran University of Medical Sciences in Iran. Participants underwent dietary assessment using a validated Food Frequency Questionnaire (FFQ). The hearing status of each participant was evaluated by a licensed audiologist in a soundproof room, using diagnostic audiometry that adhered to American National Standards specifications and followed standard audiometric clinical procedures. The dietary total antioxidant capacity (dTAC) was calculated using the Ferric Reducing-Antioxidant Power (FRAP) values. RESULTS: 43.6% of male participants had hearing loss, while 26.8% among female participants. After accounting for various confounding factors, no significant association was observed between higher levels of dTAC and reduced odds of hearing loss in the overall population. However, among men under the age of 40, higher levels of dTAC were associated with decreased odds of hearing loss, even after adjusting for several covariates (OR: 0.56, 95% CI: 0.31-1.02, Ptrend = 0.02). This relationship was not evident in men over 40 years of age or among women. CONCLUSION: The study found an inverse relationship between higher antioxidant intake in the diet and lower odds of hearing loss, specifically among men who were 40 years old or younger. However, this relationship was not observed in the overall population or among women. Additional prospective studies are necessary to validate these results.

Exploring the association between ultra-processed foods and COPD: a case-control study.

BACKGROUND: While it is known that the overconsumption of ultra-processed foods (UPFs) is associated with a heightened risk of respiratory ailments, the specific effects of UPF intake on COPD remain unclear. This study was designed to explore the potential link between COPD and the consumption of UPFs among adult individuals in Iran. METHODS: In this hospital-based case-control study conducted at Alzahra University Hospital in Isfahan, Iran, we enrolled 84 patients newly diagnosed with COPD, along with 252 healthy controls matched for age and sex. COPD was defined based on the results of spirometry tests, specifically when the forced expiratory volume per second (FEV1) was less than 80% or the ratio of FEV1 to forced vital capacity (FVC) was less than 70%. To evaluate the dietary intake of the participants, we utilized a validated food frequency questionnaire (FFQ) consisting of 168 items. Additionally, we gathered data on potential confounding factors using a pre-tested questionnaire. RESULTS: The mean ages for the case and control groups were 57.07 and 55.05 years, respectively. Our study found no significant association between the intake of ultra-processed foods (UPFs) and the likelihood of COPD, with an odds ratio (OR: 0.78, 95% CI: 0.34-1.77). This lack of association persisted even after adjusting for factors such as energy intake, sex, and age (OR: 0.48; 95% CI: 0.19-1.21). Further controlling for potential confounders like body mass index (BMI), physical activity, and smoking status did not alter this finding (OR: 0.367; 95% CI: 0.123-1.1008, P = 0.074). CONCLUSIONS: In our study, we observed no significant association between the intake of Ultra-Processed Foods (UPFs) and the odds of Chronic Obstructive Pulmonary Disease (COPD). This finding remained consistent even after adjusting for factors such as energy intake, sex, age, Body Mass Index (BMI), physical activity, and smoking status. Therefore, within the scope of our study, it appears that the consumption of UPFs does not significantly impact the likelihood of developing COPD. However, we recommend further research to deepen our understanding of the intricate relationship between dietary habits and respiratory health.

Coffee consumption and caffeine intake in relation to risk of fractures: a systematic review and dose-response meta-analysis of observational studies.

BACKGROUND: Conflicting reports are available about the association of coffee or caffeine intake and risk of fracture. We performed the current updated systematic review and dose-response meta-analysis of coffee consumption and caffeine intake and risk of fracture to quantify this association. MATERIALS AND METHODS: PubMed/Medline, ISI Web of Science, and Scopus, Cochrane database were searched up to July 2021. Random-effects model or fixed-effects model was used to pool the study-specific effect sizes (ESs) and 95% confidence intervals (CIs). Dose-response relationship was examined using linear and non-linear dose-response analyses. The certainty of evidence was assessed using NutriGrade tool. RESULTS: Out of 22 eligible studies included in the meta-analysis, 15 had cohort and 7 had case-control design. We found no significant association between coffee consumption and risk of fracture, either based on pooling cohort (RR: 0.99; 95% CI: 0.88, 1.12; I2 = 71.4%, Pheterogeneity < 0.01) or case-control studies (OR: 1.13; 95% CI: 0.87, 1.46; I2 = 49.0%, Pheterogeneity=0.08). In the subgroup analysis of cohort studies, we observed that higher coffee intake was inversely associated with risk of fracture in men (RR: 0.85; 95% CI: 0.76 to 0.94). In addition, a positive association was seen between coffee consumption and risk of fracture in studies with less than 12 years of follow-up (RR: 1.14; 95% CI: 1.02 to 1.27). With regard to caffeine intake, a statistically significant positive association was seen with risk of fracture (RR: 1.15; 95% CI, 1.08 to 1.23; I2=26.6%, n = 8). In the dose-response analysis, we found that each additional 100 mg caffeine intake was marginally associated with 2% greater risk of fracture (RR: 1.02; 95% CI: 1 to 1.05; I2= 70.3%, n = 6). CONCLUSION: High coffee consumption was protectively associated with risk of fracture in men, while caffeine intake was positive associated with risk.

Maternal caffeine consumption during pregnancy and risk of low birth weight: a dose-response meta-analysis of cohort studies.

BACKGROUND & OBJECTIVES: Earlier published studies on maternal caffeine intake during pregnancy in relation to the risk of low birth weight (LBW) (birth weight <2500 g) have indicated conflicting findings. Therefore, the present systematic review and meta-analysis was conducted to examine the association between maternal caffeine intake and risk of LBW. METHODS: We searched for relevant articles published up to Jan 2021 through PubMed and Scopus. For this purpose, we used MESH (Medical Subject Heading) and non-MESH keywords. Cohort studies that considered maternal caffeine intake as the exposure variable and LBW as the main outcome variable were included in the systematic review. Finally, seven cohort studies were considered in this systematic review and meta-analysis. RESULTS: Combining seven effect sizes, we found a significant positive association between maternal caffeine intake and risk of LBW (RR: 1.70; 95% CI: 1.19-2.43). We also found that each additional 100-mg per day of maternal caffeine intake was significantly associated with an increased risk of LBW (RR: 1.12; 95% CI: 1.03-1.22; Pheterogeneity = 0.020). In addition, nonlinear dose-response analysis showed a significant relationship (Pnonlinearity < 0.001) between maternal caffeine intake and risk of LBW. CONCLUSIONS: In this systematic review and meta-analysis, we found a significant positive association between maternal caffeine intake and risk of LBW.

Association of major dietary patterns with advanced glycation end products and high-sensitivity C-reactive protein in people with type 1 diabetes mellitus.

BACKGROUND: The associations of diet with serum levels of advanced glycation end products (AGEs) and high-sensitivity C-reactive protein (hs-CRP) have been examined in patients with type 2 diabetes mellitus (T2DM). However, data on patients with type 1 diabetes mellitus (T1DM) are limited. Therefore, this study was conducted to investigate the associations of major dietary patterns with serum levels of AGEs and hs-CRP among patients with T1DM. METHODS: A total of 229 patients with T1DM participated in this current cross-sectional study. We collected dietary data using a validated food frequency questionnaire (FFQ). The factor analysis approach was used to determine major dietary patterns. A fasting blood sample was collected from each participant to assess serum levels of AGEs and hs-CRP. The associations of dietary patterns with elevated levels of AGEs and hs-CRP were assessed using binary logistic regression. RESULTS: Patients with T1DM in the highest tertile of a Western dietary pattern had 4.32 times higher odds of having elevated AGEs than those in the lowest tertile (OR: 4.32, 95% CI: 1.86-10.05). Additionally, adherence to the Western diet was associated with 2.97 times greater odds of having elevated hs-CRP (> 3 mg/L) (OR: 2.97, 95% CI: 1.22-7.24) in these patients. Such positive associations were not observed for unhealthy and traditional dietary patterns. Moreover, higher adherence to a semi-healthy diet (characterized by high consumption of white meat, whole grains, processed meat, and a low salt intake) was associated with 87% lower odds of having elevated hs-CRP (OR: 0.13, 95% CI: 0.05-0.35). However, we found no significant association between the semi-healthy diet and AGEs levels. CONCLUSION: We found that adherence to a Western dietary pattern was associated with elevated levels of AGEs/hs-CRP in patients with T1DM. Also, we discovered a significant inverse association between adherence to a semi-healthy diet and hs-CRP levels.

Yogurt consumption and risk of mortality from all causes, CVD and cancer: a comprehensive systematic review and dose-response meta-analysis of cohort studies.

OBJECTIVES: To quantify the dose-response relation between yogurt consumption and risk of mortality from all causes, CVD and cancer. DESIGN: Systematic review and meta-analysis. SETTING: We conducted a comprehensive search of PubMed/Medline, ISI Web of Science and Scopus databases through August 2022 for cohort studies reporting the association of yogurt consumption with mortality from all causes, CVD and cancer. Summary relative risks (RR) and 95 % CI were calculated with a random-effects model. PARTICIPANTS: Seventeen cohort studies (eighteen publications) of 896 871 participants with 75 791 deaths (14 623 from CVD and 20 554 from cancer). RESULTS: High intake of yogurt compared with low intake was significantly associated with a lower risk of deaths from all causes (pooled RR 0·93; 95 % CI: 0·89, 0·98, I2 = 47·3 %, n 12 studies) and CVD (0·89; 95 % CI: 0·81, 0·98, I2 = 33·2 %, n 11), but not with cancer (0·96; 95 % CI: 0·89, 1·03, I2 = 26·5 %, n 12). Each additional serving of yogurt consumption per d was significantly associated with a reduced risk of all-cause (0·93; 95 % CI: 0·86, 0·99, I2 = 63·3 %, n 11) and CVD mortality (0·86; 95 % CI: 0·77, 0·99, I2 = 36·6 %, n 10). There was evidence of non-linearity between yogurt consumption and risk of all-cause and CVD mortality, and there was no further reduction in risk above 0·5 serving/d. CONCLUSION: Summarising earlier cohort studies, we found an inverse association between yogurt consumption and risk of all-cause and CVD mortality; however, there was no significant association between yogurt consumption and risk of cancer mortality.

Relationship between healthy eating index and sarcopenia in elderly people.

BACKGROUND: Data on the association of Alternative Healthy Eating Index-2010 (AHEI-2010) with sarcopenia are scarce. We aimed to evaluate the association between adherence to AHEI-2010 and sarcopenia and its components including low muscle mass, low muscle strength, and low muscle performance among elderly people. METHODS: In this cross-sectional study, which was conducted on 300 older people (150 men and 150 women) aged ≥55 years. Dietary information was done using a valid 117-item food frequency questionnaire (FFQ). To construct AHEI-2010 score, earlier studies were used. Sarcopenia and its components were described based on both former and new European Working Group on Sarcopenia in Older People (EWGSOP) guidelines. RESULTS: We found no significant association between AHEI-2010 score and odds of EWGSOP2-sarcopenia, either before (OR for the highest vs. lowest tertiles: 0.55; 95% CI: 0.19, 1.55) or after (OR: 0.44; 95% CI: 0.14, 1.34) adjustment for confounders. In gender-stratified analyses, we found a significant protective association between adherence to the AHEI-2010 score and odds of EWGSOP2-sarcopenia among women after controlling for confounders (0.20; 95%CI: 0.04, 0.91). CONCLUSIONS: In conclusion, healthy eating was inversely associated with odds of sarcopenia among women, but not in men. Further studies with a large sample size and prospective design are needed to examine this association.

The association between diet quality and chronic obstructive pulmonary disease: a case-control study.

BACKGROUND: Previous investigations have primarily examined the relationship between various dietary patterns and the risk of chronic obstructive pulmonary disease (COPD); however, there have been limited studies that have evaluated the association between diet quality presented by Healthy Eating Index 2010 (HEI-2010) and COPD. The aim of this study was to investigate this association in Iranian population. METHODS: This case-control study recruited 84 cases and 252 healthy controls who were randomly selected. Diet, smoking, and physical activity were assessed using validated questionnaires. The HEI-2010 score ranged from zero to hundred twenty, with zero indicating an unhealthy diet and hundred twenty indicating a healthy diet. Logistic regression models were utilized to analyze the association between HEI-2010 and the odds of COPD. RESULTS: Results from logistic regression showed that individuals with higher HEI scores had a significantly lower odds of COPD (OR: 0.34; 95% CI: 0.16-0.72). After adjusting for confounders, individuals with the highest HEI score were 82% less likely to have COPD (OR: 0.18; 95% CI: 0.03-0.96). This association remained significant after adjusting for smoking and physical activity (OR: 0.08; 95% CI: 0.01-0.93) and with additional adjustment for BMI (OR: 0.08; 95% CI: 0.01-0.92). CONCLUSIONS: This study found a significant association between a higher HEI-2010 score and a lower odd of COPD in the Iranian population. These results suggest that a healthy diet may play a crucial role in reducing the odds of COPD and in improving the function of the lungs. However, further prospective studies are warranted to elucidate this relationship.

The Association between Dietary Calcium Intake and Breast Cancer Risk among Iranian Women.

No information is available from Middle Eastern countries linking dietary calcium intake and odds of breast cancer. OBJECTIVE: This study was conducted to investigate the association between dietary calcium intake and odds of having breast cancer among Iranian women.In this population-based case-control study, 350 newly diagnosed breast cancer cases were recruited and 700 age-matched subjects were enrolled as controls. Dietary intakes were examined by the use of a 106-item validated FFQ. Total dietary calcium intake of each participant was computed by summing up calcium intake from all foods and dishes. The quartile cutoff points of energy-adjusted calcium intake was obtained in the control group. These cutoff points were used to classify all study participants into quartiles in terms of dietary calcium intake.After adjustment for age and energy intake, we found that individuals in second quartile of calcium intake were 43% less likely to have breast cancer compared with those in the bottom quartile (OR: 0.57; 95% CI: 0.38-0.86). This significant association disappeared after further controlling for other potential confounders including dietary factors and BMI (OR: 0.91; 95% CI: 0.57-1.45). When the analyses were done by menopausal status, premenopausal women with the greatest calcium intake were 60% less likely to have breast malignancy than those with the lowest intake (OR: 0.40; 95% CI: 0.16-0.99). Adjustment for potential confounders did not substantially influence this finding (OR: 0.32; 95% CI: 0.11-0.95). The association remained significant even after additional controlling for dietary covariates (OR: 021; 95% CI: 0.06-0.72) and BMI (OR: 0.21; 95% CI: 0.04-0.93). No significant association was found between dietary calcium intakes and odds of breast cancer in postmenopausal women.Dietary calcium intake was protectively associated with odds of breast cancer in premenopausal women, but not in postmenopausal women. Further prospective investigations are needed to confirm these findings.

The Association between Dietary Inflammatory Potential and Gastric Cancer: A Case Control Study.

OBJECTIVE: No report is available about diet-disease associations in the understudied region of Afghanistan. Although the inflammatory potential of diet has been linked with several cancers, information about gastric cancer is scarce. The present study aimed to investigate the relationship between the inflammatory potential of the diet and odds of gastric cancer in Afghanistan. METHODS: In this hospital-based case-control study, we enrolled 90 newly-diagnosed cases of gastric cancer and 180 age (±5) and sex-matched controls. All cases were pathologically confirmed gastric cancer patients, with no history of any type of other pathologically confirmed cancers. Controls were healthy individuals and relatives of patients in the hospital. Dietary assessment was done by a pre-tested food frequency questionnaire. DII was calculated based on energy-adjusted amounts of several foods and nutrients with inflammatory or anti-inflammatory potential, as introduced by earlier studies. RESULTS: Mean age of study participants was 54 years, of them 73% were males. After adjustment for age and sex, individuals in the highest tertile of the inflammatory potential of the diet were 2.47 times (95% CI: 1.31-4.66) more likely to have gastric cancer compared with those in the lowest tertile. Further adjustment for other potential confounders did not substantially affect the association; such that participants with the greatest inflammatory potential of the diet had approximately 3.59 times (95% CI: 1.16-11.02) increased odds of gastric cancer than those with the lowest adherence. Additional adjustment for BMI strengthened the association (OR: 3.75; 95% CI: 1.14-12.30). CONCLUSION: We found a significant positive association between inflammatory potential of the diet and risk of gastric cancer. Further studies with prospective nature are required to confirm this association.

The Association between Dietary Insulin Index and Load with Gastric Cancer in Afghanistan.

BACKGROUND: Insulin has a critical role in the pathogenesis of several cancers. We are aware of no study that examined the association between dietary insulin index (DII) and dietary insulin load (DIL) and gastric cancer. OBJECTIVE: This study aimed to investigate the relationship between dietary insulin index and DIL and odds of gastric cancer in Afghanistan. METHODS: In this hospital-based case-control study, we recruited 90 patients with newly-diagnosed gastric cancer and 180 healthy controls in Kabul, Afghanistan. Cases were chosen based on convenience-sampling method from the patients with pathologically confirmed gastric cancer aged between 20 and 75 years that had been referred to Jamhuriat Hospital, Kabul, Afghanistan. We applied a pre-tested food frequency questionnaire for dietary assessment of study participants. DIL and DII were calculated based on earlier publications. Multivariable logistic regression models were applied to examine the association between DII and DIL and gastric cancer. RESULTS: Mean BMI of study participants was 23.55 ± 3.06 kg/m2, of them 73% were males. After adjustment for potential confounders, participants in the top tertile of DII had 3.96 times greater odds for gastric cancer compared with those in the first tertile (95% CI: 1.23, 12.69; P-trend = 0.03). After adjustment for potential confounders, people in the highest tertile of DIL were 3.41 times more likely to have gastric cancer compared with those in the lowest tertile (95% CI: 1.28, 9.09; P-trend = 0.01). These associations remained significant even after further controlling for BMI, family history of cancer, H. pylori infection and salt intake. CONCLUSION: A significant positive association was seen between dietary insulin index and insulin load and odds of gastric cancer in Afghan adults. Prospective cohort studies are required to confirm our findings.

A Case-Control Study on Dietary Acid Load in Relation to Glioma.

Limited data are available linking dietary factors to glioma. The current study was conducted to investigate the association between Dietary Acid Load (DAL) and odds of glioma in Iranian adults. This case-control study was done on 128 newly diagnosed patients with glioma and 256 healthy controls in Tehran, Iran. A validated detailed food frequency questionnaire (FFQ) was used to assess dietary intakes of participants. DAL was estimated using the protein to potassium ratio (Pro: K). Glioma was diagnosed based on pathological tests. A detailed questionnaire including several non-dietary confounders was also completed. Participants in the highest tertile of DAL score had a non-significant higher odds of glioma as compared to those in the lowest tertile (OR: 1.50; 95% CI: 0.88-2.57), which remained after controlling for some potential confounders (OR: 1.66; 0.70-3.91). After further adjustment for dietary intakes of meats and processed meats, legumes and nuts, fruits, salt tea, and coffee, those in the top tertile of DAL score were significantly more likely to have glioma than those in the bottom tertile (OR: 3.09; 95% CI: 1.06, 8.99; P = 0.03). This association was also reached following further adjustment for BMI (OR: 3.05; 95% CI: 1.04, 8.91; P = 0.03). We found a significant positive association between dietary acid load, as estimated by Prot:K ratio, and odds of glioma among adults. Further studies, in particular prospective cohorts with long-term follow up, are required to confirm these findings.

High vs. low-fat dairy and milk differently affects the risk of all-cause, CVD, and cancer death: A systematic review and dose-response meta-analysis of prospective cohort studies.

Considerable controversy exists regarding the association between milk and dairy consumption and mortality risk. The present systematic review and meta-analysis of prospective studies was undertaken to examine the association of high vs. low-fat dairy and milk consumption with mortality. We searched PubMed/Medline, ISI Web of Science, and Scopus databases through February 2020 for prospective cohort studies that reported the association between milk and dairy consumption and mortality risk. High-fat milk consumption was significantly associated with a greater risk of all-cause (Pooled ES: 1.15; 95% CI: 1.09-1.20, I2=24.5%, p = 0.22), CVD (Pooled ES: 1.09; 95% CI: 1.02-1.16, I2=4.5%, p = 0.38) and cancer mortality (Pooled ES: 1.17; 95% CI: 1.08-1.28, I2=30.1%, p = 0.19). However, total dairy consumption was associated with a lower risk of CVD mortality (Pooled ES: 0.93; 95% CI: 0.88-0.98, I2=59.7%, p = 0.001). Dose-response analysis revealed a significant non-linear association of total dairy consumption with all-cause and CVD mortality. Moreover, high-fat milk consumption was significantly associated with risk of cancer mortality in linear and non-linear dose-response analysis. In conclusion, we found high-fat milk consumption was associated with a higher risk of all-cause, CVD, and cancer mortality. However, total dairy consumption was associated with a lower risk of CVD mortality.

Fish consumption during pregnancy and risk of allergic diseases in the offspring: A systematic review and meta-analysis.

Although several studies have reported the beneficial effects of maternal fish consumption on allergy diseases in the offspring, the findings are conflicting. We summarized earlier data on the association between maternal fish intake and risk of allergy diseases in the offspring through a meta-analysis. A systematic literature search of relevant reports published in Medline/PubMed, ISI web of Science, EMBASE, SCOPUS and Google Scholar prior to February 2020 was conducted. All observational studies (cross-sectional, case-control or cohort) that examined the relationship between intake of maternal fish and risk of allergy diseases in the offspring were considered. Duplicate and non-related studies were excluded. In total, 31 studies on maternal fish consumption and risk of allergic diseases in the offspring were included. Greater maternal fish intake was associated with a reduced risk of wheeze (Pooled effect size: 0.97; 95% CI: 0.96-0.99) and food allergy (0.75; 95% CI: 0.64-0.88). Maternal fish consumption was not associated with risk of asthma (pooled effect size: 0.99; 95% CI: 0.89, 1.11), eczema (pooled effect size: 0.93; 95% CI: 0.84, 1.03), allergic rhinitis (pooled effect size: 0.91; 95% CI: 0.75, 1.09), and inhalant allergy (pooled effect size: 0.86; 95% CI: 0.66, 1.13). In non-linear dose-response meta-analysis, increased intake of fish during pregnancy (at the level of 50 to 200 grams per week) was associated with a reduced risk of eczema (P non-linearity = 0.042). Meta-regression of included studies revealed an inverse linear association between maternal fish intake and risk of eczema; such that every additional 30-gram per week consumption of fish during pregnancy was associated with a 4% reduced risk of eczema. We found that fish intake during pregnancy was associated with a lower risk of wheeze, eczema and food allergy in children. No significant association was seen between maternal fish consumption and risk of offspring's asthma, allergic rhinitis, and inhalant allergy.

A systematic review and meta-analysis of prospective cohort studies on the association between alcohol intake and risk of fracture.

Previous studies on the association between alcohol intake and risk of fracture have reached conflicting findings. The aim of this systematic review and meta-analysis of prospective cohort studies was to summarize earlier studies on the association of alcohol intake with risk of fracture. A systematic search of PubMed, Scopus, and ISI Web of Science was conducted up to November 2020. Prospective cohort studies that had considered alcohol consumption as the exposure variable and fracture as the main outcome or as one of the outcome variables were included in this systematic review. Publications in which odds ratios (ORs), rate or risk ratios (RRs), or hazard ratios (HRs) and 95% confidence intervals (CIs) were reported, were included in the meta-analysis. In total, 40 prospective cohort studies including 5,084,303 participants and 170,916 subjects with fracture were included in this systematic review; of them 38 studies with a total sample size of 5,053,117 participants and 169,560 cases of fracture were included in the meta-analysis. Using a random-effects meta-analysis, we found a significant positive association between alcohol consumption and risk of total fractures (RR: 1.35; 95% CI: 1.01, 1.81) and any fractures (RR: 1.24; 95% CI: 1.11, 1.38). However, no significant association was observed between alcohol intake and risk of hip fractures (RR: 1.19; 95% CI: 0.96, 1.48), osteoporotic fractures (RR: 2.01; 95% CI: 0.76, 5.34), vertebral fractures (RR: 0.98; 95% CI: 0.68, 1.40), and wrist fractures (RR: 0.99; 95% CI: 0.85, 1.16). In conclusion, we found that alcohol consumption was positively associated with risk of total fractures and any fractures. However, we did not observe any significant association between alcohol consumption and risk of hip, osteoporotic, vertebral, and wrist fractures.

Dietary intake of total, animal and plant proteins and the risk of coronary heart disease and hypertension: a systematic review and dose-response meta-analysis of prospective cohort studies.

BACKGROUND & OBJECTIVES: Previous findings assessing the association between long-term protein intake and cardiovascular diseases (CVDs) are inconsistent. This study aimed to summarize previous investigations on the association between total, animal and plant proteins intake and the risk of coronary heart disease (CHD) and hypertension (HTN) in adults. METHODS: Related papers were found by searching through PubMed/Medline, Scopus, and Google Scholar up to April 2020. Prospective cohort studies examined the association between consumption of the dietary protein from different sources and the risk of CHD and HTN in general population, were included. The random-effects model was used to pool the reported relative risks (RR). Dose-response associations were modeled by restricted cubic splines. RESULTS: Thirteen prospective studies, in total, including 547,303 participants- 11,590 cases with total CHD and 5,620 with HTN- were included. Dietary intake of total protein was not significantly associated with the risk of total CHD (RR: 0.97; 95%CI: 0.90-1.05) and HTN (RR: 1.01; 95% CI: 0.90-1.14). Moreover, consumption of both dietary plant and animal protein was not related to the risk of total CHD and HTN. Dose-response analysis indicated that the risk of CHD and HTN did not change significantly with increasing dietary total protein intake from 10% to 25% of total calorie intake. CONCLUSIONS: Dietary protein intake from different sources had no significant association with risk of CHD and HTN. Further high-quality research is needed to examine the potential mechanistic links between dietary protein intake and health outcomes.

The effect of ketogenic diet on body composition and anthropometric measures: A systematic review and meta-analysis of randomized controlled trials.

This study aimed to summarize earlier randomized controlled trials on the effects of ketogenic diet (KD) on body composition and anthropometric measures. Four databases were searched from inception to May 2020 using relevant keywords. All clinical trials investigating the effects of KD on body weight (BW), body mass index (BMI), waist circumference (WC), fat mass (FM), fat-free mass (FFM), lean body mass (LBM), visceral adipose tissue (VAT) and percentage body fat (PBF) in adults were included. Overall, 18 trials were included in the review. Pooled effect sizes revealed a significant effect of KD on BW (weighted mean differences [WMD]: -2.87 kg, 95% confidence interval [CI]: -3.84 to -1.89), BMI (WMD: -1.44 kg/m2, 95% CI: -2.07, -0.81), FM (WMD: -1.40 kg, 95% CI: -2.50, -0.30), FFM (WMD: -0.81 kg, 95% CI: -1.32, -0.30), LBM (WMD: -0.63 kg, 95% CI: -1.21, -0.06), WC (WMD: -3.23 cm, 95% CI: -4.38, -2.09), VAT (WMD: -28.91 g, 95% CI: -50.57, -7.24) and PBF (WMD: -2.81 kg, 95% CI: -3.82, -1.80), respectively. Taken together, the data suggest that KD has beneficial effects on BW, BMI, FM, FFM, LBM, WC, VAT, and PBF. However, the effectiveness of the long term effect of this dietary pattern is unclear.

The effect of walnut consumption on cardiometabolic profiles of individuals with abnormal glucose homoeostasis: a systematic review and meta-analysis of clinical trials.

Findings on the effect of walnut consumption on cardiometabolic profiles in individuals with abnormal glucose homoeostasis are conflicting. We summarised earlier data in this regard. A systematic literature search of relevant reports published in Medline/PubMed, ISI web of Science, EMBASE, SCOPUS and Google Scholar up to October 2020 was conducted. Randomised trials that enrolled individuals with abnormal glucose homoeostasis in which the main intervention was walnut consumption were included. Abnormal glucose homoeostasis was defined as a spectrum of impaired glucose tolerance or pre-diabetic status that is associated with insulin resistance. Twelve studies were included in systematic review and eight in meta-analysis. No significant effect of walnut consumption on anthropometric measures, including weighted mean difference (WMD: -0·13; 95 % CI -0·64, 0·39 kg), BMI (-0·08; 95 % CI -0·47, 0·32 kg/m2) and waist circumference (0·01; 95 % CI -0·50, 0·52 cm) was observed. Although walnut intake did not influence on lipid profiles (including TAG, total- and HDL-cholesterol levels), individuals in the intervention group tended to have lower levels of LDL-cholesterol than those in the control group (-0·10; 95 % CI -0·20, 0·01 mmol/l; P = 0·06). Other cardiometabolic factors including markers of glycaemic control (fasting blood glucose and HbA1C levels), blood pressure and stimulus-adjusted response measure (a parameter of endothelial function) were not significantly affected. However, walnut consumption resulted in a significant increase in flow-mediated dilation (FMD) (0·93 %; 95 % CI 0·16, 1·71 %). Summarising earlier evidence, we found that walnut consumption might influence FMD and LDL-cholesterol levels in individuals with abnormal glucose homoeostasis. It did not affect other cardiometabolic profiles in these individuals.