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OBJECTIVE: To investigate the association between walking speed and the risk of type 2 diabetes. DESIGN: Systematic review and meta-analysis. DATA SOURCES: PubMed, Scopus, CENTRAL and Web of Science to 30 May 2023. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: We included cohort studies that explored the association between walking speed and the risk of type 2 diabetes in adults. We used random-effects meta-analyses to calculate relative risk (RR) and risk difference (RD). We rated the credibility of subgroup differences and the certainty of evidence using the Instrument to assess the Credibility of Effect Modification ANalyses (ICEMAN) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) tools, respectively. RESULTS: Ten cohort studies were included. Compared with easy/casual walking (<3.2 km/hour), the RR of type 2 diabetes was 0.85 (95% CI 0.70 to 1.00); RD=0.86 (95% CI 1.72 to 0) fewer cases per 100 patients; n=4, GRADE=low) for average/normal walking (3.2-4.8 km/hour), 0.76 (95% CI 0.65 to 0.87); RD=1.38 (95% CI 2.01 to 0.75) fewer cases per 100 patients; n=10, GRADE=low) for fairly brisk walking (4.8-6.4 km/hour) and 0.61 (95% CI 0.49 to 0.73; RD=2.24 (95% CI 2.93 to 1.55) fewer cases per 100 patients; n=6, GRADE=moderate) for brisk/striding walking (>6.4 km/hour). There was no significant or credible difference across subgroups based on adjustment for the total volume of physical activity and time spent walking per day. Dose-response analysis suggested that the risk of type 2 diabetes decreased significantly at a walking speed of 4 km/h and above. CONCLUSIONS: Low to moderate certainty evidence, mainly from studies with a high risk of bias, suggests that walking at faster speeds is associated with a graded decrease in the risk of type 2 diabetes. PROSPERO REGISTRATION NUMBER: CRD42023432795.
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Diabetes Mellitus Tipo 2 , Adulto , Humanos , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/etiologia , Velocidade de CaminhadaRESUMO
We aimed to review the association of dietary fats and risk of coronary events in adults. We searched PubMed, Embase, CENTRAL, Scopus, and Web of Sciences to April 2022 for prospective cohorts and randomized trials investigating the association of dietary intake and biomarkers of fats and fatty acid interventions and the risk of coronary events. We performed random-effects meta-analyses to estimate relative risk (RR) for the top versus bottom tertiles of exposures. One-hundered sixty-five prospective cohorts and randomized trials were included. Dietary intake and biomarkers of total fat and saturated, monounsaturated, and polyunsaturated fatty acids were not associated with the risk of coronary events. Dietary intake of trans fatty acids, palmitic acid, stearic acid, and saturated fatty acids from meat and unprocessed meat was modestly associated with a higher risk and, in contrast, intake of alpha-linolenic acid, long-chain omega-3 fatty acids, and linoleic acid was modestly associated with a lower risk. Supplementation with long-chain omega-3 fatty acids and increasing the consumption of alpha-linolenic and linoleic acids in place of saturated fats reduced the risk of coronary events. Existing evidence, in its totality, provides a modest support in favor of current recommendations suggesting replacement of saturated fats with polyunsaturated fats.
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PURPOSE: To investigate the potential relationship between diet quality, represented by the Mediterranean diet score, during early pregnancy and behavioral, mood, and cognitive development in children under 1 year of age in a prospective cohort study in Iran. METHODS: 658 Iranian pregnant women and their infants participated in this prospective birth cohort study. The Mediterranean diet score was calculated by using data from a food frequency questionnaire during the first trimester of pregnancy. We assessed the children's development using the Ages and Stages Questionnaire (ASQ) at 6-month age. We used Cox proportional hazard model to calculate the hazard ratio (HR) and 95% confidence interval (CI) of ASQ domains across categories of the Mediterranean diet score. RESULTS: The mean age of the mothers was 28.8 ± 5.08 years old, and the average follow-up duration was 90 weeks. The mean BMI of the mothers before pregnancy was 25.1 ± 4.43â kg/m2. In the multivariable-adjusted model, those infants whose mothers were in the second (HR: 0.44; 95% CI: 0.19, 1.04; P = 0.06) and third (HR: 0.39; 95% CI: 0.17, 0.89; P = 0.03) tertiles of the Mediterranean diet score had a lower risk of communication impairment compared to those who were at the first tertile. There was no association between maternal adherence to the Mediterranean diet during early pregnancy and other domains of the ASQ. CONCLUSIONS: Greater adherence to the Mediterranean dietary pattern during the first trimester of pregnancy may be favorably associated with communication abilities at 6-month aged infants. More large-scale cohort studies are needed to confirm our findings.
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BACKGROUND: Limited data is available on the association between adherence to the Mediterranean diet during early pregnancy and risk of gestational diabetes (GDM) in countries located in the Middle East, one of the regions with the highest prevalence of GDM. METHODS: A total of 647 pregnant mothers were included in the present prospective birth cohort study in Iran. Dietary intake was assessed by a 90-item food frequency questionnaire during the first trimester of pregnancy. Cases of GDM were ascertained by a two-step approach with a 50-g screen followed by a 100-g oral glucose tolerance for those who tested positive. Cox proportional hazard model was used to calculate the hazard ratio and 95%CI of GDM across tertiles of the Mediterranean diet score, while controlling for a wide range of potential confounders. RESULTS: A total of 647 pregnant mothers were included, of whom 77 mothers were diagnosed with GDM during their pregnancy. The average age of the mothers was 28.8 ± 5.1 years. In the multivariable analysis, being in the third tertile of the score of adherence to the Mediterranean diet was associated with a 41% lower risk of developing GDM as compared to those in the first tertile (adjusted hazard ratio: 0.59, 95%CI: 0.35, 0.99). CONCLUSIONS: Based on our findings, greater adherence to the Mediterranean diet during early pregnancy may be associated with a lower risk of developing GDM in Iranian women. Larger cohort studies are needed to confirm the findings.
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Diabetes Gestacional , Dieta Mediterrânea , Gravidez , Humanos , Feminino , Adulto Jovem , Adulto , Estudos de Coortes , Diabetes Gestacional/epidemiologia , Diabetes Gestacional/etiologia , Diabetes Gestacional/prevenção & controle , Irã (Geográfico)/epidemiologia , Estudos ProspectivosRESUMO
BACKGROUND/OBJECTIVES: We aimed to evaluate the relationships between body fat percentage (BF%), fat mass (FM), fat mass index (FMI) and visceral (VAT) and subcutaneous adipose tissue (SAT) with risk of all-cause mortality. METHODS: We did a systematic search in PubMed, Scopus, and Web of Science to June 2021. We selected prospective cohorts of the relationship between body fat with risk of all-cause mortality in the general population. We applied random-effects models to calculate the relative risks (RRs) and 95%CIs. RESULTS: A total of 35 prospective cohort studies with 923,295 participants and 68,389 deaths were identified. The HRs of all-cause mortality for a 10% increment in BF were 1.11 (95%CI: 1.02, 1.20; I2 = 93%, n = 11) in the general adult populations, and 0.92 (95%CI: 0.79, 1.06; I2 = 76%, n = 7) in adults older than 60 years. The HRs were 1.06 (95%CI: 1.01, 1.12; I2 = 86%, n = 10) for a 5 kg increment in FM, 1.11 (95%CI: 1.06, 1.16; I2 = 79%, n = 7) for a 2 kg/m2 increment in FMI, and 1.17 (95%CI: 1.03, 1.33; I2 = 72%, n = 8) and 0.81 (0.66, 0.99; I2 = 59%, n = 6) for a 1-SD increment in VAT and SAT, respectively. There was a J shaped association between BF% and FM and all-cause mortality risk, with the lowest risk at BF% of 25% and FM of 20 kg. In subgroup analyses, although there was little evidence of between-subgroup heterogeneity, the observed positive associations were more pronounced in studies which had a longer duration, excluded participants with prevalent cardiovascular disease and cancer at baseline, with adjustment for smoking or restricted to never smokers, and less pronounced in studies which adjusted for potential intermediates, suggesting an impact of reverse causation, confounding and over-adjustment in some of the studies. CONCLUSIONS: Higher body fat content was related to a higher risk of mortality in a J shaped manner. Any future studies should further assess the impact of reverse causation and residual confounding on these associations. REGISTRATION: PROSPERO (CRD42021240743).
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Tecido Adiposo , Doenças Cardiovasculares , Adulto , Índice de Massa Corporal , Doenças Cardiovasculares/epidemiologia , Humanos , Estudos Prospectivos , Gordura SubcutâneaRESUMO
The present study aimed to investigate the reduction of aflatoxins as a potent hazard for human health in nuts during roasting, irradiation, and fumigation processes. A systematic search was performed in PubMed, Scopus, and ISI Web of Science on 6 April 2020 to find interventional studies assessing the effects of roasting, fumigation, and irradiation methods on total and individual aflatoxins concentration in nuts. Study-specific results were pooled by using a random-effects model. A total of 19 trials were included in the analyses. In most studies, the influence of method on aflatoxin reduction was assessed on peanuts. The results showed that the roasting method significantly reduced aflatoxin B1, B2, G1, and G2 concentrations by 46.91%, 30.66%, 40.88%, and 26.19%, respectively. Such results for the fumigation method were 20.88% and 22.56% for aflatoxin B1 and aflatoxin total, respectively. There was a 58.60% reduction in aflatoxin B1 and a 74.97% reduction in aflatoxin total concentrations in nuts following the irradiation method. The findings indicated that the evaluated processes could be influential for reducing aflatoxin levels in nuts.
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Aflatoxinas , Aflatoxina B1/análise , Aflatoxinas/análise , Arachis , Contaminação de Alimentos/análise , Contaminação de Alimentos/prevenção & controle , Fumigação , Humanos , Nozes/químicaRESUMO
INTRODUCTION: ESBL producing Escherichia coli (E. coli) have spread in the hospital settings. The aims of this study determination of genetic relationship between Environmental E. coli with PFGE typing and investigation of IS element in blaCTX-M gene of these isolates. MATERIALS AND METHODS: A total of 50 E. coli isolates were collected from hospital environmental. The blaCTX-M producing E. coli and IS element of this gene with phylogenetic typing were detected by PCR. The PFGE was performed to detect genetic relationships between this strains. RESULTS: Most of the isolates were from urology wards, other samples were isolated from ICU, surgery and orthopedic ward. The majority of isolates were resistant to cefotaxime and ceftazidime antibiotics and also phosphomycin antibiotic resistant were detected in 10% of isolates. CTX-M gene was detected in 72% of isolates. Moreover, ISEcp1, IS26a, and IS26b were detected upstream of CTX-M in 24%, 8% and 16 of isolates. A phylogroup was the most frequent and PFGE analysis exhibited a diverse distribution of E. coli isolates. CONCLUSIONS: The results demonstrated the existence of CTX-M-producing E. coli in a hospital environment which is a source for drug-resistant strains. In the most of strains, ISEcp1 was located in the upstream of CTX-M gene and Orf477 was found in the downstream. However, in some strains, IS26 was inserted within the ISEcp1element. Our results show that despite the fact that antibiotics of phosphomycin are not used in this hospital, resistance to phosphomycin was observed in the environmental E. coli.
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Infecções por Escherichia coli , Escherichia coli , Antibacterianos/farmacologia , Elementos de DNA Transponíveis , Escherichia coli/genética , Humanos , Filogenia , Plasmídeos , beta-Lactamases/genéticaRESUMO
We aimed to investigate the association of dietary fiber consumption with mortality risk in women with breast cancer. A systematic search was undertaken in PubMed, Scopus, and ISI Web of Science till March 2020 to find cohort studies investigating the association of dietary fiber consumption with mortality risk in women with breast cancer. A random-effects model was used to combine study-specific results. The quality of evidence was rated by NutriGrade score. Seven prospective cohort studies with 1,426 cases of all-cause mortality and 679 cases of breast cancer-specific mortality among 11,295 patients with breast cancer were included. The relative risks for the highest compared to the lowest category of dietary fiber consumption were 0.63 (95%CI: 0.52, 0.77; I2 = 0%, n = 5) for all-cause mortality, and 0.72 (95%CI: 0.54, 0.96; I2 = 0%, n = 5) for breast cancer-specific mortality. There was a strong linear association between fiber intake and all-cause mortality risk. The quality of evidence was rated moderate for all-cause mortality, and low for breast cancer-specific mortality. Higher dietary fiber consumption may improve survival in patients with breast cancer. More research is needed to confirm the present results, considering types of fiber consumed and tumor estrogen receptor status.
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Neoplasias da Mama , Estudos de Coortes , Fibras na Dieta , Feminino , Humanos , Estudos Prospectivos , Risco , Fatores de RiscoRESUMO
Evaporation is an important meteorological variable that has a great impact on water resources. In the current research, climatology data, and seasonal coefficient have been used to estimate monthly pan evaporation (Epan) for 2005-2018 study years at four selected stations of the Urmia Lake basin with Dsa and six selected stations of Gavkhouni basin with Bsk climate categories, in Iran. Estimation of monthly Epan was performed using data-driven methods such as artificial neural networks (ANNs), adaptive neuro-fuzzy inference system (ANFIS), and gene expression programming (GEP) as well as wavelet-hybrids (WANN, WANFIS, and WGEP). Based on the evaluation criteria, the WGEP model performance was better than the other models in estimating the monthly Epan. The results indicated that WGEP and ANN are the best and poorest models for all stations without affecting the climate condition of basins. The values of RMSE for WGEP model for stations of Urmia Lake and Gavkhouni basins were varied from 15.839 to 26.727 and 20.651 to 70.318, respectively. Also, the values of RMSE for ANN model for stations of Urmia Lake and Gavkhouni basins were varied from 29.397 to 38.452 and 30.635 to 85.237, respectively. The model's performance was improved as a result of considering the data noise elimination and applying seasonal coefficient to estimate Epan of various climatic conditions. This study with presenting mathematical equations for estimating monthly Epan has a significant impact on the management and planning of water resources policymakers in the future.
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Monitoramento Ambiental , Lagos , Irã (Geográfico) , Redes Neurais de ComputaçãoRESUMO
BACKGROUND: Current recommendations for weight loss in individuals with prediabetes come from individual trials and are derived from older data. OBJECTIVE: To elucidate the dose-dependent impacts of weight loss on participants with prediabetes to determine the optimal magnitude of weight loss required for the implementation of the most effective diabetes prevention program. METHODS: We searched PubMed, Scopus, CENTRAL, CINAHL, and grey literature sources to September 2023 for randomized trials ≥6 months that evaluated the efficacy of a lifestyle weight loss intervention on participants with prediabetes. We conducted random-effects pairwise meta-analyses to calculate relative and absolute effects. We performed one-stage weighted mixed-effects meta-analysis to elucidate the dose-response curves. RESULTS: 44 randomized trials with 14,742 participants with prediabetes (intervention duration range: 6 to 72 months [median=24 months], average weight loss range: 1% to 9%) were included. Lifestyle weight loss interventions increased regression to normoglycemia by 11 per 100 participants (95%CI: 8 more, 17 more; risk ratio: 1.51, 95%CI: 1.27, 1.80; n=20 trials, GRADE=moderate), and reduced progression to type 2 diabetes by 8 per 100 participants (95%CI: 11 fewer, 6 fewer; risk ratio: 0.59, 95%CI: 0.51, 0.67; n=37, GRADE=moderate). There were no significant or credible differences among subgroups categorized by the type and duration of intervention. Dose-response meta-analyses indicated that the risk of regression to normoglycemia increased and the risk of progression to type 2 diabetes declined in a linear pattern within the range of weight loss from 1% to 9%. CONCLUSIONS: Over a median duration of 24 months, with weight loss ranging from 1% to 9%, the relationship between weight loss and the progression to type 2 diabetes, as well as the regression to normoglycemia, follows a linear pattern. Any form of lifestyle weight loss interventions including diet, exercise, or a combination of both, can have beneficial impacts on participants with prediabetes. PROTOCOL REGISTRATION: PROSPERO (CRD42023465322).
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Whole-body vibration (WBV), a training method based on the stimulation of muscle contraction by mechanical vibration generated in a vibrating platform, is claimed to be effective in diabetes management. This meta-analysis evaluated WBV effects against other exercises, placebo, or no intervention in type-2 diabetes. Medline, Scopus, and Web of Science databases were systematically searched through June 2023. Randomized controlled trials reported the effect of WBV on glucose (hemoglobin A1C and fasting blood glucose), and lipid profiles (total cholesterol, triglycerides, high, and low-density lipoprotein) were included. Two researchers independently extracted the characteristics of the studies, participants, WBV intervention and comparisons, and the outcomes from the included articles. The Physiotherapy Evidence Database (PEDro) scale assessed trial quality. In this review, all articles had no high risk of bias according to the PEDro scale, with studies achieving optimal, excellent, and good scores. Network meta-analysis revealed that WBV was effective for reducing hemoglobin A1C when compared with conventional (mean difference: - 1.58%, 95%CrI: - 2.51, - 0.47) and resistance exercise (mean difference: - 1.32%, 95%CrI: - 1.96, - 0.33). WBV had also a desirable but insignificant effect on hemoglobin A1C compared to stretching and balance exercises, placebo, and no intervention. The current pairwise meta-analysis did not show that WBV favors fasting blood glucose and lipids. WBV may have potential advantages for glycemic control in type-2 diabetes. However, uncertainties in the findings remain due to the limited number of studies and their heterogeneity.
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Glicemia , Diabetes Mellitus Tipo 2 , Lipídeos , Metanálise em Rede , Ensaios Clínicos Controlados Aleatórios como Assunto , Vibração , Humanos , Diabetes Mellitus Tipo 2/terapia , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/metabolismo , Vibração/uso terapêutico , Glicemia/metabolismo , Lipídeos/sangue , Hemoglobinas Glicadas/metabolismo , Hemoglobinas Glicadas/análiseRESUMO
To investigate the association of red and processed meat intake with the risk of gestational diabetes (GDM) in Iranian mothers. A total of 635 pregnant mothers were included. Dietary intake was assessed by a 90-item food frequency questionnaire during the first trimester of pregnancy. Intakes of total red meat, unprocessed red meat, and processed meat were calculated and then, Cox proportional hazard model was used to calculate the hazard ratios (HR) and 95%CIs of GDM across tertiles of red meat intake while controlling for age, occupation, pre-pregnancy body mass index, physical activities, history of cardiovascular disease, hypertension, hypothyroidism, hyperthyroidism, and pregnancy hypertension, order of pregnancy, nausea during current pregnancy, multivitamin use during current pregnancy, weight gain during current pregnancy and total energy intake. The average age of the mothers was 28.80 ± 5.09 years, the average pre-pregnancy body mass index was 25.13 ± 4.43 kg/m2, and the average weight gain during pregnancy was 13.50 ± 5.03 kg. The multivariable-adjusted HRs of GDM for the third tertiles of red and processed meat, red meat, and processed meat intake were, respectively, 1.92 (95% CI 1.06, 3.49), 1.52 (95% CI 0.85, 2.72) and 1.31 (95% CI 0.73, 2.34) when compared to the first tertiles. Our prospective cohort study suggested that there was a positive association between the consumption of red and processed meat and with risk of GDM in a small sample of Iranian mothers with low red meat intake. More large-scale cohort studies in the Iranian population are needed to present more robust evidence in this regard.
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Diabetes Gestacional , Hipertensão , Feminino , Gravidez , Humanos , Adulto Jovem , Adulto , Diabetes Gestacional/epidemiologia , Diabetes Gestacional/etiologia , Estudos Prospectivos , Estudos de Coortes , Irã (Geográfico)/epidemiologia , Carne , Aumento de PesoRESUMO
Application of anodal trans-cranial direct current stimulation (a-tDCS) versus cathodal tDCS (c-tDCS) can influence the physiological results of tDCS intervention on postural control and balance in patients or healthy adults. According to the evidence, some studies demonstrated that postural control or balance is facilitated by the application of the a-tDCS more than the c-tDCS. On the other hand, some studies indicated that there were no significant differences between a-tDCS and c-tDCS. In contrast, other studies have shown a more significant effect of c-tDCS than a-tDCS on postural control and balance. This study aimed to systematically review the studies which investigated the effectiveness of a-tDCS and c-tDCS intervention on postural control and balance. The search was performed from databases in Google Scholar, PubMed, Elsevier, Medline, Ovid, and Science Direct with the keywords of balance, balance test, postural control, postural stability, postural sway, posture, postural balance, trans-cranial direct current stimulation, tDCS, neuromodulator, neurostimulation, tDCS, a-tDCS or anodal tDCS, c-tDCS or cathodal tDCS from 2000 to 2022. The results confirmed that the study population was a key factor in determining the study's findings. Data meta-analysis showed no significant differences between active tDCS and sham tDCS on postural control in healthy individuals (P > 0.05). In addition, the results indicated the efficacy of both a-tDCS over the affected motor cortex (M1) and c-tDCS over unaffected M1 as compared to sham tDCS on postural improvement in patients with stroke (P < 0.05), however, there were no differences between the two techniques on posture and balance in these patients.
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Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Estimulação Transcraniana por Corrente Contínua , Adulto , Humanos , Postura , Reabilitação do Acidente Vascular Cerebral/métodos , Estimulação Transcraniana por Corrente Contínua/métodosRESUMO
BACKGROUND/OBJECTIVES: Plant-based dietary patterns are becoming more popular worldwide. We aimed to examine the relationship between plant-based dietary patterns and the risk of inadequate or excessive gestational weight gain (GWG) in Iranian pregnant women. METHODS: We prospectively followed 657 pregnant women in Iran. Adherence to the plant-based diet, represented by plant-based (PDI), healthy (hPDI) and unhealthy plant-based (uPDI) dietary indexes was evaluated by applying a 90-item food frequency questionnaire during the first trimester of pregnancy. Multivariable-adjusted Cox proportional-hazards regression model was used to compute hazard ratios (HRs) and 95% confidence intervals (CIs) across quartiles of plant-based diet scores. RESULTS: Over 25,562 person-weeks of follow-up, we documented 106 and 294 participants with inadequate and excessive GWG, respectively. We found a strong inverse association between adherence to the PDI and inadequate GWG after adjustment for demographic and confounding variables. Women in the highest quartile of the PDI had 50% lower risk of inadequate GWG than those in the lowest quartile (adjusted HR: 0.50; 95%CI 0.29, 0.89; P = 0.02). No significant association was found between hPDI and uPDI and inadequate GWG. There was no association between PDI, hPDI, and uPDI and the risk of excessive GWG. CONCLUSIONS: Greater adherence to a plant-based diet during the first trimester of pregnancy may be associated with a lower risk of inadequate GWG. This finding needs to be confirmed in larger cohort studies, considering other pregnancy outcomes such as birth weight and the potential changes across the trimester in terms of food types and quantity.
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Ganho de Peso na Gestação , Gravidez , Feminino , Humanos , Primeiro Trimestre da Gravidez , Estudos Prospectivos , Coorte de Nascimento , Irã (Geográfico) , Dieta , Aumento de Peso , Resultado da GravidezRESUMO
BACKGROUND: Previous meta-analyses indicated that aerobic exercise can improve glycemic control. However, the optimum dose of exercise is still being discussed. OBJECTIVE: The aim of this study was to examine the dose-dependent effect of supervised aerobic training (SAT) on glycated hemoglobin (HbA1c). METHODS: We searched PubMed, Scopus, and Web of Science to May 2021 for randomized trials with an intervention period of 12 weeks or longer evaluating the effect of SAT on HbA1c in adults with type 2 diabetes mellitus. Secondary outcomes included quality of life, change in hypoglycemic medications, and adverse events. A random-effects dose-response meta-analysis was conducted. RESULTS: The analysis of 26 trials with 1253 participants indicated that each 30-min/week SAT reduced HbA1c by - 0.22 percentage point (95% CI - 0.29 to - 0.15; GRADE = strong). Levels of HbA1c decreased proportionally with the increase in the duration of moderate to vigorous-intensity SAT to 100 min/week (mean difference100 min/week: - 0.96 percentage point, 95% CI - 1.25 to - 0.67), with flattening of the curve at higher duration. Aerobic exercise decreased antidiabetic medications by 13 per 100 patients (risk difference 0.13, 95% CI 0.02-0.23; 7 trials, n = 375; GRADE = moderate), and increased hypoglycemic reactions by 10 per 100 patients (risk difference: 0.10, 95% CI 0.03-0.17; 4 trials, n = 263; GRADE = low) and adverse events by 4 per 100 patients (risk difference: 0.04, 95% CI - 0.02 to 0.11; 2 trials, n = 236; GRADE = low). Limited evidence is available for quality of life. CONCLUSIONS: Every 30 min/week of moderate to vigorous aerobic exercise can exert a significant effect on HbA1c, with the highest effect observed from 100 min/week and above. However, exercise durations above 100 min/week seem ineffective for further reductions. PROTOCOL REGISTRATION: PROSPERO (CRD42021257251).
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Diabetes Mellitus Tipo 2 , Adulto , Diabetes Mellitus Tipo 2/terapia , Exercício Físico , Hemoglobinas Glicadas , Humanos , Hipoglicemiantes , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
Autism Spectrum Disorder (ASD) is a severe neurological/neurodegenerative syndrome that results in cognitive and communication disorders. The degree of dysbiosis is related to the severity of ASD signs. The gut is conferred with a variety of sensory receptors that cooperate with effector systems including the endocrine, nervous and gut immune systems of the intestine. Gut dysbiosis causes amplified inflammation, the launch of the HPA axis, changed levels of neurotransmitters and bacterial metabolites; these may donate to abnormal signaling throughout the Vagus nerve in ASD. Decreased integrity of the gastrointestinal barrier led to extreme leakage of substances as of the intestine in early life and inflammation followed by disruption of BBB integrity maybe increase the risk of ASD. Microbiota, by controlling the barrier permeability, regulate the quantity and types of bioactive materials that are transferred from the intestine to the brain. Exposure to metabolites and microbial products regulate significant procedures in the CNS, including glial cell role, myelination, synaptic pruning, and play a role in neurobehavioral, neurodegenerative, psychiatric, and metabolic syndrome.
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Transtorno do Espectro Autista , Transtorno Autístico , Microbioma Gastrointestinal , Microbiota , Doenças Neurodegenerativas , Transtorno do Espectro Autista/metabolismo , Transtorno Autístico/metabolismo , Encéfalo/metabolismo , Epigênese Genética , Microbioma Gastrointestinal/fisiologia , Humanos , Sistema Hipotálamo-Hipofisário/metabolismo , Doenças Neurodegenerativas/metabolismo , Sistema Hipófise-Suprarrenal/metabolismoRESUMO
Atmospheric ozone is produced when nitrogen oxides react with volatile organic compounds. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genome contains a unique N-terminal fragment in the Spike protein, which allows it to bind to air pollutants in the environment. 'Our approach in this review is to study ozone and its effect on the SARS-CoV-2 virus and patients with coronavirus disease 2019 (COVID-19). Article data were collected from PubMed, Scopus, and Google Scholar databases. Ozone therapy has antiviral properties, improves blood flow, facilitates the transfer of oxygen in hypoxemic tissues, and reduces blood coagulation phenomena in COVID-19 patients. Ozone has immunomodulatory effects by modulating cytokines (reduction of interleukin-1, interleukin-6, tumor necrosis factor-α, and interleukin-10), induction of interferon-γ, anti-inflammatory properties by modulating NOD-, LRR- and pyrin domain-containing protein 3, inhibition of cytokine storm (blocking nuclear factor-κB and stimulating nuclear factor erythroid 2-related factor 2 pathway), stimulates cellular/humoral immunity/phagocytic function and blocks angiotensin-converting enzyme 2. In direct oxygen-ozone injection, oxygen reacts with several biological molecules such as thiol groups in albumin to form ozonoids. Intravenous injection of ozonated saline significantly increases the length of time a person can remain hypoxic. The rectal ozone protocol is rectal ozone insufflation, resulting in clinical improvement in oxygen saturation and biochemical improvement (fibrinogen, D-dimer, urea, ferritin, LDH, interleukin-6, and C-reactive protein). In general, many studies have shown the positive effect of ozone therapy as a complementary therapy in the recovery of COVID-19 patients. All the findings indicate that systemic ozone therapy is nontoxic and has no side effects in these patients.
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COVID-19 , Ozônio , Síndrome da Liberação de Citocina , Humanos , Oxigênio , Ozônio/uso terapêutico , SARS-CoV-2RESUMO
OBJECTIVE: To present a comprehensive review of the association between measures of body weight, waist, and fat, and different ratios of these measures, and the risk of type 2 diabetes. DESIGN: Systematic review and dose-response meta-analysis of cohort studies. DATA SOURCES: PubMed, Scopus, and Web of Science up to 1 May 2021. REVIEW METHODS: Cohort studies looking at the association between general or central adiposity and body fat content and the risk of type 2 diabetes in the general adult population were included. Two of the authors extracted the data in duplicate. Random effects dose-response meta-analyses were performed to estimate the degree of the associations. Curvilinear associations were modelled with a one stage weighted mixed effects meta-analysis. RESULTS: 216 cohort studies with 2.3 million individuals with type 2 diabetes among 26 million participants were identified. Relative risks were 1.72 (95% confidence interval 1.65 to 1.81; n=182 studies) for an increase in body mass index of 5 units, 1.61 (1.52 to 1.70; n=78) for a 10 cm larger waist circumference, 1.63 (1.50 to 1.78; n=34) for an increase in waist-to-hip ratio of 0.1 units, 1.73 (1.51 to 1.98; n=25) for an increase in waist-to-height ratio of 0.1 units, 1.42 (1.27 to 1.58; n=9) for an increase in visceral adiposity index of 1 unit, 2.05 (1.41 to 2.98; n=6) for a 10% higher percentage body fat, 1.09 (1.05 to 1.13, n=5) for an increase in body shape index of 0.005 units, 2.55 (1.59 to 4.10, n=4) for a 10% higher body adiposity index, and 1.11 (0.98 to 1.27; n=14) for a 10 cm larger hip circumference. A strong positive linear association was found between body mass index and the risk of type 2 diabetes. Positive linear or monotonic associations were also found in all regions and ethnicities, without marked deviation from linearity at a specific cut-off value. Indices of central fatness, independent of overall adiposity, also had positive linear or monotonic associations with the risk of type 2 diabetes. Positive linear or monotonic associations were also found for total and visceral fat mass, although the number of studies was small. CONCLUSIONS: A higher body mass index was associated with a greater risk of developing type 2 diabetes. A larger waist circumference, independent of overall adiposity, was strongly and linearly associated with the risk of type 2 diabetes. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42021255338.
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Adiposidade , Índice de Massa Corporal , Diabetes Mellitus Tipo 2/etiologia , Obesidade/fisiopatologia , Circunferência da Cintura , Tecido Adiposo , Adulto , Idoso , Antropometria , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Razão Cintura-Estatura , Relação Cintura-Quadril , Adulto JovemRESUMO
We aimed to examine the association of weight gain during adulthood with the risk of cardiovascular disease (CVD) in the general population. We performed a systematic search of PubMed and Scopus, from inception to June 2019. Prospective cohort studies investigating the association of weight gain during adulthood with the risk of CVD were included. The relative risks (RRs) were calculated by using random-effect models. Twenty-three prospective cohort studies with 1,093,337 participants were included. The RRs for a 5-kg increment in body weight were 1.11 (95% CI: 1.04, 1.19; I2 = 80%, n = 11) for CVD mortality, 1.18 (95% CI: 1.04, 1.32; I2 = 90%, n = 8) for coronary heart disease (CHD), 1.08 (95% CI: 1.04, 1.12; I2 = 0%, n = 3) for stroke, 1.18 (95% CI: 1.12, 1.25; I2 = 0%, n = 2) for myocardial infarction and 1.05 (95% CI: 0.86, 1.23; I2 = 80%, n = 2) for heart failure. A dose-response analysis demonstrated that the risk of CVD mortality was unchanged with weight gain of 0-5 kg, and then increased sharply and linearly (P for nonlinearity < 0.001). The analysis of CHD indicated a sharp increase in risk from baseline up to weight gain equal to 25 kg (P for nonlinearity = 0.12). Adult weight gain may be associated with a higher risk of CVD. Measuring weight gain during adulthood may be better than static, cross-sectional assessment of weight because it considers trend over time, and thus, can be used as a supplementary approach to predict CVD.
Assuntos
Doenças Cardiovasculares , Adulto , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Estudos Transversais , Humanos , Estudos Prospectivos , Fatores de Risco , Aumento de PesoRESUMO
OBJECTIVES: Carbon nanotubes (CNTs) are allotropes of carbon with a length-to-diameter ratio greater than 106 with the potential uses as medical diagnostic or therapeutic agents. In vitro studies have revealed that gadolinium (Gd) nanoparticle-catalyzed single-walled carbon nanotubes (SWCNTs) possess superparamagnetic properties, which enable them to be used as contrast agents in magnetic resonance imaging (MRI). Our study synthesized Gd-CNT for use as MRI contrast agents. METHODS: To reduce the toxicity and solubility of CNTs, it was functionalized, and after loading with Gd was coated with polyethylene glycols (PEG). We then synthesized different concentrations of Gdn 3+@CNTs-PEG and Gadovist® to be evaluated as MRI contrast agents. RESULTS: The analysis showed that the Gd concentration in Gadovist® was 12.18% higher than synthesized Gdn 3+@CNTs-PEG, but the mean signal intensity of the Gdn 3+@CNTs-PEG was approximately 3.3% times higher than Gadovist®. CONCLUSIONS: Our findings indicate that synthesized Gdn 3+@CNTs-PEG has the potential to be used as an MRI contrast agent in vitro, but in vivo assessment is necessary to determine the bio-distribution, kinetic, and signal enhancement characteristics.