Effect of Taste Additives on the Palatability of Activated Charcoal: a Systematic Review.

INTRODUCTION: Activated charcoal is a decontaminating agent used for acute intoxication. It can be mixed with taste additives to overcome its poor palatability. Our purpose was to evaluate the taste additives used to improve activated charcoal's palatability. METHODS: We conducted a systematic review of comparative studies on taste additives used to improve activated charcoal's palatability. We searched PubMed, Embase, Web of Science, Cochrane, and CINAHL. We included controlled trials and observational studies that evaluate the effect of at least one taste additive, compared with activated charcoal alone. Our primary outcome was palatability. Our secondary outcomes included treatment adherence, adsorption efficacy, and adverse events. The risk of bias was assessed using the Quality Assessment Tool for Quantitative Studies. RESULTS: Among 38 eligible articles, seven observational studies and three crossover clinical trials met our inclusion criteria. The risk of bias was found to be high for seven studies and intermediate for three others. The preferred flavoring agents were cola and chocolate milk for children, and sweetening agents for adults. All taste additives studied seemed to improve activated charcoal's palatability, except for yogurt (n = 1). The addition of bentonite, sorbitol, carboxymethylcellulose, or yogurt showed no impact on the in-vivo adsorption capacity of activated charcoal, whereas the results were inconclusive for chocolate. No meta-analysis was performed due to insufficient data. CONCLUSION: Strategies to improve activated charcoal's palatability seem to enhance the taste. Descriptive data are in favor of a limited impact on activated charcoal's adsorption capacity when adding binding agents or sweeteners. TRIAL REGISTRATION ON PROSPERO: This review is registered as PROSPERO CRD42019135092.

Dairy Food Consumption and Mammographic Breast Density: The Role of Fat.

AIM: This cross-sectional study aimed to evaluate the associations between low and high-fat dairy food (DF) intake and breast density (BD). MATERIALS AND METHODS: A total of 775 premenopausal and 771 postmenopausal women recruited during screening mammography completed a food frequency questionnaire. Adjusted linear regression models were used to assess the associations. RESULTS: As frequency quartiles of high-fat DF consumption increased, the adjusted mean of absolute BD increased from 31.5 to 36.1 cm2 for all women (ptrend=0.0034) and from 42.4 to 50.1 cm2 for premenopausal women (ptrend=0.0047). Conversely, as frequency quartiles of low-fat DF consumption increased, the adjusted mean of absolute BD decreased from 34.7 to 29.6 cm2 for all women (ptrend=0.001) and from 49.7 to 40.7 cm2 for premenopausal women (ptrend=0.0012). CONCLUSION: A higher intake of high-fat and low-fat DF is respectively associated with higher and lower BD, particularly in premenopausal women.