Nutrition reviews最新文献

{"title":"Nutrition Outcomes and Interventions in Older People in Africa: A Systematic Umbrella and Scoping Review.","authors":"Anthony Muchai Manyara, Tadios Manyanga, Shane Naidoo, Kate Mattick, Rudo Chingono, Grace M E Pearson, Opeyemi Babatunde, Niri Naidoo, Kate A Ward, Celia L Gregson","doi":"10.1093/nutrit/nuaf109","DOIUrl":"https://doi.org/10.1093/nutrit/nuaf109","url":null,"abstract":"<p><p>Africa's older population is rapidly increasing, necessitating the development of healthy aging interventions. Nutrition is a key component of healthy aging. Evidence synthesis on nutrition outcomes of older adults in Africa is emerging but a synthesis on interventions is lacking. The aim was to synthesize evidence from reviews on older people in Africa to determine the prevalence of nutrition outcomes and associated factors (phase 1) and implemented interventions (phase 2). Literature searches using Medline, EMBASE, Web of Science, African Index Medicus, and African Journals Online were conducted up to May 9, 2024. After screening, 25 reviews (for phase 1) and 22 articles (for phase 2) were selected for inclusion. Most reviews (n = 16; 64%) were systematic, with 8 having a meta-analysis, and published between 2020 and 2023 (n = 20; 80%). The pooled prevalence of malnutrition (being underweight) was 21% (evidence from 5 reviews), 26% for sarcopenia (1 review), 27% for obesity (3 reviews), 32% for constipation (1 review), 39% for food insecurity (2 reviews), 49% for dental caries (1 review), and 64% for vitamin D insufficiency and deficiency (2 reviews). The 22 articles on nutritional interventions represented only 6 countries, mostly South Africa (64%; 14/22), evaluated using randomized trials (n = 10; 45%) and educational interventions (n = 10; 45%). Reported interventions were not typically underpinned by supporting systematic reviews or a contextual evidence base, did not account for the minimally important clinical difference, lacked evidence of community engagement, and were not reported transparently. Nutritional research is needed on older adults outside of South Africa and beyond malnutrition. Future nutritional interventions (ideally, multicomponent) for older people in Africa should consider targeting the multiple nutritional and practical needs (eg, dietary counseling, supplementation) of older adults. Intervention development should be evidence-based, include engagement with older people, and follow complete and transparent reporting.</p>","PeriodicalId":19469,"journal":{"name":"Nutrition reviews","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aspartame and Its Potential Neurocognitive Effects in Humans.","authors":"Maiah N Fogel, Alena Khalil, Sheikh F Khaled, Elizette M Rodriguez, Keaton M Payne, Jesse R Blount, Madison Petschke, Roshan Ara Nizamuddin, Faige Jeidel, Vivienne Riven, Stephanie Petrosky","doi":"10.1093/nutrit/nuaf103","DOIUrl":"https://doi.org/10.1093/nutrit/nuaf103","url":null,"abstract":"<p><p>The safety of aspartame, a widely consumed low-calorie artificial sweetener, for human consumption has recently been heavily debated. Published research has demonstrated that aspartame's breakdown products-aspartic acid, phenylalanine, and methanol-are associated with potential neurotoxicity and possible carcinogenic and metabolic effects in animal models. For this scoping review, existing literature on neurocognitive effects of aspartame was gathered and analyzed. A search of 3 literature databases (Embase, Ovid MEDLINE, and Web of Science) yielded 170 peer-reviewed, full-text articles. After consideration of exclusion criteria, 29 articles were selected for inclusion. After reviewing the findings, indications of aspartame's potential neurotoxic effects were demonstrated: multiple experimental studies revealed histopathological changes, such as elevated oxidative stress markers and neuronal loss, in various brain regions of animal models after exposure to aspartame. Additional studies showed memory and learning impairments in animal models, as well as behavioral dysfunction and mood disorders indicative of depression and anxiety in both animal and human models, illustrated by processes such as the downregulation of gamma aminobutyric acid signaling and upregulation of glutamate signaling in the amygdala. Notably, many of these studies investigated aspartame's impact not only at or above the Food and Drug Administration (FDA)-approved level, but below it as well. Two studies also indicated that populations with preexisting neurocognitive deficits, such as individuals with parkinsonism or preexisting metabolic conditions such as diabetes may have an increased vulnerability to neurocognitive harm when consuming aspartame. Interestingly, several agents were found to ameliorate aspartame's neurocognitive impacts, such as Pimpinella anisum oil and vitamin E. These negative neurocognitive effects and their potential mitigators demonstrate the necessity for further research into aspartame's possible impacts on health and safety at current FDA-approved levels, with additional consideration of certain populations at higher risk for neurocognitive injury.</p>","PeriodicalId":19469,"journal":{"name":"Nutrition reviews","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Children's Diets by Introducing Fruits and Vegetables in Group-Based Settings: A Scoping Review.","authors":"Abigail Pickard, Emma Alving-Jessep, Christopher Delivett, Rosemary H Jenkins, Luke Pullar, Claire Farrow, Jacqueline Blissett","doi":"10.1093/nutrit/nuaf092","DOIUrl":"https://doi.org/10.1093/nutrit/nuaf092","url":null,"abstract":"<p><strong>Context: </strong>In 2022, less than 18% of UK children aged 5-7 years consumed 5 portions of fruit and vegetables, with an average intake of 3 portions per day. Group settings (eg, schools or nurseries) present an opportunity to apply policies to encourage children's consumption of novel and healthy foods.</p><p><strong>Objective: </strong>The extent and types of evidence regarding efforts to increase the consumption of fruits and vegetables by young children in group settings who reside in high-income countries was investigated in this scoping review.</p><p><strong>Data sources: </strong>A systematic scoping review was conducted that followed the JBI guidelines and included articles, published from 2012 onward, about methods to increase consumption of novel and/or healthy foods by children aged 3-7 years in settings within local government control and who were residing in high-income countries.</p><p><strong>Data extraction: </strong>A total of 7000 articles were initially identified, of which 114 were included in this review after screening.</p><p><strong>Data analysis: </strong>Intervention methods included an array of different techniques from educational programs to repeated exposure, food modification, and behavioral modeling approaches.</p><p><strong>Conclusion: </strong>Interventions administered to children aged between 3 and 7 years in group-based settings have been shown to improve the consumption of healthy foods, specifically fruits and vegetables. Behavioral modeling and sensory play interventions, in particular, present the highest level of success.</p>","PeriodicalId":19469,"journal":{"name":"Nutrition reviews","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Omega-3 Polyunsaturated Fatty Acids and Adipose Tissue Inflammation in Humans: A Scoping Review.","authors":"Ji-Eun Chon, Kira Zhi Hua Lai, Zhila Semnani-Azad, Adam H Metherel, David J A Jenkins, Richard P Bazinet, Anthony J Hanley","doi":"10.1093/nutrit/nuaf089","DOIUrl":"https://doi.org/10.1093/nutrit/nuaf089","url":null,"abstract":"<p><p>Adipose tissue (AT) inflammation is a topic of increasing interest given its role in initiating systemic subclinical inflammation. Evidence from preclinical studies suggests that n-3 polyunsaturated fatty acids (PUFAs) may ameliorate AT inflammation through various pathways. However, fewer data are available from humans, and existing studies are heterogeneous in design and findings. The objective of this scoping review was to identify, review, and map the current literature on the relationship between n-3 PUFAs and AT inflammation in healthy humans. MEDLINE, EMBASE, and Cochrane databases were searched from inception to August 4, 2022. Eligible studies included experimental trials and observational studies, enrolling nonpregnant adult study populations free of diagnosed chronic/infectious diseases. Screening and data extraction were performed on study characteristics. Overall, the 25 retained studies were heterogeneous in study design, intervention formulation/exposure assessment, comparator, study duration, and methods used to characterize AT inflammation. Most experimental trials used EPA+DHA [eicosapentaenoic acid (EPA, 20:5n-3) and docosapentaenoic acid (DPA, 22:5n-3)] supplementation and measured circulating adiponectin and leptin to characterize AT inflammation. A wide range of comparators were employed, including saturated/unsaturated oils, ketogenic diets, and n-6 PUFAs. All observational studies reported a significant association with ≥1 of their primary outcomes, while 15 of 20 experimental trials documented a significant effect of n-3 supplementation on ≥1 outcomes. Existing human literature on n-3 PUFAs and AT inflammation is inconclusive due to the limited number of studies available and their heterogeneous designs. Therefore, larger, longer-term longitudinal studies and experimental trials using AT biopsy measures or validated AT-specific biomarkers are needed. Registration: Open Science Framework (https://doi.org/10.17605/OSF.IO/29WGQ).</p>","PeriodicalId":19469,"journal":{"name":"Nutrition reviews","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Vitamin D2 (Ergocalciferol) on Parathyroid Hormone, Calcium, and Phosphorus in Humans: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Junmei Lai, Xiaofan Yu, Kousalya Prabahar, Benjamin Hernández-Wolters, Hamed Kord-Varkaneh, Huang Jin, Yucui Xing","doi":"10.1093/nutrit/nuaf102","DOIUrl":"https://doi.org/10.1093/nutrit/nuaf102","url":null,"abstract":"<p><strong>Context: </strong>There is a clear link between ergocalciferol, parathyroid hormone (PTH), phosphorus, and calcium. Various randomized trials have examined the effectiveness of ergocalciferol on vitamins and minerals. However, conflicting results have been reported, and the optimal dose and duration of ergocalciferol remain unclear.</p><p><strong>Objective: </strong>This systematic review and meta-analysis of RCTs aim to evaluate the effect of vitamin D2 on PTH, calcium, and phosphorus in humans.</p><p><strong>Data sources: </strong>A comprehensive literature search was conducted with the assistance of a librarian. Independent reviewers performed searches across multiple databases, including Web of Science, Scopus, PubMed/Medline, and Embase, from their inception until September 20, 2024.</p><p><strong>Data extraction: </strong>The random-effects model, based on the DerSimonian and Laird method, was applied to compute pooled estimates of the intervention's impact on the outcomes.</p><p><strong>Data analyses: </strong>A total of 26 articles were included in the meta-analysis. The pooled analysis, using a random-effects model, demonstrated a significant reduction in serum PTH concentrations (WMD, -12.77 pg/mL, 95% CI, -20.03 to -5.51, P = .001, I2 = 96%, P < .001) and a significant increase in calcium levels (WMD, 0.15 mg/dL, 95% CI, 0.03 to 0.27, P = .011) following vitamin D2 intervention. However, a nonsignificant effect of vitamin D2 on phosphorus concentrations was observed (WMD, 0.166 mg/dL, 95% CI, -0.08 to 0.41, P = .197).</p><p><strong>Conclusion: </strong>Vitamin D2 supplementation appears to improve serum calcium levels while decreasing PTH levels. Given the low cost and wide availability of ergocalciferol, it can be recommended, especially for older adults, to help maintain bone strength.</p>","PeriodicalId":19469,"journal":{"name":"Nutrition reviews","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-Carbohydrate Dietary Interventions for Metabolic Control in Individuals With Type 2 Diabetes Mellitus: An Overview of Systematic Reviews.","authors":"Mileni Vanti Beretta, Cíntia Aparecida Oliveira Flores, Gabriella Fontes Colameo, Luana Weissheimer Echabe, Fernanda Michielin Busnello","doi":"10.1093/nutrit/nuae123","DOIUrl":"10.1093/nutrit/nuae123","url":null,"abstract":"<p><strong>Context: </strong>Dietary interventions providing different amounts of carbohydrates have been proposed as a means of achieving glycemic control and weight loss in type 2 diabetes mellitus (T2DM); however, the supporting evidence is heterogeneous, making this recommendation difficult to apply in nutritional clinical practice.</p><p><strong>Objective: </strong>The aim was to assess the quality of evidence from meta-analyses on low-carbohydrate (LC) dietary interventions for glycemic control, weight loss, and lipid profile in individuals with T2DM.</p><p><strong>Data sources: </strong>The MEDLINE, Web of Science, and Scopus databases were searched until September 2023.</p><p><strong>Data extraction: </strong>A systematic review was conducted. Systematic reviews with meta-analysis of randomized clinical trials designed to assess glycated hemoglobin (HbA1c) reductions in individuals with T2DM were eligible. The AMSTAR-2 critical appraisal tool was used to evaluate the methodological aspects of all included studies. The GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach was used to assess the certainty of the evidence.</p><p><strong>Data analysis: </strong>The LC interventions were associated with a reduction in HbA1c (%) of -0.42 (-1.45 to -0.09; high certainty of evidence) without considering follow-up time; at up to 3 months of follow-up of -0.28 (-0.13 to -0.43); at up to 6 months of follow-up of -0.40 (-0.61 to -0.09); at 6 to 12 months of follow-up of -0.32 (-0.49 to 0.11); and at >12 months of follow-up time of -0.31 (-0.14 to -0.65) compared with control diets.</p><p><strong>Conclusion: </strong>LC diets can help reduce HbA1c in individuals with T2DM in the short term (up to 3 months). However, dietary recommendations must always be individualized, as the studies reviewed herein analyzed different populations and used different definitions of what constitutes an LC diet.</p><p><strong>Systematic review registration: </strong>PROSPERO no. CRD42023404197.</p>","PeriodicalId":19469,"journal":{"name":"Nutrition reviews","volume":" ","pages":"e1677-e1692"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Vitamin C Supplements on Clinical Outcomes and Hospitalization Duration for Patients with Coronavirus Disease 2019 (COVID-19): A Systematic Review and Meta-Analysis.","authors":"Maorong Qin, Kun Xu, Zhuo Chen, Xiaojie Wen, Yifu Tang, Yangyu Gao, Hao Zhang, Xingming Ma","doi":"10.1093/nutrit/nuae154","DOIUrl":"10.1093/nutrit/nuae154","url":null,"abstract":"<p><strong>Context: </strong>Vitamin C has been used as an essential antioxidant to reduce the inflammatory response associated with pneumonia and acute respiratory distress syndrome in patients with the 2019 coronavirus disease (COVID-19), but its effect on clinical outcomes remains controversial and inconclusive.</p><p><strong>Objective: </strong>The purpose of this study was to conduct a meta-analysis and systematic review to assess the effects of vitamin C supplementation on the severity of COVID-19 in hospitalized patients.</p><p><strong>Data sources: </strong>Web of Science, Embase, Cochrane Library, PubMed, CNKI, CSTJ, Wan fang, and CBM databases were searched for publications between January 2020 and December 2023 that met the inclusion criteria.</p><p><strong>Data extraction: </strong>The meta-analyses of outcomes in more than one study were performed using Review Manager software. Heterogeneity was evaluated using the I2 statistic. A randomized controlled trial, cohort studies, and retrospective studies in which vitamin C supplementation was supplemented as monotherapy or in combination, compared with placebo, no treatment, or other standard treatment without vitamin C were included.</p><p><strong>Data analysis: </strong>After screening, 22 studies, with a total of 3429 patients, were selected for assessment. Odds ratios (ORs) with 95% CIs were calculated using fixed- and random-effects models. The meta-analysis showed significant effects of vitamin C on alleviating clinical outcomes in patients with COVID-19 (OR = 0.76, 95% CI = 0.65-0.89, P = .0007) but no shortening of the length of hospitalization (MD = 1.16, 95% CI = -0.13-2.44, P = .08) compared with the control group. Notably, vitamin C supplements significantly reduced the mortality risk (OR = 0.64, 95% CI = 0.51-0.80, P = .0001) and the incidence of severity (OR = 0.59, 95% CI = 0.43-0.80, P = .0006) in COVID-19 patients.</p><p><strong>Conclusion: </strong>The findings suggest that vitamin C supplements may have a beneficial effect on clinical outcomes, as well as reducing severity and mortality in COVID-19 patients, but more clinical randomized controlled trials are needed to evaluate the role of vitamin C in treating COVID-19.</p><p><strong>Systematic review registration: </strong>PROSPERO registration no. CRD42023491517.</p>","PeriodicalId":19469,"journal":{"name":"Nutrition reviews","volume":" ","pages":"e1406-e1420"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142624606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Micronutrients on HIV-Related Clinical Outcomes Among Adults Living With HIV on Antiretroviral Therapy: Systematic Review and Meta-analysis.","authors":"Elile Monisola Okoka, Moshood Abiodun Kuyebi, Oluwafemi Temitayo Oyadiran, Temitayo Rebecca Okusanya, Emmanuella Onaku, Moshood Olanrewaju Omotayo, Ajibola Ibraheem Abioye","doi":"10.1093/nutrit/nuae171","DOIUrl":"10.1093/nutrit/nuae171","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Context: &lt;/strong&gt;Micronutrient deficiencies are common and frequently co-occurring among people living with HIV (PLHIV) globally, with consequences for their health and clinical outcomes. Previous reviews of the influence of micronutrient supplementation on HIV outcomes were conducted in the pre-highly active antiretroviral therapy (pre-HAART) era or included both HAART-naive and HAART-experienced individuals; thus, the evidence in the context of HAART is inconclusive.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;A systematic review and meta-analysis was conducted to evaluate the effect of micronutrient supplementation on important clinical outcomes among PLHIV on HAART.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data sources: &lt;/strong&gt;Original research articles published up to August 2022 in the following medical literature databases were identified and examined: PubMed/Medline, Embase, Web of Science, and Google Scholar.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data extraction: &lt;/strong&gt;Randomized controlled trials (RCTs) and pre-post intervention studies that evaluated the relationship of micronutrient supplementation and HIV-related outcomes were included. A total of 32 studies investigating the effect of micronutrient supplementation on HIV outcomes in PLHIV on HAART were included. The main outcomes of interest were disease progression, CD4 lymphocyte count, viral load, weight, body mass index (BMI), hemoglobin, and anemia. The Cochrane Risk of Bias (RoB) 2 and ROBINS-I tools were used to assess the risk of bias in included studies, and GRADE was used to assess the certainty of the evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data analysis: &lt;/strong&gt;Vitamin D supplementation increased serum 25-hydroxyvitamin D concentration by 23.2 nmol/L (95% CI: 11.8 to 34.6; 6 RCTs, 567 participants; low-certainty evidence), but had little to no effect on CD4 lymphocyte counts (mean difference [MD]: 60 cells/µL; 95% CI: -35 to 155; 4 RCTs, 127 participants; low-certainty evidence). The effect of vitamin D on CD4 lymphocyte counts was greater among those with baseline CD4 count &lt;350 cells/µL compared with counterparts with higher CD4 lymphocyte counts. Evidence from single RCTs suggests a beneficial effect of vitamin D on the incidence of sputum-smear-positive tuberculosis (hazard ratio = 0.54; 95% CI: 0.31, 0.92; 4000 participants; low-certainty evidence), and vitamin E (MD = 0.2 g/dL; 95% CI: 0.1, 0.3; 18 participants; moderate-certainty evidence) and selenium (MD = 0.30 g/dL; 95% CI: 0.29, 0.31; 97 participants; high-certainty evidence) on hemoglobin, and selenium on BMI (MD: -0.5; 95% CI: -0.51, -0.49; high-certainty evidence). Zinc supplementation had little to no effect on CD4 lymphocyte count overall, but for every 10-µg/dL higher serum zinc concentration, the predicted change in CD4 lymphocyte count from meta-regression was lower by 28 cells/µL (95% CI: -54, -3; 5 RCTs). Moderate- or high-certainty evidence indicates that there is probably no effect of zinc supplementation on log10 viral load, vitamin D on BMI and lumbar s","PeriodicalId":19469,"journal":{"name":"Nutrition reviews","volume":" ","pages":"e1488-e1503"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of a Low-Protein Diet on Kidney Function in Patients With Chronic Kidney Disease: An Umbrella Review of Systematic Reviews and Meta-analyses of Randomized Controlled Trials.","authors":"Reza Amiri Khosroshahi, Marzieh Zare, Sheida Zeraattalab-Motlagh, Fatemeh Kiany, Sepide Talebi, Hamed Mohammadi","doi":"10.1093/nutrit/nuae178","DOIUrl":"10.1093/nutrit/nuae178","url":null,"abstract":"<p><strong>Context: </strong>Chronic kidney disease (CKD) stands out as one of the most widespread diseases globally. Dietary interventions, such as adopting a low-protein diet (LPD), play a crucial role as a key approach in impeding the advancement of CKD.</p><p><strong>Objective: </strong>The objective of this umbrella review was to provide understanding into the effects of an LPD on kidney function among individuals with CKD, along with evaluating the certainty of the available evidence.</p><p><strong>Data sources: </strong>Searches for relevant studies were conducted without limitations through databases such as PubMed, Scopus, Web of Science, and Google Scholar, encompassing findings up to June 2023.</p><p><strong>Data extraction: </strong>The effect sizes for each meta-analysis were recalibrated using a random-effects model. The certainty of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.</p><p><strong>Data analysis: </strong>Twenty-five meta-analyses including 47 randomized controlled trials were included in this study. Moderate certainty of the evidence suggests that LPDs may reduce glycated hemoglobin (HbA1c) and phosphorus levels, and the risk of progressing to end-stage renal disease in patients with CKD. Moreover, notable outcomes include increased glomerular filtration rate and decreased levels of serum albumin, blood urea nitrogen, and bicarbonate, although the certainty of evidence is low. In addition, LPDs can substantially decrease proteinuria, urine urea, and parathyroid hormone (PTH), although with very low certainty. The effects on serum creatinine, calcium, systolic blood pressure, and diastolic blood pressure are statistically nonsignificant, with the certainty of evidence ranging from low to moderate.</p><p><strong>Conclusion: </strong>LPDs demonstrated beneficial effects on renal function in patients with CKD, which is supported by moderate to very low certainty evidence.</p><p><strong>Systematic review registration: </strong>PROSPERO registration no. CRD42023473647.</p>","PeriodicalId":19469,"journal":{"name":"Nutrition reviews","volume":" ","pages":"e2127-e2138"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Effects of Iron and Multiple Micronutrient Supplementation on Hematological and Growth Indicators among Older Children, Adolescents, and Young Adults in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Ai Zhao, Xiaona Na, Fengqi Liu, Zekun Chen, Huanhuan Yang, Dongqing Wang, Christopher R Sudfeld, Zhihui Li, Wafaie W Fawzi","doi":"10.1093/nutrit/nuaf019","DOIUrl":"10.1093/nutrit/nuaf019","url":null,"abstract":"<p><strong>Context: </strong>Middle childhood, adolescence, and young adulthood are characterized by high nutritional demands and vulnerability to anemia. Limited efforts have been made to synthesize the evidence comparing the effects of iron and multiple micronutrient (MMN) supplementation in these populations.</p><p><strong>Objective: </strong>In this study we sought to examine the effects of iron and MMN on anemia and anthropometric variables among people aged 5 to 24 years in low- and middle-income countries.</p><p><strong>Data sources: </strong>The PubMed, Embase, Cochrane Library, and CINAHL databases were searched from inception to July 2024 to identify 50 randomized controlled trials (RCTs) of iron or MMN supplementation with outcomes.</p><p><strong>Data extraction: </strong>Only RCTs that used iron or MMN were included in this analysis.</p><p><strong>Data analysis: </strong>Compared to placebo, supplementation with iron and MMN was associated with 5.81 g/L (95% CI: 4.19-7.44 g/L) and 4.82 g/L (95% CI: 2.32-7.32 g/L) incremental increases in hemoglobin levels, respectively. The therapeutic effects of MMN (hemoglobin: 9.3 g/L, 95% CI: 1.52-17.09 g/L) and iron (10.24 g/L, 95% CI: 5.10-15.39 g/L) were both observed in populations of older children, adolescents, and young adults with anemia. Stratified analysis showed that with either MMN or iron supplementation, higher iron content (> 30 mg/d) could lead to a higher increment of hemoglobin, while a shorter intervention duration (< 3 months) showed more benefits in improving hemoglobin. For ferritin, the significant benefit of supplementation was observed only with iron and not with MMN. Iron was also found to decrease serum transferrin receptor and zinc protoporphyrin, but there was no effect on C-reactive protein. For growth indicators, iron was found to increase weight (0.52 kg, 95% CI: 0.12-0.93 kg), while MMN was found to increase height (0.87 cm, 95% CI: 0.16-1.59 cm).</p><p><strong>Conclusions: </strong>Overall, supplementation with iron compared with MMN had similarly beneficial effects on improving the hemoglobin level in older children, adolescents, and young adults, but there was some indication that there may be differential effects on growth indicators.</p>","PeriodicalId":19469,"journal":{"name":"Nutrition reviews","volume":" ","pages":"1227-1239"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}