The association of ultra-processed food consumption with adult inflammatory bowel disease risk: a systematic review and dose-response meta-analysis of 4 035 694 participants

CONTEXT

There is an inconsistency between the results obtained from observational studies regarding intake of ultra-processed foods (UPFs) and the risk of inflammatory bowel disease (IBD).

OBJECTIVES

A dose-response meta-analysis was performed to evaluate the relationship between UPF intake and the risk of IBD.

DATA SOURCES

Searches were performed in the PubMed, ISI Web of Science, and Scopus databases up to November 2, 2022.

DATA EXTRACTION

Data were available from 24 studies including a total of 4 035 694 participants from 20 countries.

DATA ANALYSIS

Risk ratios for IBD were analyzed by a random-effects model. Outcomes indicated that UPF intake was linked to an increased risk of IBD (relative risk [RR], 1.13; 95%CI, 1.06-1.21; P = 0.001; I2 = 73.2%; n = 59; N = 4 035 694). This association was significant, especially for the risk of Crohn's disease (CD) (RR, 1.19; 95%CI, 1.00-1.41; I2 = 78.2%; P = 0.046; n = 23; N = 2 167 160), unlike the risk of ulcerative colitis (UC) (RR = 1.11; 95%CI, 0.99-1.26; P = 0.085; I2 = 60.3%; n = 27; N = 2 167 918). Also, results revealed that each 10% enhancement in daily UPF intake was not related to the risk of IBD (RR, 1.05; 95%CI, 0.98-1.14; P = 0.168; I2 = 31.9%; n = 4) or the risk of UC (RR, 1.01; 95%CI, 0.92-1.11; P = 0.876; I2 = 34.7%; n = 2) in adults. However, results suggested that for every 10% increase in daily UPF intake, there was a 19% increase in the risk of CD (RR, 1.19; 95%CI, 1.01-1.32; P = 0.021; I2 = 0.0%; n = 2) among adults. In addition, the results showed a positive linear relation between UPF intake with CD risk (Pnonlinearity = 0.431; Pdose response = 0.049) but not risk of IBD or UC.

CONCLUSION

High intake of UPFs was linked with an enhanced IBD risk, a specific risk of CD. However, conducting more observational studies among several ethnicities and using specific tools that accurately assess the amount of UPF consumption, components of UPFs, and food additives may be necessary. Systematic Review Registration: PROSPERO registration no. CRD42023390258.

The effects of citrus flavonoids supplementation on endothelial function: A systematic review and dose-response meta-analysis of randomized clinical trials

The present systematic review and dose-response meta-analysis was conducted to synthesize existing data from randomized clinical trials (RCTs) concerning the impact of citrus flavonoids supplementation (CFS) on endothelial function. Relevant RCTs were identified through comprehensive searches of the PubMed, ISI Web of Science, and Scopus databases up to May 30, 2023. Weighted mean differences and their corresponding 95% confidence intervals (CI) were pooled utilizing a random-effects model. A total of eight eligible RCTs, comprising 596 participants, were included in the analysis. The pooled data demonstrated a statistically significant augmentation in flow-mediated vasodilation (FMD) (2.75%; 95% CI: 1.29, 4.20; I2 = 87.3%; p < 0.001) associated with CFS compared to the placebo group. Furthermore, the linear dose-response analysis indicated that each increment of 200 mg/d in CFS led to an increase of 1.09% in FMD (95% CI: 0.70, 1.48; I2 = 94.5%; p < 0.001). The findings from the nonlinear dose-response analysis also revealed a linear relationship between CFS and FMD (Pnon-linearity = 0.903, Pdose-response <0.001). Our findings suggest that CFS enhances endothelial function. However, more extensive RTCs encompassing longer intervention durations and different populations are warranted to establish more precise conclusions.

The association of ultra-processed food intake with neurodegenerative disorders: a systematic review and dose-response meta-analysis of large-scale cohorts

OBJECTIVES

Our systematic review and meta-analysis aimed to uncover the relationship between UPFs intake and neurodegenerative disorders, including multiple sclerosis (MS), Parkinson's disease (PD), Alzheimer's disease (AD), cognitive impairment, and dementia.

SETTING

A systematic search was conducted using the Scopus, PubMed/MEDLINE, and ISI Web of Science databases without any limitation until June 24, 2023. Relative risk (RR) and 95% confidence interval (CI) were pooled by using a random-effects model, while validated methods examined quality and publication bias via Newcastle-Ottawa Scale, Egger's regression asymmetry, and Begg's rank correlation tests, respectively.

RESULTS

Analysis from 28 studies indicated that a higher UPFs intake was significantly related to an enhanced risk of MS (RR = 1.15; 95% CI: 1.00, 1.33; I2 = 37.5%; p = 0.050; n = 14), PD (RR = 1.56; 95% CI: 1.21, 2.02; I2 = 64.1%; p = 0.001; n = 15), and cognitive impairment (RR = 1.17; 95% CI: 1.06, 1.30; I2 = 74.1%; p = 0.003; n = 17), although not AD or dementia. We observed that a 25 g increment in UPFs intake was related to a 4% higher risk of MS (RR = 1.04; 95% CI: 1.01, 1.06; I2 = 0.0%; p = 0.013; n = 7), but not PD. The non-linear dose-response relationship indicated a positive non-linear association between UPF intake and the risk of MS (Pnonlinearity = 0.031, Pdose-response = 0.002). This association was not observed for the risk of PD (Pnonlinearity = 0.431, Pdose-response = 0.231).

CONCLUSION

These findings indicate that persistent overconsumption of UPFs may have an adverse impact on neurodegenerative conditions, potentially leading to a decline in quality of life and reduced independence as individuals age.

The association between ultra-processed food and common pregnancy adverse outcomes: a dose-response systematic review and meta-analysis

OBJECTIVES

Given the increasing incidence of negative outcomes during pregnancy, our research team conducted a dose-response systematic review and meta-analysis to investigate the relationship between ultra-processed foods (UPFs) consumption and common adverse pregnancy outcomes including gestational diabetes mellitus (GDM), preeclampsia (PE), preterm birth (PTB), low birth weight (LBW), and small for gestational age (SGA) infants. UPFs are described as formulations of food substances often modified by chemical processes and then assembled into ready-to-consume hyper-palatable food and drink products using flavors, colors, emulsifiers, and other cosmetic additives. Examples include savory snacks, reconstituted meat products, frozen meals that have already been made, and soft drinks.

METHODS

A comprehensive search was performed using the Scopus, PubMed, and Web of Science databases up to December 2023. We pooled relative risk (RR) and 95% confidence intervals (CI) using a random-effects model.

RESULTS

Our analysis (encompassing 54 studies with 552,686 individuals) revealed a significant association between UPFs intake and increased risks of GDM (RR = 1.19; 95% CI: 1.10, 1.27; I2 = 77.5%; p < 0.001; studies = 44; number of participants = 180,824), PE (RR = 1.28; 95% CI: 1.03, 1.59; I2 = 80.0%; p = 0.025; studies = 12; number of participants = 54,955), while no significant relationships were found for PTB, LBW and SGA infants. Importantly, a 100 g increment in UPFs intake was related to a 27% increase in GDM risk (RR = 1.27; 95% CI: 1.07, 1.51; I2 = 81.0%; p = 0.007; studies = 9; number of participants = 39,812). The non-linear dose-response analysis further indicated a positive, non-linear relationship between UPFs intake and GDM risk Pnonlinearity = 0.034, Pdose-response = 0.034), although no such relationship was observed for PE (Pnonlinearity = 0.696, Pdose-response = 0.812).

CONCLUSION

In summary, both prior to and during pregnancy, chronic and excessive intake of UPFs is associated with an increased risk of GDM and PE. However, further observational studies, particularly among diverse ethnic groups with precise UPFs consumption measurement tools, are imperative for a more comprehensive understanding.

Effects of Spirulina supplementation in patients with ulcerative colitis: a double-blind, placebo-controlled randomized trial

AIM

We conducted a randomized placebo-controlled trial to assess the efficacy of Spirulina (SP) supplementation on disease activity, health-related quality of life, antioxidant status, and serum pentraxin 3 (PTX-3) levels in patients with ulcerative colitis (UC).

METHODS

Eighty patients with UC were randomly assigned to consume either 1 g/day (two 500 mg capsules/day) of SP (n = 40) or control (n = 40) for 8 weeks. Dietary intakes, physical activity, disease activity, health-related quality of life, antioxidant status, erythrocyte sedimentation rate (ESR), and serum PTX-3 levels were assessed and compared between groups at baseline and post-intervention.

RESULTS

Seventy-three patients (91.3%) completed the trial. We observed increases in serum total antioxidant capacity levels in the SP supplementation group compared to the control group after 8 weeks of intervention (p ≤ 0.001). A within-group comparison indicated a trend towards a higher health-related quality of life score after 8 weeks of taking two different supplements, SP (p < 0.001) and PL (p = 0.012), respectively. However, there were no significant changes in participant's disease activity score in response to SP administration (p > 0.05). Similarly, changes in ESR and PTX-3 levels were comparable between groups post-intervention (p > 0.05).

CONCLUSIONS

SP improved antioxidant capacity status and health-related quality of life in patients with UC. Our findings suggest that SP supplementation may be effective as an adjuvant treatment for managing patients with UC. Larger trials with longer interventions periods are required to confirm our findings.

Error mitigation enables PET radiomic cancer characterization on quantum computers

BACKGROUND

Cancer is a leading cause of death worldwide. While routine diagnosis of cancer is performed mainly with biopsy sampling, it is suboptimal to accurately characterize tumor heterogeneity. Positron emission tomography (PET)-driven radiomic research has demonstrated promising results when predicting clinical endpoints. This study aimed to investigate the added value of quantum machine learning both in simulator and in real quantum computers utilizing error mitigation techniques to predict clinical endpoints in various PET cancer patients.

METHODS

Previously published PET radiomics datasets including 11C-MET PET glioma, 68GA-PSMA-11 PET prostate and lung 18F-FDG PET with 3-year survival, low-vs-high Gleason risk and 2-year survival as clinical endpoints respectively were utilized in this study. Redundancy reduction with 0.7, 0.8, and 0.9 Spearman rank thresholds (SRT), followed by selecting 8 and 16 features from all cohorts, was performed, resulting in 18 dataset variants. Quantum advantage was estimated by Geometric Difference (GDQ) score in each dataset variant. Five classic machine learning (CML) and their quantum versions (QML) were trained and tested in simulator environments across the dataset variants. Quantum circuit optimization and error mitigation were performed, followed by training and testing selected QML methods on the 21-qubit IonQ Aria quantum computer. Predictive performances were estimated by test balanced accuracy (BACC) values.

RESULTS

On average, QML outperformed CML in simulator environments with 16-features (BACC 70% and 69%, respectively), while with 8-features, CML outperformed QML with + 1%. The highest average QML advantage was + 4%. The GDQ scores were ≤ 1.0 in all the 8-feature cases, while they were > 1.0 when QML outperformed CML in 9 out of 11 cases. The test BACC of selected QML methods and datasets in the IonQ device without error mitigation (EM) were 69.94% BACC, while EM increased test BACC to 75.66% (76.77% in noiseless simulators).

CONCLUSIONS

We demonstrated that with error mitigation, quantum advantage can be achieved in real existing quantum computers when predicting clinical endpoints in clinically relevant PET cancer cohorts. Quantum advantage can already be achieved in simulator environments in these cohorts when relying on QML.

The effects of spirulina supplementation on serum iron and ferritin, anemia parameters, and fecal occult blood in adults with ulcerative colitis: A randomized, double-blinded, placebo-controlled trial

BACKGROUND & AIMS

The present clinical trial aimed to evaluate the efficacy of spirulina administration on serum iron, ferritin, anemia parameters, and fecal occult blood test (FOBT) in adults with ulcerative colitis (UC).

METHODS

Eighty participants with UC were randomly assigned to take, either 1 g/day (two 500 mg capsules) spirulina (n = 40) or placebo (n = 40) in a double-blinded clinical trial for eight weeks. Dietary intake, physical activity status, serum iron and ferritin levels, anemia parameters, and FOBT were assessed in each participant at baseline and following the intervention. Seventy-three participants completed the trial.

RESULTS

Our results indicated significantly increased (p = 0.04) serum iron after eight weeks of spirulina supplementation compared to the placebo group. The spirulina group also demonstrated significantly increased mean corpuscular volume (p = 0.004) whereas red blood cell count (p = 0.01) and hematocrit (p = 0.03) were significantly lowered in the placebo group. No significant changes in FOBT outcomes were seen between groups at baseline (p = 0.12) and the end of the trial (p = 0.34). Eight weeks of 1 g/day spirulina supplementation improved anemia parameters in adults with UC compared to placebo.

CONCLUSIONS

These outcomes suggest that spirulina administration may be beneficial in the management of anemia in UC. Further clinical trials of longer duration are necessary to corroborate and expand our findings. Registered at: http://www.IRCT.ir (code: IRCT20170802035460N3).

The association of ultra-processed food consumption with adult mental health disorders: a systematic review and dose-response meta-analysis of 260,385 participants

OBJECTIVE

We aimed to conduct a systematic review and meta-analysis of observational studies examining the relationship between ultra-processed food (UPF) consumption and the risk of mental health disorders.

METHODS

The ISI Web of Science, PubMed/MEDLINE, and Scopus databases were searched without date restriction until 28 December 2021. Data were extracted from 26 studies, including 260,385 participants from twelve countries. Risk ratios for mental health disorders were pooled by a random-effects model.

RESULTS

Meta-analyses suggested that UPF consumption was associated with an increased risk of depression (RR = 1.28; 95% CI: 1.19, 1.38; I2 = 61.8%; p = 0.022) but not anxiety (RR = 1.35; 95% CI: 0.86, 2.11; I2 =  77.8%; p = 0.198). However, when analyzed for the dietary assessment method, UPF consumption was significantly associated with an enhanced risk of depression among studies utilizing food frequency questionnaires (RR = 1.31; 95% CI: 1.21, 1.41; I2 = 60.0%; p < 0.001) as opposed to other forms of dietary recall approaches. Additionally, for every 10% increase in UPF consumption per daily calorie intake, 11% higher risk of depression (RR = 1.11; 95% CI: 1.01, 1.17; I2 = 88.9%; p < 0.001) was observed among adults. Dose-response analysis further emphasized a positive linear association between UPF consumption with depression risk (p-nonlinearity = 0.819, p-dose-response = p < 0.001).

CONCLUSION

Our findings indicate that UPF consumption is related to an enhanced depressive mental health status risk. There may be different causes for this increased risk, and further studies are needed to investigate if there is a causal relationship between consumption of UPF and mental health.

Daytime napping and coronary heart disease risk in adults: a systematic review and dose-response meta-analysis

PURPOSE

The present study investigated the association between daytime napping and coronary heart disease (CHD) risk among adults.

METHODS

Articles were detected by using PubMed, ISI Web of Science, and Scopus databases until November 8th, 2021. The relevant data were found among the eight included articles and were pooled for meta-analysis in adult participants via a random-effects model.

RESULTS

Among 167,025 adults, the results revealed that daytime napping was associated with an enhanced risk of CHD (risk ratios [RR] = 1.30; 95% CI: 1.06, 1.60; p < 0.001). Subgroup analysis by daytime napping duration also indicated that daytime napping for at least 1 h had three times higher influence on the enhanced risk of CHD (RR = 1.34; 95% CI: 1.14, 1.58; p < 0.001) than that of daytime napping for less than 1 h (RR = 1.10; 95% CI: 1.02, 1.19; p = 0.014). In addition, subgroup analysis by region illustrated that daytime napping was linked with an enhanced risk of CHD in Chinese (RR = 1.41; 95% CI: 1.19, 1.66; p < 0.001), but not in European or American populations. Furthermore, the subgroup analysis of napping duration and risk of CHD suggested that their relation was significant just in those studies that controlled for depressive symptoms (RR = 1.52; 95% CI: 1.29, 1.80; p < 0.001, n = 3) and night sleep duration (RR = 1.42; 95% CI: 1.21, 1.66; p < 0.001, n = 5). The linear dose-response meta-analysis revealed that each 15-min increase in daytime napping was related with a 5% higher risk of CHD (RR = 1.05; 95% CI: 1.02, 1.08; I2 = 58.7%; p < 0.001). Furthermore, nonlinear dose-response meta-analysis revealed a positive linear relationship between daytime napping and CHD risk in adults (p nonlinearity = 0.484, p dose-response = 0.003).

CONCLUSION

Results showed that daytime napping was related with an increased risk of CHD in adults. The evidence from this study suggests that the public should be made conscious of the adverse outcomes of long daytime napping for CHD, notably among the Chinese population. Additional studies are required to confirm potential links between CHD risk and daytime napping.

Efficacy of propolis and triple antibiotic paste as intra-canal medicaments for revascularisation of immature teeth in dogs: a comparative study

AIM

Revascularisation is a therapeutic approach for treatment of immature teeth with necrotic pulp. The conventional protocol includes application of triple antibiotic paste (TAP). The present study aimed to compare the efficacy of propolis and TAP as intra-canal medicaments for revascularisation of immature teeth in dogs.

METHODOLOGY

This study was conducted on 20 immature (open-apex) canine teeth in mixed breaded dogs. First, the teeth were exposed to oral environment, followed by intra-canal cleaning and shaping 2 weeks later.. The teeth were divided into two groups. The TAP group received paste comprising of ciprofloxacin, metronidazole, and minocycline (at a concentration of 100 µg/mL), while propolis (15% w/v) was used in the other group. The revascularisation procedure was done by means of sodium hypochlorite, EDTA and distilled water as final irrigant. After dehumidifying and induction of bleeding, mineral trioxide aggregate (MTA) was applied At 6-month follow-up, radiographs were evaluated by two observers regarding root length and thickness, intra-canal calcification, periapical lesions, and apex formation. Data were analysed by the Chi-square and Fisher's exact tests.

RESULTS

There was no significant difference between the TAP and propolis groups in root length or root thickness increase, calcification, related lesions, or apex formation (P > 0.05).

CONCLUSION

Findings of the present study in experimental animals revealed that the efficacy of propolis as an intra-canal medicament is comparable to that of triple antibiotic paste for revascularisation therapy.

The Effect of High-Intensity Interval Training Type on Body Fat Percentage, Fat and Fat-Free Mass: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

This systematic review and meta-analysis of randomized controlled trials (RCTs) compared body compositional changes, including fat mass (FM), body fat percentage (BF%), and fat-free mass (FFM), between different types of high-intensity interval training (HIIT) (cycling vs. overground running vs. treadmill running) as well as to a control (i.e., no exercise) condition. Meta-analyses were carried out using a random-effects model. The I2 index was used to assess the heterogeneity of RCTs. Thirty-six RCTs lasting between 3 to 15 weeks were included in the current systematic review and meta-analysis. RCTs that examined the effect of HIIT type on FM, BF%, and FFM were sourced from online databases including PubMed, Scopus, Web of Science, and Google Scholar up to 21 June 2022. HIIT (all modalities combined) induced a significant reduction in FM (weighted mean difference [WMD]: −1.86 kg, 95% CI: −2.55 to −1.18, p = 0.001) despite a medium between-study heterogeneity (I2 = 63.3, p = 0.001). Subgroup analyses revealed cycling and overground running reduced FM (WMD: −1.72 kg, 95% CI: −2.41 to −1.30, p = 0.001 and WMD: −4.25 kg, 95% CI: −5.90 to −2.61, p = 0.001, respectively); however, there was no change with treadmill running (WMD: −1.10 kg, 95% CI: −2.82 to 0.62, p = 0.210). There was a significant reduction in BF% with HIIT (all modalities combined) compared to control (WMD: −1.53%, 95% CI: −2.13, −0.92, p = 0.001). All forms of HIIT also decreased BF%; however, overground running induced the largest overall effect (WMD: −2.80%, 95% CI: −3.89 to −1.71, p = 0.001). All types of HIIT combined also induced an overall significant improvement in FFM (WMD: 0.51 kg, 95% CI: 0.06 to 0.95, p = 0.025); however, only cycling interventions resulted in a significant increase in FFM compared to other exercise modalities (WMD: 0.63 kg, 95% CI: 0.17 to 1.09, p = 0.007). Additional subgroup analyses suggest that training for more than 8 weeks, at least 3 sessions per week, with work intervals less than 60 s duration and separated by ≤90 s active recovery are more effective for eliciting favorable body composition changes. Results from this meta-analysis demonstrate favorable body composition outcomes following HIIT (all modalities combined) with overall reductions in BF% and FM and improved FFM observed. Overall, cycling-based HIIT may confer the greatest effects on body composition due to its ability to reduce BF% and FM while increasing FFM.

Early vs delayed enteral nutrition or parenteral nutrition in hospitalized patients: An umbrella review of systematic reviews and meta-analyses of randomized trials

We conducted an umbrella review to summarize the existing evidence on the effect of early enteral nutrition (EEN) compared with other approaches, including delayed enteral nutrition (DEN), parenteral nutrition (PN), and oral feeding (OF) on clinical outcomes in hospitalized patients. We performed a systematic search up to December 2021, in MEDLINE (via PubMed), Scopus, and Institute for Scientific Information Web of Science. We included systematic reviews with meta-analyses (SRMAs) of randomized trials investigating EEN compared with DEN, PN, or OF for any clinical outcomes in hospitalized patients. We used "A Measurement Tool to Assess Systematic Reviews" (AMSTAR2) and the Cochrane risk-of-bias tool for assessing the methodological quality of the systematic reviews and their included trial, respectively. The certainty of the evidence was rated using the "Grading of Recommendations Assessment, Development, and Evaluation" (GRADE) approach. We included 45 eligible SRMAs contributing with a total of 103 randomized controlled trials. The overall meta-analyses showed that patients who received EEN had statistically significant beneficial effects on most outcomes compared with any control (ie, DEN, PN, or OF), including mortality, sepsis, overall complications, infection complications, multiorgan failure, anastomotic leakage, length of hospital stay, time to flatus, and serum albumin levels. No statistically significant beneficial effects were found for risk of pneumonia, noninfectious complications, vomiting, wound infection, as well as number of days of ventilation, intensive care unit days, serum protein, and pre-serum albumin levels. Our results indicate that EEN may be preferred over DEN, PN, and OF because of the beneficial effects on many clinical outcomes.

Soluble Fiber Supplementation and Serum Lipid Profile: A Systematic Review and Dose-Response Meta-Analysis of Randomized Controlled Trials

To present a comprehensive synthesis of the effect of soluble fiber supplementation on blood lipid parameters in adults, a systematic search was undertaken in PubMed, Scopus, and ISI Web of Science of relevant articles published before November 2021. Randomized controlled trials (RCTs) evaluating the effects of soluble fibers on blood lipids in adults were included. We estimated the change in blood lipids for each 5 g/d increment in soluble fiber supplementation in each trial and then calculated the mean difference (MD) and 95% CI using a random-effects model. We estimated dose-dependent effects using a dose-response meta-analysis of differences in means. The risk of bias and certainty of the evidence was evaluated using the Cochrane risk of bias tool and the Grading Recommendations Assessment, Development, and Evaluation methodology, respectively. A total of 181 RCTs with 220 treatment arms (14,505 participants: 7348 cases and 7157 controls) were included. There was a significant reduction in LDL cholesterol (MD: -8.28 mg/dL, 95% CI: -11.38, -5.18), total cholesterol (TC) (MD: -10.82 mg/dL, 95% CI: -12.98, -8.67), TGs (MD: -5.55 mg/dL, 95% CI: -10.31, -0.79), and apolipoprotein B (Apo-B) (MD: -44.99 mg/L, 95% CI: -62.87, -27.12) after soluble fiber supplementation in the overall analysis. Each 5 g/d increase in soluble fiber supplementation had a significant reduction in TC (MD: -6.11 mg/dL, 95% CI: -7.61, -4.61) and LDL cholesterol (MD: -5.57 mg/dl, 95% CI: -7.44, -3.69). In a large meta-analysis of RCTs, results suggest that soluble fiber supplementation could contribute to the management of dyslipidemia and the reduction of cardiovascular disease risk.

The Potential Effect of Blueberry on Cognitive Health and Mood State based on Human Intervention Studies: Systematic Review and Mini Meta-Analysis

BACKGROUND

Blueberries are known for their high content of several bioactive compounds, specifically anthocyanin, which are the most beneficial of the flavonoid family in terms of neuroprotection. Several human interventional studies have been conducted to assess the effects of blueberry intake on cognitive performance; however, the results of clinical trials are inconclusive. Therefore, this systematic review and meta-analysis evaluated the effect of blueberry supplementation on some aspects of cognitive performance and mood parameters using data from clinical trials based on existing evidence.

METHODS

Relevant studies, published in April 2021, were searched through PubMed/Medline, Scopus, Embase, and Google Scholar. The random effect size was used to estimate the pooled effect size. Heterogeneity between studies was evaluated by the Cochrane Q test and I-squared (I²). To detect the potential source of heterogeneity, a subgroup analysis was conducted.

RESULTS

Fourteenrandomized trials were included in the quantitative analysis, and six were pooled for statistical analysis. Blueberry intervention resulted in no significant change in mood state score (WMD = 0.03; 95% CI: -0.80 to 0.87, P = 0.16). Moreover, no significant effect of blueberry intake was shown in attention task reaction time (WMD = -1.50 ms; 95% CI: -24.75 to -21.75, P = 0.9), percentages of attention task accuracy (WMD = 0.85; 95% CI: -2.57 to 0.86, P = 0.3), one-back test accuracy (WMD = 0.03; 95% CI: -0.04 to 0.09, P = 0.4). Significant effect was indicated (WMD = 0.08; 95% CI: 0.02 to 0.13, P = 0.005) in two-back test accuracy.

CONCLUSION

We found a significant effect of blueberry consumption on two-back test accuracy as a cognitive outcome. More high-quality clinical trials according to the challenges mentioned seem to indicate the use of blueberry as a supplement for cognitive and mood health efficiently.

Celiac disease and COVID-19 in adults: A systematic review

BACKGROUND

Celiac disease (CD) is an autoimmune disease affecting around 1.4% of the total human population. Local and systemic manifestations are described in CD. Viral infections seem to trigger CD or even have a worse outcome in CD patients. The evidence on the relationship between CD and coronavirus disease (COVID-19) is limited. To evaluate existing evidence on the association between CD and COVID-19, we conducted the current systematic review.

METHODS

We systematically searched Pubmed, Scopus, and Embase databases to find articles that reported risks or outcomes of COVID-19 in CD patients. Papers in any language published up to November 17, 2022, were evaluated for possible inclusion. The results were analyzed qualitatively. This study is registered with PROSPERO(CRD42022327380).

RESULTS

We identified 509 studies by searching databases; 14 reported data on the risk or outcome of COVID-19 in CD patients and were eligible for qualitative synthesis. We found that the relative risk of acquiring COVID-19 in CD patients may be lower than in the general population. Approximately 90% of infected patients were treated as an outpatient, and 10% were hospitalized. GFD adherence and Health-related quality of life (HR-QOL) were more or less the same before and during the pandemic. The gluten-free products (GFP) supply seems to be plunged during the pandemic. The data on the psychological effects of the pandemic were conflicting.

CONCLUSION

The risk of acquiring COVID-19 in CD patients is lower than in the general population. Females were more likely to be infected by COVID-19, and the most common comorbidity in infected patients was a chronic lower respiratory disease; around 10% of infected patients needed hospitalization, GFD adherence, and HR-QOL was more or less the same before and during the pandemic, depression, anxiety, and stress levels of patients varied among studies. Patients had more difficulties accessing GFPs based on limited data.

The Association between Dietary Inflammatory Index and Aging Biomarkers/Conditions: A Systematic Review and Dose-response Meta-analysis

OBJECTIVES

We performed a current study to examine the association between dietary inflammatory index (DII) score and older age-related muscle conditions, including sarcopenia, low muscle mass, low muscle strength, frailty, and/or disability.

DESIGN

Systematic review and dose-response meta-analysis.

SETTING

A systematic literature search was performed using Scopus, PubMed/MEDLINE, and ISI Web of Science without limitation until October 04, 2022. Relative risk (RR) and 95% confidence interval (CI) were pooled by applying a random-effects model, while validated methods examined assess quality and publication bias via Newcastle-Ottawa Scale, Egger's regression asymmetry, and Begg's rank correlation tests respectively. A dose-response meta-analysis was conducted to estimate the RRs per 1-unit increment in DII scores.

PARTICIPANTS

Adults (≥18 years).

MEASURES

The risk of older age-related muscle conditions (sarcopenia, low muscle mass, low muscle strength, frailty, and/or disability).

RESULTS

Data were available from 19 studies with 68079 participants. Results revealed that a higher DII score was significantly related to an increased risk of sarcopenia (RR=1.50; 95% CI: 1.26, 1.79; I2=53.3%; p<0.001; n=10; sample size =43097), low muscle strength (RR=1.47; 95% CI: 1.24, 1.74; I2=6.6%; p<0.001; n=4; sample size =9339), frailty (RR=1.61; 95% CI: 1.41, 1.84; I2=0.0%; p<0.001; study=5; participant=3882) and disability (RR=1.41; 95% CI: 1.16, 1.72; I2=58.4%; p=0.001; n=5; sample size =13760), but not low muscle mass (RR=1.24; 95% CI: 0.98, 1.56; I2=49.3%; p=0.069; n=4; sample size =11222). Additionally, results of the linear dose-response indicated that an increase of one point in the DII score was related to a 14% higher risk of sarcopenia, 6% higher risk of low muscle mass, 7% higher risk of low muscle strength, and a 7% higher risk of disability in adults. Non-linear dose-response relationships also revealed a positive linear association between the DII score and the risk of sarcopenia (Pnonlinearity = 0.097, Pdose-response<0.001), frailty (Pnonlinearity = 0.844, Pdose-response=0.010) and disability (Pnonlinearity = 0.596, Pdose-response=0.007).

CONCLUSION

Adherence to a pro-inflammatory diet was significantly associated with a higher risk of sarcopenia and other age-associated adverse effects such as low muscle strength, disability, and frailty. These results indicate a necessity to prioritize the reduction of pro-inflammatory diets to help promote overall older age-related muscle conditions.

Mediterranean dietary pattern and bone mineral density: a systematic review and dose-response meta-analysis of observational studies

BACKGROUND

We aimed to systematically review the literature and test the dose-response relationship between adherence to the Mediterranean diet (MedDiet) and values of bone mineral density (BMD) in adults.

METHODS

Relevant observational studies were selected through searching PubMed, Scopus, and Web of Science databases up to March 4, 2021. A random-effects dose-response meta-analysis was performed to estimate the change in total and regional-specific BMD for a 2-point increment in the score of adherence to the MedDiet, and to clarify the shape of these associations.

RESULTS

Seven cross-sectional and one cohort studies with a total number of 13,209 participants were included in the final analyses. Each 2-point increment in the score of adherence to the MedDiet was associated with 0.009 (95% CI: 0.002, 0.016; I2 = 34%, n = 7), 0.006 (95% CI: 0.001, 0.012; I2 = 34%, n = 7), 0.005 (95% CI: 0.003, 0.007; I2 = 1%, n = 4), 0.005 (95% CI: 0.002, 0.008; I2 = 0%, n = 3), and 0.007 (95% CI: 0.005, 0.009; I2 = 0%, n = 4) gr/cm2 higher BMD of lumbar spine, femoral neck, hip, trochanter, and whole body, respectively. There was a positive linear relationship between the MedDiet adherence score and BMD of hip and trochanter. A nonlinear relationship was seen for lumbar spine, femoral neck, and whole body, with sharper increase in the BMD at lower MedDiet scores. The associations remained significant after controlling for important confounders including body weight, physical activity, smoking status, and energy intake.

CONCLUSION

Greater adherence to the MedDiet was associated with a small but important increase in BMD at the lumbar spine, femoral neck, hip, trochanter, and whole body. Adopting a Mediterranean-style eating pattern may have modest beneficial effects on bone health.

Food insecurity is associated with the sleep quality and quantity in adults: a systematic review and meta-analysis

OBJECTIVE

We evaluated associations between food insecurity (FI) and the quality and quantity of sleep in adults (≥18 years).

DESIGN

The current study represented a systematic review and meta-analysis of observational studies.

SETTING

Databases of PubMed, Scopus, Embase and Web of Science were searched from inception until 6 June 2022. Meta-analyses were conducted using random-effects models, and effect sizes were reported as OR and 95 % CI.

PARTICIPANTS

Data from ten eligible observational studies, including 83 764 participants, were included.

RESULTS

FI was associated with an increased risk of poor sleep quality (OR = 1·45; 95 % CI (1·24, 1·70), I2 = 95, P < 0·001, n 7). Besides, subgroup analysis showed increased risk of poor sleep quality corresponding to the severity of FI across mild (OR = 1·31; 95 % CI (1·16, 1·48), I2 = 0 %, P < 0·001, n 5), moderate (OR = 1·49; 95 % CI (1·32, 1·68), I2 = 0 %, P < 0·001, n 5) and severe (OR = 1·89; 95 % CI (1·63, 2·20), I2 = 0 %, P < 0·001, n 5) levels. Similarly, subgroup analysis by sleep problems showed that FI was associated with an increased the risk of trouble falling asleep (OR = 1·39; 95 % CI (1·05, 1·83), I2 = 91 %, P = 0·002, n 3) and trouble staying asleep (OR = 1·91; 95 % CI (1·37, 2·67), I2 = 89 %, P < 0·001, n 3). Moreover, FI was associated with the odds of shorter (OR = 1·14; 95 % CI (1·07, 1·21), I2 = 0 %, P < 0·001, n 4) and longer sleep duration (OR = 1·14; 95 % CI (1·03, 1·26), I2 = 0 %, P = 0·010, n 4).

CONCLUSIONS

Collective evidence supports that FI is associated with poor sleep quality and quantity in adults. Preventative and management strategies that address FI may provide health benefits beyond improving nutritional status per se.

Effects of almond on cardiometabolic outcomes in patients with type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials

An enhanced risk for cardiovascular disease (CVD) still exists even when T2DM patients have tight control on blood sugar. Thus, identification of treatment approaches that address CVD risk factors may be useful for patients beyond the blood sugar management. Although emerging evidence suggests that nuts consumption have beneficial effects on cardiometabolic health, the effects of almond intake in patients with type 2 diabetes are still controversial. Therefore, our objective was to investigate the effect of almond on cardiometabolic outcomes in patients with T2DM through a systematic review and meta-analysis of available randomized controlled trials (RCTs). A systematic search was conducted in PubMed, Web of Science, Scopus, Embase, and Google Scholar to identify relevant RCTs up to March 2021. There was no language and time limitation. Weighted mean difference (WMD) was pooled using a random effects model. Heterogeneity, sensitivity analysis, and publication bias were reported using standard methods. Nine RCTs were included in the final analysis. Almond intake resulted in significant reduction in low-density lipoprotein cholesterol (LDL-C) (WMD: -5.28 mg/dL; 95% CI, -9.92, -0.64; p = .026) compared with the control group. This lowering effect of LDL-C was robust in subgroups with almond consumption >50 g/day, and baseline LDL-C level <130 mg/dL. However, the effect of almond on total cholesterol, triglycerides, high-density lipoprotein cholesterol, fasting plasma glucose, insulin, hemoglobin A1c, body mass index, weight, body fat, systolic and diastolic blood pressure, and CRP was not significant compared with the control group. In summary, the current meta-analysis indicated that almond consumption decreased LDL-C, and had no favorable effect on other cardiometabolic outcomes in patients with T2DM. However, further high-quality studies are needed to firmly establish the clinical efficacy of the almond.

Monensin supplementation downregulated the expression signature of genes involved in cholesterol synthesis in the ruminal epithelium and adipose tissue of lambs

To understand the metabolic mechanisms regulating lipid metabolism by monensin, Afshari male lambs (n = 16) with 41.0 ± 2.4 kg body weight (BW, mean ± SD) at approximately 180 days of age were randomly assigned equally to two dietary treatments. After a 21-day pre-adaptation period, all animals in two groups continued to receive the basal diet, but one group received no monensin supplementation (control) while the other group received 30 mg/day of monensin per animal. Individual BW was recorded weekly to determine the average daily body weight gain (ADG). At the end of the 56-day experimental period, lambs were weighed and slaughtered. Monensin supplementation did not affect BW, ADG, and rumen fermentation characteristics. However, monensin significantly downregulated the sterol regulatory element-binding protein (SREBP)-2 gene expression in all sample tissues (p < 0.05). Also, monensin downregulated expressions of SREBP-1c and peroxisome proliferator-activated receptor (PPAR)-γ in back fat tissues. Monensin increased the expression of 3-hydroxy-3-methylglutaryl-CoA synthase (HMGCS)-2, but it decreased the mRNA abundance of HMGCS-1 in the rumen epithelial tissues (p < 0.05). Our data suggest that monensin downregulates cholesterol synthesis via inhibition of HMGCS-1 and impairment of the SREBP pathway, probably due to a crosstalk among different tissues to control energy metabolism.

[From surgery for esophageal atresia in the infancy to late complications of ib fusion and scoliosis]

Following surgey for esophageal atresia, orthopedic complications can sometimes appear late in childhood, hence the importance of regular monitoring. These complications include rib fusion secondary to thoracic surgery and possible infectious complications. Undiagnosed, this condition can lead to severe scoliosis in adolescence.

Clinical data classification with noisy intermediate scale quantum computers

Quantum machine learning has experienced significant progress in both software and hardware development in the recent years and has emerged as an applicable area of near-term quantum computers. In this work, we investigate the feasibility of utilizing quantum machine learning (QML) on real clinical datasets. We propose two QML algorithms for data classification on IBM quantum hardware: a quantum distance classifier (qDS) and a simplified quantum-kernel support vector machine (sqKSVM). We utilize these different methods using the linear time quantum data encoding technique ([Formula: see text]) for embedding classical data into quantum states and estimating the inner product on the 15-qubit IBMQ Melbourne quantum computer. We match the predictive performance of our QML approaches with prior QML methods and with their classical counterpart algorithms for three open-access clinical datasets. Our results imply that the qDS in small sample and feature count datasets outperforms kernel-based methods. In contrast, quantum kernel approaches outperform qDS in high sample and feature count datasets. We demonstrate that the [Formula: see text] encoding increases predictive performance with up to + 2% area under the receiver operator characteristics curve across all quantum machine learning approaches, thus, making it ideal for machine learning tasks executed in Noisy Intermediate Scale Quantum computers.

The association between urinary metabolites of polycyclic aromatic hydrocarbons (PAHs) and cardiovascular diseases and blood pressure: a systematic review and meta-analysis of observational studies

Although epidemiological studies have discerned the association between polycyclic aromatic hydrocarbons (PAHs) exposure and hypertension and/or cardiovascular disease in the general population, the possible mechanisms for this association are not well understood. We sought to examine the association between urinary metabolites of PAHs and cardiovascular diseases (CVDs) and blood pressure in adults, by conducting a meta-analysis of observational studies. We searched PubMed, Scopus, Embase, and Web of science, up to July 2021, for observational studies that investigated the association between urinary metabolites of PAHs and CVDs and blood pressure in adults. Nine prospective studies, including 27,280 participants, were included. Based on overall pooled results, there was a significant positive association between all types of urinary metabolites of PAH and blood pressure (OR: 1.32; 95%, CI: 1.19 to 1.48, p < 0.0001) (I² = 62.4%, p < 0.0001). There was no significant association between any urinary metabolite of PAH and CHD (OR: 0.93; 95%, CI: 0.83 to 1.03, p = 0.174) (I² = 0%, p = 0.653). Overall, there was a significant positive association between all urinary metabolites of PAH and CVD (OR: 1.23; 95%, CI: 1.16 to 1.30, p < 0.0001) (I² = 59.7%, p < 0.0001). The results of the present meta-analysis suggest that different metabolites PAHs are associated with an increased risk of CVD and HTN. Further studies, including randomized clinical trials, are needed to confirm the veracity of our findings.

Ultra-Processed Food Consumption and Adult Diabetes Risk: A Systematic Review and Dose-Response Meta-Analysis

(1) Background: Recent individual studies have demonstrated that consumption of ultra-processed food (UPF) may be related to type two diabetes mellitus (T2DM). We aimed to synthesize the results from these individual studies by conducting an updated systematic review and meta-analysis of observational studies evaluating the association between UPF consumption and the risk of T2DM. (2) Methods: A systematic search was conducted using ISI Web of Science, PubMed/MEDLINE and Scopus electronic databases from inception up to August 2021. Data were extracted from five studies (one cross-sectional study and four cohort studies, totaling 230,526 adults from four different countries). Risk ratios (RR) of pooled results were estimated using a random-effects model. (3) Results: Our results revealed that higher UPF consumption was significantly associated with an increased risk of T2DM (RR = 1.74; 95% CI: 1.36, 2.22; I² = 68.9%; p < 0.001; n = 5). Linear dose-response analysis indicated that each 10% increase in UPF consumption (kcal/d) was associated with a 15% higher risk of T2DM (RR = 1.15; 95% CI: 1.06, 1.26; I² = 86.0%; p < 0.001; n = 5) among adults. Non-linear dose-response analysis demonstrated a positive linear association between UPF consumption and T2DM (p_nonlinearity = 0.13, p_{dose-response} < 0.001; n = 5) among adults. (4) Conclusions: A higher intake of UPF was significantly associated with an increased risk of T2DM. However, underlying mechanisms remain unknown and future experimental studies are warranted.