Dose-response Meta-analysis Of Prospective Studies Research Articles

The Association Between Overall, Healthy, and Unhealthy Plant-Based Diet Index and Risk of Prediabetes and Type 2 Diabetes Mellitus: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies.

The global incidence of prediabetes and type 2 diabetes mellitus (T2DM) has increased substantially in recent years. Among the established, modifiable lifestyle factors associated with favorable prediabetes and T2DM risk, healthy dietary patterns have attracted considerable attention. The association between adherence to plant-based dietary pattern indices (PDIs), including the overall PDI (O-PDI), healthy PDI (H-PDI), and unhealthy PDI (U-PDI), and the risk of prediabetes and T2DM was investigated in this study. A literature search was conducted of the PubMed/Medline, Scopus, and Web of Sciences databases from their inception to February 2024. A systematic review and meta-analysis were conducted using random effects models and dose-response analyses. The Cochran Q test and the I2 statistic were used to evaluate heterogeneity between studies. A total of 16 publications, with data on a total of 721 012 participants, were identified for the meta-analysis. According to a pooled analysis, compared with the lowest category of O-PDI and H-PDI adherence, the highest category was associated with a 14% and 19% reduction in T2DM risk, respectively, for O-PDI (effect size [ES] = 0.86; 95%CI, 0.82-0.90; I2 = 57.7) and H-PDI (ES = 0.81; 95%CI, 0.75-0.88; I2 = 82.6). Greater adherence to U-PDI was significantly associated with an 10% increase in the risk of T2DM (ES = 1.10; 95%CI, 1.04-1.16). Consistent associations were found within the predetermined subgroups. As well, there was a nonlinear inverse association between O-PDI, H-PDI, and T2DM risk. No significant association was found between adherence to O-PDI (ES = 0.87; 95%CI, 0.75-1.01; I2 = 68%), H-PDI (ES = 0.99; 95%CI, 0.87-1.13; I2 = 0.0%), and U-PDI (ES = 1.09; 95%CI, 0.94-1.21; I2 = 22.9%) and risk of prediabetes. These findings underscore the importance of dietary selections within the framework of a plant-based dietary pattern, particularly when incorporating healthful, plant-based foods, which may have potential benefits in reducing the T2DM risk. PROSPERO registration no. CRD42023459851.

Association between tea consumption and risk of kidney stones: results from dose-response meta-analysis of prospective studies and Mendelian randomization analysis.

The association between tea consumption and kidney stones is inconsistent in observational studies. Thus, we performed a dose-response meta-analysis of prospective cohort studies and a two-sample Mendelian randomization (MR) analysis to identify this association. The prospective cohort studies reporting the relationship between tea consumption and kidney stones were searched from PubMed, the Cochrane Library, EMBASE, and Web of Science from inception to December 1, 2023. For MR analysis, the summary-level data for tea consumption and kidney stones were extracted from the UK Biobank available data and the 8th release of the FinnGen consortium, respectively. The inverse-variance weighted (IVW) method was the primary analytical method. In our dose-response meta-analysis, four prospective cohort studies involving 1,263,008 participants were included, and tea consumption was found to have significant associations with kidney stones (RR: 0.80, 95% CI: 0.73-0.87). We also observed a substantially linear negative relationship between tea consumption and the risk of kidney stones. In MR analysis, the IVW method indicated that tea consumption was inversely associated with kidney stones (OR: 0.71, 95% CI: 0.53-0.94). Our study confirmed a causal relationship between tea consumption and kidney stones, and higher tea consumption may reduce the risk of kidney stones.

The Relationship Between Major Food Sources of Fructose and Cardiovascular Outcomes: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies.

There is emerging evidence of associations between intake of sugar-sweetened beverages (SSBs), those that include various forms of added sugar, and increased risk of cardiovascular disease (CVD) but whether consumption of other dietary sources of fructose affects CVD is unclear. In this study, we conducted a meta-analysis to examine potential dose-response relationships between such foods and CVD, coronary heart disease (CHD), and stroke morbidity and mortality. We systematically searched the literature indexed in PubMed, Embase, and the Cochrane Library from the inception of each database to February 10, 2022. We included prospective cohort studies analyzing the association between at least 1 dietary source of fructose and CVD, CHD, and stroke. Based on data from 64 included studies, summary HRs and 95% CIs were calculated for the highest intake category compared with the lowest, and dose-response analyses were performed. Of all fructose sources examined, only SSB intakes showed positive associations with CVD, giving summary HRs per 250 mL/d increase of 1.10 (95% CI: 1.02, 1.17) for CVD, 1.11 (95% CI: 1.05, 1.17) for CHD, 1.08 (95% CI: 1.02, 1.13) for stroke morbidity, and 1.06 (95% CI: 1.02, 1.10) for CVD mortality. Conversely, 3 dietary sources showed protective associations: between fruits and CVD morbidity (HR: 0.97; 95% CI: 0.96, 0.98), fruits and CVD mortality (HR: 0.94; 95% CI: 0.92, 0.97), yogurt and CVD mortality (HR: 0.96; 95% CI: 0.93, 0.99), and breakfast cereals and CVD mortality (HR: 0.80; 95% CI: 0.70, 0.90). All these relationships were linear except for fruit, which was J-shaped: CVD morbidity was the lowest at 200 g/d and there was no protective association above 400 g/d. These findings indicate that the adverse associations between SSBs and CVD, CHD, and stroke morbidity and mortality do not extend to other dietary sources of fructose. The food matrix seemed to modify the association between fructose and cardiovascular outcomes.

Circulating Vitamin D Level and Risk of Sudden Cardiac Death and Cardiovascular Mortality: A Dose-Response Meta-Analysis of Prospective Studies.

We conducted a comprehensive meta-analysis of prospective cohort studies to analyze the effect of circulating vitamin D level on the risk of sudden cardiac death (SCD) and cardiovascular disease (CVD) mortality. Prospective cohort studies evaluating the association between circulating vitamin D and risk of SCD and CVD mortality were systematically searched in the PubMed and Embase. Extracted data were analyzed using a random effects model and results were expressed in terms of hazard ratio (HR) and 95% confidence interval (CI). Restricted cubic spline analysis was used to estimate the dose-response relationships. Of the 1,321 records identified using the search strategy, a total of 19 cohort studies were included in the final meta-analysis. The pooled estimate of HR (95% CI) for low vs. high circulating vitamin D level was 1.75 (1.49-2.06) with I² value of 30.4%. In subgroup analysis, strong effects of circulating vitamin D were observed in healthy general population (pooled HR, 1.84; 95% CI, 1.43-2.38) and the clinical endpoint of SCD (pooled HRs, 2.68; 95% CI, 1.48-4.83). The dose-response analysis at the reference level of < 50 nmol/L showed a significant negative association between circulating vitamin D and risk of SCD and CVD mortality. Our meta-analysis of prospective cohort studies showed that lower circulating vitamin D level significantly increased the risk of SCD and CVD mortality.

Egg Consumption and Risk of All-Cause and Cause-Specific Mortality: A Systematic Review and Dose-Response Meta-analysis of Prospective Studies.

The association between egg consumption and mortality is extremely debatable. This study aimed to investigate the potential dose-response association of egg consumption with risk of mortality from all causes and cause-specific in the general population. The primary comprehensive literature search was conducted in PubMed/Medline, Scopus, ISI Web of Science, and Embase up to March 2021, as well as reference lists of relevant original papers and key journals. We calculated summary RRs and their 95% CIs for the highest and lowest categories, as well as the linear trend estimation of egg intake, using the random-effects model. Thirty-three (32 publications) cohort studies were included. These studies enrolled 2,216,720 participants and recorded 232,408 deaths from all causes. Comparing highest versus lowest egg intake categories was not associated with the risk of mortality from all causes (RR: 1.02; 95% CI: 0.94, 1.11; n=25), cardiovascular disease (CVD) (RR: 1.04; 95% CI: 0.87, 1.23, n=11), coronary heart disease (CHD) (RR: 0.98; 95% CI: 0.84, 1.16; n=10), stroke (RR: 0.81; 95% CI: 0.64, 1.02; n=9), and respiratory disease (RR: 0.96; 95% CI: 0.53, 1.71; n=3); however, it was associated with a higher risk of cancer mortality (RR: 1.20; 95% CI: 1.04, 1.39; n=13). In the linear dose-response analysis, an additional intake of 1 egg per week was associated with a 2% and 4% increased risk of all-cause and cancer mortality, respectively, and a 4% decreased risk of stroke mortality. The certainty of the evidence was rated as low to moderate. Higher egg consumption was not associated with an increased risk of mortality from all causes, CVD, CHD, stroke, or respiratory disease, whereas an elevated risk was observed for cancer mortality. These findings suggest that eggs be consumed in low to moderate amounts (≤1 egg/d) as part of a healthy diet.

Endogenous Circulating Sex Hormone Concentrations and Colon Cancer Risk in Postmenopausal Women: A Prospective Study and Meta-Analysis.

BackgroundObservational studies have consistently reported that postmenopausal hormone therapy use is associated with lower colon cancer risk, but epidemiologic studies examining the associations between circulating concentrations of endogenous estrogens and colorectal cancer have reported inconsistent results.MethodsWe investigated the associations between circulating concentrations of estrone, estradiol, free estradiol, testosterone, free testosterone, androstenedione, dehydroepiandrosterone (DHEA), progesterone, and sex hormone–binding globulin (SHBG) with colon cancer risk in a nested case-control study of 1028 postmenopausal European women (512 colon cancer cases, 516 matched controls) who were noncurrent users of exogenous hormones at blood collection. Multivariable conditional logistic regression models were used to compute odds ratios and 95% confidence intervals to evaluate the association between circulating sex hormones and colon cancer risk. We also conducted a dose-response meta-analysis of prospective studies of circulating estrone and estradiol with colorectal, colon, and rectal cancer risk in postmenopausal women. All statistical tests were 2-sided.ResultsIn the multivariable model, a nonstatistically significantly positive relationship was found between circulating estrone and colon cancer risk (odds ratio per log2 1-unit increment = 1.17 [95% confidence interval = 1.00 to 1.38]; odds ratioquartile4-quartile1 = 1.33 [95% confidence interval = 0.89 to 1.97], Ptrend = .20). Circulating concentrations of estradiol, free estradiol, testosterone, free testosterone, androstenedione, DHEA, progesterone, and SHBG were not associated with colon cancer risk. In the dose-response meta-analysis, no clear evidence of associations were found between circulating estradiol and estrone concentrations with colorectal, colon, and rectal cancer risk.ConclusionOur observational and meta-analysis results do not support an association between circulating concentrations of endogenous sex hormones and colon or rectal cancer in postmenopausal women.

Intake of Various Food Groups and Risk of Breast Cancer: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies

Despite increasing evidence for the association of food-based dietary patterns with breast cancer risk, knowledge about the shape of the relationship and the quality of meta-evidence are insufficient. We aimed to summarize the associations between food groups and risks of breast cancer. We performed a systematic literature search of the PubMed and Embase databases up to March 2020. We included cohort, case-cohort, nested case-control studies, and follow-up studies of randomized controlled trials that investigated the relationship between breast cancer risk and at least 1 of the following food groups: red meat, processed meat, fish, poultry, egg, vegetables, fruit, dairy product (overall, milk, yogurt, and cheese), grains/cereals, nuts, legumes, soy, and sugar-sweetened beverages. Summary risk ratios (RRs) and 95% CIs were estimated using a random-effects model for linear and nonlinear relationships. Inverse linear associations were observed for vegetables (RR per 100 g/d,0.97;95% CI, 0.95-0.99), fruit (RR per 100 g/d,0.97;95% CI, 0.95-0.99), cheese (RR per 30 g/d,0.95;95% CI, 0.91-1.00), and soy (RR per 30 g/d,0.96;95% CI, 0.94-0.99), while positive associations were observed for red (RR per 100 g/d,1.10;95% CI, 1.03-1.18) and processed meat (RR per 50 g/d,1.18;95% CI, 1.04-1.33). None of the other food groups were significantly associated with breast cancer risk. A nonlinear association was observed only for milk, such that the intake of >450g/d increased the risk, while no association was observed for lower intake amounts. High intakes of vegetables, fruit, cheese, and soy products and low intakes of red and processed meat were associated with lower risks of breast cancer. However, causality cannot be inferred from these statistical correlations.

Adherence to Cancer Prevention Guidelines and Endometrial Cancer Risk: Evidence from a Systematic Review and Dose-Response Meta-analysis of Prospective Studies.

PurposeThe evidence of adherence to cancer prevention guidelines and endometrial cancer (EC) risk has been limited and controversial. This study summarizes and quantifies the relationship between adherence to cancer prevention guidelines and EC risk.Materials and MethodsThe online databases PubMed, Web of Science, and EMBASE were searched for relevant publications up to June 2, 2020. This study had been registered at PROSPERO. The registration number is CRD42020149966. Study quality evaluation was performed based on the Newcastle-Ottawa Scale. The I2 statistic was used to estimate heterogeneity among studies. Egger’s and Begg’s tests assessed potential publication bias. Summary hazard ratios (HRs) and 95% confidence intervals (CIs) for the relationship between adherence to cancer prevention guidelines score was assigned to participants by summarizing individual scores for each lifestyle-related factor. The scores ranged from least healthy (0) to most healthy (20) and the EC risk was calculated using a random-effects model.ResultsFive prospective studies (four cohort studies and one case-cohort study) consisted of 4,470 EC cases, where 597,047 participants were included. Four studies had a low bias risk and one study had a high bias risk. Summary EC HR for the highest vs. lowest score of adherence to cancer prevention guidelines was 0.54 (95% CI, 0.40 to 0.73) and had a high heterogeneity (I2=86.1%). For the dose-response analysis, an increment of 1 significantly reduced the risk of EC by 6%. No significant publication bias was detected.ConclusionThis study suggested that adherence to cancer prevention guidelines was negatively related to EC risk.

High Body Mass Index and Central Adiposity Is Associated with Increased Risk of Acute Pancreatitis: A Meta-Analysis

BackgroundHigher body mass index and waist circumference have been associated with increased risk of pancreatitis in several prospective studies; however, the results have not been entirely consistent.AimsWe conducted a systematic review and dose-response meta-analysis of prospective studies on adiposity and risk of pancreatitis to clarify this association.MethodsPubMed and Embase databases were searched for studies on adiposity and pancreatitis up to January 27, 2020. Prospective studies reporting adjusted relative risk (RR) estimates and 95% confidence intervals (CIs) for the association between adiposity and risk of pancreatitis were included, and summary RRs (95% CIs) were calculated using a random effects model.ResultsTen prospective studies with 5129 cases and 1,693,657 participants were included. The summary RR (95% CI) of acute pancreatitis was 1.18 (95% CI: 1.03–1.35, I2 = 91%, n = 10 studies) per 5 kg/m2 increase in BMI and 1.36 (95% CI: 1.29–1.43, I2 = 0%, n = 3) per 10 cm increase in waist circumference. There was evidence of a nonlinear association between BMI and acute pancreatitis, pnonlinearity < 0.0001, with a steeper association at higher levels of BMI, but not for waist circumference, pnonlinearity = 0.19. Comparing a BMI of 35 with a BMI of 22, there was a 58% increase in the RR and there was a fourfold increase in the RR comparing a waist circumference of 110 cm with 69 cm. There was no evidence of publication bias.ConclusionsThis meta-analysis suggests that both increasing BMI and waist circumference are associated with a dose-response-related increase in the risk of acute pancreatitis.

Birth Weight and Incidence of Breast Cancer: Dose-Response Meta-analysis of Prospective Studies

BackgroundMany studies have shown the association between birth weight and breast cancer (BC), but the evidence remains limited and inconsistent, especially in different menopause status. We sought to clarify the relationship and shape of the dose–response relation between birth weight and BC. MethodsThe Web of Science, PubMed, and Embase databases were searched for prospective studies involving the relationship between birth weight and risk of BC published to November 2019. Random effects of generalized least squares regression models were used to estimate the quantitative dose–response association, and restricted cubic splines were used to model the association. ResultsWe included reports of 16 prospective studies describing 16,000 incident cases among 553,644 participants. We identified a modest-in-magnitude, but significant, association between birth weight and BC risk: risk increased by 2% (risk ratio, 1.02, 95% confidence interval, 1.01-1.03) and 9% (risk ratio, 1.09, 95% confidence interval, 1.04-1.15) with a per–500 g birth weight increment in all ages and premenopausal women, respectively. Our results showed a linear dose–response relationship between birth weight and BC risk (Pnonlinearity = .311) in premenopausal women, with statistical significance when birth weight was above about 3.5 kg. No significant association was found in postmenopausal women. ConclusionHigher birth weight has a relationship with increased risk of BC in premenopausal women, particularly when birth weight is above 3.5 kg.

Low-Density Lipoprotein Cholesterol and Risk of Hemorrhagic Stroke: a Systematic Review and Dose-Response Meta-analysis of Prospective Studies.

To systematically examine the association between low-density lipoprotein cholesterol (LDL-C) and risk of hemorrhagic stroke. A previous meta-analysis of prospective studies published in 2013 showed that higher concentrations of LDL-C were associated with lower risk of hemorrhagic stroke. Recently, seven large cohort studies were published examining LDL-C and risk of hemorrhagic stroke in different populations. Twelve prospective studies with 476,173 participants and 7587 hemorrhagic stroke cases were included in the current meta-analysis. The results showed that a 10 mg/dL increase in LDL-C was associated with 3% lower risk of hemorrhagic stroke (pooled relative risk [RR] 0.97, 95% confidence interval [CI] 0.95-0.98). The association appeared to be more pronounced in Asians (pooled RR 0.95, 95% CI 0.92-0.98), relative to Caucasians (pooled RR 0.98, 95% CI 0.97-1.00), with a p heterogeneity of 0.05 between two ethnic groups. Further genetic studies and clinical trials with a stricter safety monitoring strategy are warranted to understand the underlying pathogenesis and determine the treatment target of LDL-C range with the lowest risk of hemorrhagic stroke in different population groups.

Body mass index, abdominal fatness, weight gain and the risk of urinary incontinence: a systematic review and dose-response meta-analysis of prospective studies.

Adiposity has been associated with elevated risk of urinary incontinence in epidemiological studies; however, the strength of the association has differed between studies. To conduct a systematic literature review and dose-response meta-analysis of prospective studies on adiposity and risk of urinary incontinence. We searched PubMed and Embase databases up to 19 July 2017. Prospective cohort studies were included. Data were extracted by one reviewer and checked for accuracy by a second reviewer. Summary relative risks (RRs) and 95% confidence intervals (CIs) were calculated using random effects models. Twenty-four prospective studies were included. The summary RR per 5kg/m2 increment in body mass index (BMI) was 1.20 (95% CI 1.16-1.25, I2 =62%, n=11) for population-based studies and 1.19 (95% CI 1.08-1.30, I2 =87.1%, n=8) for pregnancy-based studies, 1.18 (95% CI 1.14-1.22, I2 =0%, n=2) per 10cm increase in waist circumference and 1.34 (95% CI 1.11-1.62, I2 =90%, n=2) per 10kg of weight gain. Although the test for nonlinearity was significant for BMI, P=0.04, the association was approximately linear. For subtypes of urinary incontinence the summary RR per 5 BMI units was 1.45 (95% CI 1.25-1.68, I2 =85%, n=3) for frequent incontinence, 1.52 (95% CI 1.37-1.68, I2 =34%, n=4) for severe incontinence, 1.33 (95% CI 1.26-1.41, I2 =0%, n=8) for stress incontinence, 1.26 (95% CI 1.14-1.40, I2 =70%, n=7) for urge incontinence, and 1.52 (95% CI 1.36-1.69, I2 =0%, n=3) for mixed incontinence. These results suggest excess weight may increase risk of urinary incontinence. Overweight and obesity increase the risk of urinary incontinence.

Dietary intake and serum levels of trans fatty acids and risk of breast cancer: A systematic review and dose-response meta-analysis of prospective studies

Although the relationship between dietary intake and serum levels of trans fatty acids and risk of breast cancer has been investigated extensively, findings are inconsistent. To summarize earlier findings on the association of dietary intake and serum levels of trans fatty acids with risk of breast cancer through a dose-response meta-analysis. The online databases of PubMed, ISI Web of Science, Scopus, ProQuest, Science Direct and Embase were searched for relevant publications up to June 2018, using MeSH and non-MeSH keywords. In total, 7 prospective studies [6 cohort studies and one nested case-control study] were included on total dietary trans fat intake, and five studies [1 cohort study and 4 nested case-control studies] were included about serum trans fatty acids. Assessment of study quality was conducted using the Newcastle-Ottawa scale. Study-specific RRs were combined via fixed-effects model to compute overall RRs. Participants were apparently healthy aged 26 years or older. We observed no significant relationship between dietary intake of total trans fatty acids and risk of breast cancer (pooled effect size: 1.02, 95% CI: 0.95-1.10, P=0.403). Combining 3 effect sizes from 2 prospective and one nested case-control study, no significant relation was seen between dietary intake of CLA and risk of breast cancer (pooled effect size: 1.05, 95% CI: 0.95-1.17, P=0.513). Based on 5 effect sizes, each additional 1g/day dietary intake of total trans fats was not significantly associated with risk of breast cancer (RR=1.00; 95% CI=0.99-1.01). In addition, it seems that serum levels of trans fats might be associated with an increased risk of breast cancer only among postmenopausal women (Pooled effect size: 1.37, 95% CI: 1.04-1.81, P=0.02). In conclusion, dietary intake of trans fatty acids was not associated with risk of breast cancer; however, a significant positive association was seen between serum trans fats and risk of breast cancer in postmenopausal women.

Abstract P219: Central Obesity and All-cause and Cause Specific Mortality: a Systematic Review and Dose-response Meta-analysis of Prospective Studies

Background: The association of central obesity and mortality risk has not been systematically investigated. The strength and shape of dose-response relationship between central obesity and all-cause and cause specific mortality still remains unclear. Therefore, we conducted a systematic review and meta-analysis to clarify the associations. Methods: Categorical and dose-response meta-analysis was conducted involving of prospective studies. PubMed and Embase were searched up to April 1st, 2017 for eligible studies of waist circumference, waist-to-hip ratio and all-cause and cause specific mortality. Random-effects models were used to derive the summary relative risks (RRs) and corresponding 95% CI for specific categories of central obesity and a continuous association using generalized least-squares trend estimation. Results: A total of 1 760 947 participants in 50 studies were included in the meta-analysis. The pooled RRs for a 10 cm increase in waist circumference were 1.06 (95% CI, 1.04-1.08; I 2 =92.9%), 1.06 (95% CI, 1.03-1.08; I 2 =90.9%), 1.21 (95% CI, 1.06-1.35; I 2 =88.1%) and 1.05 (95% CI, 1.02-1.08; I 2 =86.5%) for all-cause, cardiovascular disease (CVD), coronary heart disease (CHD), and cancer mortality, respectively. We found a nonlinear relationship between waist circumference and all-cause mortality among both women (p&lt;0.001) and men (p=0.011). The summary RRs for a 0.1 unit in waist-to-hip ratio were 1.17 (95% CI, 1.12-1.21; I 2 =88.2%), 1.26 (95% CI, 1.17-1.34; I 2 =66.3%), 1.25 (95% CI, 1.10-1.40; I 2 =67.8%) and 1.13 (95% CI, 1.09-1.16; I 2 =0.0%) for all-cause, CVD, CHD, and cancer mortality, respectively. There was evidence of a nonlinear relationship between waist-to-hip ratio and all-cause mortality among women (p=0.016) rather than men (p=0.424). The dose-response relationship between central obesity and cause specific mortality were linear, except the association of waist circumference and CVD mortality (p=0.037), and waist-to-hip ratio and cancer mortality (p=0.039). Conclusions: Higher waist circumference and waist-to-hip ratio measured continuously and categorically, increase the risk of all-cause mortality among men and women and are associated with increased risk of CVD, CHD and cancer mortality.

Food Groups and Risk of Overweight, Obesity, and Weight Gain: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies

ABSTRACTThis meta-analysis summarizes the evidence of a prospective association between the intake of foods [whole grains, refined grains, vegetables, fruit, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages (SSBs)] and risk of general overweight/obesity, abdominal obesity, and weight gain. PubMed and Web of Science were searched for prospective observational studies until August 2018. Summary RRs and 95% CIs were estimated from 43 reports for the highest compared with the lowest intake categories, as well as for linear and nonlinear relations focusing on each outcome separately: overweight/obesity, abdominal obesity, and weight gain. The quality of evidence was evaluated with use of the NutriGrade tool. In the dose-response meta-analysis, inverse associations were found for whole-grain (RRoverweight/obesity: 0.93; 95% CI: 0.89, 0.96), fruit (RRoverweight/obesity: 0.93; 95% CI: 0.86, 1.00; RRweight gain: 0.91; 95% CI: 0.86, 0.97), nut (RRabdominal obesity: 0.42; 95% CI: 0.31, 0.57), legume (RRoverweight/obesity: 0.88; 95% CI: 0.84, 0.93), and fish (RRabdominal obesity: 0.83; 95% CI: 0.71, 0.97) consumption and positive associations were found for refined grains (RRoverweight/obesity: 1.05; 95% CI: 1.00, 1.10), red meat (RRabdominal obesity: 1.10; 95% CI: 1.04, 1.16; RRweight gain: 1.14; 95% CI: 1.03, 1.26), and SSBs (RRoverweight/obesity: 1.05; 95% CI: 1.00, 1.11; RRabdominal obesity: 1.12; 95% CI: 1.04, 1.20). The dose-response meta-analytical findings provided very low to low quality of evidence that certain food groups have an impact on different measurements of adiposity risk. To improve the quality of evidence, better-designed observational studies, inclusion of intervention trials, and use of novel statistical methods (e.g., substitution analyses or network meta-analyses) are needed.

Dietary intake and blood concentrations of antioxidants and the risk of cardiovascular disease, total cancer, and all-cause mortality: a systematic review and dose-response meta-analysis of prospective studies

ABSTRACTBackgroundHigh dietary intake or blood concentrations (as biomarkers of dietary intake) of vitamin C, carotenoids, and vitamin E have been associated with reduced risk of cardiovascular disease, cancer, and mortality, but these associations have not been systematically assessed.ObjectiveWe conducted a systematic review and meta-analysis of prospective studies of dietary intake and blood concentrations of vitamin C, carotenoids, and vitamin E in relation to these outcomes.DesignWe searched PubMed and Embase up to 14 February 2018. Summary RRs and 95% CIs were calculated with the use of random-effects models.ResultsSixty-nine prospective studies (99 publications) were included. The summary RR per 100-mg/d increment of dietary vitamin C intake was 0.88 (95% CI: 0.79, 0.98, I2 = 65%, n = 11) for coronary heart disease, 0.92 (95% CI: 0.87, 0.98, I2 = 68%, n = 12) for stroke, 0.89 (95% CI: 0.85, 0.94, I2 = 27%, n = 10) for cardiovascular disease, 0.93 (95% CI: 0.87, 0.99, I2 = 46%, n = 8) for total cancer, and 0.89 (95% CI: 0.85, 0.94, I2 = 80%, n = 14) for all-cause mortality. Corresponding RRs per 50-μmol/L increase in blood concentrations of vitamin C were 0.74 (95% CI: 0.65, 0.83, I2 = 0%, n = 4), 0.70 (95% CI: 0.61, 0.81, I2 = 0%, n = 4), 0.76 (95% CI: 0.65, 0.87, I2 = 56%, n = 6), 0.74 (95% CI: 0.66, 0.82, I2 = 0%, n = 5), and 0.72 (95% CI: 0.66, 0.79, I2 = 0%, n = 8). Dietary intake and/or blood concentrations of carotenoids (total, β-carotene, α-carotene, β-cryptoxanthin, lycopene) and α-tocopherol, but not dietary vitamin E, were similarly inversely associated with coronary heart disease, stroke, cardiovascular disease, cancer, and/or all-cause mortality.ConclusionsHigher dietary intake and/or blood concentrations of vitamin C, carotenoids, and α-tocopherol (as markers of fruit and vegetable intake) were associated with reduced risk of cardiovascular disease, total cancer, and all-cause mortality. These results support recommendations to increase fruit and vegetable intake, but not antioxidant supplement use, for chronic disease prevention.

Coffee Consumption and Risk of Dementia and Alzheimer's Disease: A Dose-Response Meta-Analysis of Prospective Studies.

Coffee consumption is associated with a reduced risk of several diseases but uncertainty remains about the influence of coffee consumption on the risk of dementia. We performed a dose-response meta-analysis to summarize the prospective data on coffee consumption and associated risk of dementia and Alzheimer’s disease. We identified studies by searching PubMed (from January 1966) and Web of Science (from January 1945) through 4 October 2018 and by scrutinizing the reference lists of pertinent publications. Two researchers independently reviewed the literature. Results were combined using a restricted cubic spline random-effects dose-response meta-analysis based on a one-stage approach. Eight relevant prospective studies were identified. These studies included 7486 dementia cases diagnosed among 328,885 individuals during an average follow-up of 4.9–25 years. Meta-analysis of all eight studies indicated no statistically significant association between coffee consumption and the risk of dementia and no deviations from a linear trend (p = 0.08). The relative risk of dementia per 1 cup/day increment of coffee consumption was 1.01 (95% confidence interval (CI) 0.98–1.05; p = 0.37). Meta-analysis of five studies that focused on Alzheimer’s disease revealed no association between coffee consumption and Alzheimer’s disease and no deviations from a linear trend (p = 0.79). The relative risk of Alzheimer’s disease per 1 cup/day increment of coffee consumption was 1.01 (95% confidence interval 0.95–1.07; p = 0.80). These results do not support an association between coffee consumption and an increased risk of overall dementia or Alzheimer’s disease specifically, but further research on the association of coffee consumption with dementia risk is needed.

Resting heart rate and the risk of hypertension and heart failure: a dose-response meta-analysis of prospective studies.

Studies on the relationship of resting heart rate to the risks of hypertension and heart failure have been inconsistent, and the question as to whether there is a linear association between them is unanswered. To evaluate this possible relationship, we carried out a dose-response meta-analysis of studies that looked at risks associated with resting heart rate and hypertension or heart failure. We searched PubMed, Embase, CNKI and WanFang databases for articles published before 15 June 2017. A random-effect model was used to pool relative risks and 95% confidence intervals. Restricted cubic spline analysis was used to model the resting heart rate-hypertension and heart failure risk association. We identified 13 and 17 cohort studies for hypertension and heart failure, respectively. The risk for each disease, respectively, increased by 11% relative risk: 1.11 (95% confidence interval: 1.07-1.15) and 19% relative risk: 1.19 (95% confidence interval: 1.13-1.25) for each 10 beats-per-minute increment in resting heart rate. The relationship between resting heart rate and hypertension or heart failure was consistent in most subgroup analyses except for gender subgroups, with no significant association observed in the women subgroup. The results provide no evidence of a nonlinear association of elevated resting heart rate with hypertension and heart failure risk. Resting heart rate shows a linear positive association with the incidence of hypertension and heart failure.

Blood pressure and the risk of dementia: a systematic review and dose-response metaanalysis of prospective studies (P1.196)

Blood pressure and the risk of dementia: a systematic review and dose-response metaanalysis of prospective studies (P1.196)

Body mass index, abdominal fatness, and hypertension incidence: a dose-response meta-analysis of prospective studies.

Despite the established relationship of obesity to hypertension, the question as to whether there is a linear association between these two morbidities is unanswered. To quantitatively evaluate the relationship between obesity and hypertension, we carried out a dose-response meta-analysis of studies that looked at the relationship of different adiposity measures to hypertension. We searched PubMed, Embase, and Web of Science databases for articles published before 27 June 2017. A random-effects model was used to pool relative risks and 95% confidence intervals. Restricted cubic spline analysis was used to model the relationship. A total of 59 studies were included. Fifty-seven cohort studies with 125,071 incident cases among 830,685 participants were included in the analysis of body mass index and hypertension with the summary relative risk for per 5-unit increment in body mass index of 1.50 (95% confidence interval: 1.40-1.59). We found that the risk of hypertension in the body mass index analysis was greater in populations where the baseline body mass index was <25 kg/m2. The summary relative risk for a 10-cm increase in waist circumference was 1.25 (95% confidence interval: 1.19-1.32) and per 0.1-unit increase in waist-to-hip ratio was 1.27 (95% confidence interval: 1.18-1.37). This meta-analysis suggests that in normal range of obesity indexes, as lean as possible may be the best suggestion to prevent hypertension incidence.