Meta-analysis Of Longitudinal Studies Research Articles

Longitudinal changes in executive function in autism spectrum disorder: A systematic review and meta-analyses.

Individuals with an autism spectrum disorder (ASD) diagnosis show impairment in executive function (EF). However, findings are mixed regarding differences in the age effect on EF between autistic individuals and persons with typical development (TD). Questions remain regarding whether the age-related trajectories of EF in ASD are the same as or different from those in TD. To bridge this knowledge gap, we conducted a systematic review and meta-analyses of longitudinal studies that compared age-related changes in EF between ASD and TD groups (preregistration: osf.io/j5764). A literature search was conducted using PubMed, PsycINFO, and Web of Science on January 29, 2024. After screening by two independent reviewers, 14 longitudinal studies were included. Random-effects meta-analyses of studies involving a maximum total of 518 autistic and 3558 TD children and adolescents (mean baseline ages: 5.7-12.0 years) showed that ASD had significantly poorer EF than TD at both baseline and follow-up. However, there was no significant group difference in the age-related change in EF across domains, including working memory, inhibition, shifting, and planning. Robust Bayesian meta-analyses also provided substantial evidence in favor of the null hypothesis that ASD and TD groups showed similar changes over time for most EF processes. Limitations of the literature included the limited number of longitudinal studies and a narrow range of developmental stages and EF constructs analyzed across studies. Altogether, these findings suggest that autistic children and adolescents generally can improve in EF over time similarly to their neurotypical peers. This has important implications for parents and educators, encouraging appropriate EF training and intervention for autistic children and adolescents at an early stage.

Oral dysbiosis and risk of gastrointestinal cancers: A systematic review and meta-analysis of longitudinal studies.

Poor oral health and oral dysbiosis were found to be associated with cancers, especially of the gastrointestinal (GI)system. But the cause-and-effect relationship and the effect of the risk are not yet known due to scarcity of literature. Understanding such risk relationship can contribute to an integrated multi-disciplinary approach for GI cancer prevention. The aim of the present systematic review and meta-analysis is to assess the role of oral dysbiosis on increasing the risk of digestive system cancers. To evaluate the effect of poor oral health on increasing the risk of gastrointestinal cancers. We conducted a systematic search following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in databases PubMed, Elsevier, Wiley's online library and Web of Science from inception to February 2023 to include recent cohort studies that assessed the association between poor oral health and the risk of cancer. We assessed bias using the New Castle Ottawa scale. We used inferential statistics to describe the effect of oral dysbiosis on gastrointestinal cancers. We performed a sub-group analysis to assess the effect of oral conditions on individual cancers. We included 10 longitudinal studies in the meta-analysis. The overall effect size of poor oral health and GI cancer risk was hazard's ratio (HR) =1.30 (95% CI: [1.14, 1.46]) (p<0.001) (I2 = 68.78). Sub-group analysis indicated that poor oral health increases the risk of esophageal cancer HR=1.61 (95% CI: [1.37, 1.85]), stomach cancer HR=1.33 (95% CI: [1.08, 1.58]), pancreatic cancer HR=1.90 (95%CI; [1.29, 2.50]) and colorectal and hepatocellular carcinoma HR=1.16 (95% CI: [1.08, 1.23]). The meta-analysis indicated that poor oral health was significantly associated with increasing the risk of GI cancers.

Down the rabbit hole: Acculturation, integration and adaptation

The re-analysis of Nguyen and Benet-Martínez’s (2013) meta-analytic data and a new meta-analysis of longitudinal studies by Bierwiaczonek and Kunst (2021) showed that the relationship between acculturation and adaptation is weak and that the effect size for unbiased results for integration may not differ from zero. These findings pose a major challenge to acculturation theory and research where the premises that acculturation is reliably related to adaptation and that integration is the most adaptive strategy are widely accepted. In this paper I consider how we as acculturation scholars could respond to this challenge. First, I summarize the results of Bierwiaczonek and Kunst’s (2021) meta-analytic studies and the response by Grigoryev et al. (2023), noting that the findings reported in both papers are characterized by small effect sizes and large amounts of heterogeneity. I then consider what single studies can tell us about acculturation and adaptation, highlighting the influence of methodological and contextual factors on this relationship. Finally, I synthesize research on cultural identity configurations, bicultural identity integration and cultural identity styles to show how each program of research on cultural identity integration leads to different, but more nuanced, conclusions about the relationship between acculturation and adaptation. To advance acculturation theory and research I argue that we should reframe our questions from “to what extent are acculturation and integration related to adaptation?” to “how and when are acculturation and integration related to adaptation?” I also advocate putting more emphasis on acculturation processes and contexts in future research.

Sleep characteristics and risk of Alzheimer's disease: a systematic review and meta-analysis of longitudinal studies.

Alzheimer's disease (AD) is on the rise in our aging society, making it crucial to identify additional risk factors to mitigate its increasing incidence. This systematic review and meta-analysis aimed to provide updated evidence regarding the association between sleep and AD. We conducted a comprehensive search of MEDLINE, EMBASE, and Web of Science databases from inception to July 2023 to identify longitudinal studies. Adjusted relative risks were pooled for each sleep characteristic, and a dose-response analysis was performed specifically for sleep duration. A total of 15,278 records were initially retrieved, and after screening, 35 records were ultimately included in the final analysis. The results showed that insomnia (RR, 1.43; 95%CI, 1.17-1.74), sleep-disordered breathing (RR, 1.22; 95%CI, 1.07-1.39), as well as other sleep problems, including sleep fragmentation and sleep-related movement disorders, were associated with a higher risk of developing AD, while daytime napping or excessive daytime sleepiness (RR, 1.18; 95%CI, 1.00-1.40) only exhibited a trend toward a higher risk of AD development. Furthermore, our analysis revealed a significant association between self-reported sleep problems (RR, 1.34; 95%CI, 1.26-1.42) and the incidence of AD, whereas this association was not observed with sleep problems detected by objective measurements (RR, 1.14; 95%CI, 0.99-1.31). Moreover, both quite short sleep duration (< 4h) and long duration (> 8h) were identified as potential risk factors for AD. Our study found the association between various types of sleep problems and an increased risk of AD development. However, these findings should be further validated through additional objective device-based assessments. Additional investigation is required to establish a definitive causal connection between sleep problems and AD.

The effects of parental perception of children’s weight on children’s weight change: a systematic review and meta-analysis of longitudinal studies

Childhood obesity has been a public health concern worldwide(1). Parents are a crucial part of the weight monitoring of children(2). But effects of parental perception of children’s weight on children’s weight change remain inconclusive. This systematic review and meta-analysis aimed to evaluate the effects. A systematic search of six databases was conducted from inception to March 2023 based on Cochrane guidelines. Longitudinal studies were included. Data were synthesised using a semi-quantitative approach and meta-analysis. Finally, nine studies with a total of 25,475 respondents were included in the systematic review and meta-analysis. The pooled results showed that compared to children perceived as normal weight, children who were perceived as overweight or obese by their parents had a statistically significantly greater weight gain (pooled coefficient β = 0.43, 95% confidence interval (CI): 0.1, 0.76, p&lt;0.05) during follow-up. Conversely, children perceived as underweight presented less weight gain (β=-0.16, 95%CI: −0.3,-0.02, p&lt;0.05) during follow-up compared to children perceived as normal weight. However, parental misperception of their children’s weight was not statistically significantly associated with children’s weight change (underestimation: β = 0.04, 95% CI:-0.37, 0.44, p&gt;0.05; overestimation: β=-0.09, 95% CI:-0.06, 0.23, p&gt;0.05). We found that parental perception of children’s weight, not parental misperception, might influence children’s subsequent weight change. Longitudinal and intervention studies using validated measurements and including potential confounders and mediators are needed to confirm the causalities.

Is Formal Social Participation Associated with Cognitive Function in Middle-Aged and Older Adults? A Systematic Review with Meta-Analysis of Longitudinal Studies.

This systematic review with meta-analysis aimed to explore the association between formal social participation and cognitive function in middle-aged and older adults using data from longitudinal studies. A comprehensive search was conducted in Scopus, PubMed, and Web of Science for longitudinal studies that assessed the association between formal social participation and cognitive function in middle-aged and older adults published between January 2010 to 19 August 2022. Risk of bias was judged using the RoBANS tool. Meta-analysis using a random-effects model was computed with odds ratio (OR) and 95% confidence interval (CI) for cognitive decline probability. Sensitivity analyses were made to explore any changes to the pooled statistical heterogeneity and pooled effect size. Certainty of evidence was judged using the GRADE framework. We included 15 studies comprising 136,397 participants from 5 countries. Meta-analyses showed that formal social participation was associated with reduced cognitive decline (OR = 0.78, 95% CI 0.75-0.82, p < 0.001), with very low certainty of evidence. Formal social participation appears to enhance cognition in middle-aged and older adults, but further high-quality research is needed given the very low certainty of evidence.

Stability and change in academic achievement goals: A meta-analysis of longitudinal studies.

Stability and change in academic achievement goals: A meta-analysis of longitudinal studies.

Supplemental Material for Stability and Change in Academic Achievement Goals: A Meta-Analysis of Longitudinal Studies

Supplemental Material for Stability and Change in Academic Achievement Goals: A Meta-Analysis of Longitudinal Studies

Risk of cardiovascular disease decreases over time in psoriatic arthritis but not in spondylarthritis: meta-analysis of longitudinal studies.

Spondyloarthritis (SpA) and psoriatic arthritis (PsA) represent two frequent inflammatory rheumatic disorders, characterized by an increased burden on quality of life, due to the association of several comorbidities, especially cardiovascular diseases (CVD). The estimated prevalence of CVD ranges from 12-19% and differ between the two diseases, however, its incidence is not completely known. We aimed to systematically review the literature (SLR) and perform a meta-analysis of controlled observational studies to assess the incidence rate of CVD over time, separately in SpA and PsA. We performed a SLR of longitudinal studies with a study period of at least 5 years, including SpA/PsA patients and general population. The main outcome was the occurrence of CVD, including ischemic heart disease, stroke, and death from CV cause. We then performed a random-effect model for meta-analysis. The SLR included 34 articles, mainly focused on the association between SpA/PsA and CVD. Twenty-four articles were then selected for the meta-analysis. The overall incidence of CVD was increased in PsA (HR: 1.28, 95%CI: 1.15-1.43), and in SpA (HR: 1.45, 95%CI: 1.22-1.72) compared with the general population, with consistency across the different types of CVD; Interestingly the incidence tended to decrease over time in PsA, but not in SpA. The SLR and meta-analysis confirmed the increased incidence of CVD in both SpA and PsA patients compared with the general population during the last years, although such increase seems to be less prominent in PsA than in SpA. Future studies are needed to confirm such tendence.

Association between Statins Administration and Influenza Susceptibility: A Systematic Review and Meta-Analysis of Longitudinal Studies.

Previous studies reported that the association between statins use and influenza infection was contradictory. A systematic review and meta-analysis of longitudinal studies were performed to determine the association between statins use and influenza susceptibility. The literature search was conducted in PubMed, Embase, and Web of Science, from each database's inception to 21 May 2023. The fixed effect model and random effects model were used for data synthesis. In our study, a total of 1,472,239 statins users and 1,486,881 statins non-users from five articles were included. The pooled risk ratio (RR) of all included participants was 1.05 (95% CI: 1.03-1.07), and there were still significant differences after adjusting for vaccination status. Of note, RR values in statins users were 1.06 (95% CI: 1.03-1.08) in people aged ≥60 years old and 1.05 (95% CI: 1.03-1.07) in participant groups with a higher proportion of females. Administration of statins might be associated with an increased risk of influenza infection, especially among females and elderly people. For those people using statins, we should pay more attention to surveillance of their health conditions and take measures to prevent influenza infection.

Does social isolation mediate the association between hearing loss and cognition in adults? A systematic review and meta-analysis of longitudinal studies.

There has been extensive research on the relationship between hearing and cognitive impairment in older adults but little examination of the role of mediating factors. Social isolation is a potential mediator, occurring because of hearing loss, and contributing to accelerated cognitive decline. Previous systematic reviews on this topic area have not considered the temporal nature of hearing loss and cognitive impairment exclusively or examined potential mediators within a longitudinal study design. A systematic review was conducted. Electronic searches were performed in Web of Science, PubMed (Medline), Scopus, EMBASE, PsychInfo, and ProQuest (PsychArticles and ProQuest Dissertation and Theses) based on a search string of keywords relating to hearing loss, social isolation, and cognitive impairment/dementia in June 2023. Papers were critically appraised using the CASP checklists for cohort studies. Risk of bias in the selected studies was assessed using the Item Bank for Assessment of Risk of Bias and Precision for Observational Studies of Interventions or Exposures. Eleven of the 15 included studies provide evidence of a dose-dependent association between hearing threshold (40 dB HL or greater) and later cognitive impairment or incident dementia. Only one study included social isolation as a mediator, which was found to not be a significant contributing factor. The meta-analysis of 5 studies pooled hazard ratio for cognitive impairment due to hearing loss is 1.11 (95% CI: 1.06 to 1.15, p < 0.001). The pooled hazard ratio for incident dementia due to hearing loss was HR 1.21 (95% CI: 1.11 to 1.31, p = 0.002). The analysis of included studies indicate that hearing threshold level affects later cognitive status or dementia diagnosis. There is not enough evidence to determine the role of social isolation as a mediator. Future epidemiology studies need to measure different elements of social isolation and ensure that hearing and cognition are measured at multiple time points.

Examining the reciprocal link between social anxiety and social relationships spanning from childhood to adulthood: A meta-analysis of longitudinal studies.

It is theoretically plausible that social anxiety (SA) and social relationships (SR) can influence each other. However, the available empirical evidence is inconsistent, leading to substantial uncertainty regarding the cross-lagged relations between SA and SR. This meta-analysis systematically integrates data from 107 longitudinal studies, comprising 110 independent samples and involving a total of 115,133 participants from childhood to adulthood. Four types of SR were assessed: family-related, school-related, romantic, and general relationships. One-stage meta-analytic structural equation modeling was applied to fit four cross-lagged panel models and to test potential moderators. No significant publication bias was detected. Effect size analyses revealed that prior SA significantly and negatively predicted quality of all types of SR. Family-related and general relationships each predicted prospective SA symptoms, but school-related and romantic relationships did not. No moderators were identified in analyses of family-related and romantic relationships. However, the publication year, sample age, gender, reporter, and time lag played a moderating role in analyses of school-related and general relationships. These findings suggest that SA is a crucial factor undermining SR and that dysfunctional family and general relationships also contribute to the exacerbation of SA symptoms. The strengths, limitations, and future directions of this study are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A meta-analysis of longitudinal studies on the interplay between sleep, mental health, and positive well-being in adolescents

ObjectiveThis review aimed to summarize longitudinal research about the interplay between sleep, mental health, and positive well-being in adolescents. MethodMultiple search strategies were applied until 28th January 2023 to identify relevant research published in peer-reviewed journal articles or available grey literature. A final set of 63 studies were included in the systematic review and 42 in the meta-analysis. ResultsResults highlighted that long sleep duration, good sleep quality, and low insomnia symptoms were bidirectionally related to lower internalizing (Sleep T1 → Internalizing symptoms T2: r = -.20, p < .001; Internalizing symptoms T1 → Sleep T2: r = -.21, p < .001) and externalizing (Sleep T1 → Externalizing symptoms T2: r = -.15, p < .001; Externalizing symptoms T1→ Sleep T2: r = -.17, p < .001) symptoms, and to higher levels of psychological well-being (Sleep T1 → Psychological well-being T2: r = .15, p < .001; Psychological well-being T1 → Sleep T2: r = .15, p < .05). Moreover, good sleep was positively related to higher subjective well-being at a later time point (r = .18, p < .001). ConclusionsOverall, these findings suggest a bidirectional relation between different aspects of sleep, mental health, and positive well-being.

Supplemental Material for Examining the Reciprocal Link Between Social Anxiety and Social Relationships Spanning From Childhood to Adulthood: A Meta-Analysis of Longitudinal Studies

Supplemental Material for Examining the Reciprocal Link Between Social Anxiety and Social Relationships Spanning From Childhood to Adulthood: A Meta-Analysis of Longitudinal Studies

Predictors of progression from subjective cognitive decline to objective cognitive impairment: A systematic review and meta-analysis of longitudinal studies

BackgroundSubjective cognitive decline is one of the first symptoms of dementia. With increasing awareness of brain health and a rising prevalence of dementia, a growing number of individuals seek medical assistance for purely subjective cognitive decline. However, only individuals with specific characteristics tend to experience clinical progression. ObjectivesThis study aims to summarize the predictors of objective cognitive impairment in individuals with subjective cognitive decline and to identify those at higher risk of clinical progression. DesignSystematic review and meta-analysis. MethodsWe systematically searched 11 electronic databases from inception to February 1, 2023, for longitudinal studies investigating factors associated with the clinical progression of subjective cognitive decline. Effect sizes were pooled using fixed-effects and random-effects models. Leveraging the results of the meta-analysis, we developed two risk prediction models for objective cognitive impairment. ResultsForty-six cohort studies were included in the systematic review, of which 28 met the meta-analysis criteria. Fifteen predictors were identified, including 4 biomarkers (amyloid β deposition, lower Hulstaert Formula scores, apolipoprotein e4, and hippocampus atrophy), four epidemiological factors (older age at baseline, impaired instrumental activity of daily living, depression, and anxiety), and seven neuropsychological factors (participants in clinical settings, older age at onset, stable symptom, concerns, cognitive decline confirmed by informant, severe symptoms, and poor performance on Trail Making Test B). Based on the meta-analysis results, we developed two risk prediction models. The first model (Model1) incorporates epidemiological and neuropsychological factors, distinguishing individuals with low and medium risk. The second model (Model2) includes additional biomarkers to enhance predictive performance and identify individuals at high risk. ConclusionsThis study provides a comprehensive characterization of individuals undergoing clinical progression from subjective cognitive decline to mild cognitive impairment or dementia. The developed models support the prediction of progression risk in both memory clinic and community settings, aiding in the early identification of individuals at risk of disease conversion and facilitating the translation of evidence into clinical practice. RegistrationThe systematic review and meta-analysis have been registered in PROSPERO (CRD 42023392476). Tweetable abstractFactors for predicting progression from subjective cognitive decline to objective cognitive impairment: evidence from longitudinal studies.

A Systematic Review and Meta-Analysis of Longitudinal Studies on Posttraumatic Stress Disorders in Refugees and Asylum Seekers

AbstractPosttraumatic stress disorder (PTSD) is among the common mental disorders in refugees and asylum seekers; however, it is unclear if population prevalence declines or persists after resettlement. Therefore, this study aimed to identify longitudinal studies reporting PTSD among refugees and asylum seekers in upper-middle and high-income countries and to conduct a meta-analysis to map the trajectory of PTSD prevalence over time in order to inform policymakers. Seven electronic databases were searched for relevant prospective longitudinal studies. The Joanna Briggs Institute (JBI) scale was used to assess the quality of studies, and we excluded studies with a high risk of bias leaving 21 studies: 13 with moderate and 8 with a low risk of bias. The total follow-up period ranged from 1 to 7 years. Random effects meta-analysis pooling all studies suggested a baseline prevalence of 17.65% in the immediate period after resettlement (up to 1 year after arrival) and a trend for decreasing prevalence to 11.64% over time. However, studies with over 6 years of follow-up indicated a higher longitudinal prevalence of 13–17%, and in the low-risk-of-bias study subgroup, the prevalence did not decrease (ranging between 27.54 and 30.10%), which raises the possibility that PTSD prevalence may not substantially decrease in the first 6 years after resettlement. The finding that studies with a low risk of bias reported a larger prevalence of PTSD persisting over time highlights the importance of conducting high-quality longitudinal studies to inform policy. Appropriate long-term interventions are needed to decrease the impact of traumatic events on the mental health of refugees and asylum seekers.

Should stressful life events be monitored after a first episode of psychosis?

In the 3 years following a first episode of psychosis, 50% of individuals will experience a relapse, which could be expressed as symptom exacerbation or readmission to a psychiatric inpatient unit. 1 Alvarez-Jimenez M Priede A Hetrick SE et al. Risk factors for relapse following treatment for first episode psychosis: a systematic review and meta-analysis of longitudinal studies. Schizophr Res. 2012; 139: 116-128 Crossref PubMed Scopus (312) Google Scholar Hence, finding the relevant risk factors for new episodes is an urgent matter in psychiatric research and clinical practice. Whereas risk factors such as substance misuse and non-adherence to medication are well understood and can be targeted by interventions, less is known about other factors that might also be important, such as sleep deprivation, depressive or manic symptoms, or stressful life events. 1 Alvarez-Jimenez M Priede A Hetrick SE et al. Risk factors for relapse following treatment for first episode psychosis: a systematic review and meta-analysis of longitudinal studies. Schizophr Res. 2012; 139: 116-128 Crossref PubMed Scopus (312) Google Scholar Among these factors, stressful life experiences are associated with an increased risk of developing psychosis in people who are already considered as having a high risk of psychosis. 2 Betz LT Penzel N Kambeitz-Ilankovic L et al. General psychopathology links burden of recent life events and psychotic symptoms in a network approach. NPJ Schizophr. 2020; 6: 40 Crossref PubMed Scopus (20) Google Scholar , 3 Mayo D Corey S Kelly LH et al. The role of trauma and stressful life events among individuals at clinical high risk for psychosis: a review. Front Psychiatry. 2017; 8: 55 Crossref PubMed Scopus (110) Google Scholar Therefore, it could be possible that stressful life experiences also affect the risk of relapses after the first episode of psychosis. Stressful life events and relapse of psychosis: analysis of causal association in a 2-year prospective observational cohort of individuals with first-episode psychosis in the UKThese results provide converging evidence of a causal effect of stressful life events on the risk of relapse in psychosis. They suggest that there is a need to develop interventions at the individual and health-service level that could mitigate the harmful effects of stressful life events. Full-Text PDF Open Access

A Suicide-Specific Diagnosis – The Case Against

A Suicide-Specific Diagnosis – The Case Against

Testing the bottom-up and top-down models of self-esteem: A meta-analysis of longitudinal studies.

The present meta-analysis tests the bottom-up and top-down models of self-esteem, by synthesizing the available longitudinal evidence on prospective effects between global and domain-specific self-esteem. The bottom-up model assumes that people's domain-specific self-esteem influences their global self-esteem, whereas the top-down model assumes the reverse direction of effects. Eight domains of self-esteem were assessed: academic abilities, physical appearance, athletic abilities, morality, romantic relationships, social acceptance, mathematics, and verbal abilities. We conducted a comprehensive search of the literature, which led to the inclusion of data from 43 independent samples (total N = 24,668). One-stage meta-analytic structural equation modeling was used to estimate the coefficients of interest. There was no evidence of publication bias. Overall, the results indicated a pattern of reciprocal prospective effects between global and domain-specific self-esteem. Bottom-up effects were significant in all domains except verbal abilities (mean effect sizes ranged from .05 to .19). Top-down effects were significant in all domains except mathematics (mean effect sizes ranged from .05 to .12, except .01 in the mathematics domain). None of the moderators tested (i.e., age, gender, measure, time lag, and publication year) was significant in any of the domains, which strengthens the generalizability of the results. In sum, the findings provide support for both bottom-up and top-down effects, suggesting a reciprocal relation model between global and domain-specific self-esteem. The discussion addresses the implications of the findings for research in the field of self-esteem. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Dietary recommendations in the prevention and treatment of osteoporosis.

This article presents the initial recommendations of the French Rheumatology Society (Société Française de Rhumatologie - SFR) and the Osteoporosis Research and Information Group (Groupe de Recherche et d'Informations sur les Ostéoporoses - GRIO) on the role of diet in the prevention and treatment of osteoporosis. The recommendations were produced by a working group composed of rheumatologists, physician nutrition specialists and a geriatrician. Fifteen (15) questions pertaining to "daily practices" were preselected by the working group. For the literature review, the working group focussed mainly on the effects of diet on bone mineral density (BMD) and fractures, and primarily on meta-analyses of longitudinal studies and dietary intervention studies. A Mediterranean-type diet and the daily consumption of 2 to 3 dairy products are recommended. Together, these provide the calcium and "high quality" protein required to maintain a normal calcium-phosphorus balance and bone metabolism, and are associated with lower fracture risk. Conversely, unbalanced Western diets, vegan diets, weight-loss diets in non-overweight individuals, alcohol consumption and daily consumption of sodas are advised against. In terms of the beneficial effects on bone mineral density and fracture risk, current scientific data are either insufficient or too divergent to recommend increasing or restricting the consumption of tea or coffee, vitamins other than vitamin D, vitamin D-enriched or phytoestrogen-rich foods, calcium-enriched plant-based beverages, oral nutritional supplements, or dietary sources of prebiotics and probiotics. These are the first set of recommendations addressing the role of diet in the prevention and treatment of osteoporosis. More research is necessary to direct and support guidelines.