scholarly journals The Effects of Dairy Intake on Insulin Resistance: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 2237 ◽  
Author(s):  
Kristen M. Sochol ◽  
Tanya S. Johns ◽  
Rupinder S. Buttar ◽  
Lovepreet Randhawa ◽  
Edeline Sanchez ◽  
...  

The incidence of type 2 diabetes mellitus (DM) has increased in the US over the last several years. The consumption of low-fat dairy foods has been linked with decreasing the risk of DM but studies have yet to show a clear correlation. We conducted a systematic review and meta-analysis of randomized clinical trials (RCTs) evaluating the effects of dairy intake on homeostatic model assessment of insulin resistance (HOMA-IR), waist circumference, and body weight. In MEDLINE and Embase, we identified and reviewed 49 relevant RCTs: 30 had appropriate data format for inclusion in the meta-analysis. Using the Review Manager 5 software, we calculated the pooled standardized mean differences comparing dairy dietary interventions to control for our outcomes of interest. For HOMA-IR (794 individuals), we found a mean difference of −1.21 (95% CI −1.74 to −0.67; p-value < 0.00001; I2 = 92%). For waist circumference (1348 individuals), the mean difference was −1.09 cm (95% CI 1.68 to −0.58; p-value < 0.00001; I2 = 94%). For body weight (2362 individuals), the dairy intake intervention group weighed 0.42 kg less than control (p-value < 0.00001; I2 = 92%). Our findings suggest that dairy intake, especially low-fat dairy products, has a beneficial effect on HOMA-IR, waist circumference, and body weight. This could impact dietary recommendations to reduce DM risk.

Author(s):  
Manije Darooghegi Mofrad ◽  
Jamal Rahmani ◽  
Hamed Kord Varkaneh ◽  
Alireza Teymouri ◽  
Seyed Mohammad Mousavi

Abstract. Obesity is related to increase in the incidence of morbidity and mortality. Studies have suggested anti-obesity properties of garlic; however, results are inconsistent. This systematic review and meta-analysis is done to summarize the data obtained from available randomized clinical trials on the effect of garlic supplementation on body weight, Body Mass Index (BMI), and Waist Circumference (WC). The online databases of Scopus, PubMed, Google Scholar and Cochrane library were searched until March 2018 for related publications using relevant keywords. Effect sizes of eligible studies were pooled using random-effects models. Cochran’s Q-test and I2 index were used for assessing heterogeneity. We found 1241 records in our initial search, of which 13 randomized clinical trials (RCTs) with 15 treatment arms were included. Pooled analysis showed that garlic administration might significantly decrease WC (Weighed Mean Difference (WMD): −1.10 cm, 95% CI: −2.13, −0.07, P = 0.03, I2 = 0%). However, garlic intervention had no significant effect on body weight (WMD): −0.17 kg, 95% CI: −0.75 to 0.39, P = 0.54, I2 = 0%) and BMI (WMD: −0.17 kg/m2, 95% CI: −0.52, 0.16, P = 0.30, I2 = 44.5%) as compared to controls. From Subgroup analysis, it was ascertained that the effect of garlic supplementation on BMI was significant in trials with duration < 12 weeks (WMD: −0.58 kg/m2, 95% CI: −1.08, −0.08, I2 = 19.8%, P = 0.02) compared to those with higher duration (>12 weeks). The current meta-analysis results suggest that garlic supplementation seems to reduce waist circumference unlike body weight and BMI.


Author(s):  
Seyed Mohammad Mousavi ◽  
Alireza Milajerdi ◽  
Somaye Fatahi ◽  
Jamal Rahmani ◽  
Meysam Zarezadeh ◽  
...  

Abstract. The clinical studies regarding the effect of L-arginine in human anthropometry have not been fully consistent, therefore, we carried out a systematic review and meta-analysis of randomized clinical trials in order to precisely evaluate and quantify the efficacy of L-arginine on weight, waist circumference, and BMI. We searched online databases including PubMed, SCOPUS, and Google Scholar for relevant articles up to September 2017. Eligible articles were reviewed by two independent investigators. Mean differences of the outcomes were used for calculation of weighted mean difference (WMD) derived from the random-effects model. Statistical heterogeneity between studies was examined using Cochran’s Q-test and I 2 index. Funnel plot and Egger’s tests were performed to assess the publication bias. In our initial search, we found 1598 publications, of which 8 RCTs (9 treatment arms) were included. The results of the meta-analysis displayed a significant reduction in WC following L-arginine supplementation (WMD: −2.97 cm; 95% CI: −4.75 to −1.18, P = 0.001). However, L-arginine intervention had not elicited a significant effect on BMI (WMD: −0.51 kg/m2; 95% CI: −1.11 to .08, P = 0.09) and body weight (WMD: −0.57 kg; 95% CI: −1.77 to 0.61, P = 0.34). Subgroup analyses displayed that longer-term interventions (≥8 weeks) had a positive effect on body weight and using < 8 g/day L-arginine with longer duration (≥8 weeks) could significantly decrease BMI. In conclusion, this meta-analysis result suggested L-arginine supplementation could reduce waist circumference without any significant effect on body weight and body mass index.


Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 2314-2314
Author(s):  
Murtadha K. Al-Khabori ◽  
John de Almeida ◽  
Gordon Guyatt ◽  
John Kuruvilla ◽  
Michael Crump

Abstract Abstract 2314 Poster Board II-291 Background: The impact of high dose therapy and autologous stem cell transplantation (ASCT) in the upfront management of adults with advanced follicular lymphoma (FL) on overall survival remains uncertain. A number of randomized clinical trials (RCTs) compared ASCT to conventional dose chemotherapy regimens. We performed a systematic review to address this question. Objective: To compare the overall survival (OS), event free survival (EFS), treatment related mortality (TRM), incidence of secondary myelodysplasia/acute myeloid leukemia (t-MDS/AML) and secondary solid tumors within the ASCT strategy and chemotherapy. Methods: We performed a search of MEDLINE, EMBASE, CENTRAL, American Society of Hematology (ASH), American Society of Clinical Oncology (ASCO), BIOSIS, PAPERSFIRST, PROCEEDINGS, clinical trials registries (National Cancer Institute, clinicaltrials.gov) and bibliographies of relevant studies for randomized controlled trials comparing myelo-ablative chemotherapy with ASCT to any chemotherapy in adults with untreated advanced (Ann Arbor stage III-IV) FL. Two reviewers recorded study characteristics, methodology and outcomes. Disagreement was resolved by discussion. Results: Seven trials were identified and included in the systematic review but only four with available data reporting 941 patients were included in the meta-analysis. Three trials excluded: one was never reported; the second was stopped early due to the increased toxicities in the transplant arm; and the third showed no significant difference in EFS or OS at an interim analysis with insufficient data for the meta-analysis. None of these studies has been published. In one of the 7 trials patients in both arms received rituximab during the induction treatment. High dose therapy and ASCT did not result in improved OS compared to standard therapy, Hazard Ratio (HR) 1.15 (0.85, 1.55). The HR for EFS was 0.61 (0.34, 1.11) with substantial heterogeneity, I2 =91%, Chi2 p value <0.00001. Only the duration of the follow up could explain this heterogeneity with statistically significant subgroup interaction, P <0.00001. The incidence of t-MDS/AML ranged from 1% to 7% in the ASCT arms of the four studies, with a difference in favour of standard chemotherapy, Risk Difference (RD) 4% (95%CI: -1%, 8%), and significant heterogeneity (Chi2 p value of 0.008, I2=75%) due to difference in duration of follow up (p=0.005 for the subgroup differences).There was no increase in mortality directly attributable to treatment (RD 0%, 95%CI: -2%, 1%) nor in secondary solid tumors (RD 1%, 95%CI: -2%, 4%). Conclusions: High dose therapy and ASCT as part of initial does not improve overall survival despite a trend towards better disease control, likely because of the effectiveness of second and subsequent lines of treatment for FL. T-MDS/AML occurs more commonly following ASCT and represents a significant risk to patients. With one exception, these studies were conducted before the introduction of monoclonal B cell antibodies. Future trials of ASCT in the context of current chemo-immunotherapy approaches to FL would further inform this issue. Disclosures: No relevant conflicts of interest to declare.


2019 ◽  
Vol 11 (2) ◽  
pp. 280-292 ◽  
Author(s):  
Omid Sadeghi ◽  
Mehdi Sadeghian ◽  
Sepideh Rahmani ◽  
Vahid Maleki ◽  
Bagher Larijani ◽  
...  

ABSTRACT Since the release of a previous meta-analysis on the effect of whole-grain intake on obesity measures, several clinical trials have been published. Therefore, we aimed to update the previous meta-analysis on the effect of whole-grain intake on obesity measures by including recently published studies, as well as considering the main limitations in that analysis. We searched the online databases of PubMed, Scopus, Clarivate Web of Science, EmBase, and Google Scholar for relevant studies published up to February 2019, using relevant keywords. Randomized clinical trials investigating the effect of whole-grain products or diets high in whole-grain foods, compared with a control diet, on anthropometric measures [including body weight, BMI, waist circumference, and fat mass (FM)] were included. In total, 21 studies with a total sample of 1798 participants, aged ≥18 years, were considered. Based on 22 effect sizes from 19 studies on body weight, with a total sample of 1698 adults, we found no significant effect of whole-grain consumption on body weight. The same findings were obtained for BMIs, such that using 10 effect sizes from 10 clinical trials with a total sample of 769 individuals we did not find any significant effect. With regards to body fat percentage [weighted mean difference (WMD): 0.27; 95% CI: −0.05 to 0.58%; P = 0.09], FM (WMD: 0.45; 95% CI: −0.12 to 1.02 kg; P = 0.12), fat-free mass (WMD: 0.31; 95% CI: −0.67 to 0.06 kg; P = 0.10), and waist circumference (WMD: 0.06; 95% CI: −0.50 to 0.63 cm; P = 0.82), we failed to find any significant effect of whole-grain consumption. In conclusion, our findings did not support current recommendations of whole-grain intake in attempts to control obesity measures. Given the beneficial effects of whole-grain intake on other measures of human health, additional well-designed studies are required to further investigate the effect on obesity. The protocol has been registered with PROSPERO (registration number CRD42019125320).


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