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Context Several observational and experimental studies have been conducted to evaluate the effects of pistachio intake on metabolic syndrome (MetS); however, the results are inconsistent. Objective This systematic review and meta-analysis were performed on data from randomized controlled trials (RCTs) to determine the effect of pistachio consumption on MetS components. Data sources The PubMed, Scopus, Google Scholar and Web of Science databases were searched from 1986 to 2021. Study selection English-language RCTs on pistachio intake were included that provided outcomes on hypertension, hyperglycemia, hypertriglyceridemia, and high-density lipoprotein (HDL). Data extraction Results are presented as pooled mean differences (MDs) between intervention and control groups with 95%CI reported for each of the components. Results Seventeen RCTs including 940 adults met the inclusion criteria for this systematic review and meta-analysis. Pistachio supplementation significantly reduced systolic blood pressure (BP; MD, –2.89 mmHg, 95%CI: –4.11 to –1.67; P < 0.001), triglycerides (MD, –16.76 mg/dL, 95%CI: –16.89 to –16.64; P < 0.001), fasting blood glucose (MD, –3.62 mg/dL, 95%CI: –6.45 to –0.8; P < 0.001,) and increased HDL (MD, 1.43 mg/dL, 95%CI: 1.39 to 1.47; P < 0.001) levels. However, there were not observed considerable changes in waist circumference, diastolic BP, and body mass index. Conclusion The results of this research show that pistachio consumption could improve some MetS components, including systolic blood pressure, triglyceride, fasting blood glucose, and HDL levels, without affecting anthropometric indices and diastolic BP. [ABSTRACT FROM AUTHOR]

Context Dietary patterns play a key role in mental health, depression, and mood state. However, the evidence concerning specific foods highly recommended for mental health, such as nuts, has not yet been synthesized. Objective The objective of this review was to synthesize the evidence for a relationship between higher levels of nut consumption, lower risk of depression, and better mood state in the general population. Data Sources The MEDLINE, Scopus, Cochrane Central, Web of Science, and PsycInfo databases were systematically searched from each database's inception to March 2021. Data Extraction Randomized clinical trials (RCTs) and observational studies exploring the association between nut consumption, level of depression, and mood state in the general population were included. The quality of the studies was measured through the Joanna Briggs Institute tool (cross-sectional studies), the NIH Quality Assessment Tool (cohort studies), and the Cochrane Risk-of-Bias tool (RCTs). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Data Analysis A total of 10 studies involving 66 418 individuals were included, of which 3 were cross-sectional, 3 were cohort studies, and 4 were RCTs. In studies concerned with depression (n = 6 studies), a higher level of nut consumption was associated with a lower risk of depression in 2 cross-sectional studies and 1 cohort study, while a similar but nonsignificant association was found in another cohort and in two RCTs. In studies concerned with mood state (n = 4), 1 cohort study reported an association between higher nut consumption and significant improvement in mood state, whereas (nonsignificant) associations between higher nut consumption and increased negative feelings were reported in a cross-sectional study and two RCTs. Conclusion Despite the small number of studies and the limitations related to them, such as reverse causation bias, overall, the available literature suggests that higher nut consumption could be associated with a lower risk of depression, fewer depressive symptoms, and better mood state in the general population. Systematic Review Registration PROSPERO registration no. CRD42021241070. [ABSTRACT FROM AUTHOR]

Meta-inflammation is a chronic, low-grade state of inflammation secondary to cardiometabolic disorders related to overweight (OW), obesity (OB), consumption of poor nutritional and hypercaloric diets with excessive amounts of lipids and sugars. It can lead to severe metabolic and cardiovascular diseases. Several studies have reported that plant-based diets (PBDs) can be a useful non-pharmacological therapeutic tool for the prevention and treatment of meta-inflammation, since it has been reported that patients following PBDs have lower serum levels of proinflammatory markers, a reduction in weight, and an overall healthier lipid profile. In this review, we describe the pathophysiology of meta-inflammation, the growing worldwide trend toward adoption of PBDs, and how PBDs act to reduce meta-inflammation. [ABSTRACT FROM AUTHOR]

Context A high amount of red meat consumption has been associated with higher risks of coronary heart disease (CHD) and all-cause mortality in a single food-exposure model. However, this model may overlook the potentially differential influence of red meat on these outcomes depending on the foods replaced by red meat. Objective A PRISMA-compliant meta-analysis of prospective observational studies was performed to quantify the risks of CHD and all-cause mortality associated with the replacement of total, unprocessed, or processed red meat with fish/seafood, poultry, dairy, eggs, nuts, and legumes. Data sources The PubMed and Web of Science databases were searched to identify relevant articles published in any language from database inception to October 30, 2021. Data extraction The prospective observational studies were considered relevant if they reported relative risks (RRs) and 95%CIs for the associations of interest. Data analysis Thirteen articles were included. A random-effects model was used to estimate the summary RRs and 95%CIs for the associations of interest. Replacing total red meat with poultry (RR, 0.88, 95%CI, 0.82–0.96; I 2 = 0%), dairy (RR, 0.90, 95%CI, 0.88–0.92; I 2 = 0%), eggs (RR, 0.86, 95%CI, 0.79–0.94; I 2 = 7.1%), nuts (RR, 0.84, 95%CI, 0.74–0.95; I 2 = 66.8%), or legumes (RR, 0.84, 95%CI, 0.74–0.95; I 2 = 7.3%) was associated with a lower risk of CHD, whereas substituting fish/seafood (RR, 0.91, 95%CI, 0.79–1.04; I 2 = 69.5%) for total red meat was not associated with the risk of CHD. The replacement of total red meat with fish/seafood (RR, 0.92, 95%CI, 0.89–0.96; I 2 = 86.9%), poultry (RR, 0.92, 95%CI, 0.90–0.95; I 2 = 61.6%), eggs (RR, 0.91, 95%CI, 0.87–0.95; I 2 = 33.8%), or nuts (RR, 0.92, 95%CI, 0.87–0.97; I 2 = 81.9%) was associated with a lower risk of all-cause mortality, whereas the substitution of dairy (RR, 0.97, 95%CI, 0.93–1.01; I 2 = 33.9%) or legumes (RR, 0.97, 95%CI, 0.93–1.01; I 2 = 53.5%) for total red meat was not associated with the risk of all-cause mortality. Lower risks of CHD and all-cause mortality were more consistently observed for processed red meat replacements than for unprocessed red meat replacements. The results did not materially change when the analyses of total, processed, and unprocessed red meat were restricted to the studies that used a uniform substitution amount per unit of 1 serving/d. Conclusion Keeping red meat, particularly processed red meat, consumption to a minimum along with increasing healthier alternative protein sources to replace red meat in the diet may contribute to the prevention of CHD and premature death. Systematic review registration PROSPERO registration no. CRD42021259446. [ABSTRACT FROM AUTHOR]

Context The importance and benefits of breastfeeding in children are well recognized, and it may improve motor development. Motor skills are fundamental to childhood development. Although some studies report a positive association between breastfeeding and motor development in children, others have suggested that these differences could be influenced by confounding variables. Objective To estimate the degree to which breastfeeding duration and exclusivity is associated with motor development in children. Thus, a systematic review of the literature and a meta-analysis was conducted. Data Sources MEDLINE (via PubMed), Embase, the Cochrane Database of Systematic Reviews, and the Web of Science databases were systematically searched from inception to June 2021. Data Extraction The most adjusted relative risks (RRs) or odds ratios (ORs) and their corresponding 95% confidence intervals (95% CIs) reported by included studies were used. The "breastfeeding duration" category defined by each study was used as the reference category. Additionally, subgroup analyses were performed based on the duration of breastfeeding. Data Analysis Eighteen published studies were included in the systematic review and 14 studies in the meta-analysis. The results showed that the effect size (ES) for exclusively breastfed vs never breastfed children was 0.86 (95% CI: 0.32, 1.41, I2 = 90.3%), and the ES for children breastfed for any length vs never breastfed children was 0.95 (95% CI: 0.80, 1.10, I2 = 88.0%). The remaining groups studied did not show significant differences in outcomes. Conclusions Although our data suggest that breastfeeding may improve motor development in children, more studies are needed because publication bias has been detected. Nevertheless, our results support the promotion of breastfeeding. [ABSTRACT FROM AUTHOR]

Despite producing sufficient food for the global population, the growing prevalence of food insecurity in developed countries is cause for concern. The millions of metric tons of food wasted each year could be used instead to drastically lower rates of food insecurity and address food sustainability. In this scoping review, we aimed to identify barriers to and enablers of harnessing food waste across food sectors, including food retail, households, and food rescue organizations, to address food insecurity in a developed country, Australia. The findings demonstrate that research on and responsibility for harnessing food waste for food insecurity has predominantly fallen on ill-equipped food rescue organizations. Three primary policy advancements paramount to harnessing food waste to address food insecurity include (1) improving partnerships and subsidies to minimize transportation costs for redistributing imperfect or surplus food from farmers and retailers to those who with food insecurity; (2) enhancing existing partnerships and subsidies to stably involve more nutrition experts in food rescue organizations to improve the quality of foods being redistributed to those facing food insecurity; and (3) initiating interventions and campaigns that combine the following 5 characteristics: free to the participants; address food literacy; use multiple mass-media tools; are age tailored; and frame messages within personal values. [ABSTRACT FROM AUTHOR]

Satiety is a complex state, influenced by numerous factors that go beyond food ingestion. Satiety influences food habits and behavior, thus affecting human health. This review provides an overview of physiological mechanisms involved in satiety and of methodologies to assess food intake and satiety in both animal models and humans. The following topics are highlighted: differences between satiety and satiation; how the central nervous system regulates food intake and satiety; the impact of different macronutrients on satiety; and how the manipulation of food composition might influence overall satiety. Bringing together knowledge on this myriad of satiety mechanisms and how we can study them is useful to better understand and control obesity and other eating disorders. [ABSTRACT FROM AUTHOR]

Context Most methods for assessing dietary intake have considerable measurement error. Dietary biomarkers are objective tools for dietary assessment. Dietary biomarkers of dietary patterns have not been well described, despite modern dietary guidelines endorsing dietary patterns. Objective This systematic review sought to describe the dietary biomarkers commonly used to assess dietary patterns, and the novel biomarkers of dietary patterns identified by exploratory studies. Data Sources MEDLINE, Embase, Cochrane Central, PreMEDLINE, and CINAHL databases were searched. Data Extraction Data extraction and bias assessment were undertaken in duplicate. Data Analysis A qualitative approach was applied, without statistical analysis. Conclusion In controlled settings, dietary biomarkers of single nutrients or of individual foods or food groups are commonly used to assess compliance with dietary patterns. However, currently, there are no dietary biomarkers or biomarker profiles that are able to identify the specific dietary pattern that has been consumed by an individual. Future work should seek to validate novel dietary biomarkers and biomarker profiles that are indicative of specific dietary patterns and their characteristics. A dietary biomarker panel consisting of multiple biomarkers is almost certainly necessary to capture the complexity of dietary patterns. Systematic Review Registration PROSPERO registration no. CRD42019129839. [ABSTRACT FROM AUTHOR]

Context Policy-specific actions to improve food environments will support healthy population diets. Objective To identify cited barriers and facilitators to food environment policy (FEP) processes reported in the literature, exploring these according to the nature of the policy (voluntary or mandatory) and country development status. Data sources A systematic search was conducted of 10 academic and 7 grey-literature databases, national websites, and manual searches of publication references. Data extraction Data on government-led FEPs, barriers, and facilitators from key informants were collected. Data synthesis The constant-comparison approach generated core themes for barriers and facilitators. The appraisal tool developed by Hawker et al. was adopted to determine the quality of qualitative and quantitative studies. Results A total of 142 eligible studies were identified. Industry resistance or disincentive was the most cited barrier in policy development. Technical challenges were most frequently a barrier for policy implementation. Frequently cited facilitators included resource availability or maximization, strategies in policy process, and stakeholder partnership or support. Conclusions The findings from this study will strategically inform health-reform stakeholders about key elements of public health policy processes. More evidence is required from countries with human development indices ranging from low to high and on voluntary policies. Systematic Review Registration PROSPERO registration no. CRD42018115034. [ABSTRACT FROM AUTHOR]

Obesity is characterized by chronic low-grade inflammation that could lead to other health complications, such as cardiovascular disease, diabetes, and various forms of cancer. Emerging evidence has shown that taste perception is altered during the development of obesity. Moreover, suppression of taste receptor or taste signaling molecules potentiate the inflammatory response, and the progression of inflammation attenuates the expression of taste receptors in vivo. Together, these findings suggest a possible interplay between taste signaling and inflammation. This review summarizes the interactions between type 1 (T1Rs) and type 2 taste receptors (T2Rs) and inflammation, as well as the impact of obesity on T1R- and T2R-mediated signaling. Furthermore, we evaluate the possible role that taste receptors play in regulating the inflammatory response during obesity as a therapeutic target to prevent the progression of comorbidities associated with obesity. [ABSTRACT FROM AUTHOR]

Calorie restriction regimens are popular for their purported health-promoting effects. However, it is unclear whether chronic reduction in energy intake and subsequent weight loss have beneficial effects in the absence of obesity. To this end, the results of studies that examined the effects of the same diet-induced weight loss in individuals with and without obesity were reviewed. The contribution of lean mass to the total amount of weight lost is greater in participants without obesity than in those with obesity, but the reductions in resting, nonresting, and total energy expenditure are of similar magnitude. Both in the presence as well as in the absence of obesity, weight loss decreases visceral adipose tissue and liver fat, increases insulin sensitivity in skeletal muscle (insulin-mediated whole-body glucose disposal rate) and in adipose tissue (meal-induced or insulin-induced suppression of plasma free fatty acid concentration), and augments insulin clearance rate, without affecting pancreatic insulin secretion. These effects are of similar magnitude in participants with and without obesity and result in reductions in fasting plasma glucose and insulin concentrations. These data suggest that the same degree of calorie restriction and the same amount of weight loss have multiple beneficial effects on health outcomes in individuals without obesity, similar to those observed in individuals with obesity. [ABSTRACT FROM AUTHOR]

Youth obesity has become increasingly prevalent, with 34.5% of US adolescents 12–19 years old estimated to have overweight or obesity. Disordered eating and weight concern peak in adolescence, and overeating to cope with negative emotions can affect long-term health and obesity risk. Parents significantly influence adolescent diet quality, and parental stress may influence parenting behaviors that increase the risk for stress-motivated eating and obesity in adolescents. Chronic or repeated exposure to parental stress may lead to stress-related neurophysiological changes that promote consumption of palatable foods and obesogenic eating habits in adolescents. Understanding how parental stress influences adolescents' eating behavior may reveal novel access points for reducing adolescent obesity. Here, we aim to provide a new stress-focused framework for developing intervention strategies targeted at obesity prevention in adolescents. [ABSTRACT FROM AUTHOR]

Context Optimizing nutrition in military groups through improved diet quality and nutrition knowledge is key in supporting the high physical and cognitive demands. Objective The objective of this investigation was to systematically review the effectiveness of nutrition interventions among military personnel in improving diet quality and/or nutrition knowledge. Data Sources Medline, Embase, CINAHL, and Scopus were searched from the earliest records to May 2020. Data Extraction Data were extracted by 2 reviewers. The primary outcomes were diet quality and/or nutrition knowledge. Data Analysis Twenty studies were included. The main intervention approaches identified were nutrition education of individuals (i.e. education-based studies; EB) (n = 12), and manipulation of the food service environment (i.e. dining facility studies; DFACs) (n = 8). The most common strategies were face-to-face lectures (n = 8) for EB, and healthier menus (n = 7) and education of catering staff (n = 6) for DFAC interventions. Most studies (18/20) demonstrated favorable within-group effects; however, dietary changes were inconsistent. Five of 10 studies using a comparator group demonstrated positive between-group differences. Conclusion Although potential exists for improving diet quality and nutrition knowledge in military populations, the heterogeneity of the studies to date limits conclusions on the most efficacious strategies. [ABSTRACT FROM AUTHOR]

Context There is limited evidence on strategies used to promote dietary behavior changes in socioeconomically disadvantaged urban adolescents and on their effectiveness. Objective A synthesis of nutrition interventions used in this group of adolescents is provided in this systematic review. Data Sources Five electronic databases (PubMed, Web of Science, CINAHL, PsycINFO, and ERIC) were searched until November 2020 to identify relevant studies. Data Extraction Forty-six manuscripts (n = 38 intervention studies) met the inclusion criteria. Quality was assessed with the Effective Public Health Practice Project Quality Assessment Tool. A qualitative synthesis summarizing data on study characteristics was conducted. Data Analysis Studies were classified by intervention type as those focusing on hedonic determinants of dietary intake (n = 1), environmental changes to promote a specific dietary intake (n = 3), cognitive determinants (n = 29), and multicomponent strategies (n = 13). The social cognitive theory was the most applied theoretical framework, either alone or combined with other frameworks. Most of the intervention studies targeted multiple dietary outcomes, and success was not always reported for each. Conclusions Despite the heterogeneity of the studies and lack of combination of dietary outcomes into dietary scores or patterns to evaluate changes on the individuals' whole diets, long-term, theory-driven interventions targeting a single dietary factor seem promising in obtaining sustainable dietary behavior changes. Systematic Review Registration PROSPERO registration no. CRD42020188219. [ABSTRACT FROM AUTHOR]

Context The community food environment covers the type, quantity, density, location, and access to retail food outlets, and its influence on eating behavior, obesity, and metabolic syndrome has been investigated. Objective To evaluate the evidence on longitudinal associations between objectively measured retail food outlets and metabolic syndrome components in children, adolescents, and adults. Data extraction This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study quality and risk of bias were assessed with the Newcastle-Ottawa Scale. Data sources The Scopus, Embase, Web of Science, Scielo, PubMed, MEDLINE, and Lilacs databases were searched without any restriction on publication dates. Data analysis Of the 18 longitudinal studies included, significant associations were reported in 9 between retail food outlets and metabolic syndrome components in adults (6 positive associations, 2 negative, and 1 both positive and negative), and in 3 studies of children and adolescents (2 negative associations and 1 both positive and negative). Six studies with adults found no association. Conclusion Limited evidence was found for longitudinal associations between retail food outlets and metabolic syndrome components. In future studies, researchers should consider the use of standardized retail food outlet measurements and accurate analysis to better understand the influence of the community food environment on metabolic syndrome. Systematic Review Registration PROSPERO registration no: CRD42020177137. [ABSTRACT FROM AUTHOR]

Context A relationship between obesity and poor oral health has been reported. Objective To investigate the association between overweight/obesity and oral health in Mexican children and adolescents. Data Sources A literature search was conducted of 13 databases and 1 search engine for articles published from 1995 onward. Data Analysis A total of 18 publications were included. Evidence was inconclusive and varied according to sociodemographic factors or outcome measuring tools. The Decayed, Missing, and Filled Teeth and Filled Teeth Surfaces indices and the decayed extracted filled teeth index outcomes were included in a random effects model meta-analysis. Pooled estimates showed no statistically significant oral health differences (measured via the decayed extracted filled teeth or the Decayed, Missing, and Filled Teeth Surfaces indexes) among body mass index (BMI) categories. However, pooled estimates of 6 studies showed that children with higher BMI had worse oral health in permanent teeth (measured via the Decayed Missing Filled Teeth Index) than children with lower BMI (overall mean difference, –0.42; 95%CI, –0.74, –0.11). Conclusion Whether there is an association between poor oral health and high BMI is inconclusive; however, both co-exist among Mexican children. Therefore, health promotion and prevention efforts should address common risk factors and broader risk social determinants shared between noncommunicable diseases. [ABSTRACT FROM AUTHOR]

Context The effects of probiotics on gastrointestinal (GI) symptoms have been increasingly investigated, particularly that of Bifidobacterium animalis. Clinical trials so far have shown differing evidence regarding these effects in healthy adults. Objective To synthesize the published evidence on the effects of B. animalis subspecies lactis on GI symptoms (GIS) in healthy adults. Data Source A search of the Medline, Embase, Lilacs, Scopus, Web of Science, ProQuest, and Google Scholar databases was conducted for reports on randomized controlled trials published up to October 2021. Data Extraction Population characteristics and data on colonic transit time (CTT), stool consistency, defecation frequency, abdominal pain, bloating, flatulence, volunteer compliance, and adverse events were extracted. A random-effects model was used to estimate the effect of probiotic treatment on these variables. Data Synthesis In total, 1551 studies were identified, of which 14 were included in the qualitative synthesis and 13 in the meta-analysis. Overall, probiotic supplementation increased defecation frequency (standardized mean difference [SMD], 0.26; 95%CI, 0.13–0.39). Subgroup analysis revealed a decrease in CTT (SMD, −0.34; 95%CI, −0.62 to −0.07) in short-term treatment (≤14 d) and an improvement in stool consistency (SMD, 0.76; 95%CI, 0.44–1.08) in individuals without GIS. No improvement in abdominal pain and bloating was found. Conclusions B. animalis subspecies lactis supplementation may increase defecation frequency and, in short-term treatment, may reduce CTT in healthy adults and improve stool consistency in individuals without GIS. More high-quality randomized controlled trials are needed to develop a clinical protocol for the use of this strain to improve these symptoms. Systematic Review Registration PROSPERO registration no. CRD42020154060. [ABSTRACT FROM AUTHOR]

Context Hibiscus sabdariffa (hibiscus) has been proposed to affect cardiovascular risk factors. Objective To review the evidence for the effectiveness of hibiscus in modulating cardiovascular disease risk markers, compared with pharmacologic, nutritional, or placebo treatments. Data Sources A systematic search of the Web of Science, Cochrane, Ovid (MEDLINE, Embase, AMED), and Scopus databases identified reports published up to June 2021 on randomized controlled trials using hibiscus as an intervention for lipid profiles, blood pressure (BP), and fasting plasma glucose levels in adult populations. Data Extraction Seventeen chronic trials were included. Quantitative data were examined using a random effects meta-analysis and meta-regression with trial sequential analysis to account for type I and type II errors. Data Analysis Hibiscus exerted stronger effects on systolic BP (−7.10 mmHg [95%CI, −13.00, −1.20]; I 2 = 95%; P  = 0.02) than placebo, with the magnitude of reduction greatest in those with elevated BP at baseline. Hibiscus induced reductions to BP similar to that resulting from medication (systolic BP reduction, 2.13 mmHg [95%CI, −2.81, 7.06], I 2 = 91%, P  = 0.40; diastolic BP reduction, 1.10 mmHg [95%CI, −1.55, 3.74], I 2 = 91%, P  = 0.42). Hibiscus also significantly lowered levels of low-density lipoprotein compared with other teas and placebo (−6.76 mg/dL [95%CI, −13.45, −0.07]; I 2 = 64%; P  = 0.05). Conclusions Regular consumption of hibiscus could confer reduced cardiovascular disease risk. More studies are warranted to establish an effective dose response and treatment duration. Systematic Review Registration PROSPERO registration no. CRD42020167295 [ABSTRACT FROM AUTHOR]

Cereal grains are the main dietary source of energy, carbohydrates, and plant proteins world-wide. Currently, only 41% of grains are used for human consumption, and up to 35% are used for animal feed. Cereals have been overlooked as a source of environmentally sustainable and healthy plant proteins and could play a major role in transitioning towards a more sustainable food system for healthy diets. Cereal plant proteins are of good nutritional quality, but lysine is often the limiting amino acid. When consumed as whole grains, cereals provide health-protecting components such as dietary fiber and phytochemicals. Shifting grain use from feed to traditional foods and conceptually new foods and ingredients could improve protein security and alleviate climate change. Rapid development of new grain-based food ingredients and use of grains in new food contexts, such as dairy replacements and meat analogues, could accelerate the transition. This review discusses recent developments and outlines future perspectives for cereal grain use. [ABSTRACT FROM AUTHOR]

Context Nutrition care is an effective lifestyle intervention for the treatment and prevention of many noncommunicable diseases. Primary care is a high-value setting in which to provide nutrition care. Objective The objective of this review was to evaluate the cost-effectiveness of nutrition care interventions provided in primary care settings. Data Sources Medline, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Central Register of Controlled Trials, EconLit, and the National Health Service Economic Evaluation Database (NHS EED) were searched from inception to May 2021. Data Extraction Data extraction was guided by the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) reporting guidelines. Randomized trials of nutrition interventions in primary care settings were included in the analysis if incremental cost-effectiveness ratios were reported. The main outcome variable incremental cost-effectiveness ratios (ICERs) and reported interpretations were used to categorize interventions by the cost-effectiveness plane quadrant. Results Of 6837 articles identified, 10 were included (representing 9 studies). Eight of the 9 included studies found nutrition care in primary care settings to be more costly and more effective than usual care. High study heterogeneity limited further conclusions. Conclusion Nutrition care in primary care settings is effective, though it requires investment; it should, therefore, be considered in primary care planning. Further studies are needed to evaluate the long-term cost-effectiveness of providing nutrition care in primary care settings. Systematic review registration PROSPERO registration no. CRD42020201146. [ABSTRACT FROM AUTHOR]

Context Childhood adiposity, an important predictor of adult chronic disease, has been rising dramatically. Later eating rhythm, termed night eating, is increasing in adults but rarely studied in younger ages. Objective The objective of this study was to review the association between later eating rhythm and adiposity in children and adolescents. The aspects of later eating being considered included: energy intake (for evening main meal, evening snack, whole evening period, and around bedtime); timing (any food eaten at later timing); and meal frequency in the evening/night (evening main meal skipping, evening snack consumption). Data Sources Five databases (the Cochrane Library, CINAHL, Embase, MEDLINE (via OVID), and Web of Science) were searched for eligible articles published prior to and including August 2020. Data Extraction Data extraction and quality assessment were conducted by 2 reviewers independently. Data Analysis Forty-seven studies were included, all of which were observational. Meta-analysis showed positive associations between both higher energy intake around bedtime (odds ratio [OR] 1.19, 95% CI 1.06, 1.33) and evening main meal skipping (OR 1.30, 95% CI 1.14, 1.48), and adiposity. There was evidence to suggest that consuming evening snacks reduced adiposity, but it was very weak (OR 0.80, 95% CI 0.62, 1.05). No association was seen between eating later and adiposity (OR 1.04, 95% CI 0.68, 1.61). In the narrative analysis, approximately half of the studies suggested that there was no association between later eating rhythm and adiposity, either as a whole or within exposure subsets. Conclusion The magnitude of the relationship between later eating rhythm and adiposity is very small, and may vary depending on which aspects of later eating rhythm are under consideration; however, the evidence for this conclusion is of very low certainty. Further research with a more consistent definition of "later timing", and longitudinal studies in different populations, may lead to different conclusions. Systematic Review Registration PROSPERO registration no. CRD42019134187. [ABSTRACT FROM AUTHOR]

Context Randomized controlled trials (RCTs) testing supplementation with eicosapentaenoic (EPA) and docosahexaenoic (DHA) fatty acids have failed to provide evidence supporting a suggested inverse association between fish intake and dementia risk. Objective Dose–response analyses were conducted to evaluate associations between fish intake, all-cause dementia or Alzheimer's Disease (AD), and the effect of EPA/DHA supplementation on cognitive performance. Data Sources PubMed, Scopus and Web of Science databases were searched for original research evaluating either associations between fish intake and dementia or AD, or the impact of EPA and/or DHA supplementation on the risk of cognitive decline. Data Extraction Data were collected on study characteristics and methods; number of cases/deaths (for observational studies); categories of exposure; model covariates; risk estimates from the most-adjusted model; type and dosage of supplementation (from RCTs); fatty acid levels in blood; and differences in cognition test results before and after supplementation. Risk of bias was assessed through the ROBINS-E and RoB2.0 tools for observational and experimental studies, respectively. Data Analysis Weighted mixed-effects models were applied, allowing for the inclusion of studies with 2 levels of exposure. Based on findings with low/moderate risk of bias, fish intake of up to 2 portions (250 g) per week was associated with a 10% reduction (95% confidence interval [CI]: 0.79, 1.02, Ν = 5) in all-cause dementia and a 30% reduction (95% CI: 0.54, 0.89, Ν = 3) in AD risk. Changes in EPA and DHA body status had a positive impact on participants' executive functions, but not on their overall cognitive performance. Conclusion The protection offered by fish intake against cognitive decline levels off at intakes higher than 2 portions/week and likely relates to the impact of EPA and DHA on the individual's executive functions, although there remain questions about the mechanisms linking the short- and long-term effects. Systematic Review Registration PROSPERO registration no. CRD42019139528. [ABSTRACT FROM AUTHOR]

Context Chronic obstructive lung disease (COPD) is a progressive lung disease characterized by persistent airflow limitation. An increasing amount of evidence suggests an effect of dietary quality on the risk of COPD in the general population and pulmonary function decline in patients with COPD. Objective The association of dietary intake and nutrient status with COPD risk and onset, as well as pulmonary function decline (change in forced expiratory volume in 1 second, forced vital capacity, or the ratio of the former to the latter) in patients with COPD was investigated in this systematic review. Data Sources The PubMed database was searched by combining terms of pulmonary function or COPD with diet, nutrient status, or nutritional supplementation. Data Extraction Original studies and systematic reviews and meta-analyses were included. Articles obtained were independently screened for relevance on the bases of title and abstract by 2 researchers. Eventually, 89 articles were included in the analysis. Results The unhealthy Western-style diet is associated with an increased risk of COPD and an accelerated decline of pulmonary function. Intake of fruit, vegetables, dietary fibers, vitamins C and E, polyphenols, and β-carotene were individually associated with lower COPD risk, whereas consumption of processed meat was associated with higher COPD risk. Data on the effect of dietary quality on pulmonary function decline in patients with COPD are limited and inconsistent. Strong evidence for beneficial effects on pulmonary function decline was found only for vitamin D supplementation. Conclusion Considering the increasing burden of COPD, more attention should be given to dietary quality as a modifiable factor in disease development and progression in patients with COPD. Systematic Review Registration PROSPERO registration no. CRD42021240183. [ABSTRACT FROM AUTHOR]

Context Over the past 2 decades, overweight and obesity rates have increased exponentially, along with related comorbidities including type 2 diabetes, hypertension, cardiovascular disease, and some cancers. The Mediterranean Diet (MDiet) has been suggested as a potential way to mitigate the health burdens related to overweight and obesity. Objective For this review, the literature on MDiet-focused digital interventions was examined to determine efficacy, best practices, and potential limitations. Data Sources The search was conducted across 15 databases for relevant publications published through April 2020 in English, French, Spanish, Arabic, or Italian. Data Extraction Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed using a combination of keywords and phrases and evaluated independently for relevance, merit, and inclusion and exclusion criteria. Data Analysis The systematic literature review resulted in 15 articles that met the search criteria. Ten interventions were delivered online, and 5 were delivered via smartphone using an app. The majority of online MDiet-focused interventions were effective, particularly when modeled after evidence-based and best-practice online nutrition education interventions. Such interventions also are effective for promoting positive health behaviors and health outcomes, such as increased physical activity, increased levels of high-density lipoprotein cholesterol, and a lower total high-density lipoprotein cholesterol ratio. Conclusion Technology-based interventions to educate and promote adherence to the MDiet are successful in helping individuals achieve the stated outcomes. More research is needed to determine the efficacy of MDiet interventions delivered via smartphone apps. [ABSTRACT FROM AUTHOR]

Context Atherosclerosis is a disease of chronic inflammation. Recent research has identified 2 novel inflammatory biomarkers: platelet-activating factor (PAF) and lipoprotein-associated phospholipase A2 (Lp-PLA2). Diet has been proposed as a mediator of inflammation, but to date, the focus for these novel biomarkers has been on individual foods and nutrients rather than overall dietary patterns. Objective To systematically review the literature on the association between dietary patterns and PAF and Lp-PLA2. Data Sources The PubMed, Embase, CINAHL, and Cochrane CENTRAL literature databases were searched. Data Analysis Study quality was evaluated using the Quality Criteria Checklist. Sixteen studies (n = 4 observational and n = 12 interventional) were included and assessed for associations between dietary patterns and PAF and Lp-PLA2. Conclusion Study quality varied from neutral (n = 10) to positive (n = 6). Mediterranean, heart healthy, and vegetarian dietary patterns were associated with improved levels of PAF and Lp-PLA2. Conversely, Western dietary patterns were less favorable. A range of well-established, healthier dietary patterns may lower inflammation and the risk of atherosclerosis. More well-designed studies are needed to confirm these findings and identify other dietary patterns that improve inflammation. [ABSTRACT FROM AUTHOR]

Context Mental health may be influenced by some dietary patterns. Among common elements of beneficial patterns is high fruit and vegetable intake. However, no systematic review has been conducted to date, to our knowledge, that has assessed the influence of fruit and vegetable dietary patterns on a broad spectrum of mental health. Objective We conducted a systematic review, using the PRISMA guidelines, of the observational studies analyzing the association between the dietary pattern of fruit and vegetables and the broad aspects of mental health in adult women. Data sources The databases PubMed and Web of Science were searched, and additional manual search for observational peer-reviewed studies was conducted for studies published until June 2019. Data extraction A total of 5911 studies were extracted and verified based on title and abstract for the inclusion criteria. All procedures were conducted independently by 2 researchers. The final number of included studies was 30. The review was structured around the type of observed outcome. Data analysis The included studies had defined habitual intake associated with dietary patterns with the intake of specific fruit and/or vegetables, and/or fruit or vegetable products (eg, juices), as well as any aspect of the broad spectrum of general mental health. The Newcastle–Ottawa Scale was used to assess bias. The observed association was not stated in all the included studies; some of them revealed a reverse relationship, but only for the vegetarian/vegan diet. A vegetarian diet may be characterized by high consumption of fruits and vegetables, but it sometimes may not be properly balanced, due to excluded products. This may be the reason of observed situation. Conclusions A general positive influence was observed for the dietary patterns characterized by high consumption of fruit and vegetables and of fruit or vegetable products by women. Systematic review registration PROSPERO registration no. CRD42019138148. [ABSTRACT FROM AUTHOR]

Context Online grocery services are an emerging component of the food system with the potential to address disparities in access to healthy food. Objective We assessed the barriers and facilitators of equitable access to healthy foods in the online grocery environment, and the psychosocial, purchasing, and dietary behaviors related to its use among low-income, diverse populations. Data Sources Four electronic databases were searched to identify relevant literature; 16 studies were identified. Results Barriers to equitable access to healthy food included cost and limited availability of online grocery services in food deserts and rural areas. The expansion of online grocery services and the ability to use nutrition assistance benefits online were equity-promoting factors. Perceived low control over food selection was a psychosocial factor that discouraged online grocery use, whereas convenience and lower perceived stress were facilitators. Findings were mixed regarding healthfulness of foods purchased online. Although few studies assessed diet, healthy food consumption was associated with online grocery use. Conclusion Researchers should assess the impact of online grocery shopping on low-income families' food purchases and diet. Systematic Review Registration PROSPERO registration no. CRD: 42021240277 [ABSTRACT FROM AUTHOR]

Context The literature supports the protective role of the Mediterranean diet (MD) in the prevention of some types of cancer, such as colorectal and liver cancer. The link between the MD and lung cancer, however, is still unclear. Objective The aim of this systematic review and meta-analysis was to investigate the association between the MD and risk of lung cancer. Data Sources Electronic databases (PubMed, Scopus, Embase, and Web of Science) were searched up to May 2021. Study Selection Case-control and cohort studies reporting the association between intake of the MD and risk of lung cancer and with accessible full texts published in English were included. Review articles, laboratory and animal studies, abstracts, letters to the editor, and studies lacking sufficient data were excluded. Data Extraction The risk ratio (RR) was extracted from eligible studies, and meta-analysis was performed to calculate the pooled RR of the included studies. Results Nine studies (8 cohort, 1 case-control) were included in the meta-analysis. High adherence to the MD was associated with a lower likelihood of lung cancer compared with low adherence (RR = 0.84; 95%CI, 0.77–0.91; I2  = 52%, heterogeneity P  = 0.03). Dose-response analysis showed that a 2-score increment in MD adherence was associated with a 6% lower risk of lung cancer (RR = 0.94; 95%CI, 0.91–0.96; nonlinearity P  = 0.97). Subgroup analyses showed a protective association between MD adherence and risk of lung cancer among former smokers (n = 3 studies) (RR = 0.81; 95%CI, 0.74–0.89), but no significant association was observed for never smokers (n = 3 studies) (RR = 0.78; 95%CI, 0.29–2.07) or current smokers (n = 3 studies) (RR = 0.82; 95%CI, 0.58–1.16). In addition, an inverse association between the MD and lung cancer was observed in both males (RR = 0.84; 95%CI, 0.74–0.96) and females (RR = 0.87; 95%CI, 0.77–0.98). Conclusions High adherence to the MD is associated with a lower risk of lung cancer, especially in former smokers. Systematic Review Registration PROSPERO registration no. CRD42019146460. [ABSTRACT FROM AUTHOR]

Context Moderate alcohol consumption is associated with decreased risk of cardiovascular disease (CVD) and improvement in cardiovascular risk markers, including lipoproteins and lipoprotein subfractions. Objective To systematically review the relationship between moderate alcohol intake, lipoprotein subfractions, and related mechanisms. Data sources Following PRISMA, all human and ex vivo studies with an alcohol intake up to 60 g/d were included from 8 databases. Data extraction A total of 17 478 studies were screened, and data were extracted from 37 intervention and 77 observational studies. Results Alcohol intake was positively associated with all HDL subfractions. A few studies found lower levels of small LDLs, increased average LDL particle size, and nonlinear relationships to apolipoprotein B–containing lipoproteins. Cholesterol efflux capacity and paraoxonase activity were consistently increased. Several studies had unclear or high risk of bias, and heterogeneous laboratory methods restricted comparability between studies. Conclusions Up to 60 g/d alcohol can cause changes in lipoprotein subfractions and related mechanisms that could influence cardiovascular health. Systematic Review Registration PROSPERO registration no. 98955 [ABSTRACT FROM AUTHOR]

Context Testosterone concentrations decline with age, and lower testosterone concentrations are associated with several morbidities, including sexual dysfunction, obesity, type 2 diabetes mellitus (T2DM), and metabolic syndrome. Objective Because dietary habits play a critical role in weight regulation and T2DM management, the aim of this systematic review and meta-analysis was to summarize and critically evaluate the evidence from randomized controlled trials to determine the effects of calorie restriction (CR) on testosterone concentrations in men. Data Sources A literature search was conducted across 4 databases, from their inception until March 2020. Data Extraction The screening and data extraction were completed by 2 authors independently, and in a blinded manner, according to a priori inclusion and exclusion criteria. Data Analysis Of the 4198 studies identified from the initial search, 7 randomized controlled trials were included for data extraction. Significant increases in total testosterone concentrations were reported in 3 of 4 studies in which CR was examined with overweight or obese men, compared with the control groups. Significant decreases in total testosterone concentrations were reported in 2 of 3 studies in which the effects of CR were examined with normal-weight, healthy men, compared with the control groups. In all 4 studies that examined the effect of CR on sex hormone–binding globulin concentrations, the intervention significantly increased sex hormone–binding globulin concentrations compared with that of the control groups irrespective of body composition. Conclusion This systematic review and meta-analysis provide some evidence that CR affects testosterone concentrations in men and this effect depends on their body mass index. PROSPERO registration no. CRD42020173102 [ABSTRACT FROM AUTHOR]

Context Previous reviews have focused on evaluating the efficacy and effectiveness of rice fortification, despite the need to also understand the outcomes of micronutrient retention, organoleptic properties, and acceptability to inform nutrition programs. Objective This systematic review aims to consolidate existing evidence on micronutrient retention, organoleptic properties, and acceptability of fortified rice. Data Sources Eligible articles were identified from 22 electronic databases and personal referrals and reviews. Study Selection Studies on rice fortified via extrusion or coating technologies were included in the review if they reported outcomes in at least 1 of 3 domains: micronutrient retention, organoleptic or physicochemical properties, and acceptability (evaluated by sensory tests and consumer surveys). Any years of publication and study populations were considered for inclusion. A total of 15 391 articles were screened, yielding 49 for inclusion. Data Extraction Study results were summarized descriptively through discussions by intervention conditions, study population, measurement methods, and key findings. The included studies were independently reviewed by 2 of the 3 authors, and all 3 authors reached consensus on the quality and major findings from the included articles. Results Extrusion and coating fortification technologies were found to be comparable across studies that assessed retention, organoleptic properties, and acceptability. Cooking fortified rice in excess water increased micronutrient loss for both technologies. Fortified kernels containing ferric pyrophosphate, zinc oxide, or zinc sulfate showed the most positive results for all outcomes reviewed, while retention rates of vitamin A in multiple-micronutrient-fortified rice were variable. Conclusions The current practice of fortifying rice with ferric pyrophosphate provides high micronutrient stability and results in rice with organoleptic properties and consumer acceptance levels comparable to those of unfortified milled rice, although it presents challenges regarding the effect of vitamin A–fortified rice on vitamin A status. [ABSTRACT FROM AUTHOR]

Extracellular vesicles (EVs) encompassing nanovesicles derived from the endosome system and generated by plasmatic membrane shedding are of increasing interest in view of their ability to sustain cell-to-cell communication and the possibility that they could be used as surrogate biomarkers of healthy and unhealthy trajectories. Nutritional strategies have been developed to preserve health, and the impact of these strategies on circulating EVs is arousing growing interest. Data available from published studies are now sufficient for a first integration to better understand the role of EVs in the relationship between diet and health. Thus, this review focuses on human intervention studies investigating the impact of diet or its components on circulating EVs. Because of analytical bias, only large EVs have been assessed so far. The analysis highlights that poor-quality diets with elevated fat and sugar content increase levels of circulating large EVs, and these can be partly counteracted by healthy food or some food micronutrients and bioactive compounds. However, knowledge of the content and the biological functions of these diet-induced EVs is still missing. It is important to address these aspects in new research in order to state if EVs are mediators of the effects of diet on health. [ABSTRACT FROM AUTHOR]

Context Issues related to nutrition and health are prominent, yet it is unclear if the dietetics workforce is being used optimally. Objective Trends, challenges, opportunities, and future needs of the international dietetic workforce are investigated in this review, which was registered with Open Science Framework (10.17605/OSF.IO/DXNWE). Data sources Eight academic and 5 grey-literature databases and the Google search engine were searched from 2010 onward according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. Of 2050 articles screened, 184 were eligible for inclusion. Data extraction To chart data, a directed content analysis and a constant comparison technique were used. Data analysis The following 13 themes were identified: 1) emerging or expanding areas of practice; 2) skill development; 3) economic considerations; 4) nutrition informatics; 5) diversity within the workforce; 6) specific areas of practice; 7) further education; 8) intrapersonal factors; 9) perceptions of the profession; 10) protecting the scope of practice; 11) support systems; 12) employment outcomes; and 13) registration or credentialing. Conclusions The dietetics profession is aware of the need to expand into diverse areas of employment. Comprehensive workforce data are necessary to facilitate workforce planning. [ABSTRACT FROM AUTHOR]

Context Sustained hyperglycemia triggers chronic disease, including type 2 diabetes. A considerable volume of research has explored the effects of brown seaweed on plasma glucose control, but equivocal findings have been reported. Objective A systematic review and meta-analysis was conducted to assess the evidence from human randomized controlled trials (RCTs) on the effects of brown seaweed on plasma glucose in healthy, at-risk, and individuals with type 2 diabetes. Data Sources MEDLINE/PubMed, EMBASE, and the Cochrane Library were searched for reports published between 2000 and 2020. Data Extraction Population, intervention, comparator, outcome, and study design data were extracted. Data Analysis Eighteen RCTs met our inclusion criteria. The reported results varied across and between populations. Meta-analyses showed a significant effect, favoring the intervention group for both fasting (mean difference –4.6 [95% CI –7.88, –1.33]) and postprandial (mean difference –7.1 [95% CI –7.4, –6.9]) plasma glucose. Conclusion Brown seaweed and its extracts show potential for preventing and managing hyperglycemia. Our meta-analysis confirms that brown seaweed positively affects plasma glucose homeostasis, with particularly promising postprandial plasma glucose effects. However, further research is needed because no high-quality RCT was identified. Species-specific and dose–response research is also required. Systematic Review Registration PROSPERO registration no. CRD42020187849. [ABSTRACT FROM AUTHOR]

Context Although previous observational studies have investigated the association between waist circumference (WC) values and serum vitamin D levels, findings have been inconsistent. Objective A systematic review and meta-analysis was performed to evaluate the effect of abdominal obesity (based on WC) on vitamin D deficiency or insufficiency in adults. Data Sources A systematic search of the published literature up to September 2020 was conducted in electronic databases, including MEDLINE (PubMed), EMBASE, Institute for Scientific Information (ISI) (Web of Science), Scopus, and Google Scholar, for observational studies that investigated the association between abdominal obesity (based on WC) or different categories of WC as the exposure and serum 25-hydroxy vitamin D levels as the outcome. Data Extraction Eighteen cross-sectional studies were included in the review. The relationship between WC values and combined serum vitamin D deficiency and insufficiency (<30 ng/mL) or vitamin D deficiency (<20 ng/mL) was evaluated. Data Analysis Combining 8 effect sizes from 5 investigations, including 7997 individuals, illustrated that the highest category of WC, compared with the lowest category of WC, was related to 82% increased odds of combined serum vitamin D deficiency and insufficiency (<30 ng/mL) (OR: 1.82; 95% CI: 1.34, 2.49). Moreover, in studies that investigated both genders together, the highest category of WC, compared with the lowest category of WC, was associated with 61% increased odds of serum vitamin D deficiency (<20 ng/mL) (OR: 1.61; 95% CI: 1.12, 2.31). The same results were obtained for almost all subgroups for several covariates. Conclusion This meta-analysis of cross-sectional studies confirmed that increased WC was related to the elevated risk of combined vitamin D deficiency and insufficiency in adults. More prospective studies are needed to confirm causality. Systematic Review Registration PROSPERO registration no. CRD42020190485. [ABSTRACT FROM AUTHOR]

Context The obesity epidemic is a main driver of the chronic disease epidemic; however, present treatment approaches have suboptimal efficacy. Objectives To assess the efficacy of plant-predominant (vegan, vegetarian, plant-based whole foods [PBWFs]) diets in treating obesity and its main cardiometabolic sequelae: hyperlipidemia (HLD); indices of insulin resistance, glycemic control, and diabetes mellitus type 2 (DM2); and cardiovascular disease (CVD), including hypertension (HTN). Data Sources A systematic search of multiple databases was conducted for articles published between November 2019 and February 2020; databases searched included: PubMed, Medline (Ovid), Cochrane, CENTRAL, and CINAHL. Data Extraction and Analysis All interventional trials (randomized controlled trials [RCTs] and trials of non-randomized experimental design) that met the inclusion criteria (English language, duration of at least 4 weeks, primary end point congruent with above objectives, no major flaws in research design that would prevent interpretation) were included in the review. A total of 3135 articles were scanned and 84 were selected. The articles were collated and summarized in 2 evidence tables. Risk of bias for RCTs was assessed using the Cochrane Risk-of-Bias tool 2 as a guide. For non-randomized trials, higher risk of bias was assumed, and the JBI Critical Appraisal tool was used as a guide to determine inclusion. Results Plant-based diets, in general, demonstrated improved weight control and cardiometabolic outcomes related to lipids, cardiovascular end points, blood pressure, insulin sensitivity, A1C, and fasting glucose, and a lower risk of diabetes compared with usual diets and in some cases standard health-oriented diets such as the American Heart Association (AHA), American Diabetic Association (ADA), and Mediterranean diets. Preliminary studies suggest plant-predominant diets practiced as part of healthy lifestyle interventions may stabilize or even reverse DM 2 and CVD. The acceptability and sustainability of plant-predominant diets where measured were generally similar to other health-oriented diets. Conclusion Plant-predominant diets can play a major role in reversing the obesity and chronic disease epidemics. In the setting of sustained lifestyle intervention programs, they may arrest or even reverse DM2 and CVD. Further higher-level RCTs are needed to confirm and expand on these findings. [ABSTRACT FROM AUTHOR]

Context Consumption of dietary macronutrients is associated with the progression of a wide range of inflammatory diseases, either by direct modulation of host immune response or via microbiome. This includes periodontitis, a disease affecting tooth-supporting tissues. Objective The aim of this work was to systematically review studies focusing on the effect of macronutrient (ie, carbohydrate, protein, fat) intake on periodontitis in rodents. Data Sources Electronic searches were performed in February 2021 using the PubMed and Web of Science databases. Out of 883 articles reviewed, 23 studies were selected for additional analysis. Data Extraction Investigators extracted relevant data, including author names; the year of publication; article title; macronutrient composition; number and species of animals and their age at the start of the experiment; intervention period; method of periodontitis induction; and primary and secondary periodontitis outcomes. Quality assessment was done using the risk-of-bias tool for animal studies. After completing the data extraction, descriptive statistical information was obtained. Data Analysis High intakes of dietary cholesterol, saturated fatty acids, and processed carbohydrates such as sucrose, and protein-deficient diets were positively associated with periodontitis in rodents. This included greater amounts of alveolar bone loss, more lesions on periodontal tissues, and dental plaque accumulation. In contrast, high doses of milk basic protein in diets and diets with a high ratio of ω-3 to ω-6 fatty acids were negatively associated with periodontitis in rodents. Conclusion This work highlights the fact that, despite the large body of evidence linking macronutrients with inflammation and ageing, overall there is little information on how dietary nutrients affect periodontitis in animal models. In addition, there is inconsistency in data due to differences in methodology, outcome measurement, and dietary formulation. More studies are needed to examine the effects of different dietary macronutrients on periodontitis and investigate the underlying biological mechanisms. [ABSTRACT FROM AUTHOR]

Context Diet plays a critical role in cognitive integrity and decline in older adults. However, little is known about the relationship between diet and cognitive integrity in middle age. Objective To investigate the relationship between dietary patterns in healthy middle-aged adults and neurocognition both in middle age and later in life. Data Sources Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, the following electronic databases were searched: Web of Science, Scopus, PubMed, and PsychInfo. Data Extraction Data from eligible articles was extracted by 2 reviewers. Data Analysis Articles included in the systematic review were synthesized (based on the synthesis without meta-analysis reporting guidelines) and assessed for quality (using the Joanna Briggs Institute checklist for randomized controlled trials, cohort studies, and cross-sectional studies) by 2 reviewers. Results Of 1558 studies identified, 34 met the eligibility criteria for inclusion. These comprised 9 cross-sectional studies, 23 longitudinal or prospective cohort studies, and 2 randomized controlled trials. Findings were mixed, with some studies reporting a significant positive relationship between adherence to various "healthy" dietary patterns and neurocognition, but others reporting no such relationship. Conclusion This systematic review demonstrated that adherence to the Mediterranean diet and other healthy dietary patterns in middle age can protect neurocognition later in life. Systematic Review Registration PROSPERO registration no. CRD42020153179. [ABSTRACT FROM AUTHOR]

Context Evidence shows that fructooligosaccharides (FOSs) can modulate inflammatory, oxidative, and immune activity in the gut, possibly leading to a systemic response, improving human health. Objective To assess the present knowledge of the effects of FOSs on inflammation, immunomodulation, oxidative stress, and gut immune response. Data Sources Studies published between December 2000 and January 2020 were systematically searched in four databases: MEDLINE, LILACS, Web of Science, and Scopus. After the screening of 1316 articles, 8 human studies and 20 animal models were included. Data Extraction Data were extracted separately by 2 reviewers. For each study, the design, population, exposures, main results, and conclusion were extracted. The research questions and the risk-of-bias information were also extracted. Additionally, the risk-of-bias were analyzed to guarantee the reliability of this review. Data Analysis A qualitative analysis revealed that FOSs can increase bifidobacteria counts and short-chain fatty acids in the gut, stimulate IgA secretion in the colon, and decrease proinflammatory cytokines, thus influencing metabolic diseases. Conclusion Studies suggest that FOS supplementation is positively associated with an anti-inflammatory and antioxidant effect, thus enhancing the gut immune system, which may be beneficial for the host's health. Systematic Review Registration PROSPERO registration nos 42020209865 and 42020220369. [ABSTRACT FROM AUTHOR]

Nitrate and nitrite are plant nutrients that, although ubiquitous in plant foods, are highly controversial substances in human nutrition because they are also used as additives in processed foods and may be found as contaminants in drinking water. The aim for this narrative review is to provide a thorough insight into the current literature on the relationship between dietary nitrate and nitrite and the health risks and benefits by source of intake. The results highlight beneficial effects of nitrate and nitrite consumption from plant origin on cardiovascular disease and, to date, no positive correlation has been reported with cancer. On the contrary, high intake of these compounds from processed animal-based foods is related to an increased risk of gastro-intestinal cancer. Nitrate in drinking water also raises some concern, because it appears to be related to adverse health effects. The up-to-date debate on the role of nitrate and nitrite in human nutrition seems to be justified and more research is required to verify safe consumption. [ABSTRACT FROM AUTHOR]