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Introduction: Time-restricted eating (TRE) or time-restricted feeding (TRF), a form of intermittent fasting (IF) when food consumption is restricted to a 4–12 hour window, poses unique possible health benefits that allow the nutrient to work in harmony with circadian rhythm. Whether TRF is effective in weight loss and cardiometabolic profile compare to usual diet is controversial. We conducted a meta-analysis of randomized control trials to investigate the weight and metabolic effects of TRF in humans. Methods: The systematic review was conducted according to the PRISMA guidelines. The literature search was conducted in MEDLINE, EMBASE, and CENTRAL from database inception to November 30, 2020. The search terms included time restricting feeding, time-restricted eating, periodic fasting, intermittent fasting, and periodic fasting. The eligibility criteria included a randomized controlled trial (RCT) comparing the effect of TRF as an intervention and control diet on weight and cardiometabolic risks in individuals with overweight (BMI 23–26.9 kg/m2 in Asian and 25–29.9 kg/m2 in others) or obesity (BMI≥27 kg/m2 in Asian and ≥30 kg/m2 in others) with study duration of at least 8 weeks. The primary outcome is the change in body weight between preintervention and postintervention. The secondary outcome is the change in total fat mass and lean mass, HDL, LDL, and triglycerides. Pool mean differences (MD) with 95% confidence interval (CI) were calculated for each outcome. Results: Four articles met the inclusion criteria and were included in this systematic review and meta-analysis. There were 511 participants with BMI 24 kg/m2 and above and aged between 18 and 65. TRF was defined as a 4–8 hours ad-lib unrestricted eating in 24 hours. The control diet was defined as ad-lib eating per usual habits. There was a significant improvement in weight and body composition in the TRF group. The mean weight loss was -2.08 kg (95% CI: -3.49 to -0.68) greater among TRF group. There was a significant total fat mass and lean mass loss in the TRF group with the MD of -1.29 kg (95% CI: -2.04 to -0.54) and -0.59 kg (95% CI: -1.15 to -0.03), respectively. There was no significant change in HDL, LDL, or triglycerides comparing between TRF and control diet. Conclusion: This systematic review and meta-analysis of RCT showed that TRF with no calories restriction resulted in significant decreased in weight, fat mass, and a slight decreased in total lean mass compared with control diet. Our findings support TRF as an effective lifestyle intervention for weight loss.

Objectives This meta-analysis aims to investigate the possibility of bone mineral loss and fracture in sarcoidosis. Materials and methods A comprehensive search of the MEDLINE and Embase databases was performed from inception through August 2017. The inclusion criterion was observational studies evaluating the association between sarcoidosis and bone mineral density (BMD) or fracture. The pooled odds ratio (OR) of fracture, standardized mean difference (SMD) of volumetric BMD and areal BMD, and their 95% confidence interval (CI) were calculated using a random-effects meta-analysis to compare risk between sarcoidosis and controls. The between-study heterogeneity of effect-size was quantified using the Q statistic and I2. Results Data were extracted from 10 studies involving a total of 6,448 sarcoidosis patients and 77,857 controls. The pooled result demonstrated no significant increased risk of fracture in sarcoidosis patients compared with controls (OR=1.68; 95% CI: 0.85-3.31, p value=0.14, I2=72%). There were no differences between the patients and controls in areal BMD (SMD= 0.21 g/cm2; 95% CI: -0.12-0.54, p value= 0.22, I2=0%) or volumetric BMD (SMD= 0.04 mg/cm3; 95% CI: -0.51-0.58, p value=0.89, I2=83%). Conclusion Our study has not shown an increased risk of fracture or bone mineral loss in sarcoidosis. However, based on the currently available studies with heterogeneity in between, the conclusion for the osteoporosis screening and fracture risk assessment of patients with sarcoidosis cannot be drawn until more studies are available.

Background/Aims: No medications have been approved for managing nonalcoholic fatty liver disease (NAFLD). Lifestyle intervention is the mainstay for its treatment. Hyperferritinemia, which appears to be associated with the severity of liver injury and insulin resistance, is frequently observed in patients with NAFLD. Patients and Methods: We conducted a systematic review and meta-analysis of the outcomes of four interventional trials regarding the effect of phlebotomy in patients with NAFLD versus the outcomes of NAFLD patients who did not undergo phlebotomy. Primary outcome was the pooled mean difference (MD) of the homeostasis model assessment of insulin resistance (HOMA-IR). The secondary outcomes were the changes in liver enzymes and the lipid profile. Results: Four interventional studies involving 438 participants were included in the meta-analysis. HOMA-IR was lower in patients who underwent phlebotomy, with an MD of 0.84 [95% confidence interval (CI) 0.01 to 1.67, I2 = 72%]. Phlebotomy also significantly reduced the alanine aminotransferase (MD = 10.05, 95% CI 7.19–12.92, I2 = 34%) and triglyceride (MD = 9.89, 95% CI 4.96–14.83, I2 = 22%) levels and increased the high-density cholesterol level (MD = 3.48, 95% CI 2.03–4.92, I2 = 18%). Conclusion: Phlebotomy decreased insulin resistance and liver transaminase levels in patients with NAFLD. In addition, it improved their lipid profile.

We thanked Rinaldi et al. who interested in our study entitled “Underweight and obesity increase the risk of mortality after lung transplantation: a systematic review and meta-analysis” (1) and gave an interesting thought and suggestion. Rinaldi et al. questioned why earlier studies from the same databases such as the work by Lederer et al. (2) and Allen et al. (3), which used the United Network for Organ Sharing database, were excluded from meta-analysis. This article is protected by copyright. All rights reserved.

To determine if the reduction of visceral adipose tissue (VAT) volume by lifestyle intervention improved risk factors for cardiovascular disease (CVD) independent of weight loss amount.Ancillary study of randomized-controlled trial.Data analysis using multivariable regression models.Participants of the Look AHEAD (Action for HEAlth in Diabetes) Fatty Liver Ancillary Study.Correlations between changes in VAT and in CVD risk factors, while adjusting for weight loss and treatment (intensive lifestyle intervention [ILI] vs. diabetes support and education [DSE]).Of 100 participants analyzed, 52% were women, and 36% were black, with a mean age of 61.1 years. In the DSE group, mean weight and VAT changed by 0.1 % (p=0.90) and 4.3% (p=0.39), respectively. In the ILI group, mean weight and VAT decreased by 8.0% (p0.001) and 7.7% (p=0.01), respectively. Across both groups, mean weight decreased by 3.6% (p0.001), and mean VAT decreased by 1.2% (p=0.22); the decrease in VAT was correlated with the increase in HDL-cholesterol (HDL-C; R=-0.37; p=0.03). There were no correlations between changes in VAT and blood pressure, triglycerides, LDL-C, glucose, or HbA1c. After adjusting for age, race, gender, baseline metabolic values, fitness, and treatment group, changes in HDL-C were not associated with changes in VAT, while weight changes were independently associated with decrease in glucose, HbA1c, and increase in HDL-C.VAT reduction was not correlated with improvements of CVD risk factors in a sample of overweight and obese adults with type 2 diabetes after adjusting for weight loss.

Many studies have found an association between abnormal body mass index (BMI) and poor outcomes among lung transplant recipients. We performed a systematic review and meta-analysis to identify outcomes associated with an abnormal pretransplant BMI after lung transplantation (LTx). The MEDLINE and EMBASE databases were searched from inception to May 2015 with focus on original observational studies with post-transplant survival data in candidates with abnormal BMI (underweight, overweight, or obese). We performed meta-analyses examining survival and primary graft dysfunction after LTx. We identified 866 citations; 13 observational cohort studies involving 40 742 participants met our inclusion criteria for systematic review. Seven of the 13 were included in the meta-analysis. There was a significant risk of mortality after LTx in candidates with underweight and obesity (underweight versus normal, relative risk [RR] 1.36, 95% confidence interval [CI] 1.11-1.66, I(2) = 0%; obesity vs. normal, RR 1.90, 95% CI 1.45-2.56, I(2) = 0%; overweight vs. normal, RR 1.36, 95% CI 1.11-1.66, I(2) = 0). There was also a significant risk of primary graft dysfunction in obese (RR 1.92, 95% CI 1.39-2.65, I(2) = 0%) and overweight (RR 1.72, 95% CI, 1.32-2.24, I(2) = 0%) candidates. Lung transplant candidates who are underweight or obese have a higher risk of post-transplant mortality than recipients with a normal BMI.

Introduction There is inconclusive evidence whether osteoporosis increases risk of hearing loss in current literature. Objective We conducted this meta-analysis to determine whether there is an association between hearing loss and osteoporosis. Methods This systematic review and meta-analysis was conducted from studies of MEDLINE, EMBASE, and LILACS. Osteoporosis was defined as having a bone mineral density with a T-score of less than −2.5 standard deviation. The outcome was hearing loss as assessed by audiometry or self-reported assessment. Random-effects model and pooled hazard ratio, risk ratio, or odds ratio of hearing loss with 95% confidence intervals were compared between normal bone mineral density and low bone mineral density or osteoporosis. Results A total of 16 articles underwent full-length review. Overall, there was a statistically significant increased odds of hearing loss in the low bone mineral density or osteoporosis group with odds ratio of 1.20 (95% confidence intervals 1.01–1.42, p = 0.04, I2 = 82%, Pheterogeneity = 0.01). However, the study from Helzner et al. reported significantly increase odds of hearing loss in the low bone mineral density in particular area and population included femoral neck of black men 1.37 (95% confidence intervals 1.07–1.76, p = 0.01) and total hip of black men 1.36 (95% confidence intervals 1.05–1.76, p = 0.02). Conclusion Our study proposed the first meta-analysis that demonstrated a probable association between hearing loss and bone mineral density. Osteoporosis could be a risk factor in hearing loss and might play an important role in age-related hearing loss.