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Background Although several systematic reviews and meta-analyses have been conducted to assess the relationship between fruit intake and health outcomes, the results of the relationship are inconclusive. Scope and approach We conducted an umbrella evaluation of existing research on the relationship between fruit intake and various health outcomes in humans. We used A Measurement Tool to Assess Systematic Reviews 2 and Grade of Recommendations, Assessment, Development and Evaluation to comprehensively evaluate the methodological quality and evidence quality of the research. We also performed a subgroup analysis based on the study design. Key findings and conclusions The umbrella review covered 59 qualified studies, which included 77 meta-analyses and 66 health outcomes. No adverse relationships between fruit intake and health outcomes were found. Moderate-quality evidence suggested that one serving increment of fruit per day could decrease the risks of cardiovascular disease (RR: 0.97, 95% CI: 0.95 to 0.99), stroke (RR: 0.92, 95% CI: 0.88 to 0.96), coronary heart disease (RR: 0.96, 95% CI: 0.93 to 0.99), and oral cancer (OR: 0.51, 95% CI: 0.40 to 0.65). And moderate-quality evidence presented that 200 g increment of fruit intake per day was associated with lower risk of breast cancer (RR: 0.94, 95% CI: 0.89 to 0.99), and the risk of type 2 diabetes mellitus could be reduced by 8%-12% when the fruit intake increasing to 100-500 g/d. For the remaining studies, the quality of evidence was either low or very low. We also found that the study design could influence the significance of the association between fruit intake and health outcomes. Large-sample, multi-center, and multi-country randomized controlled trials or prospective studies are required to verify our results.

Global DNA hypomethylation has been reported in patients with chronic hepatitis B (CHB) and non-alcoholic fatty-liver disease (NAFLD). However, the global DNA methylation profile of patients with concurrent NAFLD and CHB (NAFLD + CHB) is still unclear. We aimed to detect the hepatic global DNA methylation levels of NAFLD + CHB patients and assess the associated risk factors. Liver biopsies were collected from 55 NAFLD patients with or without CHB. The histological characteristics of the biopsy were then assessed. Hepatic global DNA methylation levels were quantified by fluorometric method. The hepatic global DNA methylation levels in NAFLD + CHB group were significantly lower than that in NAFLD group. Participants with fibrosis showed lower levels of hepatic global DNA methylation than those without fibrosis. Participants with both CHB and fibrosis had lower levels of hepatic global DNA methylation than those without either CHB or fibrosis. The co-occurrence of CHB and fibrosis was significantly associated with a reduction in global DNA methylation levels compared to the absence of both CHB and fibrosis. Our study suggests that patients with NAFLD + CHB exhibited lower levels of global DNA methylation than patients who had NAFLD alone. The co-occurrence of CHB and liver fibrosis in NAFLD patients was associated with a decrease in global DNA methylation levels.

Objective Clinical relevance of global DNA methylation and one-carbon metabolite levels with histological severity remains uncertain in patients with nonalcoholic fatty liver disease (NAFLD). This study aimed to evaluate hepatic global DNA methylation and serum one-carbon metabolite concentrations in patients with NAFLD and the possible associations of these parameters with liver histology. Methods Liver biopsies from 18 control participants and 47 patients with NAFLD were evaluated. Results The hepatic global DNA methylation level was significantly lower in the NAFLD group than in the control group among participants with overweight. Participants with moderate inflammation and mild fibrosis had significantly lower levels of global DNA methylation than those without these characteristics. Participants with borderline nonalcoholic steatohepatitis had significantly lower global DNA methylation levels than controls. The hepatic global DNA methylation level tended to decrease with the increasing hepatic inflammation grade and disease progression. The NAFLD group had a significantly higher serum homocysteine concentration than the control group among participants with overweight. This level tended to increase with increasing hepatic steatosis grade and disease progression. Conclusions Patients with NAFLD exhibited lower hepatic levels of global DNA methylation and elevated serum homocysteine concentrations, which are associated with the histological severity of NAFLD.