Dietary carbohydrate intake and risk of bone fracture: a systematic review and meta-analysis of observational studies.

OBJECTIVE: Despite growing evidence for the association between other dietary macronutrients and bone health, limited and inconsistent knowledge is available regarding carbohydrate intake. In this systematic review and meta-analysis, we purposed to clarify and synthesize the knowledge about the relation between carbohydrate intake and the risk of fracture. STUDY DESIGN: Systematic review and meta-analysis of observational studies. METHODS: In this study, PubMed and Scopus were used to conduct a comprehensive search for articles published up to September 2018. The screening was done independently by two authors. Pooled effect sizes were calculated using fixed and random effect models for the highest versus lowest intake categories. The dose-response nature of the relationship was also investigated. RESULTS: No association was observed between carbohydrate intake and the risk of fracture in high versus low intake meta-analysis (overall relative risk [RR]: 1.24; 95% confidence interval [95% CI]: 0.84-1.84; P = 0.27) with moderate heterogeneity (I2 = 57.7%, P heterogeneity = 0.05). Moreover, there was no relationship between carbohydrate intake and the risk of fracture in both linear (overall RR: 1.00; 95% CI: 0.94-1.05; P = 0.88) (I2 = 68.1%, P heterogeneity = 0.48) and nonlinear (Pnon-linearity = 0.14) models. CONCLUSION: No association was observed between carbohydrate intake and the risk of fracture.

The effects of vitamin D supplementation on muscle strength and mobility in postmenopausal women: a systematic review and meta-analysis of randomised controlled trials.

BACKGROUND: The results obtained from previous trials regarding the effects of vitamin D supplementation on muscle strength and mobility in postmenopausal women have been inconsistent. This systematic review and meta-analysis of randomised controlled trials (RCTs) aimed to investigate the effect of vitamin D supplementation on muscle strength and mobility in postmenopausal women. METHODS: A comprehensive search on EMBASE, PubMed, MEDLINE and SCOPUS was performed to identify relevant articles published up to 28 March 2019. RCTs published in English measuring the effect of all forms and doses of vitamin D supplementation with or without calcium on muscle strength and mobility outcomes in postmenopausal women were included. RESULTS: In total, 29 eligible studies were included in the systematic review. The pooled findings using a random effects model showed that vitamin D supplementation insignificantly increased hand grip strength (HGS) as the measurement of muscle strength (MD = 0.656; 95% confidence interval = -0.037 to 1.350, P = 0.06). However, it did not affect timed-up-and-go (TUG) as the measurement of mobility (MD = 0.118; 95% confidence interval = -0.655 to 0.892, P = 0.76). The subgroup analyses showed that vitamin D supplementation improved HGS with respect to dosages >1000 IU day-1 (P = 0.016), a treatment duration of 3 months (P Ë‚ 0.001) and subjects with baseline vitamin D <30 ng mL-1 (P = 0.033). CONCLUSIONS: The present review demonstrates that vitamin D supplementation resulted in small but nonsignificant improvements in muscle strength compared to control in postmenopausal women. No significant effect was observed in mobility after vitamin D administration.

Dietary fat, saturated fatty acid, and monounsaturated fatty acid intakes and risk of bone fracture: a systematic review and meta-analysis of observational studies.

Total dietary fat intake might influence the risk of fracture; however, conflicting findings have been reported to date. Moreover, the type of fatty acids is also of vital importance. We aimed to conduct a comprehensive review of the literature on the association between dietary fat intake, saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs), and the risk of fracture. PubMed and Scopus were used to conduct a comprehensive search for articles published up to 7 January 2018. To pool effect sizes, random effects models (the DerSimonian-Laird method) were applied. The Cochrane Q test was used to trace the source of between-study heterogeneity. Six studies met inclusion criteria for meta-analysis. We found no significant association between total dietary fat intake and risk of fracture (pooled effect size 1.31, 95% confidence interval (95% CI) 0.95-1.79, P = 0.09). A significant positive association was observed between SFA intake and the risk of hip fracture (pooled effect size 1.79, 95% CI 1.05-3.03, P = 0.03). There was also a significant positive association between MUFAs derived from animal sources and the risk of fracture (pooled effect size 2.29, 95% CI 1.50-3.50, P < 0.0001). Our findings showed a strong positive association between SFAs intake and risk of hip fracture. Moreover, there was a significant positive association between MUFAs derived from animal sources and the risk of fracture.

Trends in incidence of gastrointestinal tract cancers in Western iran, 1993-2007.

BACKGROUND: Few studies have addressed the secular trend of malignancies in developing countries such as Iran. This study aimed to determine the trend in the incidence of gastrointestinal cancers during a period of 15 years in Kermanshah, Iran. METHODS: All of the confirmed positive pathologic reports for esophageal, gastric and colorectal cancers from 1993 to 2007 were collected and compared with the data compiled in the provincial health center. The incidence rate was standardized for world population using a direct method. The Fay and Feuer method was used to calculate the 95% confidence intervals for each cancer in each year. Trends were investigated using linear regression. RESULTS: Over the period, 2951 cases of gastrointestinal cancer were reported in Kermanshah Province. The age-standardized incidence rates for gastric, esophageal and colorectal cancers were 9.2, 8.1 and 4.5 per 100,000 respectively over 15 years. In all types, the incidence increased with age. The study showed that the incidence of gastric and esophageal cancers decreased annually by 0.28 (-0.67-0.11) and 0.36 (-0.70 - (-0.02)), respectively. Colorectal cancer demonstrated an increase in the incidence [0.14 (95% CI: -0.01-0.29) annually]. CONCLUSION: A decrease in the incidence of gastric and esophageal cancers and an increase in the incidence of colorectal cancer are in line with reports from other developing countries in epidemiologic transition. Such trends warrant in depth investigation for the exact reasons.

Asthma in patients with atopic dermatitis.

OBJECTIVE: This cross-sectional study was designed to estimate the frequency of asthma in patients with atopic dermatitis (AD), and its related factors. METHODS: The study population consisted of 236 patients with AD who were referred to Children Medical Center in 1997-2002 and their diagnosis was based on Hanifin & Rajka criteria. Severity of AD was categorized based on Severity Scoring of Atopic Dermatitis (SCORAD) index. Asthma was diagnosed with medical history and clinical examination (three or more episodes of wheezing and/or dyspnea and/or cough after 1 year old). The patients were divided in two groups according to having or not having asthma. RESULTS: The mean age of patients with AD was 38.67+/-2.68 month and the mean age at onset of asthma was 20+/-2.5 month. The frequency of asthma in AD patients was 27.5%. The mean of SCORAD in nonasthmatic patients was 52.27 +/- 2.52 and in asthmatic patients was 56.2+/- 4.2 (P= 0.4). The mean of duration of breastfeeding in asthmatic patients was 12.2+/-1.6 month and in non-asthmatic patients was 11.16+/-6.3 month (P = 0.87). There was no significant difference between asthmatic patients and others in serum IgE levels (P = 0.65) and blood eosinophil count. (P = 0.49). CONCLUSION: These results confirmed that development of asthma in patients with AD is more than normal population and AD can be a significant predisposing factor to developing asthma but the causative factors are not clear.

Obesity and related risk factors.

OBJECTIVE: To study the prevalence of overweight and obesity among Iranian schoolgirls and to identify risk factors which lead to obesity. METHOD: This cross-sectional study was conducted in 2002 and a sample of 1800 female students between 7-12 years old was obtained using a multistage cluster sampling method from Tehran. Height and weight were measured and related socio-economic information was collected. RESULTS: The overall percent of overweight and obesity was 13.3% and 7.7% respectively. BMI (Body Mass Index) was directly and significantly(r=+0.28, P< 0.001) correlated with increasing age. Physical activity was significantly different between obese and non-obese children. (P=0.03) Also, economical factors such as the type of school (private&public) were different in these children. (P=0.03) The statistical analysis of the data revealed a significant and inverse correlation(r=-0.03, P=0.04) between maternal education and occurrence of overweight and obesity in children. CONCLUSION: The prevalence of overweight and obesity in young Iranian girls was high. Advanced age, lack of physical inactivity, low economical factors and maternal educational status could be risk factors for obesity in children.