Context Polyphenols have antioxidant, anti-inflammatory, and anti-glycation properties. Objective To assess the effects of dietary polyphenols, from food sources or supplements, on the anthropometric, glycemic, renal, inflammatory, and oxidative stress markers in adults with diabetic nephropathy (DN). Data sources Systematic searches for randomized clinical trials were performed in MEDLINE, Embase, CENTRAL, Web of Science, LILACS, SciELO, opengrey.eu, and ClinicalTrials.gov databases until December 2021. Data extraction Studies with adults with DN were included. Random-effects meta-analyses were conducted. Risk of bias of the studies and Grading of Recommendations, Assessment, Development, and Evaluation assessment were carried out. Data analysis The searches resulted in 5614 unique occurrences, and 34 full-text articles were retrieved. Of these, 17 studies were included in the qualitative synthesis. Most of the studies used soy protein or milk (n = 5; 0.5–1 g/kg of body weight/d of soy protein, or introduction of 240 mL/d of soy milk) or turmeric/curcumin (n = 5; dose range, 80 to 1500 mg/d) as the intervention. The following outcomes were analyzed: body mass index, glycated hemoglobin (HbA1c), proteinuria, creatinine clearance, glomerular filtration rate (GFR), urinary albumin to creatinine ratio, and levels of fasting blood glucose, insulin, serum urea and creatinine, C-reactive protein, serum tumor necrosis factor-α, and serum malondialdehyde (MDA). The polyphenol intervention significantly decreased HbA1c (n = 7 studies; –0.27% [95%CI, –0.51%, –0.04%]), proteinuria (n = 5 studies; –109.10 [95%CI, –216.57, –1.63] mg/24 h), and MDA (n = 5 studies; z-score: –0.41; 95%CI, –0.71, –0.10), and significantly increased GFR (n = 7 studies; 3.65 [95%CI, 0.15–7.15] mL/min/1.73 m2). Overall, studies showed a high risk of bias, and outcomes showed a low or very-low quality in the Grading of Recommendations, Assessment, Development, and Evaluation assessment. Conclusions There is a clinically modest effect of dietary polyphenols intervention in HbA1c, proteinuria, GFR, MDA, and C-reactive protein levels in patients with DN. It is impossible to establish clinical recommendations, because the evidence was of’ low or very-low quality and because of the heterogeneity of types and dose regimens used in the studies. Systematic Review Registration PROSPERO registration no. ID245406.
Objective: To assess the relationship between the sense of coherence (SOC), eating behavior and nutritional status. Design: It is a systematic review Setting: The following databases were searched: MEDLINE/PubMed, Science Direct/Elsevier, LILACS/Bireme, SciELO and Google Scholar, using the indexed terms’ salutogenesis', 'sense of coherence', 'nutritional status', 'nutrition', 'eating behavior’ and 'healthy eating'. The indexed terms were used in Portuguese and English according to the database searched. The data were extracted in a standardized way and the quality of the studies was assessed using the Newcastle-Ottawa scale. Participants: Observational studies were included, with no limitations on the date of publication or language. Results: After reading the titles and abstracts of 1855 articles, 107 full-texts were retrieved, of which 27 were included. Of these, 25 were cross-sectional and 2 were longitudinal. The average score for Newcastle Ottawa studies was 6 and most studies were rated as moderate and low quality. The cumulative sample size of all included studies was 28,981 adults and the elderly, aged between 18 and 81 years. The studies were carried out in 15 different countries. Fifteen articles assessed eating behavior/habit and 12 assessed nutritional status. Studies have shown that SOC has a positive relationship with an appropriate eating behavior/habit. On the other hand, the relationship between SOC and nutritional status was controversial among studies. The heterogeneity of the data resulting from the use of different methods of evaluation of the outcomes of interest (nutritional status and eating behavior) made it impossible to perform a meta-analysis. Conclusion: SOC was positively associated to adequate eating behavior. However, it was not possible to establish a relationship between SOC and nutritional status.
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