Despite earlier meta-analyses on the association between adherences to Mediterranean diet (MD) and risk of diabetes, there is no comprehensive and updated study assessing this issue. Furthermore, no earlier study has examined the nonlinear dose-response relationship between consumption of Mediterranean diet and risk of diabetes. The current systematic review and meta-analysis was done to investigate the linear and non-linear dose-response relationship between Mediterranean diet and incidence of diabetes. Using relevant keywords, electronic searches for prospective studies were conducted in ISI Web of Science, PubMed, and Scopus until January 2022. The reported hazard ratios or odds ratios in the primary studies were regarded as risk ratios (RRs). The overall effect was calculated using a random-effects model that accounts for between-study variability. The potential non-linear dose-response associations were tested using a two-stage hierarchical regression model. Based on 16 prospective studies (with 17 effect sizes), we found that the greatest adherence to the Mediterranean diet was significantly associated with a reduced risk of diabetes (Pooled RR: 0.83; 95% CI: 0.77–0.90; I2 =79%, P≤ 0.001). Based on linear dose-response analysis, each 1-score rise in the Mediterranean diet score was associated with a 3% decreased risk of diabetes (HR = 0.97; 95% CI: 0.96–0.98, P< 0.001). A nonlinear relationship (P nonlinearity = 0.001) was also observed between Mediterranean diet score and risk of type 2 diabetes. Even modest adherence to the Mediterranean diet was linked to a decreased incidence of type 2 diabetes.
BackgroundFood security is a fundamental human right that must be upheld to preserve excellent general welfare, and mental, physical, and social health. However, according to the United Nations Food and Agriculture Organization (FAO) report in 2020, the level of food insecurity in the world is increasing.ObjectiveDetermining the prevalence of food insecurity in Iran will be beneficial for Iran and other low-middle-income countries.MethodsWe searched both English and Persian (Iranian) databases including PubMed, Scopus, Web of Science, Google Scholar, SID, Irandoc, Magiran, Civilica, and Iranian Medical Sciences Theses System from 01 January 1990 to 01 February 2022. Observational studies that reported the prevalence of household food insecurity among a healthy Iranian population and assessed food insecurity at the individual or household level using validated questionnaires were included.ResultsOne hundred six studies and/or theses with a total of 152, 300 participants met the review criteria. Our analyses demonstrated that the prevalence of food insecurity among the healthy Iranian population was 55.9% (95% CI: 52.6–59.2%) and the highest prevalence of food insecurity was in the western regions with 64.8% (95% CI: 57.7–72.0%). Subgroup analyses showed that food insecurity among women at 51.3% (95% CI: 45.1–57.6%) and rural inhabitants at 66.1% (95% CI: 58.8–73.4%) was significantly higher than men at 47.8% (95% CI: 41.8–53.8%) and urban residents at 47.1% (95% CI: 44.1–50.0%), respectively. Among the age groups, the highest prevalence of food insecurity was in adults at 56.5% (95% CI: 51.7–61.2%).ConclusionThe prevalence of food insecurity in a healthy Iranian population was higher than the global average. Women, rural residents, and residents of the western regions of Iran had a higher prevalence of food insecurity. These groups should be prioritized in programs to reduce the prevalence of food insecurity in Iran.Systematic review registrationwww.crd.york.ac.uk/PROSPERO, identifier: CRD42022328473.
To date, several systematic reviews and meta-analyses (SRMAs) have investigated the effects of probiotics, but the certainty of the evidence for an effect on chemotherapy and radiotherapy-related diarrhea has not been assessed. We conducted an overview of SRMAs, searching MEDLINE, Scopus, and ISI Web of Science from inception up to February 2022. We summarized the findings of eligible SRMAs. Subsequently, we included RCTs from the SRMAs in meta-analyses, using a quality effects model to calculate the Odds ratio (ORs) and 95% confidence intervals (95%CIs) for each outcome. We used ‘A Measurement Tool to Assess Systematic Reviews’ (AMSTAR 2) and the Cochrane risk of bias (RoB) tool to assess the methodological quality of the SRMAs and their RCTs, respectively. We used the ‘Grading of Recommendations Assessment, Development, and Evaluation’ (GRADE). We included 13 SRMAs, which reported pooled effect sizes for chemotherapy and radiotherapy-related diarrhea based on a total of 18 RCTs. Our meta-analyses demonstrated statistically significant beneficial effects from probiotics on all outcomes, except stool consistency; diarrhea (any grade) OR 0.35 (95%CI 0.22, 0.54), grade ≥2 diarrhea 0.43 (0.25, 0.74), grade ≥3 diarrhea 0.30 (0.15, 0.59), use of medication 0.49 (0.27, 0.88), soft stool 1.10 (0.44, 2.76) and watery stool 0.52 (0.29, 1.29). Probiotics use can reduce the incidence of diarrhea in cancer patients in chemotherapy and radiotherapy, but the certainty of evidence for significant outcomes were very low and low.
Background & Aims: To examine the link between dietary insulin index (DII) and load (DIL) and sleep duration/quality for the first time. Methods This cross-sectional study conducted on data from the recruitment phase of YaHS-TAMYZ prospective study in Yazd, central Iran. Data on demographic characteristics, dietary intakes, sleep quantity and quality, and potential confounders were gathered by interview. Sleep quality and its components (insufficient sleep, delay in falling asleep, medication use for sleep, and sleep disorder) were assessed by a modified version of Pittsburgh questionnaire. The link between DII/DIL and low sleep quality and short/long sleep duration was studied using multivariable logistic regression. Results In total, 5925 individuals aged 20 to 70 were eligible to take part in the current study. After adjustment for all potential confounders, participants in the highest DIL score tertile had a lower chance for sleep disorder (OR = 0.38; 95%CI: 0.17–0.85, Ptrend=0.02) and delay in falling asleep (OR = 0.66; 95%CI: 0.42–1.03, Ptrend=0.05) compared to those in the lowest tertile. The DII was also linked to a lower chance for sleep disorder (OR = 0.61; 95% CI: 0.39–0.93, P trend = 0.02). The DIL was inversely associated with sleep medication use and delay in falling sleep in men and women, respectively (P < 0.05). Moreover, DII was linked to a decreased odds of sleep disorder in women (P < 0.05). The associations were observed in those with overweight or obesity but not in those without overweight (P < 0.05). Conclusion Higher DIL and DII might be associated with sleep quality and its components. Prospective investigations are needed in the future to confirm these findings.
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