http://localhost:8080/xmlui/handle/123456789/6176 Wed, 08 Apr 2026 21:11:24 GMT 2026-04-08T21:11:24Z http://localhost:8080/xmlui/handle/123456789/6225 Title: Orally Ingested Probiotic, Prebiotic, and Synbiotic Interventions as Countermeasures for Gastrointestinal Tract Infections in Nonelderly Adults: A Systematic Review and Meta-Analysis Authors: Fagnant, Heather S.; Isidean, Sandra D.; Wilson, Lydia; Bukhari, Asma S.; Allen, Jillian T.; Agans, Richard T.; Hatch-McChesney, Adrienne Abstract: ABSTRACT Meta-analyses have not examined the prophylactic use of orally ingested probiotics, prebiotics, and synbiotics for preventing gastrointestinal tract infections (GTIs) of various etiologies in adult populations, despite evidence that these gut microbiota-targeted interventions can be effective in treating certain GTIs. This systematic review and meta-analysis aimed to estimate the effects of prophylactic use of orally ingested probiotics, prebiotics, and synbiotics on GTI incidence, duration, and severity in nonelderly, nonhospitalized adults. CENTRAL, PubMed, Scopus, and Web of Science were searched through January 2022. English-language, peer-reviewed publications of randomized, placebo-controlled studies testing an orally ingested probiotic, prebiotic, or synbiotic intervention of any dose for 1 wk in adults who were not hospitalized, immunosuppressed, or taking antibiotics were included. Results were analyzed using random-effects meta-analyses of intention-to-treat (ITT) and complete case (CC) cohorts. Heterogeneity was explored by subgroup meta-analysis and meta-regression. The risk of bias was assessed using the Cochrane risk-of-bias 2 tool. Seventeen publications reporting 20 studies of probiotics (n ¼ 16), prebiotics (n ¼ 3), and synbiotics (n ¼ 1) were identified (n > 6994 subjects). In CC and ITT analyses, risk of experiencing 1 GTI was reduced with probiotics (CC analysis—risk ratio: 0.86; 95% CI: 0.73, 1.01) and prebiotics (risk ratio: 0.80; 95% CI: 0.66, 0.98). No effects on GTI duration or severity were observed. Sources of heterogeneity included the study population and number of probiotic strains administered but were often unexplained, and a high risk of bias was observed for most studies. The specific effects of individual probiotic strains and prebiotic types could not be assessed owing to a lack of confirmatory studies. Findings indicated that both orally ingested probiotics and prebiotics, relative to placebo, demonstrated modest benefit for reducing GTI risk in nonelderly adults. However, results should be interpreted cautiously owing to the low number of studies, high risk of bias, and unexplained heterogeneity that may include probiotic strain-specific or prebiotic-specific effects. This review was registered at PROSPERO as CRD42020200670. Keywords: gastrointestinal illness, infectious diarrhea, travelers’ diarrhea, gut microbiome, fermentable fiber, dietary supplement Wed, 22 Feb 2023 00:00:00 GMT http://localhost:8080/xmlui/handle/123456789/6225 2023-02-22T00:00:00Z http://localhost:8080/xmlui/handle/123456789/6222 Title: Nutrition and Exercise Interventions to Improve Body Composition for Persons with Overweight or Obesity Near Retirement Age: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials Authors: Eglseer, Doris; Traxler, Mariella; Embacher, Stefan; Reiter, Lea; Schoufour, Josje D.; . Weijs, Peter J.M; Voortman, Trudy Abstract: ABSTRACT The retirement phase is an opportunity to integrate healthy (nutrition/exercise) habits into daily life. We conducted this systematic review to assess which nutrition and exercise interventions most effectively improve body composition (fat/muscle mass), body mass index (BMI), and waist circumference (WC) in persons with obesity/overweight near retirement age (ages 55–70 y). We conducted a systematic review and network meta-analysis (NMA) of randomized controlled trials, searching 4 databases from their inception up to July 12, 2022. The NMA was based on a random effects model, pooled mean differences, standardized mean differences, their 95% confidence intervals, and correlations with multi-arm studies. Subgroup and sensitivity analyses were also conducted. Ninety-two studies were included, 66 of which with 4957 participants could be used for the NMA. Identified interventions were clustered into 12 groups: no intervention, energy restriction (i.e., 500–1000 kcal), energy restriction plus high-protein intake (1.1–1.7 g/kg/body weight), intermittent fasting, mixed exercise (aerobic and resistance), resistance training, aerobic training, high protein plus resistance training, energy restriction plus high protein plus exercise, energy restriction plus resistance training, energy restriction plus aerobic training, and energy restriction plus mixed exercise. Intervention durations ranged from 8 wk to 6 mo. Body fat was reduced with energy restriction plus any exercise or plus high-protein intake. Energy restriction alone was less effective and tended to decrease muscle mass. Muscle mass was only significantly increased with mixed exercise. All other interventions including exercise effectively preserved muscle mass. A BMI and/or WC decrease was achieved with all interventions except aerobic training/resistance training alone or resistance training plus high protein. Overall, the most effective strategy for nearly all outcomes was combining energy restriction with resistance training or mixed exercise and high protein. Health care professionals involved in the management of persons with obesity need to be aware that an energy-restricted diet alone may contribute to sarcopenic obesity in persons near retirement age. This network meta-analysis is registered at https://www.crd.york.ac.uk/prospero/ as CRD42021276465. Keywords: obesity, overweight, retirement, network meta-analysis, caloric restriction, resistance training, body composition, body mass index, fasting Thu, 06 Apr 2023 00:00:00 GMT http://localhost:8080/xmlui/handle/123456789/6222 2023-04-06T00:00:00Z http://localhost:8080/xmlui/handle/123456789/6217 Title: Commonalities among Dietary Recommendations from 2010 to 2021 Clinical Practice Guidelines: A Meta-Epidemiological Study from the American College of Lifestyle Medicine Authors: Cara, Kelly C.; Goldman, David M.; Kollman, Brooke K.; Amato, Stas S.; Tull, Martin D.; Karlsen, Micaela C. Abstract: ABSTRACT Clinical practice guidelines (CPGs) provide recommendations to clinicians based on current medical knowledge to guide and reduce variability in clinical care. With advances in nutrition science research, CPGs increasingly include dietary guidance; however, the degree of consistency in dietary recommendations across CPGs has not been investigated. Using a systematic review approach adapted for metaepidemiologic research, this study compared dietary guidance from current guidelines developed by governments, major medical professional societies, and large health stakeholder associations owing to their often well-defined and standardized processes for guideline development. CPGs making recommendations for dietary patterns and food groups or components for generally healthy adults or those with prespecified chronic diseases were eligible. Literature from January 2010 to January 2022 was searched in 5 bibliographic databases and augmented by searches in point-of-care resource databases and relevant websites. Reporting followed an adapted PRISMA statement and included narrative synthesis and summary tables. Seventy-eight CPGs for major chronic conditions (autoimmune, 7; cancers, 5; cardiovascular-related, 35; digestive, 11; diabetes, 12; weight-related, 4; or multiple, 3) and general health promotion (n ¼ 1) were included. Nearly, all (91%) made dietary pattern recommendations, and approximately half (49%) endorsed patterns centered on plant foods. Overall, CPGs were most closely aligned in promoting consumption of major plant food groups (vegetables ¼ 74% of CPGs, fruit ¼ 69%, whole grains ¼ 58%), whereas discouraging intake of alcohol (62%) and salt or sodium (56%). CVD and diabetes CPGs were similarly aligned with additional messaging to consume legumes/pulses (60% of CVD CPGs; 75%, diabetes), nuts and seeds (67%, CVD), and low-fat dairy (60%, CVD). Diabetes guidelines discouraged sweets/added sugars (67%) and sweetened beverages (58%). This alignment across CPGs should boost clinician confidence in relaying such dietary guidance to patients in accordance with their relevant CPGs. This trial was registered at the International Prospective Register of Systematic Reviews (https://www.crd.york.ac.uk/prospero; PROSPERO 2021) as CRD42021226281. Keywords: practice guideline, best practice, point-of-care systems, diet, healthy diet, health promotion, chronic disease, systematic review, meta-epidemiological Mon, 20 Mar 2023 00:00:00 GMT http://localhost:8080/xmlui/handle/123456789/6217 2023-03-20T00:00:00Z http://localhost:8080/xmlui/handle/123456789/6211 Title: Effect of Dietary Intervention, with or without Cointerventions, on Inflammatory Markers in Patients with Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis Authors: Hall, Renate L.; George, Elena S.; Tierney, Audrey C.; Reddy, Anjana J. Abstract: ABSTRACT Nonalcoholic fatty liver disease (NAFLD) encompasses a spectrum of disease from simple steatosis to nonalcoholic steatohepatitis, with inflammatory cytokines and adipokines identified as drivers of disease progression. Poor dietary patterns are known to promote an inflammatory milieu, although the effects of specific diets remain largely unknown. This review aimed to gather and summarize new and existing evidence on the effect of dietary intervention on inflammatory markers in patients with NAFLD. The electronic databases MEDLINE, EMBASE, CINAHL, and Cochrane were searched for clinical trials which investigated outcomes of inflammatory cytokines and adipokines. Eligible studies included adults >18 y with NAFLD, which compared a dietary intervention with an alternative diet or control (no intervention) group or were accompanied by supplementation or other lifestyle interventions. Outcomes for inflammatory markers were grouped and pooled for meta-analysis where heterogeneity was allowed. Methodological quality and risk of bias were assessed using the Academy of Nutrition and Dietetics Criteria. Overall, 44 studies with a total of 2579 participants were included. Meta-analyses indicated intervention with an isocaloric diet plus supplement was more effective in reducing C-reactive protein (CRP) [standard mean difference (SMD): 0.44; 95% CI: 0.20, 0.68; P ¼ 0.0003] and tumor necrosis factor-alpha (TNF-α) (SMD: 0.74; 95% CI: 0.02, 1.46; P ¼ 0.03) than an isocaloric diet alone. No significant weighting was shown between a hypocaloric diet with or without supplementation for CRP (SMD: 0.30; 95% CI: 0.84, 1.44; P ¼ 0.60) and TNF-α (SMD: 0.01; 95% CI: 0.43, 0.45; P ¼ 0.97). In conclusion, hypocaloric and energy-restricted diets alone or with supplementation, and isocaloric diets with supplementation were shown to be most effective in improving the inflammatory profile of patients with NAFLD. To better determine the effectiveness of dietary intervention alone on a NAFLD population, further investigations of longer durations, with larger sample sizes are required. Keywords: adipokines, cytokines, dietary patterns, diet, inflammation, inflammatory markers, nonalcoholic fatty liver disease, nutrition Wed, 01 Feb 2023 00:00:00 GMT http://localhost:8080/xmlui/handle/123456789/6211 2023-02-01T00:00:00Z