BMI and all cause mortality: systematic review and non-linear dose-response meta-analysis of 230 cohort studies with 3.74 million deaths among 30.3 million participants

 To conduct a systematic review and meta-analysis of cohort studies of body mass index (BMI) and the risk of all cause mortality, and to clarify the shape and the nadir of the dose-response curve, and the influence on the results of confounding from smoking, weight loss associated with disease, and preclinical disease. PubMed and Embase databases searched up to 23 September 2015. Cohort studies that reported adjusted risk estimates for at least three categories of BMI in relation to all cause mortality. Summary relative risks were calculated with random effects models. Non-linear associations were explored with fractional polynomial models. 230 cohort studies (207 publications) were included. The analysis of never smokers included 53 cohort studies (44 risk estimates) with >738 144 deaths and >9 976 077 participants. The analysis of all participants included 228 cohort studies (198 risk estimates) with >3 744 722 deaths among 30 233 329 participants. The summary relative risk for a 5 unit increment in BMI was 1.18 (95% confidence interval 1.15 to 1.21; I(2)=95%, n=44) among never smokers, 1.21 (1.18 to 1.25; I(2)=93%, n=25) among healthy never smokers, 1.27 (1.21 to 1.33; I(2)=89%, n=11) among healthy never smokers with exclusion of early follow-up, and 1.05 (1.04 to 1.07; I(2)=97%, n=198) among all participants. There was a J shaped dose-response relation in never smokers (Pnon-linearity <0.001), and the lowest risk was observed at BMI 23-24 in never smokers, 22-23 in healthy never smokers, and 20-22 in studies of never smokers with ≥20 years follow-up. In contrast there was a U shaped association between BMI and mortality in analyses with a greater potential for bias including all participants, current, former, or ever smokers, and in studies with a short duration of follow-up (<5 years or <10 years), or with moderate study quality scores. Overweight and obesity is associated with increased risk of all cause mortality and the nadir of the curve was observed at BMI 23-24 among never smokers, 22-23 among healthy never smokers, and 20-22 with longer durations of follow-up. The increased risk of mortality observed in underweight people could at least partly be caused by residual confounding from prediagnostic disease. Lack of exclusion of ever smokers, people with prevalent and preclinical disease, and early follow-up could bias the results towards a more U shaped association

Acute and chronic effects of foam rolling vs eccentric exercise on ROM and force output of the plantar flexors

Foam rolling and eccentric exercise interventions have been demonstrated to improve range of motion (ROM). However, these two modalities have not been directly compared. Twenty-three academy soccer players (age: 18 ± 1; height: 1.74 ± 0.08 m; body mass: 69.3 ± 7.5 kg) were randomly allocated to either a foam rolling (FR) or eccentric exercise intervention designed to improve dorsiflexion ROM. Participants performed the intervention daily for a duration of four weeks. Measurements of dorsiflexion ROM, isometric plantar flexion torque and drop jump reactive strength index were taken at baseline (pre-intervention) and at three subsequent time-points (30-min post, 24-hours post and 4-weeks post). A significant time x group interaction effect was observed for dorsiflexion (P = 0.036), but not for torque or reactive strength index. For dorsiflexion, there was a significant increase in both acute (30-min; P < 0.001) and chronic (4-week; P < 0.001) ROM for the eccentric group, whilst FR exhibited only an acute improvement (P < 0.001). Eccentric training would appear a more efficacious modality than foam rolling for improving dorsiflexion ROM in elite academy soccer players

Dietary intake and biomarkers of alpha linolenic acid and risk of all cause, cardiovascular, and cancer mortality: systematic review and dose-response meta-analysis of cohort studies

OBJECTIVE: To examine the associations between dietary intake and tissue biomarkers of alpha linolenic acid (ALA) and risk of mortality from all causes, cardiovascular disease (CVD), and cancer. DESIGN: Systematic review and meta-analysis of prospective cohort studies. DATA SOURCES: PubMed, Scopus, ISI Web of Science, and Google Scholar to 30 April 2021. STUDY SELECTION: Prospective cohort studies that reported the risk estimates for death from all causes, CVD, and cancer. DATA SYNTHESIS: Summary relative risks and 95% confidence intervals were calculated for the highest versus lowest categories of ALA intake using random effects and fixed effects models. Linear and non-linear dose-response analyses were conducted to assess the dose-response associations between ALA intake and mortality. RESULTS: 41 articles from prospective cohort studies were included in this systematic review and meta-analysis, totalling 1 197 564 participants. During follow-up ranging from two to 32 years, 198 113 deaths from all causes, 62 773 from CVD, and 65 954 from cancer were recorded. High intake of ALA compared with low intake was significantly associated with a lower risk of deaths from all causes (pooled relative risk 0.90, 95% confidence interval 0.83 to 0.97, I2=77.8%, 15 studies), CVD (0.92, 0.86 to 0.99, I2=48.2%, n=16), and coronary heart disease (CHD) (0.89, 0.81 to 0.97, I2=5.6%, n=9), and a slightly higher risk of cancer mortality (1.06, 1.02 to 1.11, I2=3.8%, n=10). In the dose-response analysis, a 1 g/day increase in ALA intake (equivalent to one tablespoon of canola oil or 0.5 ounces of walnut) was associated with a 5% lower risk of all cause (0.95, 0.91 to 0.99, I2=76.2%, n=12) and CVD mortality (0.95, 0.91 to 0.98, I2=30.7%, n=14). The pooled relative risks for the highest compared with lowest tissue levels of ALA indicated a significant inverse association with all cause mortality (0.95, 0.90 to 0.99, I2=8.2%, n=26). Also, based on the dose-response analysis, each 1 standard deviation increment in blood concentrations of ALA was associated with a lower risk of CHD mortality (0.92, 0.86 to 0.98, I2=37.1%, n=14). CONCLUSIONS: The findings show that dietary ALA intake is associated with a reduced risk of mortality from all causes, CVD, and CHD, and a slightly higher risk of cancer mortality, whereas higher blood levels of ALA are associated with a reduced risk of all cause and CHD mortality only. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42021229487

Role of diet in type 2 diabetes incidence: umbrella review of meta-analyses of prospective observational studies

OBJECTIVE: To summarise the evidence of associations between dietary factors and incidence of type 2 diabetes and to evaluate the strength and validity of these associations. DESIGN: Umbrella review of systematic reviews with meta-analyses of prospective observational studies. DATA SOURCES: PubMed, Web of Science, and Embase, searched up to August 2018. ELIGIBILITY CRITERIA: Systematic reviews with meta-analyses reporting summary risk estimates for the associations between incidence of type 2 diabetes and dietary behaviours or diet quality indices, food groups, foods, beverages, alcoholic beverages, macronutrients, and micronutrients. RESULTS: 53 publications were included, with 153 adjusted summary hazard ratios on dietary behaviours or diet quality indices (n=12), food groups and foods (n=56), beverages (n=10), alcoholic beverages (n=12), macronutrients (n=32), and micronutrients (n=31), regarding incidence of type 2 diabetes. Methodological quality was high for 75% (n=115) of meta-analyses, moderate for 23% (n=35), and low for 2% (n=3). Quality of evidence was rated high for an inverse association for type 2 diabetes incidence with increased intake of whole grains (for an increment of 30 g/day, adjusted summary hazard ratio 0.87 (95% confidence interval 0.82 to 0.93)) and cereal fibre (for an increment of 10 g/day, 0.75 (0.65 to 0.86)), as well as for moderate intake of total alcohol (for an intake of 12-24 g/day v no consumption, 0.75 (0.67 to 0.83)). Quality of evidence was also high for the association for increased incidence of type 2 diabetes with higher intake of red meat (for an increment of 100 g/day, 1.17 (1.08 to 1.26)), processed meat (for an increment of 50 g/day, 1.37 (1.22 to 1.54)), bacon (per two slices/day, 2.07 (1.40 to 3.05)), and sugar sweetened beverages (for an increase of one serving/day, 1.26 (1.11 to 1.43)). CONCLUSIONS: Overall, the association between dietary factors and type 2 diabetes has been extensively studied, but few of the associations were graded as high quality of evidence. Further factors are likely to be important in type 2 diabetes prevention; thus, more well conducted research, with more detailed assessment of diet, is needed. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018088106

Characterization of microbulk detectors in argon- and neon-based mixtures

A recent Micromegas manufacturing technique, so called Microbulk, has been developed, improving the uniformity and stability of this kind of detectors. Excellent energy resolutions have been obtained, reaching values as low as 11% FWHM at 5.9 keV in Ar+5%iC4H10. This detector has other advantages like its flexible structure, low material budget and high radio-purity. Two microbulk detectors with gaps of 50 and 25 um have been characterized in argon- and neon-based mixtures with ethane, isobutane and cyclohexane. The results will be presented and discussed. The gain curves have been fitted to the Rose-Korff gain model and dependences of the electron mean free path and the threshold energy for ionization have been obtained. The possible relation between these two parameters and the energy resolution will be also discussed.Comment: Submitted to the Journal of Instrumentatio

A low background Micromegas detector for the CAST experiment

A low background Micromegas detector has been operating on the CAST experiment at CERN for the search of solar axions during the first phase of the experiment (2002-2004). The detector operated efficiently and achieved a very low level of background rejection ($5\times 10^{-5}$ counts keV$^{-1}$cm$^{-2}$s$^{-1}$) thanks to its good spatial and energy resolution as well as the low radioactivity materials used in the construction of the detector. For the second phase of the experiment (2005-2007), the detector will be upgraded by adding a shielding and including focusing optics. These improvements should allow for a background rejection better than two orders of magnitude.Comment: 6 pages, 3 figures To appear on the proceedings of the 9th ICATPP Conference on AStroparticle, Particle, Space Physics, Detectors and Medical Physics Application

Progress on a spherical TPC for low energy neutrino detection

The new concept of the spherical TPC aims at relatively large target masses with low threshold and background, keeping an extremely simple and robust operation. Such a device would open the way to detect the neutrino-nucleus interaction, which, although a standard process, remains undetected due to the low energy of the neutrino-induced nuclear recoils. The progress in the development of the fist 1 m$^3$ prototype at Saclay is presented. Other physics goals of such a device could include supernova detection, low energy neutrino oscillations and study of non-standard properties of the neutrino, among others.Comment: 3 pages, talk given at the 9th Workshop on Topics in Astroparticle and Underground Physics, Zaragoza, September 10-1