Evidence Analysis Questions published to the EAL® during the past 30 days are listed below:
Evidence Analysis Questions Published in the last 30 Days: (37)
 In adults with metabolic syndrome, what is the impact of glycemic index/load, independent of weight loss, on blood pressure?
There were no studies identified to evaluate the impact of glycemic index/load on blood pressure in adults with metabolic syndrome.
Intervention studies are needed to ascertain an effect of glycemic index/load on blood pressure in adults with metabolic syndrome with or without meeting the metabolic syndrome criteria for blood pressure.
Grade V
Overall strength of the available supporting evidence: Grade I - good; Grade II - fair; Grade III - limited; Grade IV - expert opinion; Grade V: not assignable
In adults with metabolic syndrome, what is the impact of glycemic index/load, independent of weight loss, on renal outcomes?
There were no studies identified to evaluate the impact of glycemic index/load on renal outcomes in adults with metabolic syndrome.
Intervention studies are needed to ascertain an effect of glycemic index/load on renal outcomes in adults wtih metabolic syndrome with or without meeting the metabolic syndrome criteria for renal measures.
Grade V
Overall strength of the available supporting evidence: Grade I - good; Grade II - fair; Grade III - limited; Grade IV - expert opinion; Grade V: not assignable
In adults with metabolic syndrome, what is the impact of macronutrient distribution, independent of weight loss, on anthropometric outcomes (WC, WHR)?
Research is inconclusive on the effect of macronutrient distribution (as a percentage of energy) on waist circumference (WC), independent of weight loss, in adults with metabolic syndrome, related to the varying macronutrient distributions in study diets (12% to 30% protein; 20% to 38% fat; 48% to 65% carbohydrate). Although not significant, there was a trend that macronutrient distribution may lead to a decrease in WC, when fat content was at least 30%. However, in one study with fat less than 30%, there was a positive effect on waist-to-hip ratio after one year.
Additional longer-term intervention studies are needed to ascertain an effect of macronutrient distribution on anthropometric outcomes in adults with metabolic syndrome with or without meeting the metabolic syndrome criteria for anthropometric measures.
Grade II
Overall strength of the available supporting evidence: Grade I - good; Grade II - fair; Grade III - limited; Grade IV - expert opinion; Grade V: not assignable
In adults with metabolic syndrome, what is the impact of macronutrient distribution, independent of weight loss, on blood pressure?
Research is unclear on the effect of macronutrient distribution (as a percentage of energy) on blood pressure, independent of weight loss, in adults with metabolic syndrome, related to the varying macronutrient distributions in study diets (12% to 19% protein; 22% to 38% fat; 48% to 65% carbohydrate).
Additional longer-term intervention studies are needed to ascertain an effect of macronutrient distribution on blood pressure in adults with metabolic syndrome with or without meeting the metabolic syndrome criteria for blood pressure.
Grade II
Overall strength of the available supporting evidence: Grade I - good; Grade II - fair; Grade III - limited; Grade IV - expert opinion; Grade V: not assignable
In adults with metabolic syndrome, what is the impact of macronutrient distribution, independent of weight loss, on glycemic-related outcomes (such as fasting blood glucose, random blood glucose, 2-hour postprandial blood glucose, A1C)?
Research with varying macronutrient distributions (12%-30% protein; 20%-38% fat; 48%-65% carbohydrate) found no significant effect on glycemic-related outcomes, independent of weight loss, in adults with metabolic syndrome. However, two feeding studies, also with diets of varying macronutrient distributions, report inconclusive results regarding the effect of macronutrient distribution on postprandial glycemia and insulinemia.
Additional longer-term intervention studies are needed to ascertain an effect of macronutrient distribution on glycemic-related outcomes in adults with metabolic syndrome with or without meeting the metabolic syndrome criteria for impaired glucose tolerance and/or impaired fasting glucose.
Grade II
Overall strength of the available supporting evidence: Grade I - good; Grade II - fair; Grade III - limited; Grade IV - expert opinion; Grade V: not assignable
In adults with metabolic syndrome, what is the impact of macronutrient distribution, independent of weight loss, on renal outcomes?
There were no studies identified to evaluate the impact of macronutrient distribution (as a percentage of energy), independent of weight loss, on renal outcomes in adults with metabolic syndrome.
Intervention studies are needed to ascertain an effect of macronutrient distribution on renal outcomes in adults with metabolic syndrome with or without meeting the metabolic syndrome criteria for renal measures.
Grade V
Overall strength of the available supporting evidence: Grade I - good; Grade II - fair; Grade III - limited; Grade IV - expert opinion; Grade V: not assignable
In adults with metabolic syndrome, what is the impact of MNT on blood pressure?
One study regarding the impact of medical nutrition therapy (MNT) reported decreases in systolic blood pressure of 4.9mmHg, but not diastolic blood pressure, in adults with metabolic syndrome. Increased frequency of visits resulted in greater improvement in systolic blood pressure.
Additional longer-term intervention studies are needed regarding the effect of medical nutrition therapy on blood pressure in adults with metabolic syndrome with or without meeting the metabolic syndrome criteria for blood pressure.
Grade III
Overall strength of the available supporting evidence: Grade I - good; Grade II - fair; Grade III - limited; Grade IV - expert opinion; Grade V: not assignable
In adults with metabolic syndrome, what is the impact of MNT on renal outcomes?
There were no studies identified to evaluate the impact of medical nutrition therapy (MNT) on renal outcomes in adults with metabolic syndrome.
Intervention studies are needed regarding the effect of medical nutrition therapy on renal outcomes in adults with metabolic syndrome with or without meeting the metabolic syndrome criteria for renal measures.
Grade V
Overall strength of the available supporting evidence: Grade I - good; Grade II - fair; Grade III - limited; Grade IV - expert opinion; Grade V: not assignable
In adults with metabolic syndrome, what is the impact of physical activity, independent of weight loss and dietary change, on lipid outcomes (TG, HDL)?
While limited research reports that low intensity or short duration physical activity, independent of weight loss and dietary change, has no significant impact on triglyceride levels in adults with metabolic syndrome, limited research reports that moderate intensity physical activity, at a level of 135 minutes per week, significantly reduces plasma triglycerides by 33mg per dL (0.37mmol per L).
The majority of research reported no significant impact of physical activity on HDL-cholesterol levels, regardless of duration or intensity.
Additional longer-term intervention studies are needed to ascertain an effect of physical activity on lipid outcomes in adults with metabolic syndrome with or without meeting the metabolic syndrome criteria for lipid levels.
Grade III
Overall strength of the available supporting evidence: Grade I - good; Grade II - fair; Grade III - limited; Grade IV - expert opinion; Grade V: not assignable
In individuals with prediabetes, what is the impact of glycemic index/load, independent of weight loss, on lipid outcomes (HDL, TG)?
One intervention study and one feeding study regarding the relative reduction of glycemic index/load reported inconclusive results regarding lipid outcomes in individuals with prediabetes.
Additional longer-term intervention studies are needed to ascertain the effects of relative reduction as well as low glycemic index/load values on lipid outcomes in individuals with prediabetes.
Grade III
Overall strength of the available supporting evidence: Grade I - good; Grade II - fair; Grade III - limited; Grade IV - expert opinion; Grade V: not assignable
In individuals with prediabetes, what is the impact of MNT on lipid outcomes (TG, HDL)?
Most studies reported no significant impact of medical nutrition therapy (MNT) on serum triglycerides in individuals with prediabetes. All studies reported no significant change in HDL-cholesterol.
Additional intervention studies are needed regarding the effect of medical nutrition therapy on lipid outcomes (triglycerides and HDL-cholesterol) in individuals with prediabetes with elevated triglycerides or low HDL-cholesterol.
Grade II
Overall strength of the available supporting evidence: Grade I - good; Grade II - fair; Grade III - limited; Grade IV - expert opinion; Grade V: not assignable
In individuals with prediabetes, what is the impact of physical activity, independent of weight loss and dietary change, on lipid outcomes (TG, HDL)?
Limited research reports mixed results regarding the impact of moderate intensity physical activity, independent of weight loss and dietary change, on triglyceride levels in individuals with prediabetes.
Intervention studies reported no significant impact of moderate intensity physical activity on HDL cholesterol levels.
Additional longer-term intervention studies are needed to ascertain an effect of physical activity on lipid outcomes in individuals with prediabetes.
Grade II
Overall strength of the available supporting evidence: Grade I - good; Grade II - fair; Grade III - limited; Grade IV - expert opinion; Grade V: not assignable
In individuals with prediabetes, what is the impact of weight loss (over at least a three-month period) on glycemic-related outcomes (such as fasting blood glucose, random blood glucose, two-hour post-prandial blood glucose, A1C)?
The majority of lifestyle modification intervention studies reported that weight loss significantly reduces fasting blood glucose in individuals with prediabetes, while most studies report no significant impact of weight loss on two-hour post-prandial blood glucose or A1C.
Of those studies reporting a weight loss ranging from 2.6 to 7.1kg, there was a significant reduction in fasting blood glucose levels by 2.2 to 9.2mg per dL (0.12 to 0.5mmol per L).
In bariatric surgery intervention studies, a weight loss of up to 47kg or 41% of excess BMI over a period of three to five years significantly reduced fasting glucose levels by 16.2 to 20.9mg per dL (0.9 to 1.16mmol per L), two-hour glucose levels by 16mg per dL (0.9mmol per L) and A1C by 0.5%.
Additional lifestyle modification intervention studies are needed to ascertain the effects of weight loss on two-hour post-prandial blood glucose and A1C in individuals with prediabetes.
Grade I
Overall strength of the available supporting evidence: Grade I - good; Grade II - fair; Grade III - limited; Grade IV - expert opinion; Grade V: not assignable
What is the relationship between nutrition status and chemotherapy treatment tolerance in oncology patients?
Poor nutrition status is associated with decreased tolerance to chemotherapy treatment in adult oncology patients undergoing chemotherapy. All ten included studies found positive associations in one or more of the following: Treatment interruptions, infections, unplanned hospital admissions, treatment toxicity (including dose-limiting treatment toxicity) neutropenic fever, fatigue and severe thrombocytopenia.
Grade I
Overall strength of the available supporting evidence: Grade I - good; Grade II - fair; Grade III - limited; Grade IV - expert opinion; Grade V: not assignable
What is the relationship between nutrition status and mortality in oncology patients?
Poor nutrition status is associated with mortality in adult oncology patients. All 16 included studies found positive associations among one or more of the following and mortality: Weight loss, malnutrition, poor scores on validated malnutrition and quality of life (QoL) screening tools, sarcopenia, cachexia and fatigue.
Grade I
Overall strength of the available supporting evidence: Grade I - good; Grade II - fair; Grade III - limited; Grade IV - expert opinion; Grade V: not assignable
What is the relationship between nutrition status and quality of life (QOL) in oncology patients?
Poor nutrition status is associated with lower quality of life (QoL) in adult oncology patients. Fifteen of the sixteen included studies found that a decreased nutrition status is associated with a lower QoL. All eight of the studies utilizing the Patient-Generated Subjective Global Assessment (PG-SGA) found that a higher score (higher nutrition risk) was associated with a lower QoL in oncology patients.
Grade I
Overall strength of the available supporting evidence: Grade I - good; Grade II - fair; Grade III - limited; Grade IV - expert opinion; Grade V: not assignable
What is the relationship between nutrition status and radiation treatment tolerance in oncology patients?
Poor nutrition status is associated with decreased tolerance to radiation treatment in adult oncology patients undergoing radiotherapy. All included studies found positive associations between nutrition status and two or more of the following: Reduced treatment interruptions, unplanned hospital admissions, treatment toxicity, Patient-Generated Subjective Global Assessment (PG-SGA) score over time and quality of life (QoL).
Grade I
Overall strength of the available supporting evidence: Grade I - good; Grade II - fair; Grade III - limited; Grade IV - expert opinion; Grade V: not assignable
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