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39952828
A systematic review and meta-analysis on physical activity for the treatment of anxiety in older adults
Objectives: Symptoms of anxiety and anxiety disorders negatively impact the quality of life of older adults. Physical activity is a potentially accessible intervention with other health benefits and minimal risk, yet its impact on anxiety in older adults is unclear. Design: Systematic review and meta-analysis. Setting:...
Older adults aged ≥60 years, or with a mean sample age ≥65 years, who present with self-reported symptoms of anxiety or a formally diagnosed anxiety disorder (e.g., generalized anxiety disorder [GAD], panic disorder, or other DSM-5 anxiety subtypes) at baseline, measured by any validated anxiety assessment tool (e.g., ...
Structured moderate-to-vigorous intensity physical activity or exercise interventions, encompassing resistance/strength training, aerobic exercise (e.g., walking, cycling, dance, floorball), and mixed/multicomponent programs, delivered either in-person or as home-based programs, for any duration and frequency. Interven...
Non-physical activity comparators, including no intervention, usual care, waitlist control, or any active control that does not involve physical activity or structured exercise.
Primary outcome: severity of anxiety symptoms measured by validated self-reported scales (e.g., STAI trait subscale preferred over state subscale for its stability; HAM-A). Secondary outcomes include physical function, social function, and health-related quality of life (not quantitatively synthesized due to insufficie...
40325863
The Efficacy of Non-Pharmacological Interventions for Sleep Disorders in People With Multiple Sclerosis: A Systematic Review and Meta-Analysis
Sleep disorders significantly impact the quality of life in people with multiple sclerosis (pwMS), affecting up to 60% of this population. These disorders, including insomnia, sleep apnea, restless legs syndrome, narcolepsy, and REM sleep behaviour disorders, result from both the direct neurological impacts of MS and s...
People with multiple sclerosis (pwMS) aged ≥18 years, with MS clinically diagnosed based on McDonald's 2017 criteria, who have a co-occurring sleep disorder (including insomnia, sleep apnea, restless legs syndrome [RLS], narcolepsy, or REM sleep behaviour disorder) confirmed by validated cut-off values on self-reported...
Any non-pharmacological intervention aimed at improving sleep outcomes in pwMS, including but not limited to: cognitive-behavioural therapy for insomnia (CBT-I), mindfulness-based stress reduction (MBSR), aerobic exercise, exergaming, occupational therapy (e.g., PEOP model-based), and multi-component programs combining...
Standard care (care-as-usual), attentional/active control (e.g., sedentary activities, light stretching), or waitlist control, without an active non-pharmacological sleep-specific intervention.
Primary outcome: sleep quality measured by validated patient-reported outcome tools (Pittsburgh Sleep Quality Index [PSQI], Insomnia Severity Index [ISI]). Secondary outcomes: daytime sleepiness (Epworth Sleepiness Scale [ESS]), restless legs severity (International Restless Legs Syndrome Scale), health-related quality...
41065407
Does resistance training improve pain intensity, quality of life, and disability in people with chronic nonspecific low back pain? A systematic review and meta-analysis
Purpose: Systematic review with meta-analysis to evaluate the efficacy of resistance training (RT) in improving pain intensity, quality of life, and disability in people with nonspecific chronic low back pain (NSCLBP). Method: Searches were conducted in April 2025 using MEDLINE, Scopus, Web of Science, and the Cochrane...
Adults (≥18 years) diagnosed with chronic nonspecific low back pain (CNSLBP), defined as low back pain of non-specific origin with symptom duration >12 weeks. Excluded are individuals with specific secondary causes such as radicular pain, spinal stenosis, or other identifiable pathoanatomical diagnoses (e.g., fracture,...
Resistance training (strength training) utilized as the sole primary intervention in any treatment arm, encompassing any modality (free weights, machines, elastic bands, lumbar extension machines), load intensity, frequency, and program duration, without combination with other treatment modalities.
Any active or passive comparator treatment, including usual care, conventional physiotherapy, combined therapy (e.g., resistance training co-delivered with another modality), aerobic exercise, motor control exercise, cognitive-behavioral approaches, or no treatment/waitlist control.
Primary outcomes: (1) pain intensity, assessed by validated scales (e.g., Visual Analogue Scale [VAS] or Numerical Rating Scale [NRS]); (2) health-related quality of life (e.g., SF-36); (3) functional disability (e.g., Roland Morris Disability Questionnaire [RMDQ], Oswestry Disability Index [ODI]). Clinical significanc...
41388744
Antihypertensive Effects of Curcumin/Turmeric Supplementation in Prediabetes and Diabetes: A Systematic Review and Meta-Analysis of Randomised Controlled Trials
Introduction: Hypertension is a major cardiovascular risk factor in individuals with prediabetes and type 2 diabetes (T2D). Curcumin, with its anti-inflammatory and antioxidant properties, has emerged as a potential adjunct therapy, but its effect on blood pressure in this population remains unclear. Aims: This meta-an...
Adult human participants (≥18 years) with a confirmed diagnosis of prediabetes (impaired fasting glucose or impaired glucose tolerance) or type 2 diabetes mellitus (T2D), including those who are overweight or obese, and those with or without co-existing hypertension (SBP ≥130 mmHg). Both sexes are eligible.
Oral supplementation with curcumin, curcuminoids, turmeric (Curcuma longa), or any bio-enhanced/formulated derivative of curcumin, including nano-curcumin, phytosomal curcumin, and curcumin-piperine combination products, at any dose (ranging from 80 to 2100 mg/day) and for any duration (8 to 24 weeks), in parallel or c...
Placebo (matched in appearance and taste to the active intervention) or conventional/standard pharmacological therapy (non-curcumin treatment, e.g., conventional antidiabetic drugs).
Primary outcomes: changes from baseline in systolic blood pressure (SBP, mmHg) and diastolic blood pressure (DBP, mmHg). Prespecified subgroup analyses were conducted by health status (prediabetes vs. T2D), geographical region, curcumin formulation type, daily dose (≤1 g/day vs. >1 g/day), intervention duration (<12 we...
41507873
Association between green space exposure and elderly health: a systematic review and meta-analysis
Background: Exposure to green spaces is associated with many health benefits across various stages of life. However, no comprehensive synthesis currently exists to consolidate this evidence into a systematic body of knowledge that captures the overall impact of exposure to green space on the health of older adults. Thi...
Community-dwelling older adults aged 60 years and above, without restriction by sex, geography, language, or baseline health condition, as included in observational studies and the one eligible randomized trial.
Exposure to green space, operationalized through the degree of greenness exposure (e.g., NDVI), types of greenery (parks, vegetated areas, forests, open green spaces), and green-space accessibility or self-reported access. This is an exposure rather than a therapeutic intervention.
Lower, absent, or reference-category green-space exposure, including lower NDVI/greenness availability, poorer access, fewer or less proximate green spaces, or the least-exposed category within the original observational study.
Health outcomes in older adults, including respiratory tract diseases, cardiovascular diseases such as coronary heart disease and hypertension, metabolic disorders such as diabetes, osteoporosis and dyslipidemia, nervous-system diseases such as stroke, sarcopenia and sleep-wake disorders, mental disorders such as anxie...
41531667
Ambient Temperature and Risk of Renal Colic: A Systematic Review and Meta-analysis
Rationale & Objectives: Extreme ambient temperatures have been associated with a higher risk of acute and chronic health outcomes, including cardiovascular, respiratory, infectious, and kidney diseases. However, there is a lack of synthesized comprehensive evidence regarding the association of ambient temperature and r...
Human populations from any geographic area, irrespective of age, sex/gender, ethnicity, or other population characteristics, evaluated in cohort/longitudinal or other epidemiological study designs.
Exposure to measurable daily mean ambient temperature in degrees Celsius, including temperatures above or below a reference temperature, extreme heat or cold conditions defined by percentiles, and heat or cold waves persisting for days. This is an exposure rather than a therapeutic intervention.
People or person-time not exposed to the same temperature as the exposure group, or the same population during periods when it was not exposed to the same ambient temperature; reference temperatures were used for heat/cold contrasts in nonlinear models.
Confirmed renal colic outcomes and underlying causes, including kidney stone, nephrolithiasis, urolithiasis, urinary calculus, urinary tract infection, and pyelonephritis, based on ICD codes or the case definitions used in the included articles; eligible studies reported quantitative association measures such as RR, OR...
41561801
Effect of exercise on abdominal obesity and inflammatory response in the older adults: a systematic review and meta-analysis of randomized controlled trials
Background: Abdominal obesity and chronic inflammation are key indicators of aging, associated with various age-related diseases. While exercise is thought to mitigate these issues, its specific effects on abdominal obesity, adiponectin, and inflammatory markers in older adults need further exploration. Objective: This...
Older adults aged 60 years and above, including studies calculated by mean age, regardless of gender or health status, including healthy older adults and those with chronic conditions such as obesity, diabetes, or metabolic syndrome.
Exercise interventions delivered in randomized controlled trials, including aerobic exercise, resistance training, combined aerobic and resistance programs, progressive resistance training, Tai Chi, Yi Jin Jing plus resistance training, circuit training, and other structured exercise programs varying in frequency, dura...
Non-exercise control conditions, maintenance of usual lifestyle or physical activity, usual care, sham/light exercise controls, or other comparator groups without the active exercise program under evaluation.
Abdominal obesity and body-composition indicators including waist circumference, BMI, body fat percentage, and visceral fat area; inflammatory and adipokine markers including CRP, TNF-alpha, IL-6, adiponectin, leptin, IL-1beta, IL-8, IL-10, and related laboratory biomarkers.
41566983
Association of Particulate Matter (PM2.5) With COVID-19 Infection and Mortality in Low-and Middle-income Asian Countries: A Systematic Review and Meta-analysis
Objectives: Low-income and middle-income countries in Asia bear a disproportionate burden of particulate matter with an aerodynamic diameter of 2.5 micrometers or less (PM2.5) pollution, yet data remain scarce. This systematic review and meta-analysis aimed to quantify the association between PM2.5 exposure and the ris...
Human populations or area-level populations in Asian countries classified by the World Bank as low-, lower-middle-, or upper-middle-income countries, with studies reporting COVID-19 infection or mortality outcomes.
Outdoor ambient PM2.5 exposure. Short-term exposure was defined as daily or weekly PM2.5 concentrations, and long-term exposure as average PM2.5 concentrations measured over several months or years.
Lower or reference PM2.5 exposure levels, including lower-exposure periods or areas within the same study, or the least-exposed/reference category used to estimate RR, OR, or HR.
COVID-19 infection outcomes, including cases or incidence, and COVID-19 mortality outcomes, including deaths or case-fatality rates, with quantitative effect estimates and 95% confidence intervals.
41601519
Effectiveness of unguided digital cognitive behavioral therapy for insomnia on depressive symptoms: a systematic review and meta-analysis of randomized controlled trials
Objective: This study aimed to assess the intervention effects of unguided digital cognitive behavioral therapy for insomnia (dCBT-I) on patients with comorbid depression and insomnia through a systematic review and meta-analysis, in order to determine its effectiveness as a treatment strategy for comorbid depression a...
Adults aged 18 years and older with clinician-diagnosed or symptomatic insomnia according to DSM or ICSD criteria and depressive symptoms. Studies with severe physical illness, substance abuse, organic or primary sleep disorders such as sleep apnea or restless legs syndrome, bipolar disorder, schizophrenia, neurologica...
Unguided digital cognitive behavioral therapy for insomnia delivered by computer, internet, or app, incorporating at least one cognitive component such as cognitive restructuring and at least one behavioral component such as stimulus control or sleep restriction, without therapist guidance.
Placebo, active control, waitlist control, standard care, sleep education, general health education, routine treatment, or other non-dCBT-I control conditions.
Depressive symptoms measured with validated scales such as HAMD or PHQ-9; insomnia severity and sleep outcomes including ISI, SCI, SLEEP-50, sleep efficiency, sleep onset latency, wake after sleep onset, and total sleep time.
41617837
Associations of heat exposure with mental health and suicide in children and adolescents: a systematic review and meta-analysis
Limited evidence exists on the association between high temperature and mental health in younger age group. A systematic search on PubMed, Web of Science, CINAHL Plus and PsycInfo was conducted, and studies exploring associations of heat exposure with mental health and suicide among children and adolescents (<=24 years...
Children, adolescents, and young people aged 24 years or younger, including adolescents defined as individuals aged 10 to 24 years, with independent analyses reported for this age group.
High outdoor temperature or ambient heat exposure, including heat extremes, high versus low temperature definitions, percentile-based high-temperature thresholds, humidex, and continuous temperature increments. This is an environmental exposure rather than a therapeutic intervention.
Low outdoor temperature, lower percentile/reference temperature, minimum morbidity temperature, or other study-specific low/reference exposure category.
Mental health sequelae and suicide outcomes, including hospital visits or hospitalizations for mental health disorders, schizophrenia or other psychotic disorders, depression, anxiety, composite mental health illnesses, self-inflicted injury, suicidal mortality, and suicide defined by ICD codes.
41639651
Association between PM2.5 exposure and blood pressure among young adults in Asia: systematic review and meta-analysis
Background: Ambient air pollution, particularly fine particulate matter (PM2.5), and hypertension are compounding public health challenges in low- and middle-income countries. Although several studies have explored the relationship between ambient air pollution and blood pressure, evidence remains limited for young adu...
Young adults aged 18-45 years residing in Asia, including dedicated young adult cohorts and general-population studies with age-stratified young-adult results.
Ambient PM2.5 exposure, including short-term exposure within 30 days and long-term exposure longer than 6 months; exposure estimates could be ambient or personal monitoring when they primarily captured ambient PM2.5 variation.
Lower or reference PM2.5 exposure, expressed through within-study effect estimates standardized to a 10 micrograms/m3 increase; cross-over, randomized, indoor/household pollution, and no-age-stratified child/older-adult studies were excluded.
Systolic blood pressure and diastolic blood pressure, reported as beta estimates with 95% confidence intervals or sufficient data to calculate these estimates.
41639864
Association between aerobic exercise and vascular endothelial growth factor (VEGF) concentration in adults: a systematic review and meta-analysis of randomized controlled trials
Purpose: This systematic review and meta-analysis aimed to assess the effect of aerobic exercise on circulating vascular endothelial growth factor (VEGF) levels in adults, given inconsistent results in randomized controlled trials. Methods: ISI Web of Science, PubMed/MEDLINE, and Scopus were searched up to May 2025. Th...
Adults aged 18 years and older enrolled in randomized controlled trials, including healthy populations, patients with cardiovascular disease, patients with solid tumors, and other adult clinical groups; trials in children or adolescents were excluded.
Aerobic exercise interventions of at least 4 weeks, including cycling, treadmill walking, stationary bike, Taekwondo, ergometer bike/row, and other aerobic training programs, with varying frequency, duration, intensity, and intervention length.
Sedentary or no-exercise control groups, diet-only controls when the aerobic exercise effect could be isolated, or other control arms without the active aerobic exercise intervention.
Circulating vascular endothelial growth factor (VEGF) protein concentration measured in serum or plasma, reported as mean changes and standard deviations or sufficient data to calculate effect sizes.
41652340
Evidence gaps in the effects of exercise on SASP-Related biomarkers in older adults: a systematic review and meta-analysis of randomized controlled trials
Background: Cellular senescence is a hallmark of aging, characterized by secretion of proinflammatory factors known as the senescence-associated secretory phenotype (SASP). While physical exercise is proposed as a potential modulator of cellular aging, its effect on specific senescence biomarkers in older adults remain...
Older adults aged 60 years and above, without restrictions on sex or ethnicity, enrolled in randomized controlled trials reporting senescence-related biomarkers.
Structured exercise programs, including resistance/strength training, endurance/aerobic training, and combined exercise interventions, with interventions lasting from six weeks to three years in the included trials.
Usual care controls, standard care consisting of health education and maintenance of usual lifestyle, or controls undergoing alternative interventions.
Biomarkers of cellular senescence, especially SASP-related cytokines measured in blood-derived samples such as serum or plasma, including CCL2, IL-6, IL-8, and TNF-alpha; upstream markers such as p16INK4a and p21 were sought but not reported by included RCTs.
41656984
Effectiveness of Health Coaching Interventions on Anxiety, Depression, Self-Management Behaviors, Self-Efficacy, and Quality of Life Among Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Background: Health coaching has emerged as a promising intervention to improve health outcomes in older adults. However, its effectiveness has not been comprehensively synthesized. Aim: To evaluate the effectiveness of health coaching interventions on anxiety, depression, quality of life, self-management behavior, and ...
Older adults aged 60 years and over, based on average or median minimum age, including community-dwelling older adults and older adults with chronic conditions such as COPD, diabetes, cancer, CKD, heart failure, peripheral arterial disease, and other long-term conditions.
Health coaching interventions including goal setting, empowerment or motivational interviewing/coaching-style communication, and health education, delivered remotely, face-to-face, or in mixed formats by nurses, health coaches, physicians, therapists, dietitians, or other interventionists.
Usual care, waitlist control, educational programs, physical activity counseling, attention control, or other non-health-coaching interventions; comparator interventions that included health coaching were excluded.
Anxiety, depression, quality of life, self-management behaviors, self-efficacy, and patient activation, excluding studies focused only on feasibility, acceptability, cost-benefit, or component-specific quality-of-life measures without overall quality of life.
41721779
Effects of inspiratory muscle training on obstructive sleep apnea: a systematic review and meta-analysis
Rationale: Inspiratory muscle training (IMT) is a relatively new intervention for obstructive sleep apnea (OSA), with the aim of improving respiratory muscle strength and mitigating OSA-related symptoms. However, its effects on key clinical endpoints remain unclear. Objectives: To evaluate the effects of IMT on OSA sev...
Adult patients (≥18 years) with suspected or confirmed obstructive sleep apnea (OSA), defined by an apnea-hypopnea index (AHI) ≥5 events/hour as identified by polysomnography per American Academy of Sleep Medicine recommendations, across all OSA phenotypes and baseline disease severity levels.
Standalone inspiratory muscle training (IMT) used as an independent therapeutic intervention without combination with other treatment modalities (e.g., CPAP, mandibular advancement devices, positional therapy, weight loss programs). Any training protocol is eligible, including any intensity (expressed as percentage of ...
Sham IMT (low-load inspiratory training, typically ≤15–20% of MIP, providing minimal respiratory muscle stimulus) or no intervention (standard care without any IMT).
Primary outcome: apnea-hypopnea index (AHI, events/hour). Secondary outcomes: body mass index (BMI, kg/m²), neck circumference (NC, cm), Pittsburgh Sleep Quality Index (PSQI), sleep efficiency (SE, %), lowest nocturnal oxygen saturation (LSaO2, %), Epworth Sleepiness Scale (ESS), maximal inspiratory pressure (MIP, cmH₂...
41743679
Effects of aquatic exercise on improving body composition and muscle strength in the older adults: a systematic review and meta-analysis of randomized controlled trials
Background: Due to challenges posed by aging such as decreased physical abilities and higher susceptibility to chronic illnesses, effective exercise interventions are crucial for older individuals. Despite potential benefits of aquatic exercise, robust evidence supporting efficacy is limited. This systematic review and...
Healthy older adults aged 60 years and above, with Aboriginal and Torres Strait Islander peoples considered older adults from age 50 years, according to the review eligibility criteria.
Aquatic exercise programs, including swimming, non-swimming water exercise, water-based exercise, water resistance exercise, water walking, and similar aquatic interventions, with no restrictions on type, frequency, intensity, or duration.
Land-based exercise, usual daily activities, sedentary control, no exercise therapy, or other non-aquatic control groups.
Primary outcomes: muscle strength measures such as grip strength, 30-second chair stand test, and arm curl test, and body-composition/metabolic measures such as body fat mass, HDL-C, LDL-C, and total cholesterol. Secondary outcomes: flexibility, mobility such as Timed Up and Go, body weight, BMI, waist-to-hip ratio, an...
41761990
Effects of Curcumin/Turmeric Supplementation on Kidney Function in Individuals With Diabetes: A Systematic Review and Meta-Analysis of Randomised Controlled Trials
Background: Curcumin and turmeric are widely studied for their potential renoprotective effects, but evidence regarding their impact on kidney function in individuals with diabetes remains inconsistent. Objective: To systematically evaluate the effects of curcumin/turmeric supplementation on kidney function parameters ...
Adult human subjects (≥18 years) with a confirmed diagnosis of type 1 or type 2 diabetes mellitus, with or without pre-existing established kidney disease (including diabetic nephropathy, proteinuric chronic kidney disease [CKD], or impaired baseline renal function). Both sexes are included, and no restriction is place...
Oral supplementation with curcumin, turmeric (Curcuma longa), or any curcuminoid-based formulation, regardless of dose (ranging from 80 to 2000 mg/day), duration (4 to 48 weeks), or formulation type, including unformulated curcumin, piperine-enhanced curcumin, nano-curcumin, turmeric powder, and phytosomal curcumin. Tr...
Placebo (matched in appearance to the active intervention, without curcumin content) or active control (e.g., conventional pharmacological therapy for diabetes or CKD management).
Changes in serum kidney function biomarkers from baseline to end of intervention: (1) serum creatinine (mg/dL, primary outcome); (2) blood urea nitrogen (BUN, mg/dL); (3) serum uric acid (mg/dL); (4) serum urea (mg/dL); (5) serum albumin (g/dL). Subgroup analyses were prespecified by baseline creatinine level, interven...
41830012
Complex Effects of B-Vitamin Combinations on Cardiovascular Diseases: A Systematic Review and Meta-Analysis of Randomized Controlled Trials over Three Decades
Background and Purpose: The effects of B-vitamin combinations on the prevention of cardiovascular diseases, such as myocardial infarction (MI) and stroke, remain controversial. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) over three decades to evaluate the association betwee...
Adult patients (≥18 years) in both primary prevention populations (without pre-existing cardiovascular disease, with low ASCVD risk <7.5%) and secondary prevention populations (with established cardiovascular disease, including coronary artery disease, prior stroke/TIA, kidney transplant recipients, or diabetes with hi...
Oral, enteral, or parenteral supplementation with combinations of B-vitamins, specifically folic acid (vitamin B9), cobalamin (vitamin B12), and/or pyridoxine (vitamin B6), in any formulation (tablet, capsule, injectable), dosage, or combination regimen targeting homocysteine-lowering pathways.
Placebo (matched in appearance without active B-vitamin content) or B-vitamin formulations provided at doses lower than the recommended daily allowance (RDA) as comparator.
Incidence of arterial thrombotic and cardiovascular outcomes: stroke (ischemic or unspecified) and transient ischemic attack (TIA); myocardial infarction (MI, fatal and nonfatal); unstable angina; cardiovascular accident (CVA); composite 3-point major adverse cardiovascular events (MACE: cardiovascular death + nonfatal...
41835126
Heat Exposure and Health Outcomes in Construction Workers: A Systematic Review and Meta-Analysis
Climate change is becoming a recognized health concern in the scientific community, as heat exposure poses escalating health risks to outdoor occupational groups, particularly construction workers. Heat stress and climate change may lead to adverse physical health outcomes and reduced workability among construction wor...
Adults of working age (18-65 years) employed in outdoor construction settings, referred to as construction workers, without geographical setting restrictions.
Heat exposure, including extreme heat, heat stress, heat strain, heat exhaustion, heat stroke, environmental or passive heat exposure, and work-related heat strain arising from physical exertion and protective equipment. This is an occupational exposure rather than a therapeutic intervention.
The original PICO table stated that no comparison was required for inclusion; for AutoMeta compatibility, the comparator is lower or absent heat exposure, non-heat-exposed conditions, or within-study reference conditions when such comparisons were reported.
Physical health, fatigue, stress, prevalence, incidence, or performance outcomes, including dehydration, heat-related illness symptoms, heat stress/strain, kidney function impairment, acute kidney injury, chronic kidney disease, high body temperature, heat-related mortality, and work-performance effects.
41888952
The effect of hydrogen-rich water interventions on lipid profiles in adults with overweight or obesity and associated metabolic disorders: a systematic review and meta-analysis of randomized controlled trials
Objective: Obesity-related dyslipidemia remains a significant health challenge, contributing to increased cardiovascular risk. Hydrogen-rich water (HRW) has been proposed as a potential adjunctive intervention due to its antioxidant and anti-inflammatory properties. This systematic review and meta-analysis aimed to eva...
Adult participants (≥18 years) with a mean baseline body mass index (BMI) ≥25 kg/m² (overweight or obese), including those with associated cardiometabolic comorbidities such as metabolic syndrome, non-alcoholic fatty liver disease (NAFLD), hyperuricemia, impaired fasting glucose (IFG), or type 2 diabetes mellitus (T2DM...
Oral consumption of hydrogen-rich water (HRW), operationally defined as drinking water containing dissolved molecular hydrogen (H₂), delivered as pre-packaged HRW or generated in situ via hydrogen-producing tablets or caplets dissolved in water, at any hydrogen concentration (approximately 0.5–7.5 ppm) and daily intake...
Placebo water (identical in appearance and taste without dissolved hydrogen content) or standard drinking water without hydrogen supplementation.
Primary outcomes: changes in total cholesterol (TC, mg/dL) and low-density lipoprotein cholesterol (LDL-C, mg/dL) from baseline to end of intervention, given their established causal associations with cardiovascular disease risk. Secondary outcomes: changes in high-density lipoprotein cholesterol (HDL-C, mg/dL) and tri...
41901064
Effects of Nicotinamide Mononucleotide Supplementation on Blood Pressure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Background/Objectives: High blood pressure remains a primary modifiable risk factor for cardiovascular disease. Nicotinamide mononucleotide (NMN) has emerged as a promising supplement; however, its efficacy with respect to blood pressure in humans is unclear. This meta-analysis systematically evaluated the effects of v...
Adults aged 18 years and older who were healthy without cardiovascular, diabetic, or chronic underlying diseases and had elevated blood pressure or early-stage blood pressure elevation; no trials enrolled moderate-to-severe hypertension.
Oral nicotinamide mononucleotide (NMN) supplementation in randomized controlled trials, using capsules, tablets, powder, or unreported oral forms, with daily doses ranging from 250 mg to 1500 mg and intervention duration of at least 4 weeks.
Placebo control within parallel or crossover randomized trial designs.
Resting systolic blood pressure and diastolic blood pressure, based on sufficient pre- and post-intervention data to calculate net blood-pressure changes; subgroup outcomes by age, baseline BMI, region, duration, dose, and baseline blood pressure were also analyzed.
41938012
Impact of climate change on spontaneous abortion: a systematic review and meta-analysis
Purpose: This systematic review and meta-analysis synthesized evidence on the association between climate change-related factors and spontaneous abortion. Patients and method: A systematic literature search across PubMed, Embase, MEDLINE, Web of Science, PsycINFO, and Google Scholar identified English-language observat...
Women of reproductive age, including pregnant women in observational studies reporting induced or spontaneous abortion outcomes, with the primary focus on spontaneous abortion or miscarriage before fetal viability.
Climate change-related exposures, including direct and indirect effects such as extreme weather events (floods, heat waves, storms), shifts in temperature or precipitation patterns, high ambient temperature, wildfire smoke, dust storms, and ambient air pollution (SO2, ozone, CO, NO2, particulate matter).
Studies with or without comparator groups were eligible; for AutoMeta compatibility, the comparator is lower, absent, or reference climate-related exposure within each original study, such as lower pollutant concentration, lower/reference temperature, or unexposed pregnancy windows.
Abortion outcomes, especially spontaneous abortion/miscarriage defined as non-induced pregnancy loss before fetal viability, including study definitions before 20, 25, or 28 weeks of gestation; induced abortion was eligible in the broader review but the primary outcome was spontaneous abortion/miscarriage.
41939286
Impact of Ambient Air Pollution on Cardiovascular Diseases in Low- and Lower-Middle-Income Countries: A Systematic Review and Meta-Analysis
Air pollution contributes to over 8.1 million deaths annually, predominantly from cardiovascular causes. The burden is significantly higher in low-income and lower middle-income countries, yet most air pollution research is performed in higher-income countries. This review evaluated associations between ambient air pol...
Adults or all-age populations in low-income and lower middle-income countries as defined by the 2024 World Bank classification, with cardiovascular disease hospital admission or mortality outcomes.
Ambient outdoor air pollution exposure, including PM2.5, PM10, SO2, NO2, CO, and O3, assessed as short-term exposure over days to weeks or long-term exposure over months to years.
Lower or reference levels of the same ambient air pollutant, with effect estimates standardized where possible to 10 micrograms/m3 concentration increments; indoor and non-ambient occupational air pollution exposures were excluded.
Cardiovascular disease outcomes including hospital admission and mortality, overall CVD, myocardial infarction, stroke, heart failure, ischemic heart disease, and related CVD-specific endpoints reported as RR, HR, OR, or other quantitative associations.
41970007
Effectiveness of Personal-Level Protective Measures Against Air Pollution on Respiratory Health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Air pollution, particularly fine particulate matter (PM2.5), poses a significant global health risk, contributing to respiratory, and cardiovascular diseases. While personal-level interventions such as air purifiers and respirators are commonly used to reduce exposure, their effectiveness in improving clinical outcomes...
Individuals of any age (children, adults, elderly), sex, or health status (healthy individuals, asthmatics, COPD patients, allergic rhinitis patients) who are exposed to ambient or indoor air pollution in non-occupational settings. Includes non-occupationally exposed workers such as office staff and taxi drivers. Exclu...
Personal-level protective measures used in non-occupational, non-industrial settings, including: (1) air filtration devices such as portable HEPA air purifiers, ionizers, laminar airflow devices, and negative ion generators; and (2) respiratory protection devices such as face masks and respirators. Excludes central ven...
Sham/placebo protective devices (e.g., inactive sham air purifiers, non-filtering placebo masks), no intervention, or standard indoor conditions without active air purification or respiratory protection.
Primary outcomes: respiratory health measures including (1) lung function parameters: FEV1, peak expiratory flow (PEF), forced vital capacity (FVC); (2) airway inflammation biomarker: fractional exhaled nitric oxide (FeNO); (3) self-reported respiratory symptoms. Secondary outcomes: cardiovascular outcomes (blood press...
42003421
The Effect of Cranberry Consumption on Blood Pressure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Background: This systematic review and meta-analysis aimed to elucidate the effects of cranberry consumption on systolic and diastolic blood pressure based on relevant randomized controlled trials. Materials and Methods: A systematic literature search was performed across ISI Web of Science, PubMed, Embase, the Cochran...
Adults aged 18 years and older enrolled in randomized controlled trials, including healthy people and participants with metabolic syndrome, type 2 diabetes, NAFLD, coronary artery disease, peripheral endothelial dysfunction and cardiovascular risk factors, elevated fasting glucose/impaired glucose tolerance, or elevate...
Cranberry consumption as cranberry supplement, cranberry juice, cranberry extract, cranberry powder, cranberry cocktail juice, or Vaccinium macrocarpon products, without combination with other dietary supplements or interventions.
Placebo comparator group in randomized controlled trials with parallel or crossover design.
Systolic blood pressure and diastolic blood pressure measured at baseline and at the end of the intervention, with sufficient data for meta-analysis.
42015424
The effect of low-carbohydrate diets on serum concentration of soluble adhesion molecules: a systematic review and meta-analysis of randomized controlled trials
Therapeutic potential of low-carbohydrate diets in pathological conditions such as endothelial dysfunction can open new strategies for prevention and treatment of cardiovascular disease. This review pooled the effect of low-carbohydrate diets on circulating intercellular adhesion molecule (ICAM), vascular cell adhesion...
Adults aged 18 years and older regardless of health status, including overweight or obese adults, type 1 diabetes, type 2 diabetes, and overweight participants with atherogenic dyslipidemia in randomized controlled trials.
Low-carbohydrate diet defined as less than 45% of calories from carbohydrates, including stricter low-carbohydrate or ketogenic targets such as less than 10% of calories, 10-26%, or 26-45% of total energy intake.
Control dietary group in randomized controlled trials; studies without a control group, with LCD mixed with other dietary or pharmacological treatments, or with a low-carbohydrate arm at 45% or more carbohydrate were excluded.
Mean changes in serum concentrations of soluble adhesion molecules, including ICAM, VCAM, E-selectin, and P-selectin, with standard deviations or sufficient data to estimate them.
42032055
Soy isoflavone supplementation and sexual function in postmenopausal women: a systematic review and meta-analysis of randomized controlled trials
Postmenopausal women often experience sexual dysfunction, such as vaginal dryness and dyspareunia, due to estrogen decline. While hormone replacement therapy is effective, safety concerns have spurred interest in alternatives like soy isoflavones. This meta-analysis evaluated soy isoflavones' efficacy for sexual functi...
Postmenopausal women in randomized controlled trials evaluating sexual function or menopausal symptoms; non-randomized studies, wrong populations, and studies lacking sexual-function outcomes were excluded.
Soy isoflavone supplementation, typically 40-160 mg/day, including soy isoflavone tablets, powders, extracts, soy-rich diets, soy drinks, vaginal isoflavone gel, or soy-based products where soy isoflavones were the primary active compound.
Placebo, hormone therapy or low-dose hormone replacement therapy, no treatment, or control diet groups.
Sexual function and menopausal/urogenital symptoms, including vaginal dryness, dyspareunia, urogenital symptoms, vasomotor symptoms, psychological symptoms, somatic complaints, Menopause Rating Scale, Kupperman Index, vaginal cytology, Vaginal Health Index, and symptom-specific questionnaires.

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