Obesity is a central health issue due to its epidemic prevalence and its association with type 2 diabetes and other comorbidities. Obesity is not just being overweight. It is a metabolic disorder due to the accumulation of excess dietary calories into visceral fat and the release of high concentrations of free fatty acids into various organs. It represents a state of chronic oxidative stress and low-grade inflammation whose intermediary molecules may include leptin, adiponectin and cytokines. It may progress to hyperglycemia, leading to type 2 diabetes. Whether or not dietary antioxidant supplements are useful in the management of obesity and type 2 diabetes is discussed in this review. Only the benefits for obesity and diabetes are examined here. Other health benefits of antioxidants are not considered. There are difficulties in comparing studies in this field because they differ in the time frame, participants' ethnicity, administration of antioxidant supplements, and even in how obesity was measured. However, the literature presents reasonable evidence for marginal benefits of supplementation with zinc, lipoic acid, carnitine, cinnamon, green tea, and possibly vitamin C plus E, although the evidence is much weaker for omega-3 polyunsaturated fatty acids, coenzyme Q10, green coffee, resveratrol, or lycopene. Overall, antioxidant supplements are not a panacea to compensate for a fast-food and video-game way of living, but antioxidant-rich foods are recommended as part of the lifestyle. Such antioxidant foods are commonly available.

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Introduction International guidelines provide heterogenous guidance on use of corticosteroids for community-acquired pneumonia (CAP). Methods We performed a systematic review of randomized controlled trials examining corticosteroids in hospitalized adult patients with suspected or probable CAP. We performed a pairwise and dose-response meta-analysis using the restricted maximum likelihood (REML) heterogeneity estimator. We assessed the certainty of the evidence using GRADE methodology and the credibility of subgroups using the ICEMAN tool. Results We identified 18 eligible studies that included 4661 patients. Corticosteroids probably reduce mortality in more severe CAP (RR 0.62 [95% CI 0.45 to 0.85]; moderate certainty) with possibly no effect in less severe CAP (RR 1.08 [95% CI 0.83 to 1.42]; low certainty). We found a non-linear dose-response relationship between corticosteroids and mortality, suggesting an optimal dose of approximately 6 mg of dexamethasone (or equivalent) for a duration of therapy of 7 days (RR 0.44 [95% 0.30 to 0.66]). Corticosteroids probably reduce the risk of requiring invasive mechanical ventilation (RR 0.56 [95% CI 0.42 to 74] and probably reduce intensive care unit (ICU) admission (RR 0.65 [95% CI 0.43 to 0.97]) (both moderate certainty). Corticosteroids may reduce the duration of hospitalization and ICU stay (both low certainty). Corticosteroids may increase the risk of hyperglycemia (RR 1.76 [95% CI 1.46 to 2.14]) (low certainty). Conclusion Moderate certainty evidence indicates that corticosteroids reduce mortality in patients with more severe CAP, the need for invasive mechanical ventilation, and ICU admission. Supplementary Information The online version contains supplementary material available at 10.1007/s11606-023-08203-6.

Background Ulcerative colitis (UC) is a disease with a heavy burden of morbidity, for which we do not fully understand its etiology. Researchers have anecdotally observed a preventative effect of appendectomy on the risk of developing UC, with multiple studies exploring this relationship. Aims We aimed to complete a systematic review and meta-analysis, the largest of its kind, to determine with more certainty the effect of appendectomy on the subsequent development of UC. Methods A literature search and a review of reference lists of previously published articles was done to identify studies exploring the association between appendectomy and the subsequent development of UC. Our primary endpoint was the diagnosis of UC. Other variables of interest were geographical region, publication date, and age at time of appendectomy. Odds ratios with 95% confidence intervals (CI) are reported. Results Fifty-one studies (49 case-controls studies and 2 cohort studies) were included with a total of 1,270,332 participants. The pooled OR showed that appendectomy decreases the odds of developing UC (Figure 1; OR 0.37, 95% CI, 0.29–0.46, I2 = 89%). A similar pattern was seen for individuals who received an appendectomy before the age of 20 (Figure 2; OR 0.35, 95% CI, 0.21–0.61, I2 0%). The protective effect was seen again when including only high quality methodological studies with Newcastle-Ottawa scale ≥ 7 (Figure 3; OR 0.47, 95% CI, 0.34–0.65, I2 56%). Conclusions Appendectomy may be protective against subsequent development of UC. Future research should focus on the physiological explanation behind this association, and the practicality of using appendectomy as a primary prevention measure in patients at high-risk of developing ulcerative colitis. Funding Agencies None