Childhood malnutrition remains an important public health and development problem in low- and middle-income countries. This study aimed to systematically review the community-based nutrition-specific interventions and their effectiveness and/or cost-effectiveness on the nutritional status of children under 5 years of age in the Eastern Mediterranean Region (EMR). A systematic literature search of the English electronic databases, including PubMed, Scopus, ISI Web of Knowledge, Ovid, EMBASE, as well as Persian databases (SID and Magiran) was performed up to May 2019. Studies regarding the effectiveness/cost-effectiveness of the community-based nutrition-specific programs and interventions targeted at under-five-year children in EMR countries were selected. The primary outcomes were mean of Weight-for-age z-score (WAZ), Height-for-Age z-score (HAZ), and Weight-for-Height z-score (WHZ) of children or prevalence of wasting, stunting, and/or underweight among the children. Meta-analysis was also performed on the selected articles and intervention effects (mean differences) were calculated for each outcome for each study and pooled using a weighted random effects model. Risk of bias (ROB) of each included study was assessed based on the Cochrane Handbook for Systematic Reviews. The study protocol was registered in PROSPERO (CRD42020172643). Of 1036 identified studies, eight met the inclusion criteria. Amongst these, seven were from Pakistan and one from Iran. Only one study conducted in Pakistan reported the cost-effectiveness of nutrition-specific interventions in the region. Nutrition education/consultation and cash-based interventions were the most common nutrition-specific strategies used for management of child malnutrition in the EMR countries. Out of these eight studies, four were included in the meta-analysis. When different interventions were pooled, they had resulted in a significant improvement in WHZ of children (MD: 0.26; 95% CI: 0.07 to 0.46, three studies, I² 82.40%). Considering the high prevalence of child malnutrition in a number of countries in the region, capacity building and investigation regarding the implementation of new approaches to improve nutritional status of children and their effect(s) and cost-effectiveness assessment are highly recommended.

Background/Objectives: The relationship between dairy consumption and cardiovascular or bone health outcomes remains controversial, with inconsistent findings across existing meta-analyses. In this study, we aimed to systematically evaluate and synthesize the evidence from published meta-analyses on dairy consumption and cardiovascular and bone health outcomes in adults, and to conduct updated meta-analyses incorporating recently published prospective cohort studies. Methods: We performed an umbrella review following PRISMA guidelines, searching published and grey literature up to April 2024. Meta-analyses evaluating dairy intake and its impact on cardiovascular and bone health outcomes were included. Updated meta-analyses were conducted for cardiovascular outcomes, while bone health outcomes were synthesized qualitatively. Methodological quality was assessed using the Joanna Briggs Institute checklist. Random-effects models were applied, and heterogeneity, small-study effects, excess significance, and prediction intervals were evaluated. Results: We included 33 meta-analyses (26 on cardiovascular, 7 on bone health outcomes). Updated meta-analyses showed that total dairy (RR: 0.96), milk (RR: 0.97), and yogurt (RR: 0.92) were significantly associated with reduced CVD risk. Total dairy and low-fat dairy were inversely linked to hypertension (RRs: 0.89, 0.87), and milk and low-fat dairy were associated with reduced stroke risk. Small-study effects were absent for most associations. Credibility was rated as “weak” for most associations, with total dairy and stroke, and total dairy and hypertension showing "suggestive" evidence. For bone health, dairy—especially milk—was linked to higher bone mineral density (BMD). Evidence on osteoporosis risk was mixed, and while total dairy and milk showed inconsistent associations with fractures, cheese and yogurt showed more consistent protective effects. Limited evidence suggested milk may reduce bone resorption markers. Conclusions: This review suggests that dairy consumption, particularly milk and yogurt, is modestly associated with reduced cardiovascular risk, while dairy intake appears to benefit BMD and fracture prevention. However, further research is needed to confirm these associations.