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PLoS Medicine Mar 2020Fibre is promoted as part of a healthy dietary pattern and in diabetes management. We have considered the role of high-fibre diets on mortality and increasing fibre... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Fibre is promoted as part of a healthy dietary pattern and in diabetes management. We have considered the role of high-fibre diets on mortality and increasing fibre intake on glycaemic control and other cardiometabolic risk factors of adults with prediabetes or diabetes.
METHODS AND FINDINGS
We conducted a systematic review of published literature to identify prospective studies or controlled trials that have examined the effects of a higher fibre intake without additional dietary or other lifestyle modification in adults with prediabetes, gestational diabetes, type 1 diabetes, and type 2 diabetes. Meta-analyses were undertaken to determine the effects of higher fibre intake on all-cause and cardiovascular mortality and increasing fibre intake on glycaemic control and a range of cardiometabolic risk factors. For trials, meta regression analyses identified further variables that influenced the pooled findings. Dose response testing was undertaken; Grading of Recommendations Assessment, Development and Evaluation (GRADE) protocols were followed to assess the quality of evidence. Two multicountry cohorts of 8,300 adults with type 1 or type 2 diabetes followed on average for 8.8 years and 42 trials including 1,789 adults with prediabetes, type 1, or type 2 diabetes were identified. Prospective cohort data indicate an absolute reduction of 14 fewer deaths (95% confidence interval (CI) 4-19) per 1,000 participants over the study duration, when comparing a daily dietary fibre intake of 35 g with the average intake of 19 g, with a clear dose response relationship apparent. Increased fibre intakes reduced glycated haemoglobin (HbA1c; mean difference [MD] -2.00 mmol/mol, 95% CI -3.30 to -0.71 from 33 trials), fasting plasma glucose (MD -0.56 mmol/L, 95% CI -0.73 to -0.38 from 34 trials), insulin (standardised mean difference [SMD] -2.03, 95% CI -2.92 to -1.13 from 19 trials), homeostatic model assessment of insulin resistance (HOMA IR; MD -1.24 mg/dL, 95% CI -1.72 to -0.76 from 9 trials), total cholesterol (MD -0.34 mmol/L, 95% CI -0.46 to -0.22 from 27 trials), low-density lipoprotein (LDL) cholesterol (MD -0.17 mmol/L, 95% CI -0.27 to -0.08 from 21 trials), triglycerides (MD -0.16 mmol/L, 95% CI -0.23 to -0.09 from 28 trials), body weight (MD -0.56 kg, 95% CI -0.98 to -0.13 from 18 trials), Body Mass Index (BMI; MD -0.36, 95% CI -0·55 to -0·16 from 14 trials), and C-reactive protein (SMD -2.80, 95% CI -4.52 to -1.09 from 7 trials) when compared with lower fibre diets. All trial analyses were subject to high heterogeneity. Key variables beyond increasing fibre intake were the fibre intake at baseline, the global region where the trials were conducted, and participant inclusion criteria other than diabetes type. Potential limitations were the lack of prospective cohort data in non-European countries and the lack of long-term (12 months or greater) controlled trials of increasing fibre intakes in adults with diabetes.
CONCLUSIONS
Higher-fibre diets are an important component of diabetes management, resulting in improvements in measures of glycaemic control, blood lipids, body weight, and inflammation, as well as a reduction in premature mortality. These benefits were not confined to any fibre type or to any type of diabetes and were apparent across the range of intakes, although greater improvements in glycaemic control were observed for those moving from low to moderate or high intakes. Based on these findings, increasing daily fibre intake by 15 g or to 35 g might be a reasonable target that would be expected to reduce risk of premature mortality in adults with diabetes.
Topics: Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Diet, Diabetic; Diet, Healthy; Dietary Fiber; Humans; Nutritive Value; Protective Factors; Recommended Dietary Allowances; Risk Assessment; Risk Factors; Risk Reduction Behavior; Time Factors; Treatment Outcome; Whole Grains
PubMed: 32142510
DOI: 10.1371/journal.pmed.1003053 -
Nutrients Jun 2021A protective effect of vegan diets on health outcomes has been observed in previous studies, but its impact on diabetes is still debated. The aim of this review is to...
A protective effect of vegan diets on health outcomes has been observed in previous studies, but its impact on diabetes is still debated. The aim of this review is to assess the relationship between vegan diets and the risk for type 2 diabetes (T2D) along with its effect on glycemic control and diabetes-related complications. In accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, Pubmed and Cochrane library databases were systematically searched for all relevant studies. Seven observational and eight randomized controlled (RCTs) studies were included. The methodological quality of studies was assessed using the National Institutes of Health quality assessment tool for observational cohort and cross-sectional studies and the Cochrane Risk of Bias Tool for RCTs. We found that a vegan diet is associated with lower T2D prevalence or incidence and in T2D patients decreases high glucose values and improves glucose homeostasis, as reported from the majority of included studies. This approach seems to be comparable to other recommended healthful eating models, but as it may have potential adverse effects associated with the long-term exclusion of some nutrients, appropriate nutritional planning and surveillance are recommended, particularly in specific groups of diabetic patients such as frail elderly, adolescents, and pregnant or breastfeeding women.
Topics: Diabetes Mellitus, Type 2; Diet, Vegan; Female; Glycemic Control; Humans; Incidence; Male; Observational Studies as Topic; Prevalence; Randomized Controlled Trials as Topic
PubMed: 34205679
DOI: 10.3390/nu13062123 -
Obesity Facts 2021The very low-calorie ketogenic diet (VLCKD) has been recently proposed as an appealing nutritional strategy for obesity management. The VLCKD is characterized by a low... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The very low-calorie ketogenic diet (VLCKD) has been recently proposed as an appealing nutritional strategy for obesity management. The VLCKD is characterized by a low carbohydrate content (<50 g/day), 1-1.5 g of protein/kg of ideal body weight, 15-30 g of fat/day, and a daily intake of about 500-800 calories.
OBJECTIVES
The aim of the current document is to suggest a common protocol for VLCKD and to summarize the existing literature on its efficacy in weight management and weight-related comorbidities, as well as the possible side effects.
METHODS
This document has been prepared in adherence with Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Literature searches, study selection, methodology development, and quality appraisal were performed independently by 2 authors and the data were collated by means of a meta-analysis and narrative synthesis.
RESULTS
Of the 645 articles retrieved, 15 studies met the inclusion criteria and were reviewed, revealing 4 main findings. First, the VLCKD was shown to result in a significant weight loss in the short, intermediate, and long terms and improvement in body composition parameters as well as glycemic and lipid profiles. Second, when compared with other weight loss interventions of the same duration, the VLCKD showed a major effect on reduction of body weight, fat mass, waist circumference, total cholesterol and triglyceridemia as well as improved insulin resistance. Third, although the VLCKD also resulted in a significant reduction of glycemia, HbA1c, and LDL cholesterol, these changes were similar to those obtained with other weight loss interventions. Finally, the VLCKD can be considered a safe nutritional approach under a health professional's supervision since the most common side effects are usually clinically mild and easily to manage and recovery is often spontaneous.
CONCLUSIONS
The VLCKD can be recommended as an effective dietary treatment for individuals with obesity after considering potential contra-indications and keeping in mind that any dietary treatment has to be personalized. Prospero Registry: The assessment of the efficacy of VLCKD on body weight, body composition, glycemic and lipid parameters in overweight and obese subjects: a meta-analysis (CRD42020205189).
Topics: Adult; Diet, Ketogenic; Humans; Obesity; Obesity Management; Overweight; Weight Loss
PubMed: 33882506
DOI: 10.1159/000515381 -
Frontiers in Immunology 2020Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by multiple organ involvement, including the skin, joints, kidneys, lungs, central nervous...
Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by multiple organ involvement, including the skin, joints, kidneys, lungs, central nervous system and the haematopoietic system, with a large number of complications. Despite years of study, the etiology of SLE remains unclear; thus, safe and specifically targeted therapies are lacking. In the last 20 years, researchers have explored the potential of nutritional factors on SLE and have suggested complementary treatment options through diet. This study systematically reviews and evaluates the clinical and preclinical scientific evidence of diet and dietary supplementation that either alleviate or exacerbate the symptoms of SLE. For this review, a systematic literature search was conducted using PubMed, Scopus and Google Scholar databases only for articles written in the English language. Based on the currently published literature, it was observed that a low-calorie and low-protein diet with high contents of fiber, polyunsaturated fatty acids, vitamins, minerals and polyphenols contain sufficient potential macronutrients and micronutrients to regulate the activity of the overall disease by modulating the inflammation and immune functions of SLE.
Topics: Animals; Diet; Diet Therapy; Dietary Supplements; Fatty Acids, Unsaturated; Humans; Immunomodulation; Lupus Erythematosus, Systemic; Minerals; Polyphenols
PubMed: 32793202
DOI: 10.3389/fimmu.2020.01477 -
Nutrients Nov 2021Various nutritional therapies have been proposed in rheumatoid arthritis, particularly diets rich in ω-3 fatty acids, which may lead to eicosanoid reduction. Our aim... (Meta-Analysis)
Meta-Analysis
Various nutritional therapies have been proposed in rheumatoid arthritis, particularly diets rich in ω-3 fatty acids, which may lead to eicosanoid reduction. Our aim was to investigate the effect of potentially anti-inflammatory diets (Mediterranean, vegetarian, vegan, ketogenic) on pain. The primary outcome was pain on a 10 cm visual analogue scale. Secondary outcomes were C-reactive protein levels, erythrocyte sedimentation rate, health assessment questionnaire, disease activity score 28, tender/swollen joint counts, weight, and body mass index. We searched MEDLINE (OVID), Embase (Elsevier), and CINAHL for studies published from database inception to 12 November 2021. Two authors independently assessed studies for inclusion, extracted study data, and assessed the risk of bias. We performed a meta-analysis with all eligible randomized controlled trials using RevMan 5. We used mean differences or standardized mean differences and the inverse variance method of pooling using a random-effects model. The search retrieved 564 unique publications, of which we included 12 in the systematic review and 7 in the meta-analysis. All studies had a high risk of bias and the evidence was very low. The main conclusion is that anti-inflammatory diets resulted in significantly lower pain than ordinary diets (-9.22 mm; 95% CI -14.15 to -4.29; = 0.0002; 7 RCTs, 326 participants).
Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Arthralgia; Arthritis, Rheumatoid; Clinical Trials as Topic; Diet, Healthy; Diet, Ketogenic; Diet, Mediterranean; Diet, Vegan; Diet, Vegetarian; Female; Humans; Inflammation; Male; Middle Aged; Observational Studies as Topic; Pain Management; Treatment Outcome
PubMed: 34959772
DOI: 10.3390/nu13124221 -
International Journal of Environmental... May 2021Fibromyalgia (FM) is a chronic non-degenerative disease characterized by the presence of multiple symptoms such as chronic pain, which negatively influence the quality... (Review)
Review
Fibromyalgia (FM) is a chronic non-degenerative disease characterized by the presence of multiple symptoms such as chronic pain, which negatively influence the quality of life of sufferers, most of whom are women. Currently, there is no effective treatment to limit the impact of these symptoms. The aim of this research is to review the scientific evidence on the effect of following a vegetarian or vegan diet on fibromyalgia patients. A systematic review included the original articles that answered the research question. These articles were in 2021 in the PubMed, Web of Science and Scopus databases. The research used the PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines. No time restriction was applied, and grey literature was not included. The evaluation of the methodological quality of the articles was carried out using the following different scales: STROBE (strengthening the reporting of observational studies in epidemiology), PEDro (Physiotherapy Evidence Database), and MMAT (Mixed Methods Appraisal Tool) scales. A total of 88 studies were analyzed, of which 6 investigations were included in this systematic review ( = 4 clinical trials and = 2 cohort studies). These investigations show significant improvements in biochemical parameters, quality of life, quality of sleep, pain at rest and general health status when following mainly plant-based dietary patterns. In conclusion, these findings are promising but interpretation of the findings is limited due to the methodological quality of the studies. Well-designed clinical trials are needed to consolidate these dietary recommendations in FM patients.
Topics: Diet; Diet, Vegan; Female; Fibromyalgia; Humans; Male; Quality of Life; Vegetarians
PubMed: 34066603
DOI: 10.3390/ijerph18094955 -
Diabetes & Metabolic Syndrome Apr 2023Obesity is a worldwide epidemic and has quickly become a clinical and public health challenge. The primary concern is the effect of obesity on quality of life. This... (Review)
Review
BACKGROUND AND AIMS
Obesity is a worldwide epidemic and has quickly become a clinical and public health challenge. The primary concern is the effect of obesity on quality of life. This review assesses the effectiveness of interventions such as exercise and diet in the management of obesity.
METHODS
Studies selected reported on the obese adult population (18 years and older), who had a lifestyle modification using diet, exercise, or both. We screened a total of 324 articles, 25 were found to be duplicated, 261 were excluded after screening for eligibility, and 27 full-text articles due to study design, incomplete data. 11 full-text articles were reviewed and included in our study.
RESULTS
Participants placed on a dairy-based diet achieved a more significant reduction in body weight (-1.16 kg [-1.66, -0.66 kg], p < 0.001) and body fat mass (-1.49 kg [-2.06, -0.92 kg], p < 0.001). The ADF participants achieved body weight change of mean -0.9% ± 0.6% in the low-weight-loss group, and -9.9% ± 1.1% in the high-weight-loss group, whereas the caloric restricted (CR) participants achieved -1.3% ± 0.7% in the low-weight-loss, and -9.2% ± 1.2% in the high-weight-loss groups. A combination of intensive physical activity of about 175 min per week and a portion-controlled diet led to a more significant weight loss of 5%.
CONCLUSION
This systematic review identified that the most efficient regimen for obesity management in adults is the combination of strength plus endurance exercise for a minimum of 175 min per week and a customized hypocaloric diet based on patient-specific metabolic needs and overall health status.
Topics: Adult; Humans; Obesity; Diet, Reducing; Quality of Life; Body Weight; Exercise
PubMed: 37084486
DOI: 10.1016/j.dsx.2023.102759 -
The Journal of Clinical Endocrinology... Oct 2020The effect of diet on insulin resistance (IR) in polycystic ovary syndrome (PCOS) is controversial. Thus, we conducted this systematic review and meta-analysis to... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The effect of diet on insulin resistance (IR) in polycystic ovary syndrome (PCOS) is controversial. Thus, we conducted this systematic review and meta-analysis to evaluate whether diet could reduce IR in women with PCOS while providing optimal and precise nutrition advice for clinical practice.
DESIGN
The search was conducted in 8 databases through June 30, 2019. The systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. A random-effects model was adopted to calculate the overall effects.
RESULTS
A total of 19 trials (1193 participants) were included. The analysis showed that diet was significantly related to improvements in IR and body composition (eg, homeostasis model assessment of insulin resistance, fasting insulin, fasting plasma glucose, body mass index [BMI], weight, and waist circumference) in PCOS patients. The Dietary Approaches to Stop Hypertension diet and calorie-restricted diets might be the optimal choices for reducing IR and improving body composition, respectively, in the PCOS population. Additionally, the effects were associated with the course of treatment. The longer the duration, the greater the improvement was. Compared with metformin, diet was also advantageous for weight loss (including BMI and weight) and had the same effects on insulin regulation.
CONCLUSION
Overall, our findings suggest that diet is an effective, acceptable and safe intervention for relieving IR, and professional dietary advice should be offered to all PCOS patients.
Topics: Blood Glucose; Body Mass Index; Caloric Restriction; Counseling; Dietary Approaches To Stop Hypertension; Dietary Services; Fasting; Female; Humans; Insulin; Insulin Resistance; Polycystic Ovary Syndrome; Time Factors; Treatment Outcome; Weight Loss
PubMed: 32621748
DOI: 10.1210/clinem/dgaa425 -
Nutrients Aug 2020Fibromyalgia (FM) is a multifactorial syndrome of unknown etiology, characterized by widespread chronic pain and various somatic and psychological manifestations. The...
Fibromyalgia (FM) is a multifactorial syndrome of unknown etiology, characterized by widespread chronic pain and various somatic and psychological manifestations. The management of FM requires a multidisciplinary approach combining both pharmacological and nonpharmacological strategies. Among nonpharmacological strategies, growing evidence suggests a potential beneficial role for nutrition. This review summarizes the possible relationship between FM and nutrition, exploring the available evidence on the effect of dietary supplements and dietary interventions in these patients. Analysis of the literature has shown that the role of dietary supplements remains controversial, although clinical trials with vitamin D, magnesium, iron and probiotics' supplementation show promising results. With regard to dietary interventions, the administration of olive oil, the replacement diet with ancient grains, low-calorie diets, the low FODMAPs diet, the gluten-free diet, the monosodium glutamate and aspartame-free diet, vegetarian diets as well as the Mediterranean diet all appear to be effective in reducing the FM symptoms. These results may suggest that weight loss, together with the psychosomatic component of the disease, should be taken into account. Therefore, although dietary aspects appear to be a promising complementary approach to the treatment of FM, further research is needed to provide the most effective strategies for the management of FM.
Topics: Acetylcarnitine; Ascorbic Acid; Chlorella; Diet, Vegan; Dietary Supplements; Fibromyalgia; Nutrition Therapy; Nutritional Physiological Phenomena; Syndrome; Ubiquinone; Vitamin E
PubMed: 32825400
DOI: 10.3390/nu12092525 -
Nutrition Bulletin Mar 2022Recent evidence suggests that vegetarian and vegan diets may increase the risk and symptoms of depression, a mental health condition affecting 350 million people... (Review)
Review
Recent evidence suggests that vegetarian and vegan diets may increase the risk and symptoms of depression, a mental health condition affecting 350 million people globally. We aimed to systematically review the literature on the associations between vegetarian and/or vegan diets and the risk or symptoms of depression using evidence from both observational and intervention studies. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with pre-specification of all methods. A systematic search for relevant papers was performed on Medline and Embase, Web of Science and the Cochrane Library for cohort, case-control, cross-sectional studies or randomised controlled trials examining associations between a vegetarian or vegan diet and depression in adults. Three independent reviewers extracted data and assessed risk of bias using the National Heart, Lung, and Blood Institute of the National Institutes of Health for Quality Assessment of Observational Cohort and Cross-Sectional Studies and Controlled Studies. Evidence was tabulated according to the type of diet analysed as vegetarian, vegan or both and narratively synthesised. A total of 23 studies (18 cross-sectional, three prospective cohort and two randomised controlled trials) with 25 study outcomes were eligible for inclusion in this review. Conflicting evidence was found on the association between vegetarian or vegan diets and depression. Eleven (44%) of the outcomes indicated that vegetarian and vegan diets were associated with higher rates of depression, while seven (28%) outcomes revealed beneficial effects of the diets on depression. Seven (28%) outcomes found no association between vegetarian and vegan diets and depression, although two of these studies found a higher risk of depression in some groups. The quality of evidence was rated as good for four of the studies with the remaining 19 studies rated as fair. The evidence on the effect of vegetarian and vegan diets on depression is contradictory, possibly due to the heterogeneity of the studies analysed. Further research, including longitudinal and intervention studies, is required to resolve this observation.
Topics: Adult; Cross-Sectional Studies; Depression; Diet, Vegan; Diet, Vegetarian; Humans; Prospective Studies; Randomized Controlled Trials as Topic; United States; Vegetarians
PubMed: 36045075
DOI: 10.1111/nbu.12540