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Nutrition Reviews Oct 2015It is well established in the literature that healthier diets cost more than unhealthy diets. (Review)
Review
CONTEXT
It is well established in the literature that healthier diets cost more than unhealthy diets.
OBJECTIVE
The aim of this review was to examine the contribution of food prices and diet cost to socioeconomic inequalities in diet quality.
DATA SOURCES
A systematic literature search of the PubMed, Google Scholar, and Web of Science databases was performed.
STUDY SELECTION
Publications linking food prices, dietary quality, and socioeconomic status were selected.
DATA EXTRACTION
Where possible, review conclusions were illustrated using a French national database of commonly consumed foods and their mean retail prices.
DATA SYNTHESIS
Foods of lower nutritional value and lower-quality diets generally cost less per calorie and tended to be selected by groups of lower socioeconomic status. A number of nutrient-dense foods were available at low cost but were not always palatable or culturally acceptable to the low-income consumer. Acceptable healthier diets were uniformly associated with higher costs. Food budgets in poverty were insufficient to ensure optimum diets.
CONCLUSIONS
Socioeconomic disparities in diet quality may be explained by the higher cost of healthy diets. Identifying food patterns that are nutrient rich, affordable, and appealing should be a priority to fight social inequalities in nutrition and health.
Topics: Commerce; Costs and Cost Analysis; Diet; Energy Intake; Feeding Behavior; Food; Humans; Nutritional Status; Nutritive Value; Poverty; Social Class; Socioeconomic Factors
PubMed: 26307238
DOI: 10.1093/nutrit/nuv027 -
The Lancet. Diabetes & Endocrinology Dec 2015The effectiveness of low-fat diets for long-term weight loss has been debated for decades, with many randomised controlled trials (RCTs) and recent reviews giving mixed... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The effectiveness of low-fat diets for long-term weight loss has been debated for decades, with many randomised controlled trials (RCTs) and recent reviews giving mixed results. We aimed to summarise the large body of evidence from RCTs to determine whether low-fat diets contribute to greater weight loss than participants' usual diet, low-carbohydrate diets, and other higher-fat dietary interventions.
METHODS
We did a systematic review and random effects meta-analysis of RCTs comparing the long-term effect (≥1 year) of low-fat and higher-fat dietary interventions on weight loss by searching MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Cochrane Database of Systematic Reviews to identify eligible trials published from database inception up until July 31, 2014. We excluded trials if one intervention group included a non-dietary weight loss component but the other did not, and trials of dietary supplements or meal replacement drink interventions. Data including the main outcome measure of mean difference in weight change between interventions, and whether interventions were intended to lead to weight loss, weight maintenance, or neither, were extracted from published reports. We estimated the pooled weighted mean difference (WMD) with a DerSimonian and Laird random effects method.
FINDINGS
3517 citations were identified by the search and 53 studies met our inclusion criteria, including 68 128 participants (69 comparisons). In weight loss trials, low-carbohydrate interventions led to significantly greater weight loss than did low-fat interventions (18 comparisons; WMD 1·15 kg [95% CI 0·52 to 1·79]; I(2)=10%). Low-fat interventions did not lead to differences in weight change compared with other higher-fat weight loss interventions (19 comparisons; WMD 0·36 kg [-0·66 to 1·37; I(2)=82%), and led to a greater weight decrease only when compared with a usual diet (eight comparisons; -5·41 kg [-7·29 to -3·54]; I(2)=68%). Similarly, results of non-weight-loss trials and weight maintenance trials, for which no low-carbohydrate comparisons were made, showed that low-fat versus higher-fat interventions have a similar effect on weight loss, and that low-fat interventions led to greater weight loss only when compared with usual diet. In weight loss trials, higher-fat weight loss interventions led to significantly greater weight loss than low-fat interventions when groups differed by more than 5% of calories obtained from fat at follow-up (18 comparisons; WMD 1·04 kg [95% CI 0·06 to 2·03]; I(2)=78%), and when the difference in serum triglycerides between the two interventions at follow-up was at least 0·06 mmol/L (17 comparisons; 1·38 kg [0·50 to 2·25]; I(2)=62%).
INTERPRETATION
These findings suggest that the long-term effect of low-fat diet intervention on bodyweight depends on the intensity of the intervention in the comparison group. When compared with dietary interventions of similar intensity, evidence from RCTs does not support low-fat diets over other dietary interventions for long-term weight loss.
FUNDING
National Institutes of Health and American Diabetes Association.
Topics: Body Weight; Diet, Carbohydrate-Restricted; Diet, Fat-Restricted; Diet, High-Fat; Diet, Reducing; Female; Humans; Male; Randomized Controlled Trials as Topic; Weight Loss
PubMed: 26527511
DOI: 10.1016/S2213-8587(15)00367-8 -
Nutrition Journal Sep 2022Dietary factors may play a role in the etiology of endometriosis and dietary intake of some food groups and nutrients could be associated with endometriosis risk. This... (Meta-Analysis)
Meta-Analysis Review
Dietary factors may play a role in the etiology of endometriosis and dietary intake of some food groups and nutrients could be associated with endometriosis risk. This systematic review and meta-analysis of observational studies was conducted to summarize the findings on the association between dietary intakes of selected food groups and nutrients (dairy, fats, fruits, vegetables, legumes, and animal-derived protein sources), and the risk of endometriosis among adult women. PubMed, Scopus, and ISI Web of Science were systematically searched up to September 2022. The inverse variance-weighted fixed-effect method was used to estimate the effect size and corresponding 95% CI. A total of 8 publications (4 studies) including 5 cohorts and 3 case-control with a sample size ranging from 156 to 116,607 were included in this study. A higher intake of total dairy [all low-fat and high-fat dairy foods] was associated with decreased risk of endometriosis (RR 0.90; 95% CI, 0.85 to 0.95; P < 0.001; I = 37.0%), but these associations were not observed with intakes of low or high-fat dairy, cheese or milk. Increased risk of endometriosis was associated with higher consumption of red meat (RR 1.17; 95% CI, 1.08 to 1.26; P < 0.001; I = 82.4%), trans fatty acids (TFA) (RR 1.12; 95% CI, 1.02 to 1.23; P = 0.019; I = 73.0%), and saturated fatty acids (SFA) (RR 1.06; 95% CI, 1.04 to 1.09; P < 0.001; I = 57.3%). The results of this meta-analysis suggest that there may be differing associations between dietary intake of dairy foods, red meat, SFAs, and TFAs and the risk of endometriosis. It may be useful to extend the analysis to other types of food groups and dietary patterns to obtain a complete picture. Additionally, further investigations are needed to clarify the role of diet in the incidence and progression of endometriosis.Trial registration: PROSPERO, CRD42020203939.
Topics: Animals; Dairy Products; Diet; Diet, Fat-Restricted; Dietary Fats; Endometriosis; Fatty Acids; Female; Humans; Nutrients; Observational Studies as Topic; Trans Fatty Acids; Vegetables
PubMed: 36138433
DOI: 10.1186/s12937-022-00812-x -
Diabetes Research and Clinical Practice Sep 2021To compare the safety of intermittent fasting (IF) with that of continuous energy-restricted diets (CERD) in patients with T2DM and metabolic syndrome who were... (Meta-Analysis)
Meta-Analysis Review
Intermittent fasting versus continuous energy-restricted diet for patients with type 2 diabetes mellitus and metabolic syndrome for glycemic control: A systematic review and meta-analysis of randomized controlled trials.
AIMS
To compare the safety of intermittent fasting (IF) with that of continuous energy-restricted diets (CERD) in patients with T2DM and metabolic syndrome who were overweight or obese and assess their effects on glycemic control and weight loss.
MATERIALS AND METHODS
We searched MEDLINE (Ovid), Embase, and SINOMED databases up to September 13, 2020. The major outcome was glycemic control and secondary outcomes were change in weight, fasting insulin, and lipid profile.
RESULTS
Of 84 retrieved studies, 5 met our inclusion criteria. Of these, four studies comprising 355 participants were included in the meta-analysis. Based on changes in HbA1c (-0.06, 95% confidence interval [CI] -0.27 to 0.16) and fasting plasma glucose (-0.27, 95% CI -0.76 to 0.22), IF and CERD had similar effects on glycemic control. Moreover, IF had a better effect on weight loss (-1.70, 95% CI -3.28 to -0.11 kg). Patients in both groups experienced similar improvements in fasting insulin and lipid profile as well as similar hypoglycemic events.
CONCLUSIONS
IF is a safe diet pattern and could be implemented for patients with T2DM or metabolic syndrome. Further studies with a larger sample size are needed to verify the effectiveness and safety of IF in patients with T2DM.
Topics: Blood Glucose; Diabetes Mellitus, Type 2; Diet; Fasting; Humans; Metabolic Syndrome; Randomized Controlled Trials as Topic
PubMed: 34391831
DOI: 10.1016/j.diabres.2021.109003 -
Clinical Nutrition (Edinburgh, Scotland) Oct 2019There is a large body of evidence which supports the role of inflammation in the pathophysiology of mental health disorders, including depression. Dietary patterns have... (Meta-Analysis)
Meta-Analysis
BACKGROUND & AIMS
There is a large body of evidence which supports the role of inflammation in the pathophysiology of mental health disorders, including depression. Dietary patterns have been shown to modulate the inflammatory state, thus highlighting their potential as a therapeutic tool in disorders with an inflammatory basis. Here we conduct a systematic review and meta-analysis of current literature addressing whether there is a link between the inflammatory potential of a diet and risk of depression or depressive symptoms.
METHODS
A systematic literature search was performed to identify studies that reported an association between the inflammatory potential of the diet and risk of depressive symptoms or diagnosis of depression. Random effect models were used to meta-analyse effect sizes. Quality assessment, publication bias, sensitivity and subgroup analyses were also performed.
RESULTS
Eleven studies, with a total of 101,950 participants at baseline (age range: 16-72 years old), were eligible for review. A significant association between a pro-inflammatory diet and increased risk of depression diagnosis or symptoms was evident, relative to those on an anti-inflammatory diet (OR: 1.40, 95% confidence intervals: 1.21-1.62, P < 0.001). No publication bias was detected; however, some study heterogeneity was evident (I = 63%, P < 0.001). Subgroup analyses suggested the main source of study heterogeneity was the study design (cross-sectional or longitudinal) and the effect measure used (odds ratio, hazard ratio or relative risk).
CONCLUSION
These results provide an association between pro-inflammatory diet and risk of depression. Thus, adopting an anti-inflammatory diet may be an effective intervention or preventative means of reducing depression risk and symptoms.
Topics: Adolescent; Adult; Aged; Anti-Inflammatory Agents; Depressive Disorder; Diet; Female; Humans; Inflammation; Male; Middle Aged; Young Adult
PubMed: 30502975
DOI: 10.1016/j.clnu.2018.11.007 -
European Journal of Nutrition Feb 2023Vegetarian diets have been associated with reduced risk of ischemic heart disease (IHD). However, results regarding cardiovascular disease (CVD) overall and stroke are... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Vegetarian diets have been associated with reduced risk of ischemic heart disease (IHD). However, results regarding cardiovascular disease (CVD) overall and stroke are less clear. We conducted a systematic review and meta-analysis of prospective cohort studies on CVD, IHD and stroke risk among vegetarians or vegans versus nonvegetarians to clarify these associations.
METHODS
PubMed and Ovid Embase databases were searched through August 12, 2021. Prospective cohort studies reporting adjusted relative risk (RR) estimates and 95% confidence intervals (CIs) for incidence or mortality from CVD, IHD and stroke, comparing vegetarians and vegans to nonvegetarians were included. Risk of bias (RoB) was assessed using ROBINS-I and the strength of evidence was assessed using World Cancer Research Fund (WCRF) criteria. Summary RRs (95% CIs) were estimated using a random effects model.
RESULTS
Thirteen cohort studies (844,175 participants, 115,392 CVD, 30,377 IHD, and 14,419 stroke cases) were included. The summary RR for vegetarians vs. nonvegetarians was 0.85 (95% CI: 0.79-0.92, I = 68%, n = 8) for CVD, 0.79 (95% CI: 0.71-0.88, I = 67%, n = 8) for IHD, 0.90 (95% CI: 0.77-1.05, I = 61%, n = 12) for total stroke, and for vegans vs. nonvegetarians was 0.82 (95% CI: 0.68-1.00, I = 0%, n = 6) for IHD. RoB was moderate (n = 8) to serious (n = 5). The associations between vegetarian diets and CVD and IHD were considered probably causal using WCRF criteria.
CONCLUSIONS
Vegetarian diets are associated with reduced risk of CVD and IHD, but not stroke, but further studies are needed on stroke. These findings should be considered in dietary guidelines.
REVIEW REGISTRATION
No review protocol registered.
Topics: Humans; Cardiovascular Diseases; Diet, Vegan; Prospective Studies; Myocardial Ischemia; Diet, Vegetarian; Vegetarians; Cohort Studies
PubMed: 36030329
DOI: 10.1007/s00394-022-02942-8 -
Critical Reviews in Food Science and... 2021It is known that nutritional composition of breast milk is, to a certain extent, related to maternal diet. The question of nutritional adequacy of mothers' milk is often...
It is known that nutritional composition of breast milk is, to a certain extent, related to maternal diet. The question of nutritional adequacy of mothers' milk is often raised whenever a vegetarian or vegan diet during the lactation process is concerned. For this reason, in some countries, the recruitment of vegan lactating women as milk donors is excluded by milk banks. The purpose of this systematic review is to summarize existing knowledge on variability of specific nutrients in breastmilk of mothers adhering to a plant-based diet. The databases, including MEDLINE (Pubmed) and Scopus, were used to identify relevant publications. Data extraction and analysis were conducted following a PRISMA protocol. Thirteen publications concerning the impact of dietary pattern and levels of animal-origin food intake on breast milk composition were included. The systematic review has shown that all non-vegetarian, vegetarian and vegan mothers produce breast milk of comparable nutritional value. Several differences are primarily attributed to fatty acids and some micro-components, primarily vitamin B12. Regardless of dietary choices, nourishment and adequate nutrition have a significant impact on human milk composition - on the basis of the current evidence, vegetarian and vegan mothers are capable of producing nutritionally valuable milk for their infants, as far as the appropriate supplementation compensating for breastfeeding mother's nutritional requirements is provided. Dietary choices should not be a permanent exclusion criterion for donor candidates in human milk banks.
Topics: Animals; Breast Feeding; Diet; Diet, Vegan; Diet, Vegetarian; Female; Humans; Infant; Lactation; Milk, Human; Vegans
PubMed: 32319307
DOI: 10.1080/10408398.2020.1753650 -
Critical Reviews in Food Science and... 2022Cognitive decline is a rapidly increasing public health concern. A healthy diet has potential in preserving brain and maintaining cognitive health. This systematic...
Cognitive decline is a rapidly increasing public health concern. A healthy diet has potential in preserving brain and maintaining cognitive health. This systematic review was designed to evaluate the relationship between Mediterranean-DASH diet intervention for neurodegenerative delay (MIND) diet and cognitive functioning in older adults. PubMed, SCOPUS, Embase, Cochrane Library, and Google Scholar databases were searched to extract original studies on humans published until July 2020, without date restrictions. Articles that evaluated the association between MIND diet and cognitive performance in older adults were included. Duplicated and irrelevant studies were screened out and data were obtained through critical analysis. Quality of the articles and risk of bias was assessed by Newcastle-Ottawa and Cochrane Collaboration's quality assessment tools. Of the 135 studies retrieved, 13 articles (9 cohort, 3 cross-sectional, and 1 RCT studies) were included in the final review. All of the included studies indicated that adherence to the MIND diet was positively associated with specific domains, but not all, of cognition and global cognitive function (78% of the studies) in older adults. MIND diet was superior to other plant-rich diets including Mediterranean, Dietary Approaches to Stop Hypertension, Pro-Vegetarian and Baltic Sea diets, for improving cognition. Adherence to the MIND diet may possibly be associated with an improved cognitive function in older adults. MIND diet may be superior to other plant-rich diets for improving cognition.
Topics: Aged; Cognition; Cognitive Dysfunction; Cross-Sectional Studies; Diet; Diet, Mediterranean; Dietary Approaches To Stop Hypertension; Humans
PubMed: 33989093
DOI: 10.1080/10408398.2021.1925220 -
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 -
Clinical Nutrition (Edinburgh, Scotland) Sep 2022Lifestyle interventions that focus on reduced energy intake and improved dietary pattern are the mainstay of non-alcoholic fatty liver disease (NAFLD) management.... (Meta-Analysis)
Meta-Analysis
BACKGROUND & AIMS
Lifestyle interventions that focus on reduced energy intake and improved dietary pattern are the mainstay of non-alcoholic fatty liver disease (NAFLD) management. However, it remains unclear which dietary approaches are most beneficial and promote greatest adherence. We aimed to synthesise data from randomised and clinical controlled trials, describing the effects of Mediterranean Diet and Calorie Restriction interventions on NAFLD surrogate markers, in adults.
METHODS
We searched MEDLINE, Embase, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials (October 2021). Study quality was assessed using the Cochrane Collaboration's tools: risk of bias for randomised controlled trials, and risk of bias in non-randomised studies of interventions. Meta-analyses were performed using a random effects model, and the I statistic was used to assess heterogeneity.
RESULTS
Of 4041 records identified, 26 articles with 3037 participants met the inclusion criteria, including studies on calorie-restricted interventions (CRI) (n 9), Mediterranean diet (MD) interventions (n 13) and MD component interventions (n 4). Studies were heterogeneous regarding intervention components, assessment of liver status and diet outcomes. 3 studies reported zero attrition and mean attrition rate for the remaining 23 studies was 14%. Post-intervention meta-analyses revealed that dietary interventions reduced alanine aminotransferase (ALT) (P < 0.001), aspartate aminotransferase (AST) (P = 0.004), Fatty Liver Index (FLI) (P < 0.001), hepatic steatosis (HS) (P = 0.02), and liver stiffness (P = 0.01). CRI had favourable effects on ALT (P < 0.001), HS (P < 0.001) and liver stiffness (P = 0.009). MD reduced ALT (P = 0.02), FLI (P < 0.001) and liver stiffness (P = 0.05). There was a dose-response relationship between degree of calorie restriction and beneficial effects on liver function and weight loss, suggesting that this approach should remain the cornerstone of NAFLD management. In addition, diet composition changes have potential for improving NAFLD and the limited data suggest that MD may be an effective diet therapy.
CONCLUSION
These results support the current guidelines in NAFLD. However, further studies, which robustly evaluate the effects of interventions on dietary intake, acceptability and sustainability of the interventions, and quality of life and other patient-related outcomes are needed to support effective care delivery.
Topics: Adult; Humans; Caloric Restriction; Diet, Mediterranean; Life Style; Non-alcoholic Fatty Liver Disease; Quality of Life; Controlled Clinical Trials as Topic
PubMed: 35947894
DOI: 10.1016/j.clnu.2022.06.037