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Public Health Nutrition Oct 2021To identify individual-, provider- and system/environmental-level barriers and facilitators affecting cardiac rehabilitation (CR) participants' adherence to dietary...
OBJECTIVE
To identify individual-, provider- and system/environmental-level barriers and facilitators affecting cardiac rehabilitation (CR) participants' adherence to dietary recommendations.
DESIGN
A systematic review of the medical literature was conducted. Six databases were searched from inception through March 2021: APA PsycInfo, CINAHL, Embase, Emcare, Medline and PubMed. Only those studies referring to barriers and facilitators reported by CR participants were considered. Pilot and case report studies, non-peer-reviewed literature and studies published in a language other than English, Portuguese or Spanish were excluded.
RESULTS
Data were extracted and analysed on the basis of individual-, provider- and system/environmental-level factors. Of 2083 initial citations, sixteen studies were included, with nine being qualitative and seven observational in design. From these, ten multi-level barriers and seven multi-level facilitators were identified. Dietary recommendations included developing healthy eating habits, transitioning to vegetarian-rich diets and increasing fish oil and n-3 intake. Only one study reported on all of the nutrition education programme factors recommended by the Workgroup for Intervention Development and Evaluation Research.
CONCLUSION
To the best of our knowledge, this review is the first to summarise specific barriers and facilitators to recommendation adherence among CR participants. Few of the studies offered any conclusions regarding programme design that could facilitate improved dietary adherence practices. Future studies should aim to explore patient perspectives on the nutritional patterns and recommendations outlined in the Mediterranean Diet, the Dietary Approaches to Stop Hypertension Diet, Vegetarian or Vegan diets and the Portfolio Diet.
Topics: Cardiac Rehabilitation; Diet, Healthy; Diet, Mediterranean; Ethnicity; Feeding Behavior; Humans
PubMed: 34344495
DOI: 10.1017/S1368980021002962 -
Nutrients Jul 2020Long-term cancer survivors represent a sizeable portion of the population. Plant-based foods may enhance the prevention of cancer-related outcomes in these patients. We... (Meta-Analysis)
Meta-Analysis
Long-term cancer survivors represent a sizeable portion of the population. Plant-based foods may enhance the prevention of cancer-related outcomes in these patients. We aimed to synthesize the current evidence regarding the impact of plant-based dietary patterns (PBDPs) on cancer-related outcomes in the general population and in cancer survivors. Considered outcomes included overall cancer mortality, cancer-specific mortality, and cancer recurrence. A rapid review was conducted, whereby 2234 original articles related to the topic were identified via Pubmed/Medline. We selected 26 articles, which were classified into studies on PBDPs and cancer outcomes at pre-diagnosis: vegan/vegetarian diet ( = 5), provegetarian diet ( = 2), Mediterranean diet ( = 13), and studies considering the same at post-diagnosis ( = 6). Pooled estimates of the associations between the aforementioned PBDPs and the different cancer outcomes were obtained by applying random effects meta-analysis. The few studies available on the vegetarian diet failed to support its prevention potential against overall cancer mortality when compared with a non-vegetarian diet (e.g., pooled hazard ratio (HR) = 0.97; 95% confidence interval (CI): 0.88-1.06). The insufficient number of studies evaluating provegetarian index scores in relation to cancer mortality did not permit a comprehensive assessment of this association. The association between adherence to the Mediterranean diet and cancer mortality reached statistical significance (e.g., pooled HR = 0.84; 95% CI: 0.79-0.89). However, no study considered the influence of prognostic factors on the associations. In contrast, post-diagnostic studies accounted for prognostic factors when assessing the chemoprevention potential of PBDPs, but also were inconclusive due to the limited number of studies on well-defined plant-based diets. Thus, whether plant-based diets before or after a cancer diagnosis prevent negative cancer-related outcomes needs to be researched further, in order to define dietary guidelines for cancer survivors.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Diet, Mediterranean; Diet, Vegetarian; Female; Humans; Male; Middle Aged; Neoplasms; Recurrence; Young Adult
PubMed: 32640737
DOI: 10.3390/nu12072010 -
Critical Reviews in Food Science and... 2020Different dietary patterns have been positively related to the glycemic control of individuals with type 2 diabetes mellitus. However, consensual dietary pattern for... (Review)
Review
Different dietary patterns have been positively related to the glycemic control of individuals with type 2 diabetes mellitus. However, consensual dietary pattern for these individuals is not established. We aimed to evaluate the effects of adopting different dietary patterns on glycemic control markers of individuals with type 2 diabetes mellitus. PubMed, Scopus, MEDLINE, Lilacs, Open Thesis and Google Scholar databases were searched using the Medical Subject Headings and terms related to dietary pattern and glycemic control in individuals with type 2 diabetes mellitus. Interventional studies with adults of this population without diabetes-related complications, presenting data on percentage of glycated hemoglobin, and dietary patterns were included. In vitro, animal, reviews, observational, and studies with children, adolescents, pregnant and breastfeeding women were excluded. The time of adoption dietary patterns ranged from eight weeks to four years in randomized clinical trials, and six months in the cohort study. Vegetarian, vegan, Mediterranean, and Dietary Approaches to Stop Hypertension dietary patterns reduced 0.8% on average of percentage of glycated hemoglobin, considering all included studies. It was also observed reduction in fasting glycemia and improvement in Homeostasis Model Assessment of Insulin Sensitivity. However, more randomized clinical trials are required for a full elucidation of these questions.
Topics: Blood Glucose; Diabetes Mellitus, Type 2; Diet; Glycated Hemoglobin; Humans; Insulin Resistance
PubMed: 31204492
DOI: 10.1080/10408398.2019.1624498 -
Appetite Jan 2020Meat consumption has been linked to some negative health and environmental outcomes. Studies have assessed motivations among those who have reduced or eliminated meat...
INTRODUCTION
Meat consumption has been linked to some negative health and environmental outcomes. Studies have assessed motivations among those who have reduced or eliminated meat consumption; less work identifies strategies to reduce meat consumption among those who consume meat. This paper describes factors associated with lower meat consumption and reviews experimental studies that targeted those factors to either change behavior or intention/willingness to reduce meat.
METHODS
A systematic review of the literature was conducted among four databases. Inclusion criteria were experimental and quasi-experimental designs and studies that measured variables indirectly or directly related to meat consumption.
RESULTS
Twenty-two articles were identified. These studies targeted factors such as knowledge and skills with informational provisions about health and the environment; values and attitudes concerning the relationship between social dominance and meat; evocation of emotion such as empathy and disgust; social norms both dynamic and growing; changes to the food environment with default vegan menu options, perceived behavioral control, and intentions. The majority of studies (n = 15) investigated the effects of providing information such as personal health effects of meat consumption. In general, increasing knowledge alone or when combined with other methods was shown to successfully reduce meat consumption behavior or intentions/willingness to eat meat. Evoking emotions with animal images and making changes to the environment proved effective.
DISCUSSION
Factors identified in correlational studies were generally found to be useful agents of behavior change in experimental studies. However, several factors have not been tested experimentally. More experimental studies are required to confirm the results of this review; for example, experiments focused on modifications of the food environment such as increasing the number of meatless meals on restaurant menus.
Topics: Adult; Choice Behavior; Clinical Trials as Topic; Consumer Behavior; Diet, Healthy; Diet, Vegetarian; Emotions; Feeding Behavior; Female; Health Knowledge, Attitudes, Practice; Humans; Male; Meat; Motivation
PubMed: 31563453
DOI: 10.1016/j.appet.2019.104478 -
Nutrients Aug 2021Vegetarian dietary patterns provide health benefits for cardiovascular health; however, the studies examining the association of vegetarian diets with stroke incidence... (Meta-Analysis)
Meta-Analysis
Vegetarian dietary patterns provide health benefits for cardiovascular health; however, the studies examining the association of vegetarian diets with stroke incidence showed inconsistent findings. We systematically evaluated the risk of incident stroke among vegetarians (diets excluding meat, poultry, fish, and seafood) compared among nonvegetarians. A systematic search of PubMed, EMBASE, Cochrane Library, and Web of Science was performed until 20 May 2021. Prospective cohort studies comparing the risk estimates for incident stroke between vegetarians and nonvegetarians were included. Of 398 articles identified in the database search, data from seven cohort studies (408 total stroke cases in 29,705 vegetarians and 13,026 total stroke cases in 627,728 nonvegetarians) were included. The meta-analysis revealed no significant association between adhering to the vegetarian dietary patterns and the risk of incident stroke (HR = 0.86; 95% CI = 0.67-1.11; I = 68%, = 7). Subgroup analyses suggested that studies conducted in Asia and those with a mean baseline age of participants 50-65 years showed a lower risk of stroke in vegetarians. Moreover, no significant association between vegetarian diets and the risk of ischemic stroke (HR = 0.56; 95% CI = 0.22-1.42; I = 82%, = 3) or hemorrhagic stroke (HR = 0.77; 95% CI = 0.19-3.09; I = 85%, = 2) was found. To be conclusive, no strong relationship between vegetarian diets and the incidence of stroke was observed. Given the limited certainty of evidence from NutriGrade, future well-designed studies are warranted to provide solid evidence on this topic.
Topics: Aged; Cohort Studies; Diet; Diet, Vegetarian; Female; Humans; Male; Middle Aged; Prospective Studies; Stroke; Vegetarians
PubMed: 34578897
DOI: 10.3390/nu13093019 -
Pain Medicine (Malden, Mass.) Mar 2021The standard Western diet is high in processed hyperpalatable foods that displace nutrient-dense whole foods, leading to inflammation and oxidative stress. There is... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The standard Western diet is high in processed hyperpalatable foods that displace nutrient-dense whole foods, leading to inflammation and oxidative stress. There is limited research on how these adverse metabolic drivers may be associated with maladaptive neuroplasticity seen in chronic pain and whether this could be attenuated by a targeted nutritional approach. The aim of this study was to review the evidence for whole-food dietary interventions in chronic pain management.
METHOD
A structured search of eight databases was performed up to December 2019. Two independent reviewers screened studies and evaluated risk of bias by using the National Institutes of Health assessment tool for controlled or pre-post studies and the Joanna Briggs checklist for case reports. A meta-analysis was performed in Review Manager.
RESULTS
Forty-three studies reporting on 48 chronic pain groups receiving a whole-food dietary intervention were identified. These included elimination protocols (n = 11), vegetarian/vegan diets (n = 11), single-food changes (n = 11), calorie/macronutrient restriction (n = 8), an omega-3 focus (n = 5), and Mediterranean diets (n = 2). A visual analog scale was the most commonly reported pain outcome measure, with 17 groups reporting a clinically objective improvement (a two-point or 33% reduction on the visual analog scale). Twenty-seven studies reported significant improvement on secondary metabolic measures. Twenty-five groups were included in a meta-analysis that showed a significant finding for the effect of diet on pain reduction when grouped by diet type or chronic pain type.
CONCLUSION
There is an overall positive effect of whole-food diets on pain, with no single diet standing out in effectiveness. This suggests that commonalities among approaches (e.g., diet quality, nutrient density, weight loss) may all be involved in modulating pain physiology. Further research linking how diet can modulate physiology related to pain (such as inflammation, oxidative stress, and nervous system excitability) is required.
Topics: Chronic Pain; Diet; Humans; United States
PubMed: 33202007
DOI: 10.1093/pm/pnaa378 -
Nutrients Nov 2021Excessive adiposity is a major risk factor for type 2 diabetes (T2D), and dietary patterns are important determinants of weight status. Plant-based dietary patterns... (Meta-Analysis)
Meta-Analysis
Excessive adiposity is a major risk factor for type 2 diabetes (T2D), and dietary patterns are important determinants of weight status. Plant-based dietary patterns (PBDs) are known for their therapeutic effects on T2D. The aim is to systematically review RCTs to investigate the effects of various PBDs compared to regular meat-eating diets (RMDs), in individuals who normally consume a RMD on body weight, BMI, and waist circumference in T2D. RCTs investigating PBDs and body weight, BMI, WC for ≥6 weeks in adults with T2D since 1980 were eligible for inclusion. Seven trials ( = 269) were included in the meta-analysis using random-effects models and expressed as MD (95%Cls). Compared to RMDs, PBDs significantly lowered body weight (-2.35 kg, 95% CI: -3.51, -1.19, < 0.001), BMI (-0.90 kg/m, 95% CI: -1.42, -0.38, = 0.001) and WC (-2.41 cm, 95% CI: -3.72, -1.09, < 0.001). PBDs alone significantly reduced body weight by 5.1% (-4.95 kg, 95% CI: -7.34, -2.55, < 0.001), BMI by 5.4% (-1.87 kg/m, 95% CI: -2.78, -0.95, < 0.001) and WC by 4.3%(-4.23, 95% CI: -6.38, -2.07, < 0.001). Interventions not limiting energy intake led to a significant reduction in body weight (-2.54 kg, 95% CI: -4.16, -0.92, < 0.005) and BMI (-0.91 kg/m, 95% CI: -1.56, -0.25, < 0.005). Trials ≥16 weeks had a pronounced reduction in body weight (-2.93 kg, 95% CI: -5.00, -0.87, = 0.005) and BMI (-1.13 kg/m, 95% CI: -1.89, -0.38, < 0.005). These findings provide evidence for the implementation of PBDs for better management of central adiposity in individuals with T2D.
Topics: Adiposity; Adult; Aged; Body Mass Index; Body Weight; Diabetes Mellitus, Type 2; Diet, Vegetarian; Female; Humans; Male; Middle Aged; Randomized Controlled Trials as Topic; Risk Factors; Waist Circumference
PubMed: 34836356
DOI: 10.3390/nu13114099 -
BMJ Open Diabetes Research & Care 2018Diet interventions have suggested an association between plant-based diets and improvements in psychological well-being, quality of life and glycated hemoglobin (HbA1c)...
Diet interventions have suggested an association between plant-based diets and improvements in psychological well-being, quality of life and glycated hemoglobin (HbA1c) control in populations with diabetes. The aims of this review are to systematically analyze the available literature on plant-based diet interventions targeting diabetes in adults and to clearly define the benefits on well-being of such interventions. This is a systematic review of controlled trials. A computerized systematic literature search was conducted in the following electronic databases: Allied and Complementary Medicine, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, E-Journals, Excerpta Medica Database, MEDLINE, Health Management Information Consortium, PsycARTICLES, PsycINFO, PubMed, SocINDEX and Web of Science. The search strategy retrieved 1240 articles, of which 11 met the inclusion criteria (n=433; mean sample age 54.8 years). Plant-based diets were associated with significant improvement in emotional well-being, physical well-being, depression, quality of life, general health, HbA1c levels, weight, total cholesterol and low-density lipoprotein cholesterol, compared with several diabetic associations' official guidelines and other comparator diets. Plant-based diets can significantly improve psychological health, quality of life, HbA1c levels and weight and therefore the management of diabetes.
PubMed: 30487971
DOI: 10.1136/bmjdrc-2018-000534