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Nutrients May 2020The beneficial effects of a vegetarian diet on blood pressure (BP) control have been reported in previous systematic reviews; however, so far, their relative... (Meta-Analysis)
Meta-Analysis
The beneficial effects of a vegetarian diet on blood pressure (BP) control have been reported in previous systematic reviews; however, so far, their relative effectiveness is not well established. Here, we performed a systematic review together with trial sequential analysis to determine the effect of a vegetarian diet on the reduction of blood pressure. We searched the randomized controlled trial (RCT) through Medline, PubMed and Cochrane Central Register. Fifteen eligible RCTs with 856 subjects were entered into the analysis. The pooled results demonstrated that vegetarian diet consumption significantly lowered the systolic blood pressure (weighted mean difference (WMD), -2.66 mmHg (95% confidence interval (CI) = -3.76, -1.55, < 0.001) and diastolic BP was WMD, -1.69 95% CI = -2.97, -0.41, < 0.001) as compared to an omnivorous diet. In subgroup analysis, a vegan diet demonstrated a greater reduction in systolic BP (WMD, -3.12 mm Hg; 95% CI = -4.54, -1.70, < 0.001) as compared with a lacto-ovo-vegetarian diet (WMD, -1.75 mm Hg, 95% CI -5.38, 1.88, = 0.05). The vegan diet has showed a similar trend in terms of diastolic blood pressure reduction (WMD, -1.92 mm Hg (95% CI = -3.18, -0.66, < 0.001) but those with a lacto-ovo-vegetarian diet showed no changes in diastolic BP reduction (WMD, 0.00, 95% CI = 0.00, 0.00), =0.432). In conclusion, vegetarian diets are associated with significant reductions in BP compared with omnivorous diets, suggesting that they may play a key role in the primary prevention and overall management of hypertension.
Topics: Blood Pressure; Diet, Vegetarian; Female; Humans; Hypertension; Male; Randomized Controlled Trials as Topic
PubMed: 32486102
DOI: 10.3390/nu12061604 -
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 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 -
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 -
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