scholarly journals DASH Dietary Pattern and Cardiometabolic Outcomes: An Umbrella Review of Systematic Reviews and Meta-Analyses

Nutrients ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 338 ◽  
Author(s):  
Laura Chiavaroli ◽  
Effie Viguiliouk ◽  
Stephanie Nishi ◽  
Sonia Blanco Mejia ◽  
Dario Rahelić ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Cohort Studies ◽  
Systematic Reviews ◽  
Dietary Pattern ◽  
Prospective Cohort ◽  
Cardiometabolic Risk ◽  
Controlled Trials ◽  
Prospective Cohort Studies ◽  
Meta Analyses

Background: The Dietary Approaches to Stop Hypertension (DASH) dietary pattern, which emphasizes fruit, vegetables, fat-free/low-fat dairy, whole grains, nuts and legumes, and limits saturated fat, cholesterol, red and processed meats, sweets, added sugars, salt and sugar-sweetened beverages, is widely recommended by international diabetes and heart association guidelines. Objective: To summarize the available evidence for the update of the European Association of the Study of Diabetes (EASD) guidelines, we conducted an umbrella review of existing systematic reviews and meta-analyses using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach of the relation of the DASH dietary pattern with cardiovascular disease and other cardiometabolic outcomes in prospective cohort studies and its effect on blood pressure and other cardiometabolic risk factors in controlled trials in individuals with and without diabetes. Methods: MEDLINE and EMBASE were searched through 3 January 2019. We included systematic reviews and meta-analyses assessing the relation of the DASH dietary pattern with cardiometabolic disease outcomes in prospective cohort studies and the effect on cardiometabolic risk factors in randomized and non-randomized controlled trials. Two independent reviewers extracted relevant data and assessed the risk of bias of individual studies. The primary outcome was incident cardiovascular disease (CVD) in the prospective cohort studies and systolic blood pressure in the controlled trials. Secondary outcomes included incident coronary heart disease, stroke, and diabetes in prospective cohort studies and other established cardiometabolic risk factors in controlled trials. If the search did not identify an existing systematic review and meta-analysis on a pre-specified outcome, then we conducted our own systematic review and meta-analysis. The evidence was summarized as risk ratios (RR) for disease incidence outcomes and mean differences (MDs) for risk factor outcomes with 95% confidence intervals (95% CIs). The certainty of the evidence was assessed using GRADE. Results: We identified three systematic reviews and meta-analyses of 15 unique prospective cohort studies (n = 942,140) and four systematic reviews and meta-analyses of 31 unique controlled trials (n = 4,414) across outcomes. We conducted our own systematic review and meta-analysis of 2 controlled trials (n = 65) for HbA1c. The DASH dietary pattern was associated with decreased incident cardiovascular disease (RR, 0.80 (0.76–0.85)), coronary heart disease (0.79 (0.71–0.88)), stroke (0.81 (0.72–0.92)), and diabetes (0.82 (0.74–0.92)) in prospective cohort studies and decreased systolic (MD, −5.2 mmHg (95% CI, −7.0 to −3.4)) and diastolic (−2.60 mmHg (−3.50 to −1.70)) blood pressure, Total-C (−0.20 mmol/L (−0.31 to −0.10)), LDL-C (−0.10 mmol/L (−0.20 to −0.01)), HbA1c (−0.53% (−0.62, −0.43)), fasting blood insulin (−0.15 μU/mL (−0.22 to −0.08)), and body weight (−1.42 kg (−2.03 to −0.82)) in controlled trials. There was no effect on HDL-C, triglycerides, fasting blood glucose, HOMA-IR, or CRP. The certainty of the evidence was moderate for SBP and low for CVD incidence and ranged from very low to moderate for the secondary outcomes. Conclusions: Current evidence allows for the conclusion that the DASH dietary pattern is associated with decreased incidence of cardiovascular disease and improves blood pressure with evidence of other cardiometabolic advantages in people with and without diabetes. More research is needed to improve the certainty of the estimates.

Vegetarian Diets with Cardiovascular Disease Outcomes: A Systematic Review and Meta-Analyses of Prospective Cohort Studies

2018 ◽  
Vol 42 (5) ◽  
pp. S20
Author(s):  
Andrea Glenn ◽  
Effie Viguiliouk ◽  
Maxine Seider ◽  
Sonia Blanco Mejia ◽  
Cyril Kendall ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Cohort Studies ◽  
Prospective Cohort ◽  
Prospective Cohort Studies ◽  
Disease Outcomes ◽  
Vegetarian Diets ◽  
Meta Analyses

scholarly journals Plant-Based Dietary Patterns and Cardiometabolic Risk: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 416-416
Author(s):  
Sarah Jarvis ◽  
Maria Tinajero ◽  
Tauseef Khan ◽  
Anthony Hanley ◽  
David Jenkins ◽  
...  
Keyword(s):  
Cohort Studies ◽  
Dose Response ◽  
Prospective Cohort ◽  
Fixed Effects ◽  
Cardiometabolic Risk ◽  
Risk Of Bias ◽  
Cardiometabolic Health ◽  
Inverse Association ◽  
Prospective Cohort Studies ◽  
Meta Analyses

Abstract Objectives Plant-based diets defined by limited animal food consumption have been extensively associated with cardiometabolic health benefits in Western nations. Diet indices are increasingly used to distinguish the protective characteristics of a plant-based diet at different levels of adherence. We aimed to synthesize evidence on the association between adherence to plant-based diet indices and cardiometabolic risk. A plant-based diet index (PDI) is hypothesized to be inversely associated with type 2 diabetes (T2D) and cardiovascular disease (CVD) with a stronger association with the healthful index (hPDI) that emphasizes higher quality plant-based foods. Methods We systematically searched MEDLINE, EMBASE and CINAHL databases through January 2021. Prospective cohort studies assessing the association of plant-based diet indices with T2D and CVD in adults were included and appraised for risk of bias and quality (NutriGrade). We followed the PRISMA-P, Cochrane and MOOSE guidelines. Random and fixed-effects meta-analyses were conducted to pool risk ratios (RR) of extreme quantiles. Dose-response meta-analyses were conducted after harmonizing all diet index scores. I2-values of 30–60%, 50–90%, and 75–100% denoted moderate, substantial, and considerable heterogeneity respectively. Results We included a total of 10 studies from 5927 retrievals. Across 6 studies there were 22 135 cases of T2D over 4 817 308 person-years. Across 7 studies there were 15 077 cases of CVD over 6 117 016 person-years. The PDI was associated with a lower risk of T2D (RR = 0.82, 95% CI [0.75, 0.91], I2 = 55.4%), and CVD (RR = 0.88, 95% CI [0.8, 0.96], I2 = 16.2%). The hPDI had a stronger inverse association with T2D (RR = 0.73, 95% CI [0.68, 0.77], I2 = 84.3%) and CVD (RR = 0.8, 95% CI [0.77, 0.88], I2 = 55.9%). All dose-response relationships were linear (except hPDI with CVD). All studies had acceptable risk of bias and the quality of evidence was moderate. Conclusions Adherence to a plant-based diet was inversely associated with T2D and CVD with a stronger association for a healthful plant-based diet pattern. Since highest quantiles of the index still included moderate meat consumption, linear dose-responses emphasized potential benefits on risk of T2D and CVD with any incremental progression towards a plant-based diet. Funding Sources Nora Martin Fellowship, Ontario Graduate Scholarship.

scholarly journals Intake of Fish and Marine n-3 Polyunsaturated Fatty Acids and Risk of Cardiovascular Disease Mortality: A Meta-Analysis of Prospective Cohort Studies

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2342
Author(s):  
Lan Jiang ◽  
Jinyu Wang ◽  
Ke Xiong ◽  
Lei Xu ◽  
Bo Zhang ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Fatty Acids ◽  
Polyunsaturated Fatty Acids ◽  
Cohort Studies ◽  
Mortality Risk ◽  
Prospective Cohort ◽  
Meta Analysis ◽  
Pufa Intake ◽  
Prospective Cohort Studies ◽  
Cvd Mortality

Previous epidemiological studies have investigated the association of fish and marine n-3 polyunsaturated fatty acids (n-3 PUFA) consumption with cardiovascular disease (CVD) mortality risk. However, the results were inconsistent. The purpose of this meta-analysis is to quantitatively evaluate the association between marine n-3 PUFA, fish and CVD mortality risk with prospective cohort studies. A systematic search was performed on PubMed, Web of Science, Embase and MEDLINE databases from the establishment of the database to May 2021. A total of 25 cohort studies were included with 2,027,512 participants and 103,734 CVD deaths. The results indicated that the fish consumption was inversely associated with the CVD mortality risk [relevant risk (RR) = 0.91; 95% confidence intervals (CI) 0.85−0.98]. The higher marine n-3 PUFA intake was associated with the reduced risk of CVD mortality (RR = 0.87; 95% CI: 0.85–0.89). Dose-response analysis suggested that the risk of CVD mortality was decreased by 4% with an increase of 20 g of fish intake (RR = 0.96; 95% CI: 0.94–0.99) or 80 milligrams of marine n-3 PUFA intake (RR = 0.96; 95% CI: 0.94–0.98) per day. The current work provides evidence that the intake of fish and marine n-3 PUFA are inversely associated with the risk of CVD mortality.

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