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Nordic dietary patterns and cardiometabolic outcomes: a systematic review and meta-analysis of prospective cohort studies and randomised controlled trials
- Source :
- Massara, P, Zurbau, A, Glenn, A J, Chiavaroli, L, Khan, T A, Viguiliouk, E, Mejia, S B, Comelli, E M, Chen, V, Schwab, U, Risérus, U, Uusitupa, M, Aas, A-M, Hermansen, K, Thorsdottir, I, Rahelić, D, Kahleová, H, Salas-Salvadó, J, Kendall, C W C & Sievenpiper, J L 2022, ' Nordic dietary patterns and cardiometabolic outcomes : a systematic review and meta-analysis of prospective cohort studies and randomised controlled trials ', Diabetologia . https://doi.org/10.1007/s00125-022-05760-z, Massara, P, Zurbau, A, Glenn, A J, Chiavaroli, L, Khan, T A, Viguiliouk, E, Mejia, S B, Comelli, E M, Chen, V, Schwab, U, Risérus, U, Uusitupa, M, Aas, A M, Hermansen, K, Thorsdottir, I, Rahelić, D, Kahleová, H, Salas-Salvadó, J, Kendall, C W C & Sievenpiper, J L 2022, ' Nordic dietary patterns and cardiometabolic outcomes : a systematic review and meta-analysis of prospective cohort studies and randomised controlled trials ', Diabetologia, vol. 65, no. 12, pp. 2011-2031 . https://doi.org/10.1007/s00125-022-05760-z
- Publication Year :
- 2022
- Publisher :
- Springer Science and Business Media LLC, 2022.
-
Abstract
- Aims/hypothesis Nordic dietary patterns that are high in healthy traditional Nordic foods may have a role in the prevention and management of diabetes. To inform the update of the EASD clinical practice guidelines for nutrition therapy, we conducted a systematic review and meta-analysis of Nordic dietary patterns and cardiometabolic outcomes. Methods We searched MEDLINE, EMBASE and The Cochrane Library from inception to 9 March 2021. We included prospective cohort studies and RCTs with a follow-up of ≥1 year and ≥3 weeks, respectively. Two independent reviewers extracted relevant data and assessed the risk of bias (Newcastle–Ottawa Scale and Cochrane risk of bias tool). The primary outcome was total CVD incidence in the prospective cohort studies and LDL-cholesterol in the RCTs. Secondary outcomes in the prospective cohort studies were CVD mortality, CHD incidence and mortality, stroke incidence and mortality, and type 2 diabetes incidence; in the RCTs, secondary outcomes were other established lipid targets (non-HDL-cholesterol, apolipoprotein B, HDL-cholesterol, triglycerides), markers of glycaemic control (HbA1c, fasting glucose, fasting insulin), adiposity (body weight, BMI, waist circumference) and inflammation (C-reactive protein), and blood pressure (systolic and diastolic blood pressure). The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach was used to assess the certainty of the evidence. Results We included 15 unique prospective cohort studies (n=1,057,176, with 41,708 cardiovascular events and 13,121 diabetes cases) of people with diabetes for the assessment of cardiovascular outcomes or people without diabetes for the assessment of diabetes incidence, and six RCTs (n=717) in people with one or more risk factor for diabetes. In the prospective cohort studies, higher adherence to Nordic dietary patterns was associated with ‘small important’ reductions in the primary outcome, total CVD incidence (RR for highest vs lowest adherence: 0.93 [95% CI 0.88, 0.99], p=0.01; substantial heterogeneity: I2=88%, pQpp<0.05). No studies assessed CHD or stroke mortality. In the RCTs, there were small important reductions in LDL-cholesterol (mean difference [MD] −0.26 mmol/l [95% CI −0.52, −0.00], pMD=0.05; substantial heterogeneity: I2=89%, pQp<0.05). For the other outcomes there were ‘trivial’ reductions or no effect. The certainty of the evidence was low for total CVD incidence and LDL-cholesterol; moderate to high for CVD mortality, established lipid targets, adiposity markers, glycaemic control, blood pressure and inflammation; and low for all other outcomes, with evidence being downgraded mainly because of imprecision and inconsistency. Conclusions/interpretation Adherence to Nordic dietary patterns is associated with generally small important reductions in the risk of major CVD outcomes and diabetes, which are supported by similar reductions in LDL-cholesterol and other intermediate cardiometabolic risk factors. The available evidence provides a generally good indication of the likely benefits of Nordic dietary patterns in people with or at risk for diabetes. Registration ClinicalTrials.gov NCT04094194. Funding Diabetes and Nutrition Study Group of the EASD Clinical Practice. Graphical abstract
- Subjects :
- Randomised controlled trial
Inflammation
Nutrition and Dietetics
Nordic diet
Endocrinology, Diabetes and Metabolism
Cholesterol, HDL
Body Weight
Insulins
Cholesterol, LDL
Prospective cohort
Cardiovascular disease
Näringslära
Stroke
Meta-analysis
Cholesterol
Apolipoproteins
Diabetes Mellitus, Type 2
Cardiovascular Diseases
Systematic review
Internal Medicine
Humans
Prospective Studies
Obesity
Randomized Controlled Trials as Topic
Subjects
Details
- ISSN :
- 14320428 and 0012186X
- Volume :
- 65
- Database :
- OpenAIRE
- Journal :
- Diabetologia
- Accession number :
- edsair.doi.dedup.....6b41e220961a73fa43374b6d44cc815d