Jarvis C. Noronha, Stephanie K. Nishi, Tauseef A. Khan, Sonia Blanco Mejia, Cyril W. C. Kendall, Hana Kahleová, Dario Rahelić, Jordi Salas-Salvadó, Lawrence A. Leiter, Michael E. J. Lean, John L. Sievenpiper
This review synthesized the evidence from randomized controlled trials comparing the effect of meal replacements (MRs) as part of a weight loss intervention with conventional food-based weight loss diets on cardiometabolic risk in individuals with pre-diabetes and features of metabolic syndrome. MEDLINE, EMBASE, and Cochrane Library were searched through January 16, 2024. Data were pooled using the generic inverse variance method and expressed as mean difference [95% confidence intervals]. The overall certainty of the evidence was assessed using GRADE. Ten trials (n = 1254) met the eligibility criteria. MRs led to greater reductions in body weight (−1.38 kg [−1.81, −0.95]), body mass index (BMI, −0.56 kg/m2 [−0.78, −0.34]), waist circumference (−1.17 cm [−1.93, −0.41]), HbA1c (−0.11% [−0.22, 0.00]), LDL-c (−0.18 mmol/L [−0.28, −0.08]), non-HDL-c (−0.17 mmol/L [−0.33, −0.01]), and systolic blood pressure (−2.22 mmHg [−4.20, −0.23]). The overall certainty of the evidence was low to moderate owing to imprecision and/or inconsistency. The available evidence suggests that incorporating MRs into a weight loss intervention leads to small important reductions in body weight, BMI, LDL-c, non-HDL-c, and systolic blood pressure, and trivial reductions in waist circumference and HbA1c, beyond that seen with conventional food-based weight loss diets.
{"title":"Weight management using meal replacements and cardiometabolic risk reduction in individuals with pre-diabetes and features of metabolic syndrome: A systematic review and meta-analysis of randomized controlled trials","authors":"Jarvis C. Noronha, Stephanie K. Nishi, Tauseef A. Khan, Sonia Blanco Mejia, Cyril W. C. Kendall, Hana Kahleová, Dario Rahelić, Jordi Salas-Salvadó, Lawrence A. Leiter, Michael E. J. Lean, John L. Sievenpiper","doi":"10.1111/obr.13751","DOIUrl":"10.1111/obr.13751","url":null,"abstract":"<p>This review synthesized the evidence from randomized controlled trials comparing the effect of meal replacements (MRs) as part of a weight loss intervention with conventional food-based weight loss diets on cardiometabolic risk in individuals with pre-diabetes and features of metabolic syndrome. MEDLINE, EMBASE, and Cochrane Library were searched through January 16, 2024. Data were pooled using the generic inverse variance method and expressed as mean difference [95% confidence intervals]. The overall certainty of the evidence was assessed using GRADE. Ten trials (<i>n</i> = 1254) met the eligibility criteria. MRs led to greater reductions in body weight (−1.38 kg [−1.81, −0.95]), body mass index (BMI, −0.56 kg/m<sup>2</sup> [−0.78, −0.34]), waist circumference (−1.17 cm [−1.93, −0.41]), HbA<sub>1c</sub> (−0.11% [−0.22, 0.00]), LDL-c (−0.18 mmol/L [−0.28, −0.08]), non-HDL-c (−0.17 mmol/L [−0.33, −0.01]), and systolic blood pressure (−2.22 mmHg [−4.20, −0.23]). The overall certainty of the evidence was low to moderate owing to imprecision and/or inconsistency. The available evidence suggests that incorporating MRs into a weight loss intervention leads to small important reductions in body weight, BMI, LDL-c, non-HDL-c, and systolic blood pressure, and trivial reductions in waist circumference and HbA<sub>1c</sub>, beyond that seen with conventional food-based weight loss diets.</p>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":null,"pages":null},"PeriodicalIF":8.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/obr.13751","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140833741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giang Nguyen, Zoë Bell, Gemma Andreae, Stephanie Scott, Letitia Sermin-Reed, Amelia A. Lake, Nicola Heslehurst
Food insecurity is a well-established obesity driver. Less is known about food insecurity during pregnancy. This review (PROSPERO:CRD42022311669) aimed to explore associations between food insecurity, maternal obesity, gestational weight gain (GWG), and nutrition. Searches included seven databases, gray literature, references, citations, and contacting authors. Observational studies reporting data from January 1st, 2008 to 21 November 2023 in high-income countries were included. Duplicate screening, data extraction, and quality assessments were performed. Random effects meta-analysis estimated odds ratios (OR), mean difference (MD), and 95% confidence intervals (CI). Narrative synthesis was conducted when data could not be pooled. Database searches identified 22,272 results; 20 studies were included (n = 19 North America, n = 1 Europe; n = 32,803 women). Food insecurity significantly increased obesity (OR 1.53 95%CI 1.39, 1.66), but not underweight (OR 1.12 95%CI 0.89, 1.34) or overweight (OR 1.18 95%CI 0.90, 1.46). Food insecurity significantly reduced GWG (MD -0.42 kg 95%CI -0.62, −0.22) and increased inadequate GWG (OR 1.16 95%CI 1.05, 1.28), but not excessive GWG (OR 1.04 95%CI 0.96, 1.13). Diet outcomes were inconsistent, with some evidence of reduced vitamin E and diet quality and increased red/processed meat consumption. Further studies outside of North America are needed to inform practice and policy to support maternal health.
{"title":"Food insecurity during pregnancy in high-income countries, and maternal weight and diet: A systematic review and meta-analysis","authors":"Giang Nguyen, Zoë Bell, Gemma Andreae, Stephanie Scott, Letitia Sermin-Reed, Amelia A. Lake, Nicola Heslehurst","doi":"10.1111/obr.13753","DOIUrl":"10.1111/obr.13753","url":null,"abstract":"<p>Food insecurity is a well-established obesity driver. Less is known about food insecurity during pregnancy. This review (PROSPERO:CRD42022311669) aimed to explore associations between food insecurity, maternal obesity, gestational weight gain (GWG), and nutrition. Searches included seven databases, gray literature, references, citations, and contacting authors. Observational studies reporting data from January 1st, 2008 to 21 November 2023 in high-income countries were included. Duplicate screening, data extraction, and quality assessments were performed. Random effects meta-analysis estimated odds ratios (OR), mean difference (MD), and 95% confidence intervals (CI). Narrative synthesis was conducted when data could not be pooled. Database searches identified 22,272 results; 20 studies were included (n = 19 North America, n = 1 Europe; n = 32,803 women). Food insecurity significantly increased obesity (OR 1.53 95%CI 1.39, 1.66), but not underweight (OR 1.12 95%CI 0.89, 1.34) or overweight (OR 1.18 95%CI 0.90, 1.46). Food insecurity significantly reduced GWG (MD -0.42 kg 95%CI -0.62, −0.22) and increased inadequate GWG (OR 1.16 95%CI 1.05, 1.28), but not excessive GWG (OR 1.04 95%CI 0.96, 1.13). Diet outcomes were inconsistent, with some evidence of reduced vitamin E and diet quality and increased red/processed meat consumption. Further studies outside of North America are needed to inform practice and policy to support maternal health.</p>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":null,"pages":null},"PeriodicalIF":8.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/obr.13753","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140833639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}