Advances in Nutrition最新文献_第2页

Seafood Toxicant Exposure During Pregnancy, Lactation, and Childhood and Child Outcomes: A Scoping Review 妊娠期、哺乳期和儿童期的海产品毒物暴露：范围综述。

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2025-01-01 DOI: 10.1016/j.advnut.2024.100353

Rupal Trivedi , Maureen K Spill , Sanjoy Saha , Rachel C Thoerig , Julie S Davis , Amanda J MacFarlane

Determining dietary recommendations for seafood consumed during pregnancy, lactation, and childhood requires consideration of the known nutritional benefits and potential harm due to toxicant exposure as they relate to child outcomes. This study aimed to describe the scope of the evidence associated with seafood-related toxicant exposure and child outcomes and to identify toxicant–outcome pairs that may have sufficient evidence to conduct a systematic review. We included studies examining seafood toxicant exposure during pregnancy, lactation, and childhood, and child outcomes. In total, 81 studies were included: 69 studies on exposure during pregnancy and lactation and 14 on exposure during childhood. The number of studies varied by toxicant and exposure population (maternal; child): mercury (n = 49; 7), methylmercury (n = 13; 3), polychlorinated biphenyls (PCBs; n = 11; 1), selenium (n = 11; 1), lead (n = 9; 3), perfluoroalkyl and polyfluoroalkyl substances (n = 8; 2), dichlorodiphenyltrichloroethane (n = 5; 1), arsenic (n = 4; 4), cadmium (n = 4; 4), zinc (n = 3; 2), polybrominated diphenyl ethers (n = 3; 1), dioxin-like compounds (n = 3; 0), iron (n = 2; 1), and magnesium (n = 1; 1). No studies examined polybrominated biphenyls, polycyclic aromatic hydrocarbons, iodine, aldrin, dieldrin, chlordane, chlorpyrifos, or microplastic exposures. Outcomes also varied by exposure population (maternal;child): neurodevelopment (n = 35; 9), child exposure biomarkers (n = 22; 4), growth (n = 17; 1), other adverse events (n = 4; 0), cardiometabolic (n = 3; 2), chronic disease indicators (n = 2; 0), and immune-related (n = 1; 2). Twelve maternal toxicant–outcome pairs had ≥3 studies, including mercury, methylmercury, lead, PCBs, perfluoroalkyl and polyfluoroalkyl substances, and arsenic as exposures and neurodevelopment, child exposure biomarkers, growth, and cardiometabolic as outcomes. For child exposure, only mercury and neurodevelopment had ≥3 studies. In conclusion, this scoping review shows relevant evidence for 14 of the 22 toxicants. Only 12 maternal and 1 child toxicant–outcome pairs, the majority of which examined maternal (methyl)mercury exposure, had ≥3 studies, our cutoff for consideration for systematic review. This scoping review indicates a paucity of research examining seafood toxicants beyond mercury and exposure during childhood. Systematic reviews are required to evaluate the associations for each toxicant–outcome pairs.

The protocol was registered at Open Science Framework (https://doi.org/10.17605/OSF.IO/FQZTA).

背景：确定孕期、哺乳期和儿童期食用海鲜的膳食建议，需要考虑已知的营养益处和有毒物质暴露对儿童结局的潜在危害。目的：描述与海鲜相关毒物暴露和儿童结果相关的证据范围，并确定可能有足够证据进行系统审查的毒物-结果对。方法：我们纳入了有关怀孕、哺乳期和儿童期海鲜毒物暴露和儿童结局的研究。结果：纳入81项研究；70项关于孕期和哺乳期暴露的研究14项关于儿童期暴露的研究。研究的数量因毒物和接触人群（母亲；儿童）而异：汞（n=49;7）、甲基汞（n=14;2）、多氯联苯(PCBs；n=11;1)、硒（n=11;1）、铅（n=9;3）、全氟烷基和多氟烷基物质(PFAS/PFCs；N =8;2)、二氯二苯三氯乙烷（N =5;1）、砷（N =4;4）、镉（N =4;4）、锌（N =3;2）、多溴二苯醚（N =3;1）、类二恶英化合物（N =3;0）、铁（N =2;1）和镁（N =1;1）。没有研究检查多溴联苯、多环芳烃、碘、艾氏剂、狄氏剂、氯丹、毒死蜱或微塑料暴露。结果也因暴露人群（母亲；儿童）而异：神经发育（n=35;9）、儿童暴露生物标志物（n=23;4）、生长（n=17;1）、其他不良事件（n=4;0）、心脏代谢（n=3;2）、慢性疾病指标（n=2;0）和免疫相关（n=1;2）。12个母体毒物结局对有≥3个研究，包括汞、甲基汞、铅、多氯联苯、PFAS/PFCs和砷作为暴露，以及神经发育、儿童暴露生物标志物、生长和心脏代谢作为结果。对于儿童暴露，只有汞和神经发育有≥3项研究。结论：本次范围审查确定了22种毒物中14种的相关证据。只有12个母体和1个儿童毒性结局对，其中大多数检查母体（甲基）汞暴露，有≥3个研究，我们的截止值用于系统评价。这一范围审查表明，对汞以外的海产品毒物和儿童接触的研究很少。需要进行系统评价，以评估每个毒物-结果对之间的关联。注册和注册编号：该方案已在开放科学框架（https://doi.org/10.17605/OSF.IO/FQZTA）.Statement)中注册，具有重要意义：对于妊娠或哺乳期暴露，12个毒性结局对有≥3个研究；然而，对于儿童时期海鲜毒物暴露，只有1个毒物结局对有≥3项研究。数量有限的毒物结局对有足够的证据进行系统评价。

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引用次数: 0

Dietary Polyphenols as Potential Therapeutic Agents in Type 2 Diabetes Management: Advances and Opportunities 膳食多酚作为治疗 2 型糖尿病的潜在药物：进展与机遇。

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2025-01-01 DOI: 10.1016/j.advnut.2024.100346

Sisir Kumar Barik , Srabasti Sengupta , Rakesh Arya , Surendra Kumar , Jong Joo Kim , Reetika Chaurasia

Poor dietary intake or unhealthy lifestyle contributes to various health disorders, including postprandial hyperglycemia, leading to type 2 diabetes mellitus (T2DM). Reduction of postprandial glucose concentrations through diet is a key strategy for preventing and managing T2DM. Thus, it is essential to understand how dietary components affect glycemic regulation. Dietary polyphenols (DPs), such as anthocyanins and other phenolics found in various fruits and vegetables, are often recommended for their potential health benefits, although their systemic effectiveness is subject to ongoing debate. Therefore, this review assesses the current and historical evidence of DPs bioactivities, which regulate crucial metabolic markers to lower postprandial hyperglycemia. Significant bioactivities such as modulation of glucose transporters, activation of AMP kinase, and regulation of incretins are discussed, along with prospects for diet-induced therapeutics to prevent the onset of T2DM.

不良的饮食摄入或不健康的生活方式会导致各种健康问题，包括餐后高血糖，从而引发 2 型糖尿病（T2DM）。通过饮食降低餐后血糖水平是预防和控制 T2DM 的关键策略。因此，了解膳食成分如何影响血糖调节至关重要。膳食多酚（DPs），如各种水果和蔬菜中的花青素和其他酚类物质，因其潜在的健康益处而经常被推荐使用，但其系统有效性仍存在争议。因此，本综述评估了 DPs 生物活性的当前和历史证据，这些生物活性可调节关键的代谢指标，从而降低餐后高血糖。本文讨论了葡萄糖转运体的调节、5'单磷酸腺苷激活蛋白激酶（AMPK）的激活和增量蛋白的调节等重要的生物活性，以及饮食诱导疗法预防 T2DM 发病的前景。意义说明：这篇综述独特地综合了有关膳食多酚（DPs）代谢生物活性的当前和历史数据，尤其侧重于其机制，如葡萄糖转运体调节、AMPK 激活和增量蛋白调节，这可能有助于降低餐后高血糖，从而为膳食诱导的 T2DM 预防策略提供更全面的理解。

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引用次数: 0

Are We What We Breathe? Rethinking Air as a Nutritional Source 我们就是我们呼吸的东西吗？重新思考空气作为一种营养来源。

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2025-01-01 DOI: 10.1016/j.advnut.2024.100360

Jean Debédat

引用次数: 0

Associations Between Maternal Polychlorinated Biphenyls (PCBs) Exposure from Seafood Consumption during Pregnancy and Lactation and Child Growth: A Systematic Review and Meta-Analysis 孕期和哺乳期食用海产品中母体多氯联苯（PCBs）暴露与儿童发育的关系：一项系统综述和荟萃分析

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2025-01-01 DOI: 10.1016/j.advnut.2024.100350

Arin A Balalian , Maureen K Spill , Rachel C Thoerig , Rupal Trivedi , Sanjoy Saha , Margaret J Foster , Amanda J MacFarlane

Beyond its nutritional benefits, seafood is a source of toxicant exposure including polychlorinated biphenyls (PCB). The association of PCB exposure from seafood intake during pregnancy and/or lactation (PL) and child growth outcomes is uncertain. This systematic review investigated the evidence and quantified the association between PCB exposure during PL from seafood intake and child growth outcomes. Embase, PubMed, and CENTRAL databases were searched from their inception for peer-reviewed English articles. Records were screened independently by 2 researchers at title and abstract, and then full-text levels. Studies were included if they: 1) were conducted in a country with a high Human Development Index, 2) measured maternal PCB exposure directly, 3) assessed the relationship between PCB and seafood exposures or PCB or seafood associations with a child growth outcome, and 4) were randomized or nonrandomized interventions, cohort, or nested case-control studies. Pooled partial correlations (r_p) were calculated using random-effects models for studies with sufficient data and narratively for the remaining studies. Cochrane ROBINS-E and GRADE tools were used to assess risk of bias and certainty of evidence, respectively. Child growth outcomes included birthweight, birth length, head and chest circumference at birth, and small for gestational age (SGA). Seven studies were included. PCB exposure during PL was weakly but significantly associated with lower birthweight [r_p = −0.07; 95% confidence interval (CI): −0.12, −0.02; n = 5], but showed no association with birth length (r_p = −0.04; 95% CI: −0.09, 0.02; n = 4) and head circumference (r_p = −0.03, 95% CI: −0.09, 0.03; n = 3). Studies on SGA and chest circumference yielded inconclusive results. The certainty of the evidence was low or very low because of the risk of bias from confounding, missing data, and exposure misclassification. The evidence suggests minimal to no link between PCB exposure from seafood during PL on child growth outcomes but with low to very low certainty.

This trial was registered at PROSPERO as CRD42023493302.

背景：除了营养价值，海鲜也是包括多氯联苯（PCB）在内的有毒物质暴露的来源。妊娠期和/或哺乳期（PL）海鲜摄入中多氯联苯暴露与儿童生长结局的关系尚不确定。目的：本系统综述调查了证据并量化了多氯联苯暴露与儿童生长结局之间的关系。方法：从Embase、PubMed和CENTRAL数据库开始检索同行评议的英文文章。记录由两位研究人员在标题和摘要，然后全文水平上独立筛选。如果研究是在人类发展指数高的国家进行的，ii)直接测量母体多氯联苯暴露，iii)评估多氯联苯和海产品暴露之间的关系，或多氯联苯或海产品与儿童生长结局的关联，iv)随机或非随机干预、队列或嵌套病例对照研究，则纳入研究。对于有足够数据的研究，采用随机效应模型计算合并偏相关性（rp），其余研究采用叙述性方法。使用Cochrane ROBINS-E和GRADE工具分别评估偏倚风险和证据确定性。儿童生长结局包括出生体重、出生长度、出生时头围和胸围以及小于胎龄（SGA）。结果：纳入7项研究。分娩期间多氯联苯暴露与较低出生体重有微弱但显著的相关性(rp =-0.07；95%ci: -0.12, -0.02；N =5)，但与出生长度无关(rp=-0.04；95%ci: -0.09, 0.02；n=4)和头围(rp=-0.03, 95%CI: -0.09, 0.03；n = 3)。对SGA和胸围的研究结果不确定。由于混杂、数据缺失和暴露错误分类的偏倚风险，证据的确定性很低或很低。结论：有证据表明，在PL期间从海鲜中接触多氯联苯与儿童生长结果之间的联系很小或没有联系，但确定性很低或很低。系统评价或荟萃分析的注册中心和注册编号。该系统评价方案已在PROSPERO注册（CRD42023493302）。

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引用次数: 0

Introducing Two New Prestigious Awards to Advance Nutrition & Obesity Science

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2025-01-01 DOI: 10.1016/j.advnut.2025.100369

Paul Coates PhD (Chair) , Arne Astrup MD, DMSc (Senior Vice President) , Sarah Booth PhD (President)

引用次数: 0

Nine Myths about Enteral Feeding in Critically Ill Adults: An Expert Perspective 重症成人肠内喂养的九大误区：专家视角。

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2025-01-01 DOI: 10.1016/j.advnut.2024.100345

Tara Ramaswamy , Michael P DeWane , Hassan S Dashti , Meghan Lau , Paul E Wischmeyer , Alexander Nagrebetsky , Jamie Sparling

Malnutrition is a well-studied and significant prognostic risk factor for morbidity and mortality in critically ill perioperative patients. Common nutrition myths in the critically ill may prevent early, consistent, and adequate delivery of enteral nutrition. We outlined 9 common intensive care unit (ICU) nutrition misconceptions and our recommendations to optimize enteral nutrition in critically ill patients based on the review of available literature. Our approach is to treat every patient admitted to the ICU as at risk for malnutrition and to initiate enteral nutrition upon admission in the absence of contraindications. Early enteral nutrition via the gastric route is more beneficial than delaying feeding while awaiting small bowel access and daytime-intermittent nutrition support can safely be initiated over continuous feeding. Gastric residual volumes to assess feeding tolerance should no longer be routinely measured. For perioperative nutrition, we recommend continuing enteral nutrition for most patients with secure airways undergoing anesthesia and resuming nutrition within 24 h of abdominal surgery; even patients with open abdomens can be safely fed in the absence of bowel injury. Critically ill patients who are proned, paralyzed, and on vasopressors can usually continue enteral nutrition. Finally, continuing enteral nutrition before extubation may optimize nutrition without compromising extubation success. In this review, we highlight several common misconceptions regarding ICU nutrition that may prevent achieving nutrition goals and subsequently lead to increased malnutrition, morbidity, and mortality. This knowledge may contribute to increased implementation of early and consistent enteral nutrition strategies to improve outcomes in critically ill adult patients.

重要性：营养不良是经过充分研究的危重病人围手术期发病率和死亡率的重要预后风险因素。重症患者常见的营养误区可能会阻碍肠内营养的早期、持续和充分供给：我们概述了九种常见的重症监护病房（ICU）营养误区，并根据现有文献综述提出了优化重症患者肠内营养的建议。我们的方法是将每一位入住重症监护病房的患者都视为有营养不良风险的患者，并在无禁忌症的情况下在患者入院时即开始肠内营养。在等待小肠通路期间，尽早通过胃途径进行肠内营养比延迟喂食更有益，而且日间间歇性营养支持比持续喂食更安全。评估进食耐受性的胃剩余容积不应再作为常规测量方法。对于围手术期营养，我们建议大多数呼吸道安全的麻醉患者继续使用肠内营养，并在腹部手术后 24 小时内恢复营养；即使是开腹患者，在没有肠道损伤的情况下也可以安全进食。处于代偿期、瘫痪和使用血管加压剂的重症患者通常可以继续接受肠内营养。最后，在拔管前继续进行肠内营养可在不影响拔管成功率的情况下优化营养：在这篇综述中，我们强调了有关 ICU 营养的几个常见误区，这些误区可能会阻碍营养目标的实现，进而导致营养不良、发病率和死亡率的增加。这些知识可能有助于加强早期和持续肠内营养策略的实施，从而改善重症成人患者的预后：关于重症监护病房的营养，有几种常见的误解可能会加重营养不良。我们介绍了九种常见的重症监护病房（ICU）营养误区，并在回顾现有文献的基础上提出了优化重症患者营养的建议。

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引用次数: 0

Exploring Opportunities to Better Characterize the Effects of Dietary Protein on Health across the Lifespan 探索更好地描述膳食蛋白质在整个生命周期中对健康的影响的机会。

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2025-01-01 DOI: 10.1016/j.advnut.2024.100347

John W Carbone , Stuart M Phillips , Connie M Weaver , Julie M Hughes , Stefan M Pasiakos

Remarkable advances have been made over the last 30 y in understanding the role of dietary protein in optimizing muscle health across the lifespan. That is, acute (<24 h) stable isotope-derived measures of muscle protein synthesis have led to established recommendations for protein quantity, quality, source, and timing of protein ingestion to support muscle health at rest, post exercise, and to overcome age-related anabolic resistance in older adults. Although muscle health is undoubtedly important, moving from muscle to other associated or disease-specific outcomes is a critical next step for the field, given the mounting evidence documenting the effects of dietary protein on measures of chronic disease and age-related decline (for example, cardiovascular disease, type 2 diabetes mellitus, obesity, frailty, and osteoporosis). In this narrative review, we posit that future studies evaluating the potential role of dietary protein build off of the existing knowledge base generated from decades of past research and focus their efforts on closing unanswered knowledge gaps pertaining to dietary protein and health across the lifespan. Throughout this review, we highlight potential methodologies and novel outcome measures that researchers may consider as starting points to facilitate the next 30 y of advances in the field of dietary protein and health.

在过去的三十年里，在了解膳食蛋白质在优化整个生命周期的肌肉健康中的作用方面取得了显著的进展。也就是说，急性(

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引用次数: 0

With Appreciation

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2025-01-01 DOI: 10.1016/j.advnut.2024.100354

引用次数: 0

Effect of Soy Isoflavones on Measures of Estrogenicity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials 大豆异黄酮对雌激素测量的影响：随机对照试验的系统回顾和荟萃分析。

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2025-01-01 DOI: 10.1016/j.advnut.2024.100327

Gabrielle Viscardi , Songhee Back , Amna Ahmed , Shuting Yang , Sonia Blanco Mejia , Andreea Zurbau , Tauseef A Khan , Amanda Selk , Mark Messina , Cyril WC Kendall , David JA Jenkins , John L Sievenpiper , Laura Chiavaroli

Despite recommendations to increase plant food consumption for public and planetary health and the role that soy foods can play in plant-predominant diets, controversies around the effects of soy foods, especially soy isoflavones, are a barrier to their intake. Given their cardioprotective effects and ability to alleviate menopausal symptoms, addressing these concerns is particularly relevant to women. This systematic review and meta-analysis of randomized controlled trials aimed to determine the effect of soy isoflavones on measures of estrogenicity in postmenopausal women. MEDLINE, Embase, and Cochrane Library were searched through August 2024 for randomized trials

\geq

3-mo investigating soy isoflavones compared with non-isoflavone controls in postmenopausal women. Outcomes included endometrial thickness (ET), vaginal maturation index (VMI), follicle-stimulating hormone (FSH), and estradiol. Independent authors extracted data and assessed risk of bias. Grading of Recommendations, Assessment, Development and Evaluation was used to assess certainty of evidence. We included 40 trials (52 trial comparisons, n = 3285) assessing the effect of a median reported dose of 75 mg/d of soy isoflavones in substitution for non-isoflavone controls over a median of 24 wk. Soy isoflavones had no statistically significant effect on any measure of estrogenicity; ET [mean difference, –0.22 mm (95% confidence interval, –0.45, 0.01 mm), P_MD = 0.059], VMI [2.31 (–2.14, 6.75), P_MD = 0.310], FSH [–0.02 IU/L (–2.39, 2.35 IU/L), P_MD = 0.987], and estradiol [1.61 pmol/L (–1.17, 4.38 pmol/L), P_MD = 0.256]. The certainty of evidence was high to moderate for all outcomes. Current evidence suggests that soy isoflavones do not exhibit estrogenic effects compared with non-isoflavone controls on 4 measures of estrogenicity in postmenopausal women. This synthesis supports that soy isoflavones likely act as selective estrogen receptor modulators, differing clinically from the hormone estrogen. Addressing public health concerns may promote soy foods as high-quality plant protein sources with low environmental impact and cost, particularly benefiting postmenopausal women and aligning with sustainable dietary patterns and guidelines.

This study was registered in PROSPERO as CRD42023439239.

背景：尽管有人建议增加植物性食物的摄入量以促进公众和地球健康，而且大豆食品在以植物为主的膳食中可以发挥作用，但围绕大豆食品，尤其是大豆异黄酮功效的争议阻碍了人们对其的摄入。鉴于大豆异黄酮具有保护心脏的作用并能缓解更年期症状，解决这些问题对女性尤为重要：本研究对随机对照试验进行了系统回顾和荟萃分析，旨在确定大豆异黄酮对绝经后女性雌激素水平的影响：方法：检索了MEDLINE、Embase和Cochrane图书馆截至2024年8月对绝经后妇女进行为期3个月的大豆异黄酮与非异黄酮对照的随机试验。研究结果包括子宫内膜厚度（ET）、阴道成熟指数（VMI）、卵泡刺激素（FSH）和雌二醇。独立作者提取了数据并评估了偏倚风险。GRADE（建议评估、制定和评价分级）用于评估证据的确定性：我们纳入了 40 项试验（52 项试验比较，n=3285），这些试验评估了大豆异黄酮替代非异黄酮对照组的中位剂量（75 毫克/天）在 24 周内的效果。大豆异黄酮对雌激素的任何指标都没有统计学意义上的显著影响；ET（平均差异，-0.22 毫米[95% 置信区间，-0.45，0.01mm]，PMD=0.059）、VMI（2.31 [-2.14, 6.75]，PMD=0.310）、FSH（-0.02IU/L [-2.39, 2.35IU/L]，PMD=0.987）和雌二醇（1.61pmol/L [-1.17, 4.38pmol/L]，PMD=0.256）。所有结果的证据确定性均为高到中等：目前的证据表明，与非异黄酮对照组相比，大豆异黄酮在绝经后妇女雌激素的 4 项指标上不表现出雌激素效应。这一综合结果证明，大豆异黄酮可能是一种选择性雌激素受体调节剂，在临床上不同于雌激素。解决公众健康问题可促进大豆食品成为对环境影响小、成本低的优质植物蛋白来源，尤其有利于绝经后妇女，并符合可持续膳食模式和指南：PROPRONO (CRD42023439239)。

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引用次数: 0

An Overview of Reviews on the Association of Low Calorie Sweetener Consumption With Body Weight and Adiposity 低热量甜味剂消费与体重和肥胖关系的综述。

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2024-12-01 DOI: 10.1016/j.advnut.2024.100239

Kelly A Higgins , Rita Rawal , Matthew Kramer , David J Baer , Aaron Yerke , David M Klurfeld

Background

Numerous systematic reviews (SR) and meta-analyses (MA) on low calorie sweeteners (LCS) have been published in recent years, concluding that LCS have beneficial, neutral, or detrimental effects on various health outcomes, depending on the review.

Objectives

The objective of this overview of reviews was to determine how the methodologies of SR investigating the association between LCS consumption and body weight (BW) influence their findings and whether MA results can provide a consistent estimated effect.

Methods

Systematic searches of PubMed, Scopus, and Cochrane Library were conducted in November 2022 to identify SR of randomized controlled trials (RCT) or non-randomized studies (NRS) investigating the association between LCS consumption and BW. The methods, MA results, and conclusions were extracted from each eligible SR.

Results

Of the 985 search results, 20 SR evaluated the association between LCS and BW, drawing from publications of 75 RCT, 42 prospective cohort studies, and 10 cross-sectional studies. There was a considerable lack of overlap of studies included within each SR attributed, in part, to the inclusion of studies based on design; thus, each SR synthesized results from distinctly different studies. Evidence synthesis methods were heterogeneous and often opaque, making it difficult to determine why results from certain studies were excluded or why disparate results were observed between SR.

Conclusions

SR investigating the effect of LCS on BW implement different methodologies to answer allegedly the same question, drawing from a different set of heterogeneous studies, ignoring the basic assumptions required for MA, resulting in disparate results and conclusions. Previous MA show the large effects of study design, which results in inconsistent estimates of the effect of LCS on BW between MA of RCT and NRS. Given the availability of long-term RCT, these studies should be the basis of determining causal relationships (or lack thereof) between LCS and BW.

This trial was registered at PROSPERO as CRD42022351200.

背景：近年来发表了许多关于低热量甜味剂（LCS）的系统综述（SR）和荟萃分析（MA），其结论是 LCS 对各种健康结果具有有益、中性或有害的影响，具体取决于综述的内容：本综述旨在确定研究低碳水化合物摄入量与体重（BW）之间关系的 SR 的研究方法如何影响其研究结果，以及 MA 结果是否能提供一致的估计效应：2022 年 11 月，对 PubMed、Scopus 和 Cochrane 图书馆进行了系统检索，以确定调查食用低碳水化合物与体重之间关系的随机对照试验 (RCT) 或非随机研究 (NRS) 的 SR。从每个符合条件的SR中提取了方法、MA结果和结论：结果：在 985 项搜索结果中，有 20 项 SR 评估了低碳水化合物与体重之间的关系，其中包括 75 项 RCT、42 项前瞻性队列研究和 10 项横断面研究。每个 SR 中纳入的研究在很大程度上缺乏重叠，部分原因是根据设计纳入研究；因此，每个 SR 综合了截然不同的研究结果。证据综合方法不尽相同，而且往往不透明，因此很难确定为什么某些研究的结果被排除在外，或者为什么SR之间会出现不同的结果：调查 LCS 对生物量影响的 SR 采用不同的方法来回答据称相同的问题，从不同的异质研究中汲取资料，忽视了 MA 所需的基本假设，导致结果和结论的差异。以往的千年生态系统评估表明，研究设计的影响很大，这导致 RCT 和 NRS 的千年生态系统评估对 LCS 对体重影响的估计不一致。鉴于长期 RCT 的存在，这些研究应成为确定 LCS 与体重之间因果关系（或缺乏因果关系）的基础。该试验在 PROSPERO 注册为 CRD42022351200。

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引用次数: 0