Advances in Nutrition最新文献_第6页

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IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2024-11-01 DOI: 10.1016/j.advnut.2024.100324

引用次数: 0

Associations between Variability in Between- and Within-Day Dietary Intake with Adiposity and Glucose Homeostasis in Adults: A Systematic Review 成人日间和日内膳食摄入量的变化与肥胖和葡萄糖稳态之间的关系：系统综述。

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2024-11-01 DOI: 10.1016/j.advnut.2024.100310

Perdana ST Suyoto , Nindya P Pamungkas , Jeanne HM de Vries , Edith JM Feskens

This systematic review aims to comprehensively evaluate the literature regarding the impact of variations in dietary intake, both between- and within-day, on adiposity and glucose metabolism. We included observational and experimental articles obtained from PubMed, Scopus, Cochrane Library, and gray literature until 9 October, 2023, evaluating the impact of between- or within-day variations in meal, energy, or macronutrient intake on these outcomes. Our focus was on adults aged ≥18 y, spanning both healthy individuals and those with type 2 diabetes mellitus (T2DM). Given the diverse range of exposures, treatments, and outcomes among the selected articles, we chose a qualitative synthesis approach to effectively analyze the data. Eighty articles from 43 observational and 37 experimental studies were included, involving 89,178 participants. Patterns of dietary intake variation were identified and systematically organized into distinct categories based on similarities. Between-day variations in dietary intake consisted of between-day variations in both the quantity consumed and meal timing. Meanwhile, within-day variations encompassed factors such as eating window, meal omission, within-day meal timing, within-day variation in dietary intake quantity, and temporal distribution. Despite mixed results, time-restricted eating was generally associated with lower adiposity. However, limited control for total daily energy intake (TDEI) suggests that the contribution of lower energy intake cannot be conclusively excluded. Conversely, the adverse effect of meal omission on glucose parameters was consistently supported by randomized trials. Interestingly, the results showed that consuming a substantial portion of TDEI in the morning may increase the likelihood of observing improvements in adiposity. Furthermore, inconsistencies in outcomes across articles examining the effects in healthy compared with T2DM populations, or in energy-sufficient compared with deficient individuals, indicate potential condition-specific effects. These findings support the need for further investigation into the effects of between- and within-day variations in dietary intake to better understand their impact on adiposity and glucose homeostasis.

This review was registered in PROSPERO as CRD42020214307.

本系统综述旨在全面评估有关日间和日内膳食摄入量变化对脂肪和糖代谢影响的文献。我们收录了截至 2023 年 10 月 9 日从 PubMed、Scopus、Cochrane 图书馆和灰色文献中获得的观察性和实验性文章，这些文章评估了日间或日内膳食、能量或宏量营养素摄入量的变化对这些结果的影响。我们的研究重点是年龄≥18 岁的成年人，包括健康人和 2 型糖尿病 (T2DM) 患者。鉴于所选文章的暴露、治疗和结果多种多样，我们选择了一种定性综合方法来有效地分析数据。我们纳入了来自 43 项观察性研究和 37 项实验性研究的 80 篇文章，涉及 89,178 名参与者。我们确定了膳食摄入量的变化模式，并根据相似性将其系统地分为不同的类别。膳食摄入量的日间变化包括摄入量和进餐时间的日间变化。同时，日内变化包括进食窗口、漏餐、日内进餐时间、日内膳食摄入量变化和时间分布等因素。尽管结果参差不齐，但限时进食通常与较低的脂肪含量有关。然而，由于对每日总能量摄入量（TDEI）的控制有限，因此不能最终排除能量摄入量较低的影响。相反，不进餐对血糖参数的不利影响得到了随机试验的一致支持。有趣的是，研究结果表明，早上摄入大量 TDEI 可能会增加观察到脂肪含量改善的可能性。此外，在研究健康人群与 T2DM 人群、能量充足人群与能量不足人群的效果的文章中，结果并不一致，这表明可能存在条件特异性效应。这些研究结果表明，有必要进一步研究膳食摄入量日间和日内变化的影响，以更好地了解它们对脂肪和葡萄糖稳态的影响。

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引用次数: 0

Effects of Varying Protein Amounts and Types on Diet-Induced Thermogenesis: A Systematic Review and Meta-Analysis 不同蛋白质数量和类型对饮食诱导产热的影响：系统回顾与元分析》。

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2024-10-31 DOI: 10.1016/j.advnut.2024.100332

Liana L Guarneiri , Caryn G Adams , Bibiana Garcia-Jackson , Katie Koecher , Meredith L Wilcox , Kevin C Maki

Protein is the most thermogenic macronutrient, but it is unclear how different amounts and types of protein impact diet-induced thermogenesis (DIT). The purpose of this meta-analysis was to compare the impact of isocaloric meals/diets containing different amounts or types of protein on energy metabolism. Databases were searched in June 2024 for studies that compare DIT or total daily energy expenditure (TDEE) in response to isocaloric acute meals or longer-term diets containing different amounts or types of protein. After identifying 3894 records, 52 studies were included. Standardized mean difference (SMD) estimates and 95% confidence intervals (CIs) were calculated for each outcome. In acute studies, intake of higher compared with lower-protein meals resulted in greater DIT (SMD: 0.45; 95% CI: 0.26, 0.65; P < 0.001) and TDEE (SMD: 0.52; 95% CI: 0.30, 0.73; P < 0.001). Notably, the subgroup analysis indicated that this effect on DIT was statistically significant for studies involving participants with normal weight but not overweight/obesity, although it is not clear if this finding was a true effect or because of study design characteristics. In chronic studies (ranging from 4 d to 1 y), intake of higher compared with lower-protein diets resulted in greater TDEE (SMD: 0.29; 95% CI: 0.10, 0.48; P = 0.003) and resting energy expenditure (SMD: 0.18; 95% CI: 0.01, 0.35; P = 0.039), but no differences in DIT (SMD: 0.10; 95% CI: –0.08, 0.28; P = 0.27). There was no evidence that different types of protein impacted energy metabolism. Higher protein meals/diets increase components of energy expenditure.

This trial was registered at the International Prospective Register of Systematic Reviews (https://www.crd.york.ac.uk/prospero; PROSPERO 2023) as CRD42023389642.

背景：蛋白质是最能产生热量的宏量营养素，但目前还不清楚不同数量和类型的蛋白质对饮食诱导产热（DIT）的影响：本荟萃分析旨在比较含有不同数量或类型蛋白质的等热量膳食/饮食对能量代谢的影响：2024 年 6 月，我们在数据库中搜索了对含有不同数量或类型蛋白质的急性等热量膳食或长期膳食的 DIT 或每日总能量消耗 (TDEE) 进行比较的研究。在识别了 3,894 条记录后，纳入了 52 项研究。计算了每种结果的标准化平均差（SMD）估计值和 95% 置信区间（CI）：结果：在急性期研究中，摄入高蛋白膳食与低蛋白膳食会导致更高的 DIT（SMD：0.45；95% CI：0.26，0.65；PC 结论：高蛋白膳食/饮食会增加 DIT 的摄入量：高蛋白膳食/饮食可增加能量消耗的组成部分（PROSPERO：CRD42023389642）。

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引用次数: 0

A Breath of Fresh Air: Perspectives on Inhaled Nutrients and Bacteria to Improve Human Health 呼吸新鲜空气：吸入营养物质和细菌改善人类健康的前景。

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2024-10-30 DOI: 10.1016/j.advnut.2024.100333

Flávia Fayet-Moore , Stephen R Robinson

We propose that the human respiratory system and olfactory pathways sequester airborne nutrients (vitamins, fatty acids, and trace minerals) that are beneficial for health, which we term “aeronutrients.” In addition, airborne bacteria, termed “aeromicrobes,” have the potential for positive health effects by improving species diversity in the microbiotas of the respiratory and gastrointestinal tracts. These concepts have implications for people living in urban areas or those who have limited access to nature, such as astronauts exposed for long periods to highly filtered air that may be depleted of aeronutrients and aeromicrobes. The possibility that fresh air contributes to human nutrition and health may stimulate a re-evaluation of guidelines pertaining to nutrition and access to natural environments, and will open new avenues of scientific enquiry.

我们提出，人类的呼吸系统和嗅觉通路会封存空气中对健康有益的营养物质（维生素、脂肪酸和微量元素），我们称之为 "空气营养素"。此外，空气中的细菌被称为 "空气微生物"，有可能通过改善呼吸道和胃肠道微生物群的物种多样性而对健康产生积极影响。这些概念对生活在城市地区或接触大自然的机会有限的人有影响，例如宇航员长期暴露在高度过滤的空气中，可能会耗尽空气营养素和空气微生物。新鲜空气有助于人类营养和健康的可能性可能会促使人们重新评估有关营养和利用自然环境的指导方针，并为科学探索开辟新的途径。

引用次数: 0

Effects of Dietary Approaches and Exercise Interventions on Gestational Diabetes Mellitus: A Systematic Review and Bayesian Network Meta-analysis 饮食方法和运动干预对妊娠糖尿病的影响：系统综述和贝叶斯网络荟萃分析。

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2024-10-29 DOI: 10.1016/j.advnut.2024.100330

Liang Zhang , Fang Wang , Syoichi Tashiro , Peng Ju Liu

Although lifestyle interventions are recommended as the frontline therapeutic strategy for women with gestational diabetes mellitus (GDM), the optimal dietary regimen or form of exercise has yet to be definitively established. We aimed to compare the effectiveness of lifestyle therapies for GDM. Four databases (PubMed, Web of Science, EMBASE, and Cochrane Library) were systematically searched by multiple researchers for randomized controlled trials (RCTs). RCTs comparing lifestyle therapies to treat GDM with control or another treatment were included. Data extraction and synthesis were performed, estimating mean differences (MDs) or relative risk (RR) through pair-wise and network meta-analysis with a randomized or fixed-effects model when appropriate. The primary outcomes were maternal glucose control, birth weight of newborns, macrosomia and preterm birth rate, and rate of need for insulin therapy. In total, 39 trials with information obtained from 2712 women assessed 15 treatments. After sensitivity analysis, we confirmed the dietary approaches to stop hypertension (DASH) diet [MD: −11.52; 95% credible intervals (CrIs): −14.01, −9.07, very low certainty of evidence (CoE)] and low glycemic index (GI) diets (MD: −6.3; 95% CrI: −9.9, −2.7, low CoE) have shown significant advantages in fasting plasma glucose and 2-h postprandial glucose control, respectively. Furthermore, the DASH diet and resistance exercise reduced insulin requirements independently by 71% (95% CrI: 52%, 84%) and 67% (95% CrI: 48%, 85%), respectively. Additionally, both the DASH (MD: −587.6; 95% CrI: −752.12, −421.85, low CoE) and low GI diets (MD: −180.09, 95% CrI: −267.48, −94.65, low CoE) reduced birth weight significantly, with the DASH diet also demonstrating effects in reducing macrosomia by 89% (95% CrI: 53%, 98%) and lowering the cesarean section rate by 46% (95% CI: 27%, 60%). However, exercise did not affect infant outcomes. Our findings suggest that the DASH diet and low GI diet and resistance exercise may be beneficial for maternal outcomes in pregnancies with GDM. The impact on infants is primarily observed through dietary interventions. Future research, characterized by higher quality and evidence grades, is necessary to complement and substantiate our findings.

This study was registered with PROSPERO as CRD 42024527587.

目的：尽管生活方式干预被推荐为妊娠期糖尿病（GDM）妇女的一线治疗策略，但最佳饮食方案或运动形式尚未明确确定。我们旨在比较生活方式疗法对 GDM 的有效性：多位研究人员对四个数据库（Pubmed、Web of Science、Embase 和 Cochrane Library）进行了系统检索，以寻找随机对照试验（RCT）：研究入选标准：纳入比较生活方式疗法与对照疗法或其他疗法治疗 GDM 的 RCT：方法：进行数据提取和综合，通过配对分析和网络荟萃分析估算平均差（MDs）或相对风险（RR），适当时采用随机或固定效应模型。主要结果包括产妇血糖控制、新生儿出生体重、巨大儿和早产率以及胰岛素治疗需求率。本研究已在 PROSPERO 注册，注册号为 42024527587：39项试验从2712名妇女那里获得了信息，评估了15种治疗方法。经过敏感性分析后，我们证实了高血压饮食疗法（DASH）（MD -11-52，95% 可信区间（CrI）[-14-01，-9-07]，极低 CoE）和低血糖指数饮食疗法（GI）（MD -6-3，95% CrI [-9-9，-2-7]，低证据确凿度（CoE））分别在空腹血浆葡萄糖和餐后 2 小时血糖控制方面具有显著优势。此外，DASH 饮食和抗阻力运动分别将胰岛素需求量独立降低了 71%（95%CrI，[52%，84%]）和 67%（95%CrI，[48%，85%]）。此外，DASH（MD -587-6，95% CrI [-752-12，-421-85]），低 CoE）和低 GI 饮食（MD -180-09，95% CrI [-267-48，-94-65]，低 CoE）都能显著降低出生体重，其中 DASH 饮食还能将巨大儿减少 89%（95%CrI，[53%，98%]），并将剖宫产率降低 46%（95%CI，[27%，60%]）。然而，运动并不影响婴儿的预后：我们的研究结果表明，DASH 饮食和低 GI 饮食以及阻力运动可能对 GDM 孕妇的预后有益。对婴儿的影响主要是通过饮食干预观察到的。今后有必要开展更高质量和证据等级更高的研究，以补充和证实我们的发现。

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引用次数: 0

Revisiting the Concepts of Prebiotic and Prebiotic Effect in Light of Scientific and Regulatory Progress—A Consensus Paper From the Global Prebiotic Association 透视：根据科学和监管进展重新审视益生菌和益生菌效应的概念--全球益生菌协会 (GPA) 的共识文件。

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2024-10-29 DOI: 10.1016/j.advnut.2024.100329

Edward C Deehan , Santa Al Antwan , Rhonda S Witwer , Paula Guerra , Tania John , Len Monheit

The term prebiotic has been used for almost 3 decades and has undergone numerous updates over the years. The scientific literature reveals that despite continuous efforts to establish a globally unified definition to guide jurisdictional regulations and product innovations, ambiguity continues to surround the terms prebiotic and prebiotic effect, leading to products that lack in full regulatory adherence being marketed worldwide. Thus, to reflect the current state of scientific research and knowledge and for the continuous advancement of the category, an update to the current prebiotic definition is warranted. This update includes removing the term selectivity, considering additional locations of action besides the gut, highlighting prebiotic performance benefits such as cognitive and athletic, and providing a clear standalone definition for prebiotic effect. The Global Prebiotic Association (GPA) is a leading information and industry hub committed to raising awareness about prebiotics, their emerging and well-established health benefits, and prebiotic product integrity and efficacy. In this position paper, GPA builds on previous prebiotic definitions to propose the following expanded definition for prebiotic: “a compound or ingredient that is utilized by the microbiota producing a health or performance benefit.” In addition to prebiotic, GPA also defines prebiotic effect as “a health or performance benefit that arises from alteration of the composition and/or activity of the microbiota, as a direct or indirect result of the utilization of a specific and well-defined compound or ingredient by microorganisms.” With these 2 definitions, GPA aims to paint a clearer picture for the term prebiotic, and by incorporating an industry point of view, these updated definitions may be used alongside current scientific and regulatory perspectives to move the category forward.

益生菌一词已使用了近三十年，多年来经历了多次更新。科学文献显示，尽管人们一直在努力建立一个全球统一的定义，以指导辖区监管和产品创新，但益生元和益生元效应这两个术语仍然含糊不清，导致一些不完全符合监管要求的产品在全球范围内销售。因此，为了反映科学研究和知识的现状，并促进该类别的不断发展，有必要对当前的益生菌定义进行更新。更新内容包括删除选择性一词，考虑除肠道外的其他作用部位，强调益生元在认知和运动等方面的功效，并为益生元效应提供明确的独立定义。全球益生元协会（GPA）是一个领先的信息和行业中心，致力于提高人们对益生元、益生元对健康的新兴和公认益处以及益生元产品完整性和功效的认识。在本立场文件中，GPA 以以前的益生元定义为基础，提出了益生元的以下扩展定义："被微生物群利用，产生健康或性能益处的化合物或成分"。除益生元外，GPA 还将益生元效应定义为"由于微生物利用特定和明确定义的化合物或成分而直接或间接改变微生物群的组成和/或活性，从而产生的健康或性能益处"。通过这两个定义，GPA 旨在更清晰地描述益生菌这一术语，并通过纳入行业观点，将这些更新的定义与当前的科学和监管观点结合起来，推动益生菌类别的发展。意义说明：本文旨在通过提供基于科学的行业观点，重新审视益生菌和益生效应的概念。在国际益生菌和益生元科学协会（ISAPP）2017 年发布益生菌定义之后，本文提出的益生菌和益生元效应定义反映了元基因组学和益生元研究的最新发现，并提出了及时和必要的术语变更。这些修改旨在保持益生菌定义对科学界、产业界、医疗保健提供者和消费者的清晰性和实用性，同时确保益生菌定义各部分的科学性、全面性和合理性，包括放弃选择性一词，引入性能益处和益生菌效果的概念。

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引用次数: 0

Environmental and Health Sustainability of the Mediterranean Diet: A Systematic Review 地中海饮食的环境和健康可持续性：系统性。

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2024-10-18 DOI: 10.1016/j.advnut.2024.100322

Victoria Lorca-Camara , Marina Bosque-Prous , Maira Bes-Rastrollo , Cristina O'Callaghan-Gordo , Anna Bach-Faig

The Mediterranean diet (MD) has been shown to be a healthy dietary pattern (DP), and lately it is increasingly being studied as a sustainable DP. The aim of this study is to analyze whether the MD is a sustainable and healthy DP accounting for its carbon footprint, water footprint (WF), land use (LU), and/or energy use, based on the existing scientific literature. We conducted a systematic review following PRISMA guidelines and registered in PROSPERO (CRD42022309916). We included 35 studies: 25 modeling studies, 7 cross-sectional, and 3 longitudinal. Twenty-four studies compared the sustainability of the MD with that of other DPs; 21 assessed the sustainability of the MD compared with dietary consumption data; and 9 evaluated the MD's adherence and its environmental impacts. A total of 29 studies analyzed the carbon footprint, 11 the LU, 20 the WF, and 7 the energy use of the MD. Six articles assessed the health aspect of the diet apart from the environmental impact. The MD showed high nutritional quality, ranging between 122 and 178 points on the health score and between 13.51 and 90.6 points on the nutrient-rich food index. Using the results for environmental footprints in the same measurement units, we were able to quantitatively compare the most frequently assessed diets with MD. When compared with other diets, 91% of the studies referred to the MD as a sustainable DP, and most of the articles in which its adherence was assessed obtained an inverse correlation with the environmental footprints. Environmental footprints of the MD ranged from 1.03 to 5.08 kg CO₂-eq/person-day for greenhouse gas emissions, 257.2–2735.2 L/person-day for WF, and 4–14.8 m²/person-day and 2.85–3.32 m²∗year/d for LU. In summary, the available evidence suggests that, in general, the MD is a sustainable and healthy DP, which aligns with planetary health.

地中海饮食（Mediterranean diet，MD）已被证明是一种健康的饮食模式（DP），最近，越来越多的研究将其视为一种可持续的饮食模式。本研究的目的是根据现有的科学文献，从碳足迹、水足迹（WF）、土地利用（LU）和/或能源利用等方面分析地中海饮食是否是一种可持续的健康饮食模式。我们按照 PRISMA 指南进行了系统综述，并在 PROSPERO（CRD42022309916）上进行了注册。我们纳入了 35 项研究：25 项建模研究、7 项横断面研究和 3 项纵向研究。24 项研究比较了 MD 与其他膳食模式的可持续性；21 项研究评估了 MD 与膳食消费数据的可持续性；9 项研究评估了 MD 的坚持率及其对环境的影响。共有 29 项研究分析了 MD 的碳足迹、11 项 LU、20 项 WF 和 7 项能源使用。除环境影响外，有 6 篇文章对饮食的健康方面进行了评估。千年发展目标显示出较高的营养质量，健康评分在 122 分至 178 分之间，营养丰富食物指数在 13.51 分至 90.6 分之间。使用相同测量单位的环境足迹结果，我们能够对最常评估的膳食与 MD 进行定量比较。与其他膳食相比，91% 的研究将 MD 称作可持续发展的膳食，大多数对 MD 的坚持情况进行评估的文章都发现 MD 与环境足迹呈反相关。在温室气体排放（GHGE）方面，MD 的环境足迹为 1.03-5.08 千克二氧化碳当量/人-天；在 WF 方面，为 257.2-2735.2 升/人-天；在 LU 方面，为 4-14.8 平方米/人-天和 2.85-3.32 平方米*年/天。总之，现有证据表明，总体而言，千年发展目标是一个可持续的健康发展目标，与地球健康相一致。

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引用次数: 0

Early Influences on Development of Sensory Perception and Eating Habits 早期对感知和饮食习惯发展的影响。

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2024-10-18 DOI: 10.1016/j.advnut.2024.100325

Kelly Guedes de Oliveira Scudine , Paula Midori Castelo , João Paulo Maires Hoppe , André Krumel Portella , Patricia Pelufo Silveira

Infancy and early childhood are important periods for the development of food choices and eating preferences that are tracked into adult life, influencing weight gain, body composition, and metabolism and ultimately affecting the balance between health and disease. In this narrative review, we discuss studies focused on the effects of fetal programming and early food experiences, highlighting recent advances in the discovery of factors that contribute to the development of food preferences and eating behavior. Food preference can be influenced by early direct contact with flavors, textures, and aromas, as well as by environmental adversities during early development. Evidence suggests that exposure to intrauterine growth restriction is associated with increased preferences for highly palatable foods, such as those rich in carbohydrates and fats, over the life course. Early flavor experiences, whether from amniotic fluid or human milk, may also shape the development of food preferences. Finally, children are more likely to accept textures that they are able to manipulate, and early exposure to a range of textures facilitates the acceptance of foods of various textures later on. Improving dietary habits during gestation (fetal) and postnatal periods is of critical importance for the establishment of positive eating habits and healthy growth in infants and should be an important focus of primary prevention efforts.

婴幼儿时期是形成食物选择和饮食偏好的重要时期，这些选择和偏好会在成年后影响体重增加、身体组成和新陈代谢，并最终影响健康与疾病之间的平衡。在这篇叙述性综述中，我们旨在讨论有关胎儿编程和早期饮食经验影响的研究，重点介绍在发现促进食物偏好和饮食行为发展的因素方面取得的最新进展。食物偏好会受到早期直接接触味道、质地和香气的影响，也会受到早期发育过程中环境不利因素的影响。有证据表明，宫内生长受限与一生中对高适口性食物（如富含碳水化合物和脂肪的食物）的偏好增加有关。早期的味道体验，无论是来自羊水还是母乳，也可能会影响食物偏好的形成。最后，儿童更容易接受他们能够操作的质地，早期接触各种质地的食物有助于日后接受各种质地的食物。改善妊娠期（胎儿期）和产后的饮食习惯对婴儿建立积极的饮食习惯和健康成长至关重要，应成为一级预防工作的重点。

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引用次数: 0

Vegetarian and Vegan Dietary Patterns to Treat Adult Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials 治疗成人 2 型糖尿病的素食和纯素饮食模式：随机对照试验的系统回顾和元分析

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2024-10-01 DOI: 10.1016/j.advnut.2024.100294

Nanci S Guest , Sudha Raj , Matthew J Landry , A Reed Mangels , Roman Pawlak , Katelyn E Senkus , Deepa Handu , Mary Rozga

Plant-based dietary patterns, including vegetarian and vegan dietary patterns, may help to manage type 2 diabetes (T2DM) by contributing to maintenance of a healthy body weight, improved glycemic control, and reduced risk of diabetes complications. Several diabetes clinical practice guidelines support the use of vegetarian dietary patterns, but there has not been a recently updated systematic review (SR) of evidence from randomized controlled trials (RCTs) to examine efficacy. The primary objective of this SR was to examine the effect of vegetarian dietary patterns compared with nonvegetarian dietary patterns in adults with T2DM. MEDLINE, CINAHL, Cochrane CENTRAL Database of Controlled Trials, Food Science Source, and SportsDiscus databases were searched for RCTs published from 1998 to May 2023. Two independent reviewers extracted data and assessed risk of bias using the Cochrane RoB 2 tool. Data were pooled using a DerSimonian–Laird random-effects model and expressed as mean differences (MDs) with 95% confidence intervals (CIs). Heterogeneity was assessed using the I² statistic, and certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation approach. Full texts of 66 articles were reviewed, and 7 RCTs (n = 770 participants) were included in this SR. Vegetarian dietary patterns likely reduce hemoglobin A1c [MD (95% CI): –0.40% (–0.59, –0.21)] and body mass index [MD (95% CI): –0.96 kg/m² (–1.58, –0.34)] (moderate certainty evidence); may allow for reduced diabetes medication (in 2 of 3 included studies) (low certainty); and may improve metabolic clearance of glucose (insulin sensitivity) [MD (95% CI): 10% (1.86, 18.14)] (very low certainty), compared with nonvegetarian dietary patterns. There were no effects of vegetarian dietary patterns on fasting blood glucose, fasting insulin, or low-density lipoprotein cholesterol concentrations. These findings support the inclusion of vegetarian or vegan dietary patterns as options in nutrition care plans for adults with T2DM.

PROSPERO Registration

CRD42023396453.

以植物为基础的饮食模式（包括素食和纯素饮食模式）有助于维持健康体重、改善血糖控制和降低糖尿病并发症风险，从而有助于控制 2 型糖尿病（T2DM）。一些糖尿病临床实践指南支持使用素食饮食模式，但最近尚未对随机对照试验（RCT）的证据进行系统性回顾（SR），以检查其疗效。本系统综述的主要目的是研究与荤食饮食模式相比，素食饮食模式对成人 T2DM 患者的影响。在 MEDLINE、CINAHL、Cochrane CENTRAL 对照试验数据库、Food Science Source 和 SportsDiscus 数据库中检索了 1998 年至 2023 年 5 月期间发表的 RCT。两位独立审稿人提取数据，并使用 Cochrane RoB 2 工具评估偏倚风险。数据采用 DerSimonian-Laird 随机效应模型进行汇总，并以平均差 (MD) 和 95% 置信区间 (CI) 表示。异质性采用 I2 统计量进行评估，证据的确定性采用推荐、评估、发展和评价分级法进行评估。本研究对 66 篇文章的全文进行了审查，并纳入了 7 项 RCT 研究（n = 770 名参与者）。素食饮食模式可降低血红蛋白 A1c [MD（95% CI）：-0.40% (-0.59, -0.21)]和体重指数 [MD（95% CI）：-0.96 kg/m2 (-1.58, -0.34)]（中等确定性证据）。34）]（中度确定性证据）；与非素食饮食模式相比，可减少糖尿病药物治疗（3 项纳入研究中的 2 项）（低确定性）；可改善葡萄糖代谢清除率（胰岛素敏感性）[MD（95% CI）：10%（1.86，18.14）]（极低确定性）。素食饮食模式对空腹血糖、空腹胰岛素或低密度脂蛋白胆固醇浓度没有影响。这些研究结果支持将素食或纯素饮食模式作为 T2DM 成人患者营养护理计划的选项。

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引用次数: 0

Time for Paradigm Shift in Anemia Assessment? 是改变贫血评估范式的时候了吗？

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2024-10-01 DOI: 10.1016/j.advnut.2024.100293

Melissa F Young

引用次数: 0