scholarly journals Adherence to the Mediterranean Diet in Relation to All-Cause Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies

2019 ◽  
Vol 10 (6) ◽  
pp. 1029-1039 ◽  
Author(s):  
Sepideh Soltani ◽  
Ahmad Jayedi ◽  
Sakineh Shab-Bidar ◽  
Nerea Becerra-Tomás ◽  
Jordi Salas-Salvadó
Keyword(s):  
Cohort Studies ◽  
Mediterranean Diet ◽  
Dose Response ◽  
Prospective Studies ◽  
Prospective Cohort ◽  
Meta Analysis ◽  
Inverse Association ◽  
Prospective Cohort Studies ◽  
Subgroup Analyses ◽  
All Cause Mortality

ABSTRACT A previous meta-analysis provided convincing evidence for an inverse association between adherence to a Mediterranean diet (MedDiet) and the risk of all-cause mortality. Since then, 19 prospective studies have been published. We updated the evidence from these prospective studies and conducted a dose-response meta-analysis to test the linear and potential nonlinear dose-response associations between adherence to a MedDiet and the risk of all-cause mortality. The PubMed, Scopus, ISI Web of Knowledge, and Embase bibliographic databases were systematically searched up to August 24, 2018. Summary HRs were estimated with the use of a random-effects meta-analysis to assess the association between a 2-point increment in MedDiet adherence and the risk of all-cause mortality. Sensitivity and subgroup analyses were performed and potential publication bias was tested. Twenty-nine prospective studies with 1,676,901 participants and 221,603 cases of all-cause mortality were included in the final analysis. The pooled HR of all-cause mortality was 0.90 (95% CI: 0.89, 0.91; I2 = 81.1%) for a 2-point increment in adherence to a MedDiet. Subgroup analyses showed that a significant inverse association was stronger in participants who lived in the Mediterranean region compared with non-Mediterranean areas (HRs: 0.82 compared with 0.92, respectively), and in studies that used the Panagiotakos MedDiet score. A nonlinear dose-response meta-analysis indicated that the risk of all-cause mortality linearly decreased with the increase in adherence to a MedDiet. The robustness of findings was confirmed in the sensitivity analyses. In conclusion, low-quality evidence from prospective cohort studies suggests an inverse association between adherence to a MedDiet and the risk of all-cause mortality, especially in Mediterranean regions. An inverse linear dose-response relation was also observed between adherence to a MedDiet and the risk of all-cause mortality.

Abstract MP48: Whole Grain Intake is Inversely Associated with Mortality From All Causes, Cardiovascular Disease, and Cancer in a Dose-response Manner, a Meta-analysis of Prospective Cohort Studies

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Geng Zong ◽  
Alisa Gao ◽  
Frank Hu ◽  
Qi Sun
Keyword(s):  
Cohort Studies ◽  
Dose Response ◽  
Cancer Mortality ◽  
Prospective Cohort ◽  
Meta Analysis ◽  
Multiple Chronic Conditions ◽  
Whole Grain ◽  
Prospective Cohort Studies ◽  
All Cause Mortality ◽  
Cvd Mortality

Introduction: Whole grain intake has been associated with lower risks of multiple chronic conditions, but its association with mortality warrants further evaluation. Hypothesis: We performed a meta-analysis of prospective cohort studies on the association of whole grain intake with all-cause and cause-specific mortality, and tested the hypothesis that they followed inverse dose-response pattern. Methods: Published studies reporting relative risks (RRs) between whole grain consumption and mortality from Medline and Embase through August, 2015. Original results from National Health and Nutrition Examination Survey (NHANES) III and NHANES 1999-2004 were included. Whole grain ingredients (gram/day) were estimated among studies reporting RRs for ≥3 categories of whole grain intake. Results: Fourteen unique analyses were included, which consisted of 786,076 participants, 97,867 all-cause deaths, 23,957 CVD deaths, and 37,492 cancer deaths. Pooled RRs (95% confidence intervals) comparing high with low whole grain categories were 0.84 (0.80, 0.88; P <0.001, I2=74%, P heterogeneity<0.001) for all-cause mortality, 0.82 (0.79, 0.85; P <0.001, I2=0%, P heterogeneity=0.53) for CVD mortality, and 0.88(0.83, 0.94; P <0.001, I2=54%, P heterogeneity=0.02) for cancer mortality. Whole grain consumption was <50 grams/day among most studies. Dose-response meta-analysis showed strong monotonic associations between whole grain and mortality (All P nonlinearity > 0.05): RRs (95%CIs) for each 16 grams/day increase (approximately 1 serving/day) in whole grain were 0.93(0.92, 0.94) for all-cause mortality, 0.91(0.90, 0.93) for CVD mortality, and 0.95(0.94, 0.96) for cancer mortality. These findings were robust in several stratified analyses and/or sensitivity analyses. Egger’s test did not suggest significant publication bias. Conclusions: Our findings supported health benefit of increasing current whole grain intake of <1 serving/day to ≥3 servings/day as recommended by current Dietary Guidelines for Americans.

scholarly journals Dietary intake of total, animal, and plant proteins and risk of all cause, cardiovascular, and cancer mortality: systematic review and dose-response meta-analysis of prospective cohort studies

BMJ ◽  
2020 ◽  
pp. m2412 ◽  
Author(s):  
Sina Naghshi ◽  
Omid Sadeghi ◽  
Walter C Willett ◽  
Ahmad Esmaillzadeh
Keyword(s):  
Cardiovascular Disease ◽  
Cohort Studies ◽  
Dose Response ◽  
Cancer Mortality ◽  
Prospective Cohort ◽  
Lower Risk ◽  
Meta Analysis ◽  
Plant Protein ◽  
Prospective Cohort Studies ◽  
All Cause Mortality

AbstractObjectiveTo examine and quantify the potential dose-response relation between intake of total, animal, and plant protein and the risk of mortality from all causes, cardiovascular disease, and cancer.DesignSystematic review and meta-analysis of prospective cohort studies.Data sourcesPubMed, Scopus, and ISI Web of Science until December 2019, and references of retrieved relevant articles.Study selectionProspective cohort studies that reported the risk estimates for all cause, cardiovascular, and cancer mortality in adults aged 18 or older.Data synthesisRandom effects models were used to calculate pooled effect sizes and 95% confidence intervals for the highest versus lowest categories of protein intake and to incorporate variation between studies. Linear and non-linear dose-response analyses were done to evaluate the dose-response relations between protein intake and mortality.Results32 prospective cohort studies were included in the systematic review and 31 in the meta-analysis. During the follow-up period of 3.5 to 32 years, 113 039 deaths (16 429‬ from cardiovascular disease and 22 303‬ from cancer) occurred among 715 128 participants. Intake of total protein was associated with a lower risk of all cause mortality (pooled effect size 0.94, 95% confidence interval 0.89 to 0.99, I2=58.4%, P<0.001). Intake of plant protein was significantly associated with a lower risk of all cause mortality (pooled effect size 0.92, 95% confidence interval 0.87 to 0.97, I2=57.5%, P=0.003) and cardiovascular disease mortality (pooled hazard ratio 0.88, 95% confidence interval 0.80 to 0.96, I2=63.7%, P=0.001), but not with cancer mortality. Intake of total and animal protein was not significantly associated with risk of cardiovascular disease and cancer mortality. A dose-response analysis showed a significant inverse dose-response association between intake of plant protein and all cause mortality (P=0.05 for non-linearity). An additional 3% energy from plant proteins a day was associated with a 5% lower risk of death from all causes.ConclusionsHigher intake of total protein was associated with a lower risk of all cause mortality, and intake of plant protein was associated with a lower risk of all cause and cardiovascular disease mortality. Replacement of foods high in animal protein with plant protein sources could be associated with longevity.

scholarly journals Mediterranean Diet and Mortality in People with Cardiovascular Disease: A Meta-Analysis of Prospective Cohort Studies

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2623
Author(s):  
Chengyao Tang ◽  
Xiaowen Wang ◽  
Li-Qiang Qin ◽  
Jia-Yi Dong
Keyword(s):  
Cardiovascular Disease ◽  
Cohort Studies ◽  
Publication Bias ◽  
Cardiovascular Mortality ◽  
Prospective Cohort ◽  
Meta Analysis ◽  
Prospective Cohort Studies ◽  
Subgroup Analyses ◽  
All Cause Mortality ◽  
History Of

The association of the Mediterranean diet (MD) with mortality among people with a history of cardiovascular disease (CVD) has not been systematically examined. Hereby, our objective was to investigate the association of MD with all-cause and cardiovascular mortality in people with a history of CVD. We searched five electronic databases including Embase, PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials to screen eligible studies published before 31 August 2020. A random-effect model was used to examine the association of a 2-unit increment in MD score with the risk of all-cause and cardiovascular mortality. We conducted sensitivity and subgroup analyses and examined potential publication bias by Egger’s and Begg’s tests. Seven cohort studies (eight datasets) with a total of 37,879 participants who had a history of CVD were eligible for the main analysis. The pooled hazard ratios were 0.85 (95% CIs: 0.78–0.93; n = 8) for all-cause mortality and 0.91 (95% CIs; 0.82–1.01; n = 4) for cardiovascular mortality for each 2-unit increment in a score of adherence to MD. Subgroup analyses for all-cause mortality showed that the association appeared relatively stronger in Mediterranean areas (HR = 0.76 [0.69–0.83]) than non-Mediterranean areas (HR = 0.95 [0.93–0.98]) and in studies with a shorter duration (HR = 0.75 [0.66–0.84] for <7 years vs. HR = 0.94 [0.91–0.98] for ≥7 years). No evidence of publication bias was observed. The present meta-analysis of prospective cohort studies provided evidence that adherence to MD improved survival in people with a history of CVD.

scholarly journals The association between napping and the risk of cardiovascular disease and all-cause mortality: a systematic review and dose-response meta-analysis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Z Pan ◽  
M Huang ◽  
J Huang ◽  
Z Yao
Keyword(s):  
Cardiovascular Disease ◽  
Cohort Studies ◽  
Dose Response ◽  
Prospective Cohort ◽  
Meta Analysis ◽  
Random Effect ◽  
Response Analysis ◽  
Night Sleep ◽  
Prospective Cohort Studies ◽  
All Cause Mortality

Abstract Background Napping is a habit prevalent worldwide and occurs from an early age. Some sleep specialists have suggested it as a potential public health tool due to the prevalence of sleep disorder. However, the association between napping and the risk of cardiovascular disease (CVD) and all-cause mortality remains unclear. Purpose To assess the association between napping and the risk of CVD and all-cause mortality. Methods We conducted a systematic search of Medline, Embase and Cochrane databases from inception through December 2019 for prospective cohort studies investigating the association between napping and the risk of CVD and/or all-cause mortality. Overall estimates were calculated using random effect models with inverse variance weighting. Dose-response meta-analysis was performed using restricted cubic spline models. The results were reported as hazard ratio (HR) and 95% confidence interval (CI). Results A total of 313651 participants (57.8% female, 38.9% took naps) from 20 cohort studies were included in the analysis. Overall, pooled analysis detected no association between daytime nap and CVD (HR 1.13, 95% CI 0.99–1.28). However, in subgroup analysis including only participants who were female (HR 1.31, 95% CI 1.09–1.58), older (age&gt;65 years) (HR 1.36, 95% CI 1.07–1.72), or took a longer nap (nap time&gt;60 minutes) (HR 1.34, 95% CI 1.05–1.63), napping was significantly associated with a higher risk of CVD comparing to not napping. All-cause mortality was associated with napping overall (HR 1.19, 95% CI 1.12–1.26), and effect sizes were even more pronounced in females (HR 1.22, 95% CI 1.13–1.31), older participants (HR 1.27, 95% CI 1.11–1.45) and those who took a long nap (HR 1.30, 95% CI 1.12–1.47). Furthermore, after stratifying participants by night sleep time (&lt;6 and &gt;6h/day), no significant association was detected except those who slept &gt;6h/day at night and took a long nap (HR 1.13, 95% CI 1.03–1.24). Dose-response analysis showed a J-curve relation between nap time and CVD (Figure 1). The HR decreased from 0 to 25 min/day, followed by a sharp increase in the risk at longer times. A positive linear relationship between nap time and all-cause mortality was also observed. Conclusion Long napping over 60 minutes per day is associated with increased risks of CVD and all-cause mortality. Night sleep duration may play a role in the relation between napping and all-cause mortality. Further, large-scale prospective cohort studies need to confirm our conclusion and investigate the underlying mechanisms driving these associations. Funding Acknowledgement Type of funding source: None

scholarly journals White Meat Consumption, All-Cause Mortality, and Cardiovascular Events: A Meta-Analysis of Prospective Cohort Studies

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 676
Author(s):  
Roberta Lupoli ◽  
Marilena Vitale ◽  
Ilaria Calabrese ◽  
Annalisa Giosuè ◽  
Gabriele Riccardi ◽  
...  
Keyword(s):  
Cohort Studies ◽  
Prospective Cohort ◽  
Meta Analysis ◽  
Meat Consumption ◽  
Processed Meat ◽  
Inverse Association ◽  
White Meat ◽  
Mortality And Morbidity ◽  
Prospective Cohort Studies ◽  
All Cause Mortality

The association of meat consumption with mortality and morbidity for non-communicable diseases has been extensively studied. However, the relation of white meat consumption with health outcomes remains controversial. The present meta-analysis was conducted to comprehensively analyze the available evidence on the consistency and strength of the association between the consumption of white meat, death from any cause and incidence of fatal and non-fatal cardiovascular (CV) events. PubMed, Web of Science, Scopus and Embase databases were searched for articles published up to April 30, 2020. We included prospective cohort studies reporting relative risks and pertinent 95% confidence intervals (CI) for all-cause mortality and/or CV events (fatal or non-fatal). A total of 22 studies were included in the meta-analysis. Eleven studies (14 data sets) reported data on all-cause mortality, 10 studies (15 datasets) on cardiovascular disease (CVD) mortality and 10 studies (11 datasets) on non-fatal CV events. When comparing the highest versus the lowest consumption of white meat, the pooled OR and pertinent 95% CI were 0.94 (0.90, 0.97, p < 0.001) for all-cause mortality, 0.95 (0.89, 1.01, p = 0.13) for CV mortality, and 0.99 (0.95, 1.02, p = 0.48) for non-fatal CV events. In conclusion, the study shows for the first time a robust and inverse association between white meat consumption and all-cause mortality and a neutral association with CV mortality and morbidity. This highlights the importance of differentiating the meat types for what concerns their health effects and suggests that white meat might be a healthier alternative to read and processed meat consumption.

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