scholarly journals Effect of low glycaemic index or load dietary patterns on glycaemic control and cardiometabolic risk factors in diabetes: systematic review and meta-analysis of randomised controlled trials

BMJ ◽  
2021 ◽  
pp. n2114
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Glycaemic Control ◽  
Dietary Patterns ◽  
Randomised Controlled Trials ◽  
Cardiometabolic Risk ◽  
Meta Analysis ◽  
Glycaemic Index ◽  
Controlled Trials ◽  
Randomised Controlled

scholarly journals Effect of low glycaemic index or load dietary patterns on glycaemic control and cardiometabolic risk factors in diabetes: systematic review and meta-analysis of randomised controlled trials

BMJ ◽  
2021 ◽  
pp. n1651 ◽  
Author(s):  
Laura Chiavaroli ◽  
Danielle Lee ◽  
Amna Ahmed ◽  
Annette Cheung ◽  
Tauseef A Khan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Glycaemic Control ◽  
Dietary Patterns ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Glycaemic Index ◽  
Controlled Trials ◽  
Apo B ◽  
Randomised Controlled

Abstract Objective To inform the update of the European Association for the Study of Diabetes clinical practice guidelines for nutrition therapy. Design Systematic review and meta-analysis of randomised controlled trials. Data sources Medline, Embase, and the Cochrane Library searched up to 13 May 2021. Eligibility criteria for selecting studies Randomised controlled trials of three or more weeks investigating the effect of diets with low glycaemic index (GI)/glycaemic load (GL) in diabetes. Outcome and measures The primary outcome was glycated haemoglobin (HbA 1c ). Secondary outcomes included other markers of glycaemic control (fasting glucose, fasting insulin); blood lipids (low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), non-HDL-C, apo B, triglycerides); adiposity (body weight, BMI, waist circumference), blood pressure (systolic blood pressure (SBP) and diastolic blood pressure (DBP)), and inflammation (C reactive protein (CRP)). Data extraction and synthesis Two independent reviewers extracted data and assessed risk of bias. Data were pooled by random effects models. GRADE (grading of recommendations assessment, development, and evaluation) was used to assess the certainty of evidence. Results 29 trial comparisons were identified in 1617 participants with type 1 and 2 diabetes who were predominantly middle aged, overweight, or obese with moderately controlled type 2 diabetes treated by hyperglycaemia drugs or insulin. Low GI/GL dietary patterns reduced HbA 1c in comparison with higher GI/GL control diets (mean difference −0.31% (95% confidence interval −0.42 to −0.19%), P<0.001; substantial heterogeneity, I 2 =75%, P<0.001). Reductions occurred also in fasting glucose, LDL-C, non-HDL-C, apo B, triglycerides, body weight, BMI, and CRP (P<0.05), but not blood insulin, HDL-C, waist circumference, or blood pressure. A positive dose-response gradient was seen for the difference in GL and HbA 1c and for absolute dietary GI and SBP (P<0.05). The certainty of evidence was high for the reduction in HbA 1c and moderate for most secondary outcomes, with downgrades due mainly to imprecision. Conclusions This synthesis suggests that low GI/GL dietary patterns result in small important improvements in established targets of glycaemic control, blood lipids, adiposity, and inflammation beyond concurrent treatment with hyperglycaemia drugs or insulin, predominantly in adults with moderately controlled type 1 and type 2 diabetes. The available evidence provides a good indication of the likely benefit in this population. Study registration ClinicalTrials.gov NCT04045938 .

scholarly journals Effect of pasta in the context of low-glycaemic index dietary patterns on body weight and markers of adiposity: a systematic review and meta-analysis of randomised controlled trials in adults

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e019438 ◽  
Author(s):  
Laura Chiavaroli ◽  
Cyril W C Kendall ◽  
Catherine R Braunstein ◽  
Sonia Blanco Mejia ◽  
Lawrence A Leiter ◽  
...  
Keyword(s):  
Systematic Review ◽  
Body Weight ◽  
Body Fat ◽  
Dietary Patterns ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Glycaemic Index ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomised Controlled

ObjectiveCarbohydrate staples such as pasta have been implicated in the obesity epidemic. It is unclear whether pasta contributes to weight gain or like other low-glycaemic index (GI) foods contributes to weight loss. We synthesised the evidence of the effect of pasta on measures of adiposity.DesignSystematic review and meta-analysis using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.Data sourcesMEDLINE, Embase, CINAHL and the Cochrane Library were searched through 7 February 2017.Eligibility criteria for selecting studiesWe included randomised controlled trials ≥3 weeks assessing the effect of pasta alone or in the context of low-GI dietary patterns on measures of global (body weight, body mass index (BMI), body fat) and regional (waist circumference (WC), waist-to-hip ratio (WHR), sagittal abdominal diameter (SAD)) adiposity in adults.Data extraction and synthesisTwo independent reviewers extracted data and assessed risk of bias. Data were pooled using the generic inverse-variance method and expressed as mean differences (MDs) with 95% CIs. Heterogeneity was assessed (Cochran Q statistic) and quantified (I2statistic). GRADE assessed the certainty of the evidence.ResultsWe identified no trial comparisons of the effect of pasta alone and 32 trial comparisons (n=2448 participants) of the effect of pasta in the context of low-GI dietary patterns. Pasta in the context of low-GI dietary patterns significantly reduced body weight (MD=−0.63 kg; 95% CI −0.84 to –0.42 kg) and BMI (MD=−0.26 kg/m2; 95% CI −0.36 to –0.16 kg/m2) compared with higher-GI dietary patterns. There was no effect on other measures of adiposity. The certainty of the evidence was graded as moderate for body weight, BMI, WHR and SAD and low for WC and body fat.ConclusionsPasta in the context of low-GI dietary patterns does not adversely affect adiposity and even reduces body weight and BMI compared with higher-GI dietary patterns. Future trials should assess the effect of pasta in the context of other ‘healthy’ dietary patterns.Trial registration numberNCT02961088; Results.

scholarly journals Multifactorial e- and mHealth interventions for cardiovascular disease primary prevention: Protocol for a systematic review and meta-analysis of randomised controlled trials

2019 ◽  
Vol 5 ◽  
pp. 205520761989048
Author(s):  
Artur Direito ◽  
Jonathan Rawstorn ◽  
Jacqueline Mair ◽  
Reza Daryabeygi-Khotbehsara ◽  
Ralph Maddison ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Community Dwelling ◽  
Controlled Trials ◽  
Cvd Risk ◽  
Health Lifestyle ◽  
Randomised Controlled ◽  
Preventative Interventions

Objective Cardiovascular diseases (CVD) are a leading cause of mortality and disease burden. Preventative interventions to augment the population-level adoption of health lifestyle behaviours that reduce CVD risk are a priority. Face-to-face interventions afford individualisation and are effective for improving health-related behaviours and outcomes, but they are costly and resource intensive. Electronic and mobile health (e- and mHealth) approaches aimed at modifying lifestyle risk factors may be an effective and scalable approach to reach many individuals while preserving individualisation. This systematic review aims to (a) determine the effectiveness of multifactorial e- and mHealth interventions on CVD risk and on lifestyle-related cardiometabolic risk factors and self-management behaviours among adults without CVD; and (b) describe the evidence on adverse events and on the cost-effectiveness of these interventions. Methods Methods were detailed prior to the start of the review in order to improve conduct and prevent inconsistent decision making throughout the review. This protocol was prepared following the PRISMA-P 2015 statement. MEDLINE, CINAHL, Embase, PsycINFO, Web of Science, Cochrane Public Health Group Specialised Register and CENTRAL electronic databases will be searched between 1991 and September 2019. Eligibility criteria are: (a) population: community-dwelling adults; (b) intervention/comparison: randomised controlled trials comparing e- or mHealth CVD risk preventative interventions with usual care; and (c) outcomes: modifiable CVD risk factors. Selection of study reports will involve two authors independently screening titles and abstracts, followed by a full-text review of potentially eligible reports. Two authors will independently undertake data extraction and assess risk of bias. Where appropriate, meta-analysis of outcome data will be performed. Discussion This protocol describes the pre-specified methods for a systematic review that will provide quantitative and narrative syntheses of current multifactorial e- and mHealth CVD preventative interventions. A systematic review and meta-analysis will be conducted following the methods outlined in the Cochrane Handbook for Systematic Reviews of Interventions and reported according to PRISMA guidelines.

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