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Review
. 2019 Sep 13;11(9):2209.
doi: 10.3390/nu11092209.

Dietary Patterns and Cardiometabolic Outcomes in Diabetes: A Summary of Systematic Reviews and Meta-Analyses

Hana Kahleova  1   2 , Jordi Salas-Salvadó  3   4 , Dario Rahelić  5   6 , Cyril Wc Kendall  7   8   9   10 , Emilie Rembert  11 , John L Sievenpiper  12   13   14   15   16
Affiliations
Review

Dietary Patterns and Cardiometabolic Outcomes in Diabetes: A Summary of Systematic Reviews and Meta-Analyses

Hana Kahleova et al. Nutrients. .

Abstract

The Diabetes and Nutrition Study Group (DNSG) of the European Association for the Study of Diabetes (EASD) conducted a review of existing systematic reviews and meta-analyses to explain the relationship between different dietary patterns and patient-important cardiometabolic outcomes. To update the clinical practice guidelines for nutrition therapy in the prevention and management of diabetes, we summarize the evidence from these evidence syntheses for the Mediterranean, Dietary Approaches to Stop Hypertension (DASH), Portfolio, Nordic, liquid meal replacement, and vegetarian dietary patterns. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of evidence. We summarized the evidence for disease incidence outcomes and risk factor outcomes using risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs), respectively. The Mediterranean diet showed a cardiovascular disease (CVD) incidence (RR: 0.62; 95%CI, 0.50, 0.78), and non-significant CVD mortality (RR: 0.67; 95%CI, 0.45, 1.00) benefit. The DASH dietary pattern improved cardiometabolic risk factors (P < 0.05) and was associated with the decreased incidence of CVD (RR, 0.80; 95%CI, 0.76, 0.85). Vegetarian dietary patterns were associated with improved cardiometabolic risk factors (P < 0.05) and the reduced incidence (0.72; 95%CI: 0.61, 0.85) and mortality (RR, 0.78; 95%CI, 0.69, 0.88) of coronary heart disease. The Portfolio dietary pattern improved cardiometabolic risk factors and reduced estimated 10-year coronary heart disease (CHD) risk by 13% (-1.34% (95%CI, -2.19 to -0.49)). The Nordic dietary pattern was correlated with decreased CVD (0.93 (95%CI, 0.88, 0.99)) and stroke incidence (0.87 (95%CI, 0.77, 0.97)) and, along with liquid meal replacements, improved cardiometabolic risk factors (P < 0.05). The evidence was assessed as low to moderate certainty for most dietary patterns and outcome pairs. Current evidence suggests that the Mediterranean, DASH, Portfolio, Nordic, liquid meal replacement and vegetarian dietary patterns have cardiometabolic advantages in populations inclusive of diabetes.

Keywords: DASH; Mediterranean; Nordic; cardiometabolic outcomes; cardiovascular disease; diabetes; dietary patterns; liquid meal replacements; portfolio; vegetarian.

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Conflict of interest statement

Hana Kahleova works as the Director of Clinical Research at the Physicians Committee for Responsible Medicine, a nonprofit organization promoting plant-based nutrition. Jordi Salas-Salvadó reports serving on the board of the International Nut and Dried Fruit Council, the Danone International Institute, and the Eroski Foundation and receiving grant support from these entities through his institution. He also reports serving on the Executive Committee of the Instituto Danone Spain. He has received research funding from the Instituto de Salud Carlos III, Spain; Ministerio de Educación y Ciencia, Spain; Departament de Salut Pública de la Generalitat de Catalunya, Catalonia, Spain, and the European Commission. He has also received research funding from the California Walnut Commission, Sacramento CA, USA; Patrimonio Comunal Olivarero, Spain; La Morella Nuts, Spain; and Borges S.A., Spain. He reports receiving consulting fees or travel expenses from Danone; the California Walnut Commission, the Eroski Foundation, the Instituto Danone - Spain, Nuts for Life, the Australian Nut Industry Council, Nestlé, Abbot Laboratories, and Font Vella Lanjarón. He is on the Clinical Practice Guidelines Expert Committee of the European Association for the study of Diabetes (EASD) and has served on the Scientific Committee of the Spanish Food and Safety Agency, and the Spanish Federation of the Scientific Societies of Food, Nutrition and Dietetics. He is a member of the International Carbohydrate Quality Consortium (ICQC), and Executive Board Member of the Diabetes and Nutrition Study Group (DNSG) of the EASD. Dario Rahelić has served as principal investigator or co-investigator in clinical trials of AstraZeneca, Eli Lilly, MSD, Novo Nordisk, Sanofi Aventis, Solvay and Trophos. He received honoraria for speaking or advisory board engagements and consulting fees from Abbott, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, Lifescan–Johnson & Johnson, Novartis, Novo Nordisk, MSD, Merck Sharp & Dohme, Pfizer, Pliva, Roche, Salvus, Sanofi Aventis and Takeda. He served as a Board member and Secretary of IDF Europe in biennium 2015–2017. He is a president of Croatian Society for Diabetes and Metabolic Disorders of Croatian Medical Association, chair of IDF Young Leaders in Diabetes Programme, Executive committee member of Diabetes and Cardiovascular Disease Study Group of EASD, Croatian Endocrine Society, Croatian Society for Obesity and Croatian Society for Endocrine Oncology. Cyril WC Kendall has received grants or research support from the Advanced Food Materials Network, Agriculture and Agri-Foods Canada (AAFC), Almond Board of California, American Pistachio Growers, Barilla, Calorie Control Council, Canadian Institutes of Health Research (CIHR), Canola Council of Canada, International Nut and Dried Fruit Council, International Tree Nut Council Research and Education Foundation, Loblaw Brands Ltd., Pulse Canada, Saskatchewan Pulse Growers and Unilever. He has received in-kind research support from the Almond Board of California, American Peanut Council, Barilla, California Walnut Commission, Kellogg Canada, Loblaw Companies, Quaker (Pepsico), Primo, Unico, Unilever, WhiteWave Foods. He has received travel support and/or honoraria from the American Peanut Council, American Pistachio Growers, Barilla, California Walnut Commission, Canola Council of Canada, General Mills, International Nut and Dried Fruit Council, International Pasta Organization, Loblaw Brands Ltd., Nutrition Foundation of Italy, Oldways Preservation Trust, Paramount Farms, Peanut Institute, Pulse Canada, Sabra Dipping Co., Saskatchewan Pulse Growers, Sun-Maid, Tate & Lyle, Unilever and White Wave Foods. He has served on the scientific advisory board for the International Tree Nut Council, International Pasta Organization, McCormick Science Institute, Oldways Preservation Trust, Paramount Farms and Pulse Canada. He is a member of the International Carbohydrate Quality Consortium (ICQC), Executive Board Member of the Diabetes and Nutrition Study Group (DNSG) of the European Association for the Study of Diabetes (EASD), is on the Clinical Practice Guidelines Expert Committee for Nutrition Therapy of the EASD and is a Director of the Toronto 3D Knowledge Synthesis and Clinical Trials foundation. Emilie Rembert works as a Clinical Research Assistant at the Physicians Committee for Responsible Medicine, a nonprofit organization promoting plant-based nutrition. John L Sievenpiper has received research support from the Canadian Foundation for Innovation, Ontario Research Fund, Province of Ontario Ministry of Research and Innovation and Science, Canadian Institutes of health Research (CIHR), Diabetes Canada, PSI Foundation, Banting and Best Diabetes Centre (BBDC), American Society for Nutrition (ASN), INC International Nut and Dried Fruit Council Foundation, National Dried Fruit Trade Association, The Tate and Lyle Nutritional Research Fund at the University of Toronto, The Glycemic Control and Cardiovascular Disease in Type 2 Diabetes Fund at the University of Toronto (a fund established by the Alberta Pulse Growers), and the Nutrition Trialists Fund at the University of Toronto (a fund established by an inaugural donation from the Calorie Control Council). He has received in-kind food donations to support a randomized controlled trial from the Almond Board of California, California Walnut Commission, American Peanut Council, Barilla, Unilever, Unico/Primo, Loblaw Companies, Quaker, Kellogg Canada, and WhiteWave Foods. He has received travel support, speaker fees and/or honoraria from Diabetes Canada, Mott’s LLP, Dairy Farmers of Canada, FoodMinds LLC, International Sweeteners Association, Nestlé, Pulse Canada, Canadian Society for Endocrinology and Metabolism (CSEM), GI Foundation, Abbott, Biofortis, ASN, Northern Ontario School of Medicine, INC Nutrition Research & Education Foundation, European Food Safety Authority (EFSA), and Physicians Committee for Responsible Medicine. He has or has had ad hoc consulting arrangements with Perkins Coie LLP, Tate & Lyle, and Wirtschaftliche Vereinigung Zucker e.V. He is a member of the European Fruit Juice Association Scientific Expert Panel. He is on the Clinical Practice Guidelines Expert Committees of Diabetes Canada, European Association for the study of Diabetes (EASD), Canadian Cardiovascular Society (CCS), and Obesity Canada. He serves or has served as an unpaid scientific advisor for the Food, Nutrition, and Safety Program (FNSP) and the Technical Committee on Carbohydrates of the International Life Science Institute (ILSI) North America. He is a member of the International Carbohydrate Quality Consortium (ICQC), Executive Board Member of the Diabetes and Nutrition Study Group (DNSG) of the EASD, and Director of the Toronto 3D Knowledge Synthesis and Clinical Trials foundation. His wife is an employee of Sobeys Inc.

Figures

Figure 1
Figure 1
The study selection flow diagram. SRMA: Systematic review and meta-analysis. RCT: Randomized controlled trial. DASH: Dietary Approaches to Stop Hypertension.
Figure 2
Figure 2
Summary and GRADE of the pooled effect estimates of prospective cohort studies, randomized controlled trials, and systematic reviews and meta-analyses assessing the association between dietary patterns and the incidence and mortality of major cardiovascular events. RR: Risk ratio. CI: confidence interval. CVD: cardiovascular disease. CHD: coronary heart disease. (A) Mediterranean Diet Randomized Clinical Trials. Reprinted from Critical Reviews in Food Science and Nutrition, Nerea Becerra-Tomás, Sonia Blanco Mejía, Effie Viguiliouk, Tauseef Khan, Cyril W.C. Kendall, Hana Kahleová, Dario Rahelić, John L. Sievenpiper, and Jordi Salas-Salvadó, Mediterranean Diet, Cardiovascular Disease and Mortality in Diabetes: A Systematic Review and Meta-Analysis of Prospective Cohort Studies and Randomized Clinical Trials, 2019 Taylor & Francis Ltd., https://doi.org/10.1080/10408398.2019.1565281 reprinted by permission of the publisher (Taylor & Francis Ltd., http://www.tandfonline.com). (B) Mediterranean Diet Prospective Cohorts. Reprinted from Critical Reviews in Food Science and Nutrition, Nerea Becerra-Tomás, Sonia Blanco Mejía, Effie Viguiliouk, Tauseef Khan, Cyril W.C. Kendall, Hana Kahleová, Dario Rahelić, John L. Sievenpiper, and Jordi Salas-Salvadó, Mediterranean Diet, Cardiovascular Disease and Mortality in Diabetes: A Systematic Review and Meta-Analysis of Prospective Cohort Studies and Randomized Clinical Trials, 2019 Taylor & Francis Ltd., https://doi.org/10.1080/10408398.2019.1565281 reprinted by permission of the publisher (Taylor & Francis Ltd., http://www.tandfonline.com). (C) Dietary Approaches to Stop Hypertension (DASH) Diet Prospective Cohorts. (D) Vegetarian Diet Prospective Cohorts.
Figure 2
Figure 2
Summary and GRADE of the pooled effect estimates of prospective cohort studies, randomized controlled trials, and systematic reviews and meta-analyses assessing the association between dietary patterns and the incidence and mortality of major cardiovascular events. RR: Risk ratio. CI: confidence interval. CVD: cardiovascular disease. CHD: coronary heart disease. (A) Mediterranean Diet Randomized Clinical Trials. Reprinted from Critical Reviews in Food Science and Nutrition, Nerea Becerra-Tomás, Sonia Blanco Mejía, Effie Viguiliouk, Tauseef Khan, Cyril W.C. Kendall, Hana Kahleová, Dario Rahelić, John L. Sievenpiper, and Jordi Salas-Salvadó, Mediterranean Diet, Cardiovascular Disease and Mortality in Diabetes: A Systematic Review and Meta-Analysis of Prospective Cohort Studies and Randomized Clinical Trials, 2019 Taylor & Francis Ltd., https://doi.org/10.1080/10408398.2019.1565281 reprinted by permission of the publisher (Taylor & Francis Ltd., http://www.tandfonline.com). (B) Mediterranean Diet Prospective Cohorts. Reprinted from Critical Reviews in Food Science and Nutrition, Nerea Becerra-Tomás, Sonia Blanco Mejía, Effie Viguiliouk, Tauseef Khan, Cyril W.C. Kendall, Hana Kahleová, Dario Rahelić, John L. Sievenpiper, and Jordi Salas-Salvadó, Mediterranean Diet, Cardiovascular Disease and Mortality in Diabetes: A Systematic Review and Meta-Analysis of Prospective Cohort Studies and Randomized Clinical Trials, 2019 Taylor & Francis Ltd., https://doi.org/10.1080/10408398.2019.1565281 reprinted by permission of the publisher (Taylor & Francis Ltd., http://www.tandfonline.com). (C) Dietary Approaches to Stop Hypertension (DASH) Diet Prospective Cohorts. (D) Vegetarian Diet Prospective Cohorts.
Figure 2
Figure 2
Summary and GRADE of the pooled effect estimates of prospective cohort studies, randomized controlled trials, and systematic reviews and meta-analyses assessing the association between dietary patterns and the incidence and mortality of major cardiovascular events. RR: Risk ratio. CI: confidence interval. CVD: cardiovascular disease. CHD: coronary heart disease. (A) Mediterranean Diet Randomized Clinical Trials. Reprinted from Critical Reviews in Food Science and Nutrition, Nerea Becerra-Tomás, Sonia Blanco Mejía, Effie Viguiliouk, Tauseef Khan, Cyril W.C. Kendall, Hana Kahleová, Dario Rahelić, John L. Sievenpiper, and Jordi Salas-Salvadó, Mediterranean Diet, Cardiovascular Disease and Mortality in Diabetes: A Systematic Review and Meta-Analysis of Prospective Cohort Studies and Randomized Clinical Trials, 2019 Taylor & Francis Ltd., https://doi.org/10.1080/10408398.2019.1565281 reprinted by permission of the publisher (Taylor & Francis Ltd., http://www.tandfonline.com). (B) Mediterranean Diet Prospective Cohorts. Reprinted from Critical Reviews in Food Science and Nutrition, Nerea Becerra-Tomás, Sonia Blanco Mejía, Effie Viguiliouk, Tauseef Khan, Cyril W.C. Kendall, Hana Kahleová, Dario Rahelić, John L. Sievenpiper, and Jordi Salas-Salvadó, Mediterranean Diet, Cardiovascular Disease and Mortality in Diabetes: A Systematic Review and Meta-Analysis of Prospective Cohort Studies and Randomized Clinical Trials, 2019 Taylor & Francis Ltd., https://doi.org/10.1080/10408398.2019.1565281 reprinted by permission of the publisher (Taylor & Francis Ltd., http://www.tandfonline.com). (C) Dietary Approaches to Stop Hypertension (DASH) Diet Prospective Cohorts. (D) Vegetarian Diet Prospective Cohorts.
Figure 3
Figure 3
Summary and GRADE of the pooled effect estimates of prospective cohort studies, randomized controlled trials, and systematic reviews and meta-analyses assessing the association between dietary patterns and cardiometabolic risk factors. MD: mean difference. CI: confidence interval. HbA1c: hemoglobin A1c. LDL-C: low-density lipoprotein cholesterol. HDL-C: high-density lipoprotein cholesterol. Non-HDL-C: non-high-density lipoprotein cholesterol. BMI: body mass index. BP: blood pressure. ApoB: apolipoprotein B. CRP: c-reactive protein. CHD: coronary heart disease. (A) Mediterranean Diet Prospective Cohorts and Randomized Clinical Trials. Reprinted from Progress in Cardiovascular Diseases, Volume 61, Jordi Salad-Salvadó, Nerea Becerra-Tomás, Jesús Francisco García-Gavilán, Mònica Bulló, Laura Barrubés, Mediterranean Diet and Cardiovascular Disease Prevention: What Do We Know?, 62–67., https://doi.org/10.1016/j.pcad.2018.04.006. Copyright 2018, with permission from Elsevier. (B) DASH Diet Controlled Trials. (C) Portfolio Diet Controlled Trials. Reprinted from Progress in Cardiovascular Diseases, 61(1), Laura Chiavaroli, Stephanie K. Nishi, Tauseef A. Khan, Catherine R. Braunstein, Andrea J. Glenn, Sonia Blanco Mejia, Dario Rahelic, Hana Kahleova, Jordi Salas-Salvado, David J.A Jenkins, Cyril W.C Kendall, Johns L. Sievenpiper, Portfolio Dietary Pattern and Cardiovascular Disease: A Systematic Review and Meta-Analysis of Controlled Trials, 45–53., https://doi.org/10.1016/j.pcad.2018.05.004, Copyright (2018), with permission from Elsevier. (D) Liquid Meal Replacement Diet Randomized Controlled Trails. Reprinted with permission from Jarvis. C Noronha, Stephanie K. Nishi, Catherine R. Braunstein, Tauseef A. Khan, Sonia Blanco Mejia, Cyril W.C. Kendall, Hana Kahleová, Dario Rahelić, Jordi Salas-Salvadó, Lawrence A. Leiter and John L. Sievenpiper: The Effect of Liquid Meal Replacements on Cardiometabolic Risk Factors in Overweight/Obese Individuals With Type 2 Diabetes: A systematic Review and Meta-analysis of Randomized Controlled Trials, Diabetes Care 2019 May; 42(5): 767–776: https://doi.org/10.2337/dc18-2270. Copyright 2019 by the American Diabetes Association. (E) Vegetarian Diet Randomized Controlled Trials. Reprinted from Clinical Nutrition, 38(3), Effie Viguiliouk, Cyril WC. Kendall, Hana Kahleová, Dario Rahelić, Jordi Salas-Salvadó, Vivian L. Choo, Sonia Blanco Mejia, Sarah E. Stewart, Lawrence A. Leiter, David JA. Jenkins, John L. Sievenpiper, Effect of Vegetarian Dietary Patterns on Cardiometabolic Risk Factors in Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials, 1133–1145., https://doi.org/10.1016/j.clnu.2018.05.032, Copyright (2018), with permission from Elsevier.
Figure 3
Figure 3
Summary and GRADE of the pooled effect estimates of prospective cohort studies, randomized controlled trials, and systematic reviews and meta-analyses assessing the association between dietary patterns and cardiometabolic risk factors. MD: mean difference. CI: confidence interval. HbA1c: hemoglobin A1c. LDL-C: low-density lipoprotein cholesterol. HDL-C: high-density lipoprotein cholesterol. Non-HDL-C: non-high-density lipoprotein cholesterol. BMI: body mass index. BP: blood pressure. ApoB: apolipoprotein B. CRP: c-reactive protein. CHD: coronary heart disease. (A) Mediterranean Diet Prospective Cohorts and Randomized Clinical Trials. Reprinted from Progress in Cardiovascular Diseases, Volume 61, Jordi Salad-Salvadó, Nerea Becerra-Tomás, Jesús Francisco García-Gavilán, Mònica Bulló, Laura Barrubés, Mediterranean Diet and Cardiovascular Disease Prevention: What Do We Know?, 62–67., https://doi.org/10.1016/j.pcad.2018.04.006. Copyright 2018, with permission from Elsevier. (B) DASH Diet Controlled Trials. (C) Portfolio Diet Controlled Trials. Reprinted from Progress in Cardiovascular Diseases, 61(1), Laura Chiavaroli, Stephanie K. Nishi, Tauseef A. Khan, Catherine R. Braunstein, Andrea J. Glenn, Sonia Blanco Mejia, Dario Rahelic, Hana Kahleova, Jordi Salas-Salvado, David J.A Jenkins, Cyril W.C Kendall, Johns L. Sievenpiper, Portfolio Dietary Pattern and Cardiovascular Disease: A Systematic Review and Meta-Analysis of Controlled Trials, 45–53., https://doi.org/10.1016/j.pcad.2018.05.004, Copyright (2018), with permission from Elsevier. (D) Liquid Meal Replacement Diet Randomized Controlled Trails. Reprinted with permission from Jarvis. C Noronha, Stephanie K. Nishi, Catherine R. Braunstein, Tauseef A. Khan, Sonia Blanco Mejia, Cyril W.C. Kendall, Hana Kahleová, Dario Rahelić, Jordi Salas-Salvadó, Lawrence A. Leiter and John L. Sievenpiper: The Effect of Liquid Meal Replacements on Cardiometabolic Risk Factors in Overweight/Obese Individuals With Type 2 Diabetes: A systematic Review and Meta-analysis of Randomized Controlled Trials, Diabetes Care 2019 May; 42(5): 767–776: https://doi.org/10.2337/dc18-2270. Copyright 2019 by the American Diabetes Association. (E) Vegetarian Diet Randomized Controlled Trials. Reprinted from Clinical Nutrition, 38(3), Effie Viguiliouk, Cyril WC. Kendall, Hana Kahleová, Dario Rahelić, Jordi Salas-Salvadó, Vivian L. Choo, Sonia Blanco Mejia, Sarah E. Stewart, Lawrence A. Leiter, David JA. Jenkins, John L. Sievenpiper, Effect of Vegetarian Dietary Patterns on Cardiometabolic Risk Factors in Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials, 1133–1145., https://doi.org/10.1016/j.clnu.2018.05.032, Copyright (2018), with permission from Elsevier.
Figure 3
Figure 3
Summary and GRADE of the pooled effect estimates of prospective cohort studies, randomized controlled trials, and systematic reviews and meta-analyses assessing the association between dietary patterns and cardiometabolic risk factors. MD: mean difference. CI: confidence interval. HbA1c: hemoglobin A1c. LDL-C: low-density lipoprotein cholesterol. HDL-C: high-density lipoprotein cholesterol. Non-HDL-C: non-high-density lipoprotein cholesterol. BMI: body mass index. BP: blood pressure. ApoB: apolipoprotein B. CRP: c-reactive protein. CHD: coronary heart disease. (A) Mediterranean Diet Prospective Cohorts and Randomized Clinical Trials. Reprinted from Progress in Cardiovascular Diseases, Volume 61, Jordi Salad-Salvadó, Nerea Becerra-Tomás, Jesús Francisco García-Gavilán, Mònica Bulló, Laura Barrubés, Mediterranean Diet and Cardiovascular Disease Prevention: What Do We Know?, 62–67., https://doi.org/10.1016/j.pcad.2018.04.006. Copyright 2018, with permission from Elsevier. (B) DASH Diet Controlled Trials. (C) Portfolio Diet Controlled Trials. Reprinted from Progress in Cardiovascular Diseases, 61(1), Laura Chiavaroli, Stephanie K. Nishi, Tauseef A. Khan, Catherine R. Braunstein, Andrea J. Glenn, Sonia Blanco Mejia, Dario Rahelic, Hana Kahleova, Jordi Salas-Salvado, David J.A Jenkins, Cyril W.C Kendall, Johns L. Sievenpiper, Portfolio Dietary Pattern and Cardiovascular Disease: A Systematic Review and Meta-Analysis of Controlled Trials, 45–53., https://doi.org/10.1016/j.pcad.2018.05.004, Copyright (2018), with permission from Elsevier. (D) Liquid Meal Replacement Diet Randomized Controlled Trails. Reprinted with permission from Jarvis. C Noronha, Stephanie K. Nishi, Catherine R. Braunstein, Tauseef A. Khan, Sonia Blanco Mejia, Cyril W.C. Kendall, Hana Kahleová, Dario Rahelić, Jordi Salas-Salvadó, Lawrence A. Leiter and John L. Sievenpiper: The Effect of Liquid Meal Replacements on Cardiometabolic Risk Factors in Overweight/Obese Individuals With Type 2 Diabetes: A systematic Review and Meta-analysis of Randomized Controlled Trials, Diabetes Care 2019 May; 42(5): 767–776: https://doi.org/10.2337/dc18-2270. Copyright 2019 by the American Diabetes Association. (E) Vegetarian Diet Randomized Controlled Trials. Reprinted from Clinical Nutrition, 38(3), Effie Viguiliouk, Cyril WC. Kendall, Hana Kahleová, Dario Rahelić, Jordi Salas-Salvadó, Vivian L. Choo, Sonia Blanco Mejia, Sarah E. Stewart, Lawrence A. Leiter, David JA. Jenkins, John L. Sievenpiper, Effect of Vegetarian Dietary Patterns on Cardiometabolic Risk Factors in Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials, 1133–1145., https://doi.org/10.1016/j.clnu.2018.05.032, Copyright (2018), with permission from Elsevier.
Figure 3
Figure 3
Summary and GRADE of the pooled effect estimates of prospective cohort studies, randomized controlled trials, and systematic reviews and meta-analyses assessing the association between dietary patterns and cardiometabolic risk factors. MD: mean difference. CI: confidence interval. HbA1c: hemoglobin A1c. LDL-C: low-density lipoprotein cholesterol. HDL-C: high-density lipoprotein cholesterol. Non-HDL-C: non-high-density lipoprotein cholesterol. BMI: body mass index. BP: blood pressure. ApoB: apolipoprotein B. CRP: c-reactive protein. CHD: coronary heart disease. (A) Mediterranean Diet Prospective Cohorts and Randomized Clinical Trials. Reprinted from Progress in Cardiovascular Diseases, Volume 61, Jordi Salad-Salvadó, Nerea Becerra-Tomás, Jesús Francisco García-Gavilán, Mònica Bulló, Laura Barrubés, Mediterranean Diet and Cardiovascular Disease Prevention: What Do We Know?, 62–67., https://doi.org/10.1016/j.pcad.2018.04.006. Copyright 2018, with permission from Elsevier. (B) DASH Diet Controlled Trials. (C) Portfolio Diet Controlled Trials. Reprinted from Progress in Cardiovascular Diseases, 61(1), Laura Chiavaroli, Stephanie K. Nishi, Tauseef A. Khan, Catherine R. Braunstein, Andrea J. Glenn, Sonia Blanco Mejia, Dario Rahelic, Hana Kahleova, Jordi Salas-Salvado, David J.A Jenkins, Cyril W.C Kendall, Johns L. Sievenpiper, Portfolio Dietary Pattern and Cardiovascular Disease: A Systematic Review and Meta-Analysis of Controlled Trials, 45–53., https://doi.org/10.1016/j.pcad.2018.05.004, Copyright (2018), with permission from Elsevier. (D) Liquid Meal Replacement Diet Randomized Controlled Trails. Reprinted with permission from Jarvis. C Noronha, Stephanie K. Nishi, Catherine R. Braunstein, Tauseef A. Khan, Sonia Blanco Mejia, Cyril W.C. Kendall, Hana Kahleová, Dario Rahelić, Jordi Salas-Salvadó, Lawrence A. Leiter and John L. Sievenpiper: The Effect of Liquid Meal Replacements on Cardiometabolic Risk Factors in Overweight/Obese Individuals With Type 2 Diabetes: A systematic Review and Meta-analysis of Randomized Controlled Trials, Diabetes Care 2019 May; 42(5): 767–776: https://doi.org/10.2337/dc18-2270. Copyright 2019 by the American Diabetes Association. (E) Vegetarian Diet Randomized Controlled Trials. Reprinted from Clinical Nutrition, 38(3), Effie Viguiliouk, Cyril WC. Kendall, Hana Kahleová, Dario Rahelić, Jordi Salas-Salvadó, Vivian L. Choo, Sonia Blanco Mejia, Sarah E. Stewart, Lawrence A. Leiter, David JA. Jenkins, John L. Sievenpiper, Effect of Vegetarian Dietary Patterns on Cardiometabolic Risk Factors in Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials, 1133–1145., https://doi.org/10.1016/j.clnu.2018.05.032, Copyright (2018), with permission from Elsevier.
Figure 3
Figure 3
Summary and GRADE of the pooled effect estimates of prospective cohort studies, randomized controlled trials, and systematic reviews and meta-analyses assessing the association between dietary patterns and cardiometabolic risk factors. MD: mean difference. CI: confidence interval. HbA1c: hemoglobin A1c. LDL-C: low-density lipoprotein cholesterol. HDL-C: high-density lipoprotein cholesterol. Non-HDL-C: non-high-density lipoprotein cholesterol. BMI: body mass index. BP: blood pressure. ApoB: apolipoprotein B. CRP: c-reactive protein. CHD: coronary heart disease. (A) Mediterranean Diet Prospective Cohorts and Randomized Clinical Trials. Reprinted from Progress in Cardiovascular Diseases, Volume 61, Jordi Salad-Salvadó, Nerea Becerra-Tomás, Jesús Francisco García-Gavilán, Mònica Bulló, Laura Barrubés, Mediterranean Diet and Cardiovascular Disease Prevention: What Do We Know?, 62–67., https://doi.org/10.1016/j.pcad.2018.04.006. Copyright 2018, with permission from Elsevier. (B) DASH Diet Controlled Trials. (C) Portfolio Diet Controlled Trials. Reprinted from Progress in Cardiovascular Diseases, 61(1), Laura Chiavaroli, Stephanie K. Nishi, Tauseef A. Khan, Catherine R. Braunstein, Andrea J. Glenn, Sonia Blanco Mejia, Dario Rahelic, Hana Kahleova, Jordi Salas-Salvado, David J.A Jenkins, Cyril W.C Kendall, Johns L. Sievenpiper, Portfolio Dietary Pattern and Cardiovascular Disease: A Systematic Review and Meta-Analysis of Controlled Trials, 45–53., https://doi.org/10.1016/j.pcad.2018.05.004, Copyright (2018), with permission from Elsevier. (D) Liquid Meal Replacement Diet Randomized Controlled Trails. Reprinted with permission from Jarvis. C Noronha, Stephanie K. Nishi, Catherine R. Braunstein, Tauseef A. Khan, Sonia Blanco Mejia, Cyril W.C. Kendall, Hana Kahleová, Dario Rahelić, Jordi Salas-Salvadó, Lawrence A. Leiter and John L. Sievenpiper: The Effect of Liquid Meal Replacements on Cardiometabolic Risk Factors in Overweight/Obese Individuals With Type 2 Diabetes: A systematic Review and Meta-analysis of Randomized Controlled Trials, Diabetes Care 2019 May; 42(5): 767–776: https://doi.org/10.2337/dc18-2270. Copyright 2019 by the American Diabetes Association. (E) Vegetarian Diet Randomized Controlled Trials. Reprinted from Clinical Nutrition, 38(3), Effie Viguiliouk, Cyril WC. Kendall, Hana Kahleová, Dario Rahelić, Jordi Salas-Salvadó, Vivian L. Choo, Sonia Blanco Mejia, Sarah E. Stewart, Lawrence A. Leiter, David JA. Jenkins, John L. Sievenpiper, Effect of Vegetarian Dietary Patterns on Cardiometabolic Risk Factors in Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials, 1133–1145., https://doi.org/10.1016/j.clnu.2018.05.032, Copyright (2018), with permission from Elsevier.
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MeSH terms

  NODES
Association 23
innovation 2
INTERN 14
twitter 2