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Effect of vegetarian diets on the presentation of metabolic syndrome or its components: A systematic review and meta-analysis.
Clin Nutr. 2019 06; 38(3):1117-1132.CN

Abstract

BACKGROUND & AIMS

Several studies have examined the effect of vegetarian diets (VD) on metabolic syndrome (MetS) or its components, but findings have been inconsistent. The aim of this study was to perform a systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies to assess the association between VD and MetS or its components (systolic blood pressure [SBP], diastolic blood pressure [DBP], fasting glucose triglycerides, waist circumference [WC], HDL-cholesterol (HDL-C)) in adults.

METHODS

The Cochrane Library, EMBASE, PubMed, Web of Science, and Scopus were searched. RCTs, cohort studies and cross-sectional studies evaluating the effects of VD on MetS or its components in adults, with omnivore diet as control group, were included. Random effects meta-analyses stratified by study design were employed to calculate pooled estimates.

RESULTS

A total of 71 studies (n = 103 008) met the inclusion criteria (6 RCTs, 2 cohorts, 63 cross-sectional). VD were not associated with MetS in comparison to omnivorous diet (OR 0.96, 95% CI 0.50-1.85, p = 0.9) according to meta-analysis of five cross-sectional studies. Likewise, meta-analysis of RCTs and cohort studies indicated that consumption of VD were not associated with MetS components. Meta-analysis of cross-sectional studies demonstrated that VD were significantly associated with lower levels of SBP (mean difference [MD] -4.18 mmHg, 95%CI -5.57 to -2.80, p < 0.00001), DBP (MD -3.03 mmHg, 95% CI -4.93 to -1.13, p = 0.002), fasting glucose (MD -0.26 mmol/L, 95% CI -0.35to -0.17, p < 0.00001), WC (MD -1.63 cm, 95% CI -3.13 to -0.13, p = 0.03), and HDL-C (MD -0.05 mmol/L, 95% CI -0.07 to -0.03, p < 0.0001) in comparison to omnivorous diet. Heterogeneity of effects among cross-sectional studies was high. About, one-half of the included studies had high risk of bias.

CONCLUSIONS

VD in comparison with omnivorous diet is not associated with a lower risk of MetS based on results of meta-analysis of cross-sectional studies. The association between VD and lower levels of SBP, DBP, HDL-C, and fasting glucose is uncertain due to high heterogeneity across the cross-sectional studies. Larger and controlled studies are needed to evaluate the association between VD and MetS and its components.

Authors+Show Affiliations

School of Nutrition, Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru. Electronic address: mariaclaudiapicasso@gmail.com.School of Nutrition, Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru. Electronic address: jlotayraco@gmail.com.School of Nutrition, Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru. Electronic address: jurv1114@gmail.com.ProEd Communications Inc., Cleveland, OH 44122, USA. Electronic address: lepiscean@gmail.com.School of Medicine, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru; University of Connecticut/Hartford Hospital Evidence-based Practice Center, Hartford, CT 06102, USA. Electronic address: adrianhernandezdiaz@gmail.com.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

29907356

Citation

Picasso, Maria C., et al. "Effect of Vegetarian Diets On the Presentation of Metabolic Syndrome or Its Components: a Systematic Review and Meta-analysis." Clinical Nutrition (Edinburgh, Scotland), vol. 38, no. 3, 2019, pp. 1117-1132.
Picasso MC, Lo-Tayraco JA, Ramos-Villanueva JM, et al. Effect of vegetarian diets on the presentation of metabolic syndrome or its components: A systematic review and meta-analysis. Clin Nutr. 2019;38(3):1117-1132.
Picasso, M. C., Lo-Tayraco, J. A., Ramos-Villanueva, J. M., Pasupuleti, V., & Hernandez, A. V. (2019). Effect of vegetarian diets on the presentation of metabolic syndrome or its components: A systematic review and meta-analysis. Clinical Nutrition (Edinburgh, Scotland), 38(3), 1117-1132. https://doi.org/10.1016/j.clnu.2018.05.021
Picasso MC, et al. Effect of Vegetarian Diets On the Presentation of Metabolic Syndrome or Its Components: a Systematic Review and Meta-analysis. Clin Nutr. 2019;38(3):1117-1132. PubMed PMID: 29907356.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of vegetarian diets on the presentation of metabolic syndrome or its components: A systematic review and meta-analysis. AU - Picasso,Maria C, AU - Lo-Tayraco,Jessica A, AU - Ramos-Villanueva,Juselly M, AU - Pasupuleti,Vinay, AU - Hernandez,Adrian V, Y1 - 2018/06/06/ PY - 2017/01/20/received PY - 2018/05/16/revised PY - 2018/05/29/accepted PY - 2018/6/17/pubmed PY - 2020/5/29/medline PY - 2018/6/17/entrez KW - Blood lipids KW - Blood pressure KW - Glucose KW - Metabolic syndrome KW - Vegetarian diets KW - Waist circumference SP - 1117 EP - 1132 JF - Clinical nutrition (Edinburgh, Scotland) JO - Clin Nutr VL - 38 IS - 3 N2 - BACKGROUND & AIMS: Several studies have examined the effect of vegetarian diets (VD) on metabolic syndrome (MetS) or its components, but findings have been inconsistent. The aim of this study was to perform a systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies to assess the association between VD and MetS or its components (systolic blood pressure [SBP], diastolic blood pressure [DBP], fasting glucose triglycerides, waist circumference [WC], HDL-cholesterol (HDL-C)) in adults. METHODS: The Cochrane Library, EMBASE, PubMed, Web of Science, and Scopus were searched. RCTs, cohort studies and cross-sectional studies evaluating the effects of VD on MetS or its components in adults, with omnivore diet as control group, were included. Random effects meta-analyses stratified by study design were employed to calculate pooled estimates. RESULTS: A total of 71 studies (n = 103 008) met the inclusion criteria (6 RCTs, 2 cohorts, 63 cross-sectional). VD were not associated with MetS in comparison to omnivorous diet (OR 0.96, 95% CI 0.50-1.85, p = 0.9) according to meta-analysis of five cross-sectional studies. Likewise, meta-analysis of RCTs and cohort studies indicated that consumption of VD were not associated with MetS components. Meta-analysis of cross-sectional studies demonstrated that VD were significantly associated with lower levels of SBP (mean difference [MD] -4.18 mmHg, 95%CI -5.57 to -2.80, p < 0.00001), DBP (MD -3.03 mmHg, 95% CI -4.93 to -1.13, p = 0.002), fasting glucose (MD -0.26 mmol/L, 95% CI -0.35to -0.17, p < 0.00001), WC (MD -1.63 cm, 95% CI -3.13 to -0.13, p = 0.03), and HDL-C (MD -0.05 mmol/L, 95% CI -0.07 to -0.03, p < 0.0001) in comparison to omnivorous diet. Heterogeneity of effects among cross-sectional studies was high. About, one-half of the included studies had high risk of bias. CONCLUSIONS: VD in comparison with omnivorous diet is not associated with a lower risk of MetS based on results of meta-analysis of cross-sectional studies. The association between VD and lower levels of SBP, DBP, HDL-C, and fasting glucose is uncertain due to high heterogeneity across the cross-sectional studies. Larger and controlled studies are needed to evaluate the association between VD and MetS and its components. SN - 1532-1983 UR - https://www.unboundmedicine.com/medline/citation/29907356/Effect_of_vegetarian_diets_on_the_presentation_of_metabolic_syndrome_or_its_components:_A_systematic_review_and_meta_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0261-5614(18)30207-3 DB - PRIME DP - Unbound Medicine ER -