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Evaluating Mediterranean diet and risk of chronic disease in cohort studies: an umbrella review of meta-analyses.
Eur J Epidemiol. 2018 Oct; 33(10):909-931.EJ

Abstract

Several meta-analyses have been published summarizing the associations of the Mediterranean diet (MedDiet) with chronic diseases. We evaluated the quality and credibility of evidence from these meta-analyses as well as characterized the different indices used to define MedDiet and re-calculated the associations with the different indices identified. We conducted an umbrella review of meta-analyses on cohort studies evaluating the association of the MedDiet with type 2 diabetes, cardiovascular disease, cancer and cognitive-related diseases. We used the AMSTAR (A MeaSurement Tool to Assess systematic Reviews) checklist to evaluate the methodological quality of the meta-analyses, and the NutriGrade scoring system to evaluate the credibility of evidence. We also identified different indices used to define MedDiet; tests for subgroup differences were performed to compare the associations with the different indices when at least 2 studies were available for different definitions. Fourteen publications were identified and within them 27 meta-analyses which were based on 70 primary studies. Almost all meta-analyses reported inverse associations between MedDiet and risk of chronic disease, but the credibility of evidence was rated low to moderate. Moreover, substantial heterogeneity was observed on the use of the indices assessing adherence to the MedDiet, but two indices were the most used ones [Trichopoulou MedDiet (tMedDiet) and alternative MedDiet (aMedDiet)]. Overall, we observed little difference in risk associations comparing different MedDiet indices in the subgroup meta-analyses. Future prospective cohort studies are advised to use more homogenous definitions of the MedDiet to improve the comparability across meta-analyses.

Authors+Show Affiliations

Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany. NutriAct - Competence Cluster Nutrition Research Berlin-Potsdam, Nuthetal, Germany.NutriAct - Competence Cluster Nutrition Research Berlin-Potsdam, Nuthetal, Germany. lukas.schwingshackl@dife.de. Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany. lukas.schwingshackl@dife.de.NutriAct - Competence Cluster Nutrition Research Berlin-Potsdam, Nuthetal, Germany. Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.NutriAct - Competence Cluster Nutrition Research Berlin-Potsdam, Nuthetal, Germany. Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany. NutriAct - Competence Cluster Nutrition Research Berlin-Potsdam, Nuthetal, Germany. Institute of Nutritional Sciences, University of Potsdam, Nuthetal, Germany.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

30030684

Citation

Galbete, Cecilia, et al. "Evaluating Mediterranean Diet and Risk of Chronic Disease in Cohort Studies: an Umbrella Review of Meta-analyses." European Journal of Epidemiology, vol. 33, no. 10, 2018, pp. 909-931.
Galbete C, Schwingshackl L, Schwedhelm C, et al. Evaluating Mediterranean diet and risk of chronic disease in cohort studies: an umbrella review of meta-analyses. Eur J Epidemiol. 2018;33(10):909-931.
Galbete, C., Schwingshackl, L., Schwedhelm, C., Boeing, H., & Schulze, M. B. (2018). Evaluating Mediterranean diet and risk of chronic disease in cohort studies: an umbrella review of meta-analyses. European Journal of Epidemiology, 33(10), 909-931. https://doi.org/10.1007/s10654-018-0427-3
Galbete C, et al. Evaluating Mediterranean Diet and Risk of Chronic Disease in Cohort Studies: an Umbrella Review of Meta-analyses. Eur J Epidemiol. 2018;33(10):909-931. PubMed PMID: 30030684.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluating Mediterranean diet and risk of chronic disease in cohort studies: an umbrella review of meta-analyses. AU - Galbete,Cecilia, AU - Schwingshackl,Lukas, AU - Schwedhelm,Carolina, AU - Boeing,Heiner, AU - Schulze,Matthias B, Y1 - 2018/07/20/ PY - 2018/01/30/received PY - 2018/07/17/accepted PY - 2018/7/22/pubmed PY - 2018/11/27/medline PY - 2018/7/22/entrez KW - Chronic diseases KW - Cohort studies KW - Heterogeneity KW - Mediterranean diet KW - Meta-analyses KW - Umbrella review SP - 909 EP - 931 JF - European journal of epidemiology JO - Eur J Epidemiol VL - 33 IS - 10 N2 - Several meta-analyses have been published summarizing the associations of the Mediterranean diet (MedDiet) with chronic diseases. We evaluated the quality and credibility of evidence from these meta-analyses as well as characterized the different indices used to define MedDiet and re-calculated the associations with the different indices identified. We conducted an umbrella review of meta-analyses on cohort studies evaluating the association of the MedDiet with type 2 diabetes, cardiovascular disease, cancer and cognitive-related diseases. We used the AMSTAR (A MeaSurement Tool to Assess systematic Reviews) checklist to evaluate the methodological quality of the meta-analyses, and the NutriGrade scoring system to evaluate the credibility of evidence. We also identified different indices used to define MedDiet; tests for subgroup differences were performed to compare the associations with the different indices when at least 2 studies were available for different definitions. Fourteen publications were identified and within them 27 meta-analyses which were based on 70 primary studies. Almost all meta-analyses reported inverse associations between MedDiet and risk of chronic disease, but the credibility of evidence was rated low to moderate. Moreover, substantial heterogeneity was observed on the use of the indices assessing adherence to the MedDiet, but two indices were the most used ones [Trichopoulou MedDiet (tMedDiet) and alternative MedDiet (aMedDiet)]. Overall, we observed little difference in risk associations comparing different MedDiet indices in the subgroup meta-analyses. Future prospective cohort studies are advised to use more homogenous definitions of the MedDiet to improve the comparability across meta-analyses. SN - 1573-7284 UR - https://www.unboundmedicine.com/medline/citation/30030684/Evaluating_Mediterranean_diet_and_risk_of_chronic_disease_in_cohort_studies:_an_umbrella_review_of_meta_analyses_ L2 - https://doi.org/10.1007/s10654-018-0427-3 DB - PRIME DP - Unbound Medicine ER -