TY - JOUR T1 - Food groups and intermediate disease markers: a systematic review and network meta-analysis of randomized trials. AU - Schwingshackl,Lukas, AU - Hoffmann,Georg, AU - Iqbal,Khalid, AU - Schwedhelm,Carolina, AU - Boeing,Heiner, PY - 2018/4/6/received PY - 2018/6/13/accepted PY - 2018/12/12/entrez PY - 2018/12/12/pubmed PY - 2019/8/16/medline PY - 2018/9/11/pmc-release SP - 576 EP - 586 JF - The American journal of clinical nutrition JO - Am J Clin Nutr VL - 108 IS - 3 N2 - BACKGROUND: In previous meta-analyses of prospective observational studies, we investigated the association between food groups and risk of chronic disease. OBJECTIVE: The aim of the present network meta-analysis (NMA) was to assess the effects of these food groups on intermediate-disease markers across randomized intervention trials. DESIGN: Literature searches were performed until January 2018. The following inclusion criteria were defined a priori: 1) randomized trial (≥4 wk duration) comparing ≥2 of the following food groups: refined grains, whole grains, nuts, legumes, fruits and vegetables, eggs, dairy, fish, red meat, and sugar-sweetened beverages (SSBs); 2) LDL cholesterol and triacylglycerol (TG) were defined as primary outcomes; total cholesterol, HDL cholesterol, fasting glucose, glycated hemoglobin, homeostasis model assessment insulin resistance, systolic and diastolic blood pressure, and C-reactive protein were defined as secondary outcomes. For each outcome, a random NMA was performed, and for the ranking, the surface under the cumulative ranking curves (SUCRA) was determined. RESULTS: A total of 66 randomized trials (86 reports) comparing 10 food groups and enrolling 3595 participants was identified. Nuts were ranked as the best food group at reducing LDL cholesterol (SUCRA: 93%), followed by legumes (85%) and whole grains (70%). For reducing TG, fish (97%) was ranked best, followed by nuts (78%) and red meat (72%). However, these findings are limited by the low quality of the evidence. When combining all 10 outcomes, the highest SUCRA values were found for nuts (66%), legumes (62%), and whole grains (62%), whereas SSBs performed worst (29%). CONCLUSION: The present NMA provides evidence that increased intake of nuts, legumes, and whole grains is more effective at improving metabolic health than other food groups. For the credibility of diet-disease relations, high-quality randomized trials focusing on well-established intermediate-disease markers could play an important role. This systematic review was registered at PROSPERO (www.crd.york.ac.uk/PROSPERO) as CRD42018086753. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/30535089/full_citation DB - PRIME DP - Unbound Medicine ER -