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

Abstract

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 (I2 statistic). 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 number NCT02961088; Results.

Pasta Consumption and Connected Dietary Habits: Associations with Glucose Control, Adiposity Measures, and Cardiovascular Risk Factors in People with Type 2 Diabetes—TOSCA.IT Study

“…These findings do not lend support to the commonly held paradigm that pasta is "fattening". In contrast with this misconception and in line with our results, a recent meta-analysis of randomized controlled studies has shown that in people with or without diabetes, pasta consumption, within the context of a low GI eating pattern, is associated with a lower BMI compared with high GI eating patterns [9]. Along the same line are the results of two observational studies, which demonstrate the benefits of pasta consumption on body weight and adiposity in large, free-living populations [10,11].…”

“…The scientific evidence linking pasta consumption with obesity/overweight is however scarce. A recent metanalysis of randomized controlled trials has shown that in people with or without diabetes, pasta within the context of low-GI dietary patterns does not adversely affect adiposity; on the contrary, it slightly reduces body weight as compared with higher-GI dietary patterns [9]. These findings are in line with the results of observational studies showing benefits of pasta consumption on body weight and markers of adiposity [10,11].…”

Durum wheat grain and pasta from locally-grown crops: a case-study on Saragolla (Triticum turgidum ssp. turanicum) and Senatore Cappelli (Triticum turgidum ssp. durum) wheats

“…Pasta is a staple food and one of the major sources of carbohydrates. Despite it provides refined carbohydrates, it has a low glycemic index and it has been reported that it has no adverse effect on body weight and body mass index, in the context of low glycemic index dietary patterns (Chiavaroli et al, 2018). As a matter of fact, the compacted and dense structure of extruded pasta, alongside the gluten matrix, closely adheres to starch granules preventing the access of α-amylase.…”

Effectiveness of carbohydrates as a functional ingredient in glycemic control

“…Two systematic reviews have evaluated pasta consumption and concluded that these foods have a low glycemic response. Pasta intake, along with the consumption of low GO foods, may contribute to the reduction of body weight (Chiavaroli et al, 2018), but more studies are needed to evaluate the relationship between the masses and the reduction of risk of cardiovascular diseases (Huang et al, 2017). Different types of pasta elicit varied glycemic responses, but always smaller in relation to white bread and potatoes.…”

“…This is due to a more compact structure, as a function of the extrusion process and manufacturing techniques, which hinders the hydrolysis of the starch, and thus a delay in gastric emptying and digestion occurs. On addition, it is common to use durum wheat in the manufacture of pasta, which maintains the aleurone layer, which also keeps the content of micronutrients and protein, which in turn may contribute to the reduction of glycemic response (Huang et al, 2017;Chiavaroli et al, 2018).…”