Food Groups and Risk of Overweight, Obesity, and Weight Gain: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies

Abstract

This meta-analysis summarizes the evidence of a prospective association between the intake of foods [whole grains, refined grains, vegetables, fruit, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages (SSBs)] and risk of general overweight/obesity, abdominal obesity, and weight gain. PubMed and Web of Science were searched for prospective observational studies until August 2018. Summary RRs and 95% CIs were estimated from 43 reports for the highest compared with the lowest intake categories, as well as for linear and nonlinear relations focusing on each outcome separately: overweight/obesity, abdominal obesity, and weight gain. The quality of evidence was evaluated with use of the NutriGrade tool. In the dose-response meta-analysis, inverse associations were found for whole-grain (RRoverweight/obesity: 0.93; 95% CI: 0.89, 0.96), fruit (RRoverweight/obesity: 0.93; 95% CI: 0.86, 1.00; RRweight gain: 0.91; 95% CI: 0.86, 0.97), nut (RRabdominal obesity: 0.42; 95% CI: 0.31, 0.57), legume (RRoverweight/obesity: 0.88; 95% CI: 0.84, 0.93), and fish (RRabdominal obesity: 0.83; 95% CI: 0.71, 0.97) consumption and positive associations were found for refined grains (RRoverweight/obesity: 1.05; 95% CI: 1.00, 1.10), red meat (RRabdominal obesity: 1.10; 95% CI: 1.04, 1.16; RRweight gain: 1.14; 95% CI: 1.03, 1.26), and SSBs (RRoverweight/obesity: 1.05; 95% CI: 1.00, 1.11; RRabdominal obesity: 1.12; 95% CI: 1.04, 1.20). The dose-response meta-analytical findings provided very low to low quality of evidence that certain food groups have an impact on different measurements of adiposity risk. To improve the quality of evidence, better-designed observational studies, inclusion of intervention trials, and use of novel statistical methods (e.g., substitution analyses or network meta-analyses) are needed.

Mediterranean diet and health status: Active ingredients and pharmacological mechanisms

“…In addition, vegetables are characterized by many other nutrients, including dietary fibre, potassium, vitamin A, vitamin C, vitamin K, copper, magnesium, vitamin E, vitamin B6, folate, iron, thiamine, niacin, and choline (Delgado, Vaz‐Almeida, & Parisi, ). In several dose–response meta‐analyses of prospective observational studies, a higher consumption of vegetables has been associated with lower risk of all‐cause mortality, CHD, stroke, heart failure, Type 2 diabetes, CRC, and adiposity (Bechthold et al, ; Schlesinger et al, ; Schwingshackl, Hoffmann, Lampousi, et al, ; Schwingshackl, Schwedhelm, et al, ; Schwingshackl, Schwedhelm, Hoffmann, Lampousi, et al, ).…”

“…Nuts are a rich source of monounsaturated (MUFAs) and polyunsaturated fatty acids (PUFAs) including linoleic and linolenic acid, phenols, flavonoids, isoflavonoids, phytosterols and phytic acid, vitamin E, vitamin B2, folate, and fibre as well as minerals and trace elements such as magnesium, phosphorus, potassium, copper, and selenium (Delgado et al, ). In dose–response meta‐analyses of prospective observational studies, nut consumption has been associated with lower risk of all‐cause mortality, CHD, hypertension, and adiposity (Bechthold et al, ; Schlesinger et al, ; Schwingshackl, Schwedhelm, Hoffmann, Knuppel, et al, ; Schwingshackl, Schwedhelm, Hoffmann, Lampousi, et al, ). In meta‐analyses of RCTs, higher nuts intake showed beneficial effects on total cholesterol, LDL‐C, triacylglycerols (TG), SBP, FG, and glycosylated haemoglobin (HbA1c; Schwingshackl, Schlesinger, et al, ).…”

“…Whole grains are a source of nutrients such as dietary fibre, iron, zinc, manganese, folate, magnesium, copper, thiamine, niacin, vitamin B6, phosphorus, selenium, and riboflavin (Delgado et al, ). In dose–response meta‐analyses of prospective observational studies, a high consumption of whole grains has been associated with lower risk of all‐cause mortality, CHD, heart failure, Type 2 diabetes, CRC, hypertension, and adiposity (Bechthold et al, ; Schlesinger et al, ; Schwingshackl, Hoffmann, Lampousi, et al, ; Schwingshackl, Schwedhelm, Hoffmann, Knuppel, et al, ; Schwingshackl, Schwedhelm, et al, ; Schwingshackl, Schwedhelm, Hoffmann, Lampousi, et al, ). Meta‐analyses of RCTs have shown a beneficial effect of whole grain intake on total cholesterol, LDL‐C, TG, and FG (Schwingshackl, Schlesinger, et al, ).…”

“…Vegetables are the most important sources of (Trichopoulou et al, 2003) aMedDiet (Fung et al, 2006) (Delgado, Vaz-Almeida, & Parisi, 2017). In several dose-response meta-analyses of prospective observational studies, a higher consumption of vegetables has been associated with lower risk of all-cause mortality, CHD, stroke, heart failure, Type 2 diabetes, CRC, and adiposity Schlesinger et al, 2019;.…”

“…Whole grains are a source of nutrients such as dietary fibre, iron, zinc, manganese, folate, magnesium, copper, thiamine, niacin, vitamin B6, phosphorus, selenium, and riboflavin (Delgado et al, 2017). In dose-response meta-analyses of prospective observational studies, a high consumption of whole grains has been associated with lower risk of all-cause mortality, CHD, heart failure, Type 2 diabetes, CRC, hypertension, and adiposity Schlesinger et al, 2019;.…”