Evaluating Mediterranean diet and risk of chronic disease in cohort studies
- 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 27Several 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.…
Author details: | Cecilia GalbeteORCiD, Lukas SchwingshacklORCiDGND, Carolina SchwedhelmORCiD, Heiner BoeingORCiDGND, Matthias Bernd SchulzeORCiDGND |
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DOI: | https://doi.org/10.1007/s10654-018-0427-3 |
ISSN: | 0393-2990 |
ISSN: | 1573-7284 |
Pubmed ID: | https://pubmed.ncbi.nlm.nih.gov/30030684 |
Title of parent work (English): | European journal of epidemiology |
Subtitle (English): | an umbrella review of meta-analyses |
Publisher: | Springer |
Place of publishing: | Dordrecht |
Publication type: | Review |
Language: | English |
Date of first publication: | 2018/07/20 |
Publication year: | 2018 |
Release date: | 2021/09/22 |
Tag: | Chronic diseases; Cohort studies; Heterogeneity; Mediterranean diet; Meta-analyses; Umbrella review |
Volume: | 33 |
Issue: | 10 |
Number of pages: | 23 |
First page: | 909 |
Last Page: | 931 |
Funding institution: | NutriAct - Competence Cluster Nutrition Research Berlin-Potsdam - German Federal Ministry of Education and Research [FKZ: 01EA1408A-G] |
Organizational units: | Mathematisch-Naturwissenschaftliche Fakultät / Institut für Ernährungswissenschaft |
DDC classification: | 5 Naturwissenschaften und Mathematik / 57 Biowissenschaften; Biologie / 570 Biowissenschaften; Biologie |
6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit | |
Peer review: | Referiert |
Publishing method: | Open Access / Hybrid Open-Access |
License (German): | CC-BY - Namensnennung 4.0 International |