TY - JOUR A1 - Galbete, Cecilia A1 - Schwingshackl, Lukas A1 - Schwedhelm, Carolina A1 - Boeing, Heiner A1 - Schulze, Matthias Bernd T1 - Evaluating Mediterranean diet and risk of chronic disease in cohort studies BT - an umbrella review of meta-analyses JF - European journal of epidemiology 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. KW - Mediterranean diet KW - Chronic diseases KW - Umbrella review KW - Meta-analyses KW - Cohort studies KW - Heterogeneity Y1 - 2018 U6 - https://doi.org/10.1007/s10654-018-0427-3 SN - 0393-2990 SN - 1573-7284 VL - 33 IS - 10 SP - 909 EP - 931 PB - Springer CY - Dordrecht ER - TY - JOUR A1 - Schulze, Matthias Bernd T1 - Metabolic health in normal-weight and obese individuals JF - Diabetologia : journal of the European Association for the Study of Diabetes (EASD) N2 - Cardiovascular complications are commonly associated with obesity. However, a subgroup of obese individuals may not be at an increased risk for cardiovascular complications; these individuals are said to have metabolically healthy obesity (MHO). In contrast, metabolically unhealthy individuals are at high risk of cardiovascular disease (CVD), irrespective of BMI; thus, this group can include individuals within the normal weight category (BMI 18.5-24.9kg/m(2)). This review provides a summary of prospective studies on MHO and metabolically unhealthy normal-weight (MUHNW) phenotypes. Notably, there is ongoing dispute surrounding the concept of MHO, including the lack of a uniform definition and the potentially transient nature of metabolic health status. This review highlights the relevance of alternative measures of body fatness, specifically measures of fat distribution, for determining MHO and MUHNW. It also highlights alternative approaches of risk stratification, which account for the continuum of risk in relation to CVD, which is observable for most risk factors. Moreover, studies evaluating the transition from metabolically healthy to unhealthy phenotypes and potential determinants for such conversions are discussed. Finally, the review proposes several strategies for the use of epidemiological research to further inform the current debate on metabolic health and its determination across different stages of body fatness. KW - Cardiovascular diseases KW - Cohort studies KW - Metabolically benign KW - Obesity KW - Review Y1 - 0208 U6 - https://doi.org/10.1007/s00125-018-4787-8 SN - 0012-186X SN - 1432-0428 VL - 62 IS - 4 SP - 558 EP - 566 PB - Springer CY - New York ER - TY - JOUR A1 - Dietrich, Stefan A1 - Jacobs, Simone A1 - Zheng, Ju-Sheng A1 - Meidtner, Karina A1 - Schwingshackl, Lukas A1 - Schulze, Matthias Bernd T1 - Gene-lifestyle interaction on risk of type 2 diabetes BT - A systematic review JF - Obesity reviews : an official journal of the International Association for the Study of Obesity N2 - The pathophysiological influence of gene-lifestyle interactions on the risk to develop type 2 diabetes (T2D) is currently under intensive research. This systematic review summarizes the evidence for gene-lifestyle interactions regarding T2D incidence. MEDLINE, EMBASE, and Web of Science were systematically searched until 31 January 2019 to identify publication with (a) prospective study design; (b) T2D incidence; (c) gene-diet, gene-physical activity, and gene-weight loss intervention interaction; and (d) population who are healthy or prediabetic. Of 66 eligible publications, 28 reported significant interactions. A variety of different genetic variants and dietary factors were studied. Variants at TCF7L2 were most frequently investigated and showed interactions with fiber and whole grain on T2D incidence. Further gene-diet interactions were reported for, eg, a western dietary pattern with a T2D-GRS, fat and carbohydrate with IRS1 rs2943641, and heme iron with variants of HFE. Physical activity showed interaction with HNF1B, IRS1, PPAR gamma, ADRA2B, SLC2A2, and ABCC8 variants and weight loss interventions with ENPP1, PPAR gamma, ADIPOR2, ADRA2B, TNF alpha, and LIPC variants. However, most findings represent single study findings obtained in European ethnicities. Although some interactions have been reported, their conclusiveness is still low, as most findings were not yet replicated across multiple study populations. KW - diet KW - gene-lifestyle interaction KW - incident type 2 diabetes KW - physical activity KW - weight loss intervention Y1 - 2019 U6 - https://doi.org/10.1111/obr.12921 SN - 1467-7881 SN - 1467-789X VL - 20 IS - 11 SP - 1557 EP - 1571 PB - Wiley CY - Hoboken ER -