坚持地中海饮食、五年体重变化与超重和肥胖风险：前瞻性队列研究的系统评价和剂量反应荟萃分析。
Adherence to the Mediterranean Diet, Five-Year Weight Change, and Risk of Overweight and Obesity: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies.
出版信息
Adv Nutr. 2022 Feb 1;13(1):152-166. doi: 10.1093/advances/nmab092.
Findings from earlier studies on the association between adherence to a Mediterranean diet and risk of overweight/obesity were inconsistent. We summarized cohort studies investigating the association between the Mediterranean diet and risk of overweight and/or obesity and weight change in adults. A systematic search of PubMed, Scopus, ISI Web of Science, and Google Scholar was conducted up to May 2021. Prospective cohorts that examined the Mediterranean diet adherence in adults as the exposure, and overweight and/or obesity or weight change as the outcomes, and reported RRs or β coefficients and 95% CIs as the effect sizes were included. Seven prospective cohort studies were included of which 6 studies (with 244,678 adult participants) reported the risk of overweight and/or obesity, and 4 cohorts (with 436,617 participants) reported the weight change (3 cohorts reported both overweight and/or obesity risk and weight change). Combining 15 effect sizes from 6 cohorts revealed that greater adherence to the Mediterranean diet was significantly associated with a 9% decreased risk of overweight and/or obesity (RR: 0.91; 95% CI: 0.88, 0.94; I2 = 44.7%; PQ-test = 0.031). This association was significant in the case of studies investigating combined overweight and obesity (RR: 0.92; 95% CI: 0.88, 0.96; I2 = 29.4%; PQ-test = 0.166), but not for studies that reported on obesity (RR: 0.68; 95% CI: 0.43, 1.10, I2 = 50.6%, PQ-test = 0.132). Linear dose-response analysis of 6 studies showed a 2% decreased risk of overweight and/or obesity for 1 additional Mediterranean diet score (RR: 0.98; 95% CI: 0.96, 0.99). Each unit increase in the Mediterranean diet score was associated with 0.04 kg less weight gain over 5 y (-0.04 kg; 95% CI: -0.07, -0.02 kg; 13 effect sizes from 4 cohorts). In conclusion, Mediterranean diet adherence is inversely associated with risk of overweight and/or obesity as well as 5-y weight gain and thus has practical importance for public health.
先前关于地中海饮食与超重/肥胖风险之间关联的研究结果并不一致。我们总结了队列研究，这些研究调查了地中海饮食与成年人超重和/或肥胖以及体重变化之间的关系。对 PubMed、Scopus、ISI Web of Science 和 Google Scholar 进行了系统检索，截至 2021 年 5 月。纳入的前瞻性队列研究将成年人的地中海饮食依从性作为暴露因素，将超重和/或肥胖或体重变化作为结局，并报告 RR 或 β系数和 95%CI 作为效应大小。共纳入 7 项前瞻性队列研究，其中 6 项研究（涉及 244678 名成年参与者）报告了超重和/或肥胖的风险，4 项队列研究（涉及 436617 名参与者）报告了体重变化（3 项研究同时报告了超重和/或肥胖风险和体重变化）。合并来自 6 项研究的 15 个效应大小表明，较高的地中海饮食依从性与 9%的超重和/或肥胖风险降低显著相关（RR：0.91；95%CI：0.88，0.94；I2=44.7%；PQ 检验=0.031）。这种关联在研究联合超重和肥胖的研究中是显著的（RR：0.92；95%CI：0.88，0.96；I2=29.4%；PQ 检验=0.166），但在报告肥胖的研究中并不显著（RR：0.68；95%CI：0.43，1.10；I2=50.6%，PQ 检验=0.132）。对 6 项研究进行线性剂量反应分析表明，每增加 1 个地中海饮食评分，超重和/或肥胖的风险降低 2%（RR：0.98；95%CI：0.96，0.99）。地中海饮食评分每增加 1 分，5 年内体重增加 0.04 公斤（-0.04 公斤；95%CI：-0.07，-0.02 公斤；4 项研究中的 13 个效应大小）。总之，地中海饮食的依从性与超重和/或肥胖的风险以及 5 年内的体重增加呈负相关，因此对公共卫生具有实际意义。
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