Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
Appl Physiol Nutr Metab. 2022 Dec 1;47(12):1115-1133. doi: 10.1139/apnm-2022-0059. Epub 2022 Aug 19.
The worldwide prevalence of obesity and its comorbidities is staggering, and elevated body mass index represents a leading risk factor of death globally. Consistent evidence demonstrates a high-quality plant-based diet as an effective intervention for weight management, although it may be particularly challenging to adopt in its entirety for habitual meat consumers or individuals with especially poor-quality diets. Plant-based diets are increasingly studied using indices such as the overall plant-based diet index (PDI), healthful PDI, and unhealthful PDI, which offer more flexibility than a binary classification of vegetarianism and better facilitate translation into dietary recommendations. We summarized these recently accumulated studies to comprehensively evaluate plant-based diets in relation to obesity risk. We searched Medline, Embase, and CINAHL databases through January 2022 and identified 9 prospective adult cohorts. Reporting of results was consistent with Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines and certainty of the evidence was assessed using domains from GRADE. The PDI had a protective association with body weight gain and adiposity. Emphasis of healthful plant foods strengthened this association and emphasis of unhealthful plant foods demonstrated either a positive or null association. The certainty of the evidence was considered moderate. These findings have wide application to inform dietary interventions and sustainable policy recommendations. (Prospero ID: CRD42020198143).
全球肥胖及其合并症的患病率令人震惊，升高的体重指数代表着全球死亡的主要风险因素。一致的证据表明，高质量的植物性饮食是体重管理的有效干预措施，尽管对于习惯性肉食者或饮食质量特别差的个体来说，完全采用这种饮食可能特别具有挑战性。植物性饮食越来越多地使用整体植物性饮食指数 (PDI)、健康 PDI 和不健康 PDI 等指数进行研究，这些指数比素食主义的二分法更灵活，更有利于转化为饮食建议。我们总结了这些最近积累的研究，全面评估了植物性饮食与肥胖风险的关系。我们通过 2022 年 1 月在 Medline、Embase 和 CINAHL 数据库中进行了搜索，确定了 9 项前瞻性成人队列研究。结果报告符合系统评价和荟萃分析的 Preferred Reporting Items 指南，证据的确定性使用 GRADE 中的领域进行评估。PDI 与体重增加和肥胖呈保护相关性。强调健康的植物性食物强化了这种相关性，而强调不健康的植物性食物则表现出正相关或无相关性。证据的确定性被认为是中等的。这些发现广泛适用于为饮食干预和可持续政策建议提供信息。（Prospero ID：CRD42020198143）。
