饱和脂肪与人类健康：一项系统综述和荟萃分析的方法创新议定书，为公共卫生营养指南提供信息。
Saturated fat and human health: a protocol for a methodologically innovative systematic review and meta-analysis to inform public health nutrition guidelines.
机构信息
Department of Nutrition, College of Agriculture and Life Science, Texas A&M University, College Station, TX, USA.
Department of Epidemiology and Biostatistics, School of Public Health, College Station, TX, USA.
出版信息
Syst Rev. 2023 Mar 14;12(1):39. doi: 10.1186/s13643-023-02209-1.
BACKGROUND
The health effects of dietary fats are a controversial issue on which experts and authoritative organizations have often disagreed. Care providers, guideline developers, policy-makers, and researchers use systematic reviews to advise patients and members of the public on optimal dietary habits, and to formulate public health recommendations and policies. Existing reviews, however, have serious limitations that impede optimal dietary fat recommendations, such as a lack of focus on outcomes important to people, substantial risk of bias (RoB) issues, ignoring absolute estimates of effects together with comprehensive assessments of the certainty of the estimates for all outcomes.
OBJECTIVE
We therefore propose a methodologically innovative systematic review using direct and indirect evidence on diet and food-based fats (i.e., reduction or replacement of saturated fat with monounsaturated or polyunsaturated fat, or carbohydrates or protein) and the risk of important health outcomes.
METHODS
We will collaborate with an experienced research librarian to search MEDLINE, EMBASE, CINAHL, and the Cochrane Database of Systematic Reviews (CDSR) for randomized clinical trials (RCTs) addressing saturated fat and our health outcomes of interest. In duplicate, we will screen, extract results from primary studies, assess their RoB, conduct de novo meta-analyses and/or network meta-analysis, assess the impact of missing outcome data on meta-analyses, present absolute effect estimates, and assess the certainty of evidence for each outcome using the GRADE contextualized approach. Our work will inform recommendations on saturated fat based on international standards for reporting systematic reviews and guidelines.
CONCLUSION
Our systematic review and meta-analysis will provide the most comprehensive and rigorous summary of the evidence addressing the relationship between saturated fat modification for people-important health outcomes. The evidence from this review will be used to inform public health nutrition guidelines.
TRIAL REGISTRATION
PROSPERO Registration: CRD42023387377 .
背景
膳食脂肪对健康的影响是一个备受争议的问题，专家和权威机构经常对此意见不一。医疗保健提供者、指南制定者、政策制定者和研究人员使用系统评价为患者和公众提供最佳饮食习惯建议，并制定公共卫生建议和政策。然而，现有的综述存在严重的局限性，阻碍了最佳膳食脂肪推荐，例如缺乏对人们重要结局的关注、存在大量偏倚（RoB）问题、忽视了对所有结局的效应的绝对估计和全面评估。
目的
因此，我们提出了一种方法创新的系统评价，使用关于饮食和以食物为基础的脂肪（即用单不饱和脂肪或多不饱和脂肪或碳水化合物或蛋白质替代饱和脂肪）与重要健康结局风险的直接和间接证据。
方法
我们将与经验丰富的研究馆员合作，在 MEDLINE、EMBASE、CINAHL 和 Cochrane 系统评价数据库（CDSR）中搜索解决饱和脂肪和我们感兴趣的健康结局的随机临床试验（RCT）。我们将重复筛选、从主要研究中提取结果、评估其 RoB、进行新的荟萃分析和/或网络荟萃分析、评估缺失结局数据对荟萃分析的影响、呈现绝对效应估计，并使用 GRADE 上下文方法评估每个结局的证据确定性。我们的工作将为基于系统评价和指南报告国际标准的饱和脂肪建议提供最全面和最严格的证据总结。
结论
我们的系统评价和荟萃分析将提供关于饱和脂肪与对人们重要的健康结局之间关系的最全面和最严格的证据总结。本综述的证据将用于为公共卫生营养指南提供信息。
试验注册
PROSPERO 注册：CRD42023387377。
Zotero 插件