Law Lynette, Heerey Joshua J, Devlin Brooke L, Brukner Peter, De Livera Alysha M, Kemp Joanne, Attanayake Amanda, Skou Søren Thorgaard, Bricca Alessio, Culvenor Adam G
La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
School of Human Movement and Nutrition Sciences, The University of Queensland - St Lucia Campus, Brisbane, Queensland, Australia.
BMJ Nutr Prev Health. 2025 Jun 10;8(1):e001257. doi: 10.1136/bmjnph-2025-001257. eCollection 2025.
To evaluate the effectiveness of anti-inflammatory diets on health-related quality of life (HRQOL) in adults with at least one chronic disease.
Systematic review and meta-analysis of randomised controlled trials (RCTs).
MEDLINE, EMBASE, CINAHL, Web of Science and the Cochrane Centre Register of Controlled Trials from inception to 6 May 2024.
Full-text RCTs published in English assessing the effectiveness of any anti-inflammatory dietary intervention (ie, a diet that emphasises the intake of nutrient-rich, minimally processed foods rich in polyphenols, carotenoids and omega-3 polyunsaturated fatty acids and limits highly-processed, pro-inflammatory foods) on HRQOL in adults with at least one chronic disease were included.
Data extraction, risk-of-bias assessments and strength-of-evidence assessments were done by two independent reviewers. Pooled effects (standardised mean difference (SMD)) for HRQOL (separated into mental and physical component scores wherever possible) were calculated using random effects models with restricted maximum likelihood estimations. Subgroup analyses and meta-regressions were performed to assess the influence of study-level characteristics on HRQOL outcomes.
23 studies reporting HRQOL for 3294 participants were included. The most common chronic diseases were type two diabetes, musculoskeletal conditions and cardiovascular conditions. Anti-inflammatory diets were associated with small improvements in HRQOL physical component scores compared with usual care/other dietary interventions (18 trials, SMD=0.17, 95% CI 0.06 to 0.27) but not in mental component scores (18 trials, SMD=0.09, 95% CI -0.02 to 0.20) or general HRQOL scores (four trials, SMD=0.27, 95% CI -0.22 to 0.77). Pooled effects did not differ by available study-level characteristics; however, diet-only interventions (compared with multi-component interventions) had a greater effect on mental component scores. No study met the Cochrane criteria for low risk of bias. Certainty of evidence was low for physical and mental HRQOL scores and very low for general HRQOL scores.
In adults with at least one chronic disease, anti-inflammatory diets lead to small improvements in physical component HRQOL, which may not be clinically relevant. No effect was found on the mental component or general HRQOL. Further high-quality RCTs may change this conclusion.
评估抗炎饮食对至少患有一种慢性病的成年人健康相关生活质量（HRQOL）的有效性。
随机对照试验（RCT）的系统评价和荟萃分析。
从创刊至2024年5月6日的MEDLINE、EMBASE、CINAHL、Web of Science以及Cochrane对照试验中心注册库。
以英文发表的全文RCT，评估任何抗炎饮食干预（即强调摄入富含多酚、类胡萝卜素和ω-3多不饱和脂肪酸的营养丰富、最少加工的食物，并限制高加工、促炎食物）对至少患有一种慢性病的成年人HRQOL的有效性。
由两名独立评审员进行数据提取、偏倚风险评估和证据强度评估。使用具有限制最大似然估计的随机效应模型计算HRQOL的合并效应（标准化均值差（SMD））（尽可能分为心理和身体成分得分）。进行亚组分析和荟萃回归以评估研究水平特征对HRQOL结果的影响。
纳入了23项报告3294名参与者HRQOL的研究。最常见的慢性病是2型糖尿病、肌肉骨骼疾病和心血管疾病。与常规护理/其他饮食干预相比，抗炎饮食与HRQOL身体成分得分的小幅改善相关（18项试验，SMD = 0.17，95%CI 0.06至0.27），但与心理成分得分无关（18项试验，SMD = 0.09，95%CI -0.02至0.20）或总体HRQOL得分无关（4项试验，SMD = 0.27，95%CI -0.22至0.77）。合并效应在可用的研究水平特征方面没有差异；然而，仅饮食干预（与多成分干预相比）对心理成分得分的影响更大。没有研究符合Cochrane低偏倚风险标准。身体和心理HRQOL得分的证据确定性低，总体HRQOL得分的证据确定性非常低。
在至少患有一种慢性病的成年人中，抗炎饮食导致身体成分HRQOL有小幅改善，这可能在临床上不具有相关性。未发现对心理成分或总体HRQOL有影响。进一步的高质量RCT可能会改变这一结论。
