Effects of different dietary approaches on inflammatory markers in patients with metabolic syndrome: A systematic review and meta-analysis

Abstract Objective Chronic low-grade inflammation has been associated with insulin resistance, diabetes, atherosclerosis, obesity, and metabolic syndrome (MetS). A proinflammatory environment contributes to several metabolic disturbances and possibly the development of MetS. Dietary approaches have...

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Veröffentlicht in:Nutrition (Burbank, Los Angeles County, Calif.) Los Angeles County, Calif.), 2016-03, Vol.32 (3), p.338-348
Hauptverfasser: Steckhan, Nico, M.Sc, Hohmann, Christoph-Daniel, M.D, Kessler, Christian, M.D, Dobos, Gustav, M.D, Michalsen, Andreas, M.D, Cramer, Holger, Ph.D
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container_end_page 348
container_issue 3
container_start_page 338
container_title Nutrition (Burbank, Los Angeles County, Calif.)
container_volume 32
creator Steckhan, Nico, M.Sc
Hohmann, Christoph-Daniel, M.D
Kessler, Christian, M.D
Dobos, Gustav, M.D
Michalsen, Andreas, M.D
Cramer, Holger, Ph.D
description Abstract Objective Chronic low-grade inflammation has been associated with insulin resistance, diabetes, atherosclerosis, obesity, and metabolic syndrome (MetS). A proinflammatory environment contributes to several metabolic disturbances and possibly the development of MetS. Dietary approaches have defined impact on immune function and putative antiinflammatory effects. The aim of this study was to assess the effects of different dietary approaches on markers of inflammation in patients with MetS. Further effects on weight loss and fasting insulin were analyzed. Methods Medline/PubMed, Scopus, and the Cochrane Library were screened in September 2014 for randomized controlled trials (RCTs) on different dietary approaches for participants with MetS as defined by National Cholesterol Education Program Adult Treatment Panel III. Primary outcomes were markers of the immune system. Secondary outcome was body weight and fasting insulin. Standardized mean differences (SMD) and 95% confidence intervals (95% CIs) were calculated. Results Thirteen randomized controlled trials with a total of 2017 patients were included. Low-fat diets (29 ± 2% energy from fats) decreased C-reactive protein compared with control diets (SMD: −0.98; 95% CI: −1.6 to −0.35; P  = 0.002). Low-carbohydrate diets (23 ± 10% energy from carbohydrates; SMD: −0.33; 95% CI: −0.63 to −0.03; P  = 0.004) and multimodal interventions (SMD: −1.02; 95% CI: −1.97 to −0.07; P  = 0.04) were able to induce significant weight loss. Low-carbohydrate diets were able to decrease insulin (SMD: −0.33; 95% CI: −0.63 to −0.03; P  = 0.03). Conclusions C-reactive protein; however, this effect is also dependent on weight loss. Furthermore, low-carbohydrate diets have beneficial effects on insulin and body weight. Dietary approaches should mainly be tried to reduce macronutrients and enrich functional food components such as vitamins, flavonoids, and unsaturated fatty acids. People with MetS will benefit most by combining weight loss and anti-inflammatory nutrients.
doi_str_mv 10.1016/j.nut.2015.09.010
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A proinflammatory environment contributes to several metabolic disturbances and possibly the development of MetS. Dietary approaches have defined impact on immune function and putative antiinflammatory effects. The aim of this study was to assess the effects of different dietary approaches on markers of inflammation in patients with MetS. Further effects on weight loss and fasting insulin were analyzed. Methods Medline/PubMed, Scopus, and the Cochrane Library were screened in September 2014 for randomized controlled trials (RCTs) on different dietary approaches for participants with MetS as defined by National Cholesterol Education Program Adult Treatment Panel III. Primary outcomes were markers of the immune system. Secondary outcome was body weight and fasting insulin. Standardized mean differences (SMD) and 95% confidence intervals (95% CIs) were calculated. Results Thirteen randomized controlled trials with a total of 2017 patients were included. Low-fat diets (29 ± 2% energy from fats) decreased C-reactive protein compared with control diets (SMD: −0.98; 95% CI: −1.6 to −0.35; P  = 0.002). Low-carbohydrate diets (23 ± 10% energy from carbohydrates; SMD: −0.33; 95% CI: −0.63 to −0.03; P  = 0.004) and multimodal interventions (SMD: −1.02; 95% CI: −1.97 to −0.07; P  = 0.04) were able to induce significant weight loss. Low-carbohydrate diets were able to decrease insulin (SMD: −0.33; 95% CI: −0.63 to −0.03; P  = 0.03). Conclusions C-reactive protein; however, this effect is also dependent on weight loss. Furthermore, low-carbohydrate diets have beneficial effects on insulin and body weight. Dietary approaches should mainly be tried to reduce macronutrients and enrich functional food components such as vitamins, flavonoids, and unsaturated fatty acids. People with MetS will benefit most by combining weight loss and anti-inflammatory nutrients.</description><identifier>ISSN: 0899-9007</identifier><identifier>EISSN: 1873-1244</identifier><identifier>DOI: 10.1016/j.nut.2015.09.010</identifier><identifier>PMID: 26706026</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject><![CDATA[Biomarkers - blood ; Body Weight ; C-Reactive Protein - metabolism ; Carbohydrates ; Cholesterol ; Databases, Factual ; Diet ; Diet - methods ; Diet, Carbohydrate-Restricted ; Diet, Fat-Restricted ; Dietary Carbohydrates - administration & dosage ; Dietary Fats - administration & dosage ; Diets ; Fatty Acids - administration & dosage ; Fatty Acids, Unsaturated - administration & dosage ; Flavonoids ; Flavonoids - administration & dosage ; Functional foods & nutraceuticals ; Gastroenterology and Hepatology ; Humans ; Immune response ; Immune system ; Inflammation ; Insulin ; Insulin - blood ; Insulin resistance ; Meta-analysis ; Metabolic disorders ; Metabolic syndrome ; Metabolic Syndrome - blood ; Metabolic Syndrome - diet therapy ; Micronutrients - administration & dosage ; NCEP ATP III ; Nutrients ; Randomized Controlled Trials as Topic ; Studies ; Systematic review ; Tumor necrosis factor-TNF ; Vitamins]]></subject><ispartof>Nutrition (Burbank, Los Angeles County, Calif.), 2016-03, Vol.32 (3), p.338-348</ispartof><rights>Elsevier Inc.</rights><rights>2016 Elsevier Inc.</rights><rights>Copyright © 2016 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Mar 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c539t-ce22baa0e1c9dddf28eaf9e397c841debbdedfd76b213310edb5a96fea186aee3</citedby><cites>FETCH-LOGICAL-c539t-ce22baa0e1c9dddf28eaf9e397c841debbdedfd76b213310edb5a96fea186aee3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1763066575?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>315,781,785,3551,27926,27927,45997,64387,64389,64391,72471</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26706026$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Steckhan, Nico, M.Sc</creatorcontrib><creatorcontrib>Hohmann, Christoph-Daniel, M.D</creatorcontrib><creatorcontrib>Kessler, Christian, M.D</creatorcontrib><creatorcontrib>Dobos, Gustav, M.D</creatorcontrib><creatorcontrib>Michalsen, Andreas, M.D</creatorcontrib><creatorcontrib>Cramer, Holger, Ph.D</creatorcontrib><title>Effects of different dietary approaches on inflammatory markers in patients with metabolic syndrome: A systematic review and meta-analysis</title><title>Nutrition (Burbank, Los Angeles County, Calif.)</title><addtitle>Nutrition</addtitle><description>Abstract Objective Chronic low-grade inflammation has been associated with insulin resistance, diabetes, atherosclerosis, obesity, and metabolic syndrome (MetS). A proinflammatory environment contributes to several metabolic disturbances and possibly the development of MetS. Dietary approaches have defined impact on immune function and putative antiinflammatory effects. The aim of this study was to assess the effects of different dietary approaches on markers of inflammation in patients with MetS. Further effects on weight loss and fasting insulin were analyzed. Methods Medline/PubMed, Scopus, and the Cochrane Library were screened in September 2014 for randomized controlled trials (RCTs) on different dietary approaches for participants with MetS as defined by National Cholesterol Education Program Adult Treatment Panel III. Primary outcomes were markers of the immune system. Secondary outcome was body weight and fasting insulin. Standardized mean differences (SMD) and 95% confidence intervals (95% CIs) were calculated. Results Thirteen randomized controlled trials with a total of 2017 patients were included. Low-fat diets (29 ± 2% energy from fats) decreased C-reactive protein compared with control diets (SMD: −0.98; 95% CI: −1.6 to −0.35; P  = 0.002). Low-carbohydrate diets (23 ± 10% energy from carbohydrates; SMD: −0.33; 95% CI: −0.63 to −0.03; P  = 0.004) and multimodal interventions (SMD: −1.02; 95% CI: −1.97 to −0.07; P  = 0.04) were able to induce significant weight loss. Low-carbohydrate diets were able to decrease insulin (SMD: −0.33; 95% CI: −0.63 to −0.03; P  = 0.03). Conclusions C-reactive protein; however, this effect is also dependent on weight loss. Furthermore, low-carbohydrate diets have beneficial effects on insulin and body weight. Dietary approaches should mainly be tried to reduce macronutrients and enrich functional food components such as vitamins, flavonoids, and unsaturated fatty acids. 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dosage</subject><subject>NCEP ATP III</subject><subject>Nutrients</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Studies</subject><subject>Systematic review</subject><subject>Tumor necrosis factor-TNF</subject><subject>Vitamins</subject><issn>0899-9007</issn><issn>1873-1244</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFks1u1TAQhS0EopfCA7BBkdiwSRg7iRODhFRV5UeqxAJYW449Vn2bn4udUOUVeGomvQWkLmDlkec7I805w9hzDgUHLl_vi3GZCwG8LkAVwOEB2_G2KXMuquoh20GrVK4AmhP2JKU9AHAl1WN2ImQDEoTcsZ8X3qOdUzb5zAWqI44zVTibuGbmcIiTsVdI_TELo-_NMJh5otZg4jXGRJ_ZwcyBVCm7CfNVNpC0m_pgs7SOLk4DvsnOqE4zkpS-I_4IeJOZ0d2yuRlNv6aQnrJH3vQJn929p-zb-4uv5x_zy88fPp2fXea2LtWcWxSiMwaQW-Wc86JF4xWWqrFtxR12nUPnXSM7wcuSA7quNkp6NLyVBrE8Za-Oc2m37wumWQ8hWex7M-K0JM3bStS8Bqj_jzZSKNkKuaEv76H7aYm02i1VgpR1s1H8SNk4pRTR60MMZOWqOegtU73XlKneMtWgNGVKmhd3k5duQPdH8TtEAt4eASTXyNuok6VALLoQKVvtpvDP8e_uqW0fxmBNf40rpr9b6CQ06C_bUW03tTlUgajLX14_ypI</recordid><startdate>20160301</startdate><enddate>20160301</enddate><creator>Steckhan, Nico, M.Sc</creator><creator>Hohmann, Christoph-Daniel, M.D</creator><creator>Kessler, Christian, M.D</creator><creator>Dobos, Gustav, M.D</creator><creator>Michalsen, Andreas, M.D</creator><creator>Cramer, Holger, Ph.D</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RQ</scope><scope>7RV</scope><scope>7TS</scope><scope>7U7</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20160301</creationdate><title>Effects of different dietary approaches on inflammatory markers in patients with metabolic syndrome: A systematic review and meta-analysis</title><author>Steckhan, Nico, M.Sc ; 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A proinflammatory environment contributes to several metabolic disturbances and possibly the development of MetS. Dietary approaches have defined impact on immune function and putative antiinflammatory effects. The aim of this study was to assess the effects of different dietary approaches on markers of inflammation in patients with MetS. Further effects on weight loss and fasting insulin were analyzed. Methods Medline/PubMed, Scopus, and the Cochrane Library were screened in September 2014 for randomized controlled trials (RCTs) on different dietary approaches for participants with MetS as defined by National Cholesterol Education Program Adult Treatment Panel III. Primary outcomes were markers of the immune system. Secondary outcome was body weight and fasting insulin. Standardized mean differences (SMD) and 95% confidence intervals (95% CIs) were calculated. Results Thirteen randomized controlled trials with a total of 2017 patients were included. Low-fat diets (29 ± 2% energy from fats) decreased C-reactive protein compared with control diets (SMD: −0.98; 95% CI: −1.6 to −0.35; P  = 0.002). Low-carbohydrate diets (23 ± 10% energy from carbohydrates; SMD: −0.33; 95% CI: −0.63 to −0.03; P  = 0.004) and multimodal interventions (SMD: −1.02; 95% CI: −1.97 to −0.07; P  = 0.04) were able to induce significant weight loss. Low-carbohydrate diets were able to decrease insulin (SMD: −0.33; 95% CI: −0.63 to −0.03; P  = 0.03). Conclusions C-reactive protein; however, this effect is also dependent on weight loss. Furthermore, low-carbohydrate diets have beneficial effects on insulin and body weight. Dietary approaches should mainly be tried to reduce macronutrients and enrich functional food components such as vitamins, flavonoids, and unsaturated fatty acids. People with MetS will benefit most by combining weight loss and anti-inflammatory nutrients.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26706026</pmid><doi>10.1016/j.nut.2015.09.010</doi><tpages>11</tpages></addata></record>
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subjects Biomarkers - blood
Body Weight
C-Reactive Protein - metabolism
Carbohydrates
Cholesterol
Databases, Factual
Diet
Diet - methods
Diet, Carbohydrate-Restricted
Diet, Fat-Restricted
Dietary Carbohydrates - administration & dosage
Dietary Fats - administration & dosage
Diets
Fatty Acids - administration & dosage
Fatty Acids, Unsaturated - administration & dosage
Flavonoids
Flavonoids - administration & dosage
Functional foods & nutraceuticals
Gastroenterology and Hepatology
Humans
Immune response
Immune system
Inflammation
Insulin
Insulin - blood
Insulin resistance
Meta-analysis
Metabolic disorders
Metabolic syndrome
Metabolic Syndrome - blood
Metabolic Syndrome - diet therapy
Micronutrients - administration & dosage
NCEP ATP III
Nutrients
Randomized Controlled Trials as Topic
Studies
Systematic review
Tumor necrosis factor-TNF
Vitamins
title Effects of different dietary approaches on inflammatory markers in patients with metabolic syndrome: A systematic review and meta-analysis
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