A Systematic Review and Meta-Analysis of the Impact of Different Intensity of Dietary Counselling on Cardiometabolic Health in Middle-Aged and Older Adults.

Jasmine Hui Min Low,Ee Heok Kua,Johnson Fam,Jung Eun Kim,Magdeline Tao Tao Ng,Darel Wee Kiat Toh

doi:10.3390/nu13092936

Abstract

Dietary counselling has been identified as one of the nutritional strategies to alleviate cardiometabolic health conditions. Its effectiveness however may vary due to factors such as intensity level and provider while this has not been comprehensively studied. This systematic review and meta-analysis aimed to assess the effects of dietary counselling on the cardiometabolic health in middle-aged and older adults and the sub-group analyses with dietary counselling intensity and the provider were also assessed. Four databases including PubMed, CINAHL Plus with Full Text, Cochrane Library and EMBASE were systematically searched. Data from 22 randomised controlled trials (RCTs) were compiled and those from 9 RCTs were utilised for meta-analysis. Dietary counselling lowered total cholesterol (TC) and fasting blood sugar (FBS) but had no impact on triglycerides (TG) and low-density lipoprotein (LDL). Sub-group analysis revealed significant lowering effect of high intensity dietary counselling for TG (weighted mean difference (WMD): −0.24 mmol/L, 95% confidence intervals (CIs): −0.40 to −0.09), TC (WMD: −0.31 mmol/L, 95% CIs: −0.49 to −0.13), LDL (WMD: −0.39 mmol/L, 95% CIs: −0.61 to −0.16) and FBS (WMD: −0.69 mmol/L, 95% CIs: −0.99 to −0.40) while medium or low intensity dietary counselling did not show favouring effects. Counselling provider showed differential responses on cardiometabolic health between dietitian and all other groups. The findings from this systematic review and meta-analysis suggest that dietary counselling is a beneficial dietary strategy to improve cardiometabolic health in middle-aged and older adults with the emphasis on the counselling intensity.

Highlights

Introduction iationsAging has become a worldwide phenomenon and according to the United Nations, the projected number of older people over the thirty years will double, reaching over 1.5 billion persons [1]
Articles were rejected after full text screening based on 1 of the 3 reasons: (1) study design was not an randomised controlled trials (RCTs), or the intervention included exercises or co-consumption of other supplementation or medication; (2) population was not human or had a mean age of
22 articles were selected for qualitative systematic review and 9 articles were eligible for quantitative analysis as the remaining 13 articles did not provide sufficient details required for the analysis (Figure 1)

Summary

Introduction

Aging has become a worldwide phenomenon and according to the United Nations, the projected number of older people over the thirty years will double, reaching over 1.5 billion persons [1]. The largest increase is anticipated to occur in Eastern and. Aging can be associated with increased morbidity including cardiometabolic risks [2]. A longitudinal cohort study reported an increase in cardiometabolic multimorbidity with age from 5.2% and 11.6% in the population aged ≥40 and ≥60 respectively [3]. Some studies have advanced the research in examining the relationship between overall diet quality and cardiometabolic disorders. A wide array of evidence has shown that a lower dietary quality in older age is associated with an increased risk of cardiovascular disease (CVD) and type 2 diabetes mellitus [4,5]. In a recent study conducted to assess the Licensee MDPI, Basel, Switzerland

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Conclusion