Abstract P058: Comparative Effects Of Different Dietary Patterns On Biomarkers Of Non-Communicable Diseases: A Systematic Review And Network Meta-Analysis

Abstract

Each year, there are millions non-communicable diseases (NCDs) related deaths that are attributed to dietary risk factors. Dietary pattern describes the overall combination of dietary components, therefore is a more proximate representation of real-world dietary intake. The comparisons of different dietary patterns have been largely limited by the traditional pair-wise meta-analysis. We conducted a systematic review and network meta-analysis of randomised trials with healthy participants to compare major dietary patterns in NCD prevention, using biomarkers of NCDs as outcomes. For each biomarker outcome, a random effects network meta-analysis was conducted to estimate all possible pair-wise relative effects and to obtain a relative ranking of the dietary patterns in a connected network. The relative effects were estimated by calculating the summary mean differences (MD) with corresponding 95% CI. The relative ranking was assessed using the distribution of the ranking probabilities and the surface under the cumulative ranking curves (SUCRA). Of the 4008 records identified from the systematic literature search, 72 articles met our inclusion criteria and 68 were included in the quantitative synthesis. We compared up to 11 dietary patterns (Mediterranean diet, DASH diet, Paleo diet, dietary guidelines-based diet, low GI / GL diet, plant based diet, low fat diet, low carbohydrate high fat diet, traditional Mexican diet, high GI / GL diet and western habitual diet) for their effects on 11 NCD biomarkers (HDL, TG, LDL, TC, glucose, insulin, hsCRP, apoB, apoA1, HOMA-IR, and IL-6). Compared to western habitual diet, the Mediterranean diet, DASH diet, dietary guidelines based diet, plant based diet and low fat diet reduced LDL, TC, and apoB (MD range: -0.29 to -0.17 mmol/L, -0.36 to -0.24 mmol/L, and -0.11 to -0.07 g/L, respectively, all p<0.05); the Paleo diet, plant based diet and dietary guidelines based diet reduced HOMA-IR (MD range: -0.95 to -0.35, all p<0.05). While no dietary pattern ranked consistently highest across all NCD biomarkers, the Mediterranean diet was best to improve lipid profile (LDL, HDL, TC, TG, apoB and apoA1 combined average SUCRA: 63.1%); low carbohydrate high fat diet was best for glycaemic control (glucose, insulin and HOMA-IR combined average SUCRA: 66.4%); and Paleo diet was best in inflammation reduction (hsCRP and IL-6 combined average SUCRA: 87.0%). The Paleo diet had the highest all-outcomes-combined ranking (average SUCRA: 63.1%), followed by the Mediterranean diet (58.9%) and DASH diet (58.8%), while the western habitual diet (37.8%) and high GI / GL diet (38.5%) received the lowest all-outcomes-combined SUCRAs. Our findings suggest that the Paleo diet may provide potential health benefit and warrants further consideration for NCD prevention.