Abstract
Increased vegetable and fruit consumption is encouraged to promote health, including the maintenance of a healthy body weight. Population health strategies (e.g. 5-A-Day or similar campaigns and subsidies on vegetables or fruit) that emphasize increased consumption may theoretically lead to increased energy intake and weight gain. We undertook a systematic review of trials that sought to increase vegetable and fruit consumption, in the absence of advice or specific encouragement to remove other foods from the diet, to understand the effect on body weight and energy intake. We included only randomised controlled trials. We pooled data using a random effects model for two outcomes: change in body weight and change in energy intake. Sensitivity and secondary analyses were also undertaken, including a one-study removed analysis and analysis by study sub-type to explore sources of heterogeneity. A total of eight studies, including 1026 participants, were identified for inclusion in the review. The mean study duration was 14.7 weeks (range four to 52 weeks). The mean difference in vegetable and fruit consumption between arms was 133 g (range 50 g to 456 g). The mean change in body weight was 0.68 kg (95% CI: 0.15-1.20; n = 8; I2 for heterogeneity = 83%, p = 0.01) less in the “high vegetable and fruit” intake arms than in the “low vegetable and fruit intake” arms. There was no significant difference in measured change daily energy intake between the two arms (368 kJ; 95% CI: -27 to 762, comparing high vs low; n = 6; I2 = 42%, p = 0.07). Promoting increased fruit and vegetable consumption, in the absence of specific advice to decrease consumption of other foods, appears unlikely to lead to weight gain in the short-term and may have a role in weight maintenance or loss. Longer studies or other methods are needed to understand the long-term effects on weight maintenance and loss.
Highlights
Erratum There were some errors in the original published article [1]
We have halved the size of the control group, which is one approach to correct for the potential problem of double counting the control group [6]
The first line of the Results, under Primary Analysis, should read: “The mean change in body weight was 0.54 kg less in the ‘high vegetable and fruit’ intake arms than in the ‘low vegetable and fruit intake’ arms (Fig. 2a).”
Summary
Erratum to: systematic review and metaanalysis of the effect of increased vegetable and fruit consumption on body weight and energy intake. The study by Whybrow et al had three arms (control, arm A, arm B) [2]. We used an incorrect approach to derive standard errors for the difference in change between two arms of the study, from the standard errors for change in each arm of the study. This affected three studies [2, 5, 7]. The correct p-value for the difference in change in body weight between the control and intervention arm is 0.18. Additional files 1 and 2: Tables S1 and S2 below show the derivation of the standard error for the difference in change in body weight between the control and intervention group, deriving standard errors from p-values and from standard errors for the change in body weight within each group respectively
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