Abstract
Background: Although the body of evidence indicates clear benefits of dietary modifications for prevention of type-2 diabetes mellitus (T2DM), it may be difficult for healthcare providers to recommend which diet interventions or dietary factors are appropriate for patients as there are too many modalities available. Accordingly, we performed an umbrella review to synthesize evidence on diet interventions and dietary factors in prevention of T2DM. Methods: Medline and Scopus databases were searched for relevant studies. Systematic reviews with meta-analyses of randomized-controlled trial or observational studies were eligible if they measured effects of diet interventions and/or dietary factors including dietary patterns, food groups, and nutrients on risk of T2DM. The effect of each diet intervention/factor was summarized qualitatively. Results: Sixty systematic reviews and meta-analyses were eligible. Results of the review suggest that healthy dietary patterns such as Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets, and high consumption of whole grains, low-fat dairy products, yogurt, olive oil, chocolate, fiber, magnesium, and flavonoid significantly reduced the risk of T2DM. In contrast, high glycemic index and glycemic load diets, high consumption of red and processed meat, and sugar or artificial sugar-sweetened beverages significantly increased risk of T2DM. Prescribing diet interventions with or without physical activity interventions significantly decreased risk of T2DM in both high-risk and general population. Conclusion: High consumption of Mediterranean and DASH diet, and interventions that modified the quality of diet intake significantly reduced risk of T2DM especially in the high-risk population. These lifestyle modifications should be promoted in both individual and population levels to prevent and decrease burden from T2DM in the future.
Highlights
Type-2 diabetes mellitus (T2DM) is a major public health problem
Two systematic reviews and meta-analyses (SRMA) of cohort studies [9,29] assessed the association between red and processed meat consumption and the risk of type-2 diabetes mellitus (T2DM). These two SRMAs found that high intake of red and processed meat significantly increased the risk of T2DM with pooled RR of 1.21 for red meat and pooled RR ranging from 1.27 to 1.41 for processed meat
Results from one SRMA of cohort [9] studies suggest that high intake of egg did not significantly decrease the risk of T2DM but high and every intake of olive oil 10 g/day significantly lowered the risk of T2DM with pooled RRs of 0.84 and 0.91, respectively (Figure 2A,B)
Summary
Type-2 diabetes mellitus (T2DM) is a major public health problem. Around 425 million people globally were diagnosed with T2DM in 2017 and this is predicted to increase to 629 million by 2045 [1].T2DM is a significant risk factor of cardiovascular diseases, the leading cause of morbidity and mortality in population worldwide [2]. Several systematic reviews and meta-analyses (SRMA) of randomized controlled trials (RCT) [4,5,6] indicated that interventions that modified diet quality (e.g., low calories and low-fat diet) and/or enhanced level of physical activity can delay or prevent the onset of T2DM. Systematic reviews with meta-analyses of randomized-controlled trial or observational studies were eligible if they measured effects of diet interventions and/or dietary factors including dietary patterns, food groups, and nutrients on risk of T2DM. Results of the review suggest that healthy dietary patterns such as Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets, and high consumption of whole grains, low-fat dairy products, yogurt, olive oil, chocolate, fiber, magnesium, and flavonoid significantly reduced the risk of T2DM. Prescribing diet interventions with or without physical activity interventions significantly decreased risk of T2DM in both high-risk and general population
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