Skip to main content Accessibility help
×
Home

Fruit and vegetable consumption and the metabolic syndrome: a systematic review and dose–response meta-analysis

  • Mijin Lee (a1), Miso Lim (a1) and Jihye Kim (a1)

Abstract

A systematic review and meta-analysis of observational studies were performed to assess the dose–response associations between fruit or vegetable consumption and the chance of the metabolic syndrome (MetS). Studies on the association between fruit or vegetable consumption and the risk of the MetS published from January 1958 to 30 October 2018 were searched using the PubMed, MEDLINE and Embase databases, and the references of relevant articles were reviewed. Random-effects models were used to estimate the summary OR with 95 % CI for the MetS, and dose–response analysis was conducted to quantify the associations. Heterogeneity among studies was evaluated using Q and I2 statistics. A total of nine observational studies (seven cross-sectional studies and two cohort studies) were included in the meta-analysis. In a dose–response analysis of cohort studies and cross-sectional studies, the summary estimate of the MetS for an increase of 100 g/d in fruit consumption (nine studies) was 0·97 (95 % CI 0·95, 0·99; I2 = 26·7 %), whereas an increase of 100 g/d in vegetable consumption (nine studies) was not associated with a reduction in the MetS (OR 0·98; 95 % CI 0·96, 1·01; I2 = 54·6 %). In conclusion, an increased intake of fruit may reduce the risk of the MetS. For future research, prospective studies or randomised clinical trials are needed to identify the effects of fruits and vegetables by variety on the risk of the MetS.

Copyright

Corresponding author

*Corresponding author: J. Kim, fax +82 31 204 8119, email kjhye@khu.ac.kr

References

Hide All
1.Lutsey, PL, Steffen, LM & Stevens, J (2008) Dietary intake and the development of the metabolic syndrome: the Atherosclerosis Risk in Communities study. Circulation 117, 754761.
2.McCracken, E, Monaghan, M & Sreenivasan, S (2018) Pathophysiology of the metabolic syndrome. Clin Dermatol 36, 1420.
3.Chung, SJ, Lee, Y, Lee, S, et al. (2015) Breakfast skipping and breakfast type are associated with daily nutrient intakes and metabolic syndrome in Korean adults. Nutr Res Pract 9, 288295.
4.Aune, D, Giovannucci, E, Boffetta, P, et al. (2017) Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality – a systematic review and dose–response meta-analysis of prospective studies. Int J Epidemiol 46, 10291056.
5.Kim, OY, Kwak, SY, Kim, B, et al. (2017) Selected food consumption mediates the association between education level and metabolic syndrome in Korean adults. Ann Nutr Metab 70, 122131.
6.Kouki, R, Schwab, U, Hassinen, M, et al. (2011) Food consumption, nutrient intake and the risk of having metabolic syndrome: the DR’s EXTRA study. Eur J Clin Nutr 65, 368377.
7.Babio, N, Bullo, M, Basora, J, et al. (2009) Adherence to the Mediterranean diet and risk of metabolic syndrome and its components. Nutr Metab Cardiovasc Dis 19, 563570.
8.Baik, I, Lee, M, Jun, NR, et al. (2013) A healthy dietary pattern consisting of a variety of food choices is inversely associated with the development of metabolic syndrome. Nutr Res Pract 7, 233241.
9.Esmaillzadeh, A, Kimiagar, M, Mehrabi, Y, et al. (2006) Fruit and vegetable intakes, C-reactive protein, and the metabolic syndrome. Am J Clin Nutr 84, 14891497.
10.Jung, HJ, Han, SN, Song, S, et al. (2011) Association between adherence to the Korean Food Guidance System and the risk of metabolic abnormalities in Koreans. Nutr Res Pract 5, 560568.
11.Tian, Y, Su, L, Wang, J, et al. (2018) Fruit and vegetable consumption and risk of the metabolic syndrome: a meta-analysis. Public Health Nutr 21, 756765.
12.Zhang, Y & Zhang, DZ (2018) Associations of vegetable and fruit consumption with metabolic syndrome. A meta-analysis of observational studies. Public Health Nutr 21, 16931703.
13.Modesti, PA, Reboldi, G, Cappuccio, FP, et al. (2016) Panethnic differences in blood pressure in Europe: a systematic review and meta-analysis. PLOS ONE 11, e0147601.
14.DerSimonian, R & Laird, N (1986) Meta-analysis in clinical trials. Control Clin Trials 7, 177188.
15.Cheraghi, Z, Mirmiran, P, Mansournia, MA, et al. (2016) The association between nutritional exposures and metabolic syndrome in the Tehran Lipid and Glucose Study (TLGS): a cohort study. Public Health 140, 163171.
16.Montano, D (2017) Association between socioeconomic determinants and the metabolic syndrome in the German Health Interview and Examination Survey for Adults (DEGS1) – a mediation analysis. Rev Diabet Stud 14, 279294.
17.Shin, A, Lim, SY, Sung, J, et al. (2009) Dietary intake, eating habits, and metabolic syndrome in Korean men. J Am Diet Assoc 109, 633640.
18.Greenland, S & Longnecker, MP (1992) Methods for trend estimation from summarized dose–response data, with applications to meta-analysis. Am J Epidemiol 135, 13011309.
19.Orsini, N, Bellocco, R & Greenland, S (2006) Generalized least squares for trend estimation of summarized dose–response data. Stata J 6, 4057.
20.Harrell, FE Jr, Lee, KL & Pollock, BG (1988) Regression models in clinical studies: determining relationships between predictors and response. J Natl Cancer Inst 80, 11981202.
21.Durrleman, S & Simon, R (1989) Flexible regression models with cubic splines. Stat Med 8, 551561.
22.Smith, PL (1979) Splines as a useful and convenient statistical tool. Am Stat 33, 5762.
23.Higgins, JP & Thompson, SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21, 15391558.
24.Higgins, JP, Thompson, SG, Deeks, JJ, et al. (2003) Measuring inconsistency in meta-analyses. BMJ 327, 557560.
25.Egger, M, Davey Smith, G, Schneider, M, et al. (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315, 629634.
26.Sterne, JA, Sutton, AJ, Ioannidis, JP, et al. (2011) Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials. BMJ 343, d4002.
27.Furuya-Kanamori, L, Barendregt, JJ & Doi, SA (2018) A new improved graphical and quantitative method for detecting bias in meta-analysis. Int J Evid Based Healthc 16, 195203.
28.National Cholesterol Education Program Expert Panel on Detection Evaluation Treatment of High Blood Cholesterol in Adults (2002) Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report. Circulation 106, 31433421.
29.International Diabetes Federation Clinical Guidelines Task Force (2006) Global guideline for type 2 diabetes: recommendations for standard, comprehensive, and minimal care. Diabet Med 23, 579593.
30.Shin, JY, Kim, JY, Kang, HT, et al. (2015) Effect of fruits and vegetables on metabolic syndrome: a systematic review and meta-analysis of randomized controlled trials. Int J Food Sci Nutr 66, 416425.
31.Khalil, A, Gaudreau, P, Cherki, M, et al. (2011) Antioxidant-rich food intakes and their association with blood total antioxidant status and vitamin C and E levels in community-dwelling seniors from the Quebec longitudinal study NuAge. Exp Gerontol 46, 475481.
32.Bokov, A, Chaudhuri, A & Richardson, A (2004) The role of oxidative damage and stress in aging. Mech Ageing Dev 125, 811826.
33.Watzl, B, Kulling, SE, Moseneder, J, et al. (2005) A 4-wk intervention with high intake of carotenoid-rich vegetables and fruit reduces plasma C-reactive protein in healthy, nonsmoking men. Am J Clin Nutr 82, 10521058.
34.Hermsdorff, HH, Zulet, MA, Puchau, B, et al. (2010) Fruit and vegetable consumption and proinflammatory gene expression from peripheral blood mononuclear cells in young adults: a translational study. Nutr Metab (Lond) 7, 42.
35.Mahoney, SE & Loprinzi, PD (2014) Influence of flavonoid-rich fruit and vegetable intake on diabetic retinopathy and diabetes-related biomarkers. J Diabetes Complications 28, 767771.
36.Jayaprakasam, B, Vareed, SK, Olson, LK, et al. (2005) Insulin secretion by bioactive anthocyanins and anthocyanidins present in fruits. J Agric Food Chem 53, 2831.
37.Chen, JP, Chen, GC, Wang, XP, et al. (2017) Dietary fiber and metabolic syndrome: a meta-analysis and review of related mechanisms. Nutrients 10, 24.
38.Park, S, Ham, JO & Lee, BK (2015) Effects of total vitamin A, vitamin C, and fruit intake on risk for metabolic syndrome in Korean women and men. Nutrition 31, 111118.
39.Luo, WP, Fang, YJ, Lu, MS, et al. (2015) High consumption of vegetable and fruit colour groups is inversely associated with the risk of colorectal cancer: a case–control study. Br J Nutr 113, 11291138.
40.VanderWeele, TJ & Ding, P (2017) Sensitivity analysis in observational research: introducing the E-value. Ann Intern Med 167, 268274.

Keywords

Type Description Title
UNKNOWN
Supplementary materials

Lee et al. supplementary material
Lee et al. supplementary material

 Unknown (118 KB)
118 KB

Fruit and vegetable consumption and the metabolic syndrome: a systematic review and dose–response meta-analysis

  • Mijin Lee (a1), Miso Lim (a1) and Jihye Kim (a1)

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed