2 results
Effects of popular diets on anthropometric and metabolic parameters: an umbrella review of meta-analyses of randomized controlled trials
- Monica Dinu, Giuditta Pagliai, Donato Angelino, Alice Rosi, Margherita Dall'Asta, Letizia Bresciani, Cinzia Ferraris, Monica Guglielmetti, Justyna Godos, Cristian Del Bò, Daniele Nucci, Erika Meroni, Linda Landini, Daniela Martini, Francesco Sofi
-
- Journal:
- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E672
-
- Article
-
- You have access Access
- Export citation
-
Introduction:
The prevalence of overweight, obesity, and their related complications is increasing worldwide. We aimed to summarise and critically evaluate the effects of different popular diets on anthropometric parameters and metabolic risk factors.
Material and methods:An umbrella review of meta-analyses of randomized controlled trials was conducted according to the Joanna Briggs Institute Umbrella Review Methodology. The review protocol has been registered on PROSPERO (ID: CRD42019126103). Medline, Embase, Scopus, Cochrane Database of Systematic Reviews, and Web of Science were searched from inception to April 2019 to identify meta-analyses of randomized controlled trials that examined the effects of different diets on anthropometric parameters and metabolic risk factors. For each association, we estimated the summary effect size by random-effects and fixed-effects models, the 95% confidence interval, and the 95% prediction interval. We also assessed the between-study heterogeneity and evidence for small-study effects. We further applied standardized methodological criteria to evaluate the epidemiological credibility of the statistically significant associations.
Results:Overall, 80 articles reporting 495 unique meta-analyses were examined, covering a wide range of popular diets: low-carbohydrate (n = 21 articles), high-protein (n = 8), low-fat (n = 9), palaeolithic (n = 2), low glycaemic index/load (n = 12), intermittent energy restriction (n = 6), Mediterranean (n = 11), Nordic (n = 2), vegetarian (n = 9), Dietary Approaches to Stop Hypertension or DASH (n = 6), and portfolio dietary pattern (n = 1). The methodological quality of most articles (n = 65; 81%), evaluated using the AMSTAR-2 questionnaire, was low or critically low. The strength of evidence was generally weak. The most consistent evidence was reported for Mediterranean diet, with suggestive evidence of an improvement in weight, body mass index (BMI), total cholesterol, glucose and blood pressure. Suggestive evidence of an improvement in weight and blood pressure was also reported for DASH diet. Low-carbohydrate, high-protein, low-fat and low-glycaemic index/load diets showed suggestive and/or weak evidence of a reduction in weight and BMI, but contrasting evidence for lipid, glycaemic and blood pressure parameters, suggesting potential risks of unfavourable effects. Finally, evidence for palaeolithic, intermittent energy restriction, Nordic, vegetarian and portfolio dietary patterns was graded as weak or not statistically significant.
Discussion:Most meta-analyses showed low methodological quality and the strength of evidence, assessed using evidence classification criteria, was generally weak. Among all the diets evaluated, Mediterranean diet had the strongest and most consistent evidence of a positive effect on both anthropometric parameters and metabolic risk factors.
PP148 Development And Evaluation Of A Tool Supporting Prescription Behavior
- Valentina Lorenzoni, Vincenzo Ferrari, Cinzia Freschi, Giuseppe Turchetti
-
- Journal:
- International Journal of Technology Assessment in Health Care / Volume 33 / Issue S1 / 2017
- Published online by Cambridge University Press:
- 12 January 2018, p. 139
-
- Article
-
- You have access Access
- Export citation
-
INTRODUCTION:
The increasing complexity of decision-making in clinical practice and the financial pressure requires clinicians to develop some background about the economic consequences of their decisions and to become more and more managers of pre-defined budgets. The present work aims at describing a simple technology solution that could support prescription decisions and illustrates the results of a preliminary assessment of the tool in a sample of professionals. The solution has been developed to allow informed decision-making in the prescription of oral anti-diabetic drugs (OADs) in type II diabetes mellitus (T2DM) patients by supporting prescriptive appropriateness.
METHODS:The tool developed is compatible with many kinds of hardware architectures and the most diffused web browsers. The system allows real-time reproduction of economic evaluation of the different therapeutic options for the management of T2DM patients. Assessment of “ease to use” and “usefulness” of the tool was performed in a convenience sample of clinicians and pharmacists through a specific questionnaire.
RESULTS:The tool was developed to compare dipeptidyl-peptidase inhibitors (DPP4i) with sulfonylureas, as second line therapy, for T2DM patients. The tool has a user-friendly Graphical User Interface allowing users to quickly and easily select the therapeutic options to compare, choosing geographical context, perspective of analysis, and changing some model parameters. Feedbacks obtained from thirty-three different professionals were generally positive for the “ease to understand information offered”, “ease of introduction of the tool to support usual working activity”, “usefulness within the usual working activity”.
CONCLUSIONS:The study showed that the introduction of the tool as a support for clinicians in optimizing their practice could satisfy unmet needs of professionals by supporting informed prescriptive appropriateness in the choice of OADs as it allows to consider diabetes drug related costs in a comprehensive way. The routinely use of the tool developed could become a solution helping clinicians in the management of several diseases.