Systematic review and meta-analysis of the effect of increased vegetable and fruit consumption on body weight and energy intake - PubMed (original) (raw)

Meta-Analysis

Systematic review and meta-analysis of the effect of increased vegetable and fruit consumption on body weight and energy intake

Oliver T Mytton et al. BMC Public Health. 2014.

Erratum in

Abstract

Background: 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.

Methods: 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.

Results: 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 -0.54kg (95% CI: -1.05 to -0.04; n=8; I2 for heterogeneity = 73%, 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).

Conclusion: 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.

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Figures

Figure 1

Figure 1

Flow chart of papers identified, screened and reviewed.

Figure 2

Figure 2

Meta-analyses of the effect of high vegetable and fruit intake compared to low vegetable and fruit intake on body weight and energy intake. a: Meta-analysis of the effect of high fruit and vegetable intake compared to low fruit and vegetable intake on change in body weight. b: Meta-analysis of the effect of high fruit and vegetable intake compared to low fruit and vegetable intake on energy intake.

Figure 3

Figure 3

Funnel plots for the outcomes of change in body weight and change in energy intake. a: Funnel plot for the outcome of change in body weight. The funnel plot is a test for publication bias. Publication bias may be indictated by an absence of small negative trials, in this case trials missing from the bottom right hand corner. b: Funnel plot for the outcome of change in energy intake. The funnel plot is a test for publication bias. Publication bias may be indictated by an absence of small negative trials, in this case trials missing from the bottom right hand corner.

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Pre-publication history
    1. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2458/14/886/prepub

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