Dietary patterns and bone health a systematic review
The Committee qualitatively synthesized the body of evidence to inform development of a conclusion statement(s), and graded the strength of evidence using pre-established criteria for risk of bias, consistency, directness, precision, and generalizability.3. Dietary patterns were defined as the quant...
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| Format: | eBook |
| Language: | English |
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Alexandria, VA
USDA Nutrition Evidence Systematic Review, Dietary Guidelines Advisory Committee
2020, 2020
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| Collection: | National Center for Biotechnology Information - Collection details see MPG.ReNa |
| Summary: | The Committee qualitatively synthesized the body of evidence to inform development of a conclusion statement(s), and graded the strength of evidence using pre-established criteria for risk of bias, consistency, directness, precision, and generalizability.3. Dietary patterns were defined as the quantities, proportions, variety, or combination of different foods, drinks, and nutrients (when available) in diets, and the frequency with which they are habitually consumed. SUMMARY OF THE EVIDENCE: 1. This systematic review update includes nine prospective cohort studies (PCSs) that examined the relationship between dietary patterns and bone health, met inclusion criteria, and were published between January 2014 and November 2019. ○ Based on the 7 additional studies in this update to the existing review examining dietary patterns consumed by adults, moderate evidence is now available to indicate a significant relationship between dietary patterns and risk of hip fracture in older adults.○ Based on the 2 additional studies in this update to the existing review examining dietary patterns consumed by children or adolescents, no change is warranted in the level of evidence to evaluate the relationship between dietary patterns and bone health in children.○ Although the number of recent studies is modest, they are consistent in how dietary intake was evaluated, in magnitude of effect reported, and in evaluated outcome The body of evidence consistently had risks of bias, including lack of adjustment for all potential confounders and a lack of accounting for possible changes in dietary intake that may have occurred over follow-up.4. This systematic review updates and builds upon an existing systematic review from the 2015 Dietary Guidelines Advisory Committee, which previously determined that limited evidence suggests a relationship between dietary patterns and bone health in adults. In that previous review, a grade was not assignable in children and adolescents due to limited evidence from a small number of studies with wide variation in study design, dietary assessment methodology, and bone health outcomes. BACKGROUND: 1. This important public health question was identified by the U.S. Departments of Agriculture (USDA) and Health and Human Services (HHS) to be examined by the 2020 Dietary Guidelines Advisory Committee.2. The 2020 Dietary Guidelines Advisory Committee, Dietary Patterns Subcommittee conducted a systematic review to answer this question with support from the Nutrition Evidence Systematic Review (NESR) team.3. The goal of this systematic review was to examine the following question: What is the relationship between dietary patterns consumed and bone health? CONCLUSION STATEMENTS AND GRADES: 1. Moderate evidence indicates that a dietary pattern higher in fruits, vegetables, legumes, nuts, low-fat dairy, whole grains, and fish, and lower in meats (particularly processed meats), sugar sweetened beverages, and sweets is associated with favorable bone health outcomes in adults, primarily decreased risk of hip fracture. (Grade: Adults - Moderate)2. ○ Seven studies examined dietary patterns consumed by adults and bone health in older adults.○ Two articles from the same study were conducted that examined dietary patterns consumed by children and adolescents and bone health outcomes after a 4-year follow-up (approximately age 17 years).2. The direction and magnitude of effect across the body of evidence was consistent, pointing to healthier dietary patterns leading to a reduced risk of hip fractures. The studies in adults had large analytic sample sizes with a sufficient number of hip fracture cases occurring over follow-up to examine associations. Although the search strategy included other bone health outcomes, the eligible studies looked only at fractures (mainly hip) and forearm bone mineral density (in adolescents).3. Insufficient evidence is available to determine the relationship between dietary patterns consumed during childhood and bone health. (Grade: Children - Grade not assignable) METHODS: 1. Two literature searches were conducted using 3 databases (PubMed, Cochrane, Embase) to identify articles that evaluated the intervention or exposure of dietary patterns consumed and the outcomes of bone health. A manual search was conducted to identify articles that may not have been included in the electronic databases searched. Articles were screened by two NESR analysts independently for inclusion based on pre-determined criteria.2. Data extraction and risk of bias assessment were conducted for each included study, and both were checked for accuracy. |
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| Physical Description: | 1 PDF file (56 pages) illustrations |