Background/Objectives: Lifestyle interventions such as dietary changes have been proposed to control the cardiometabolic risk factors and thus prevent cardiovascular (CV) disease (CVD). We performed an umbrella review to investigate whether different dietary patterns affect CV risk in individuals with at least one cardiometabolic risk factor (hypertension, dyslipidemia, obesity, diabetes, metabolic syndrome) but not established CVD. Methods: We systematically searched the PubMed and Scopus databases (up to August 2024) for the systematic reviews and meta-analyses of randomized controlled trials (RCTs). Articles should be written in English and refer to a specific dietary pattern (such as Mediterranean diet, etc.). The population studied referred to adults with at least one cardiovascular (CV) risk factor. Results: From 4512 records identified, we finally included 25 meta-analyses with a total of 329 associations. Strong evidence for a benefit was found for LCD with reductions in BW [MD: −4.79 (95% CI −5.85, −3.72) kg, p ≤ 0.001], SBP [MD: −6.38 (95% CI −7.84, −4.93) mmHg, p ≤ 0.001], TG [WMD: −5.81 (95% CI −7.96, −3.66) mg/dL, p ≤ 0.001], and fasting plasma insulin [MD: −15.35 (95% CI −19.58, −11.12) pmol/L, p ≤ 0.001], as well as for low-GI diet for the reduction of BW [SMD: −0.66 (95% CI −0.90, −0.43) kg, p ≤ 0.001]. Conclusions: Across many dietary patterns, LCD showed strong or highly suggestive evidence for a benefit on SBP, BW reduction, and lipid profile improvement. Secondarily, low-GI, DASH, and Portfolio and Nordic diets suggested beneficial effects on controlling CV risk.
Síntesis amplia/ Revisión panorámica de revisiones sistemáticas
ABSTRACT CONTEXT AND OBJECTIVE: Autism spectrum disorders (ASDs) include autistic disorder, Asperger’s disorder and pervasive developmental disorder. The manifestations of ASDs can have an important impact on learning and social functioning that may persist during adulthood. The aim here was to summarize the evidence from Cochrane systematic reviews on interventions for ASDs. DESIGN AND SETTING: Review of systematic reviews, conducted within the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo. METHODS: We included and summarized the results from Cochrane systematic reviews on interventions for ASDs. RESULTS: Seventeen reviews were included. These found weak evidence of benefits from acupuncture, gluten and casein-free diets, early intensive behavioral interventions, music therapy, parent-mediated early interventions, social skill groups, Theory of Mind cognitive model, aripiprazole, risperidone, tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRI); this last only for adults. No benefits were found for sound therapies, chelating agents, hyperbaric oxygen therapy, omega-3, secretin, vitamin B6/magnesium and SSRI for children. CONCLUSION: Acupuncture, gluten and casein-free diets, early intensive behavioral interventions, music therapy, parent-mediated early interventions, social skill groups and the Theory of Mind cognitive model seem to have benefits for patients with autism spectrum disorders (very low to low-quality evidence). Aripiprazole, risperidone, tricyclic antidepressants and SSRI (this last only for adults) also showed some benefits, although associated with higher risk of adverse events. Experimental studies to confirm a link between probable therapies and the disease, and then high-quality long-term clinical trials, are needed.
Síntesis amplia/ Revisión panorámica de revisiones sistemáticas
OBJETIVO: Evaluar los beneficios y daños del consumo de sal reducido en pacientes con hipertensión esencial se centra en resultados relevantes al paciente y la presión arterial.
MÉTODOS: Se realizó una búsqueda sistemática de las cinco bases de datos electrónicas se realizó para identificar de alta calidad basado en la literatura secundaria de ensayos controlados aleatorios (ECA). Una búsqueda actualizada bibliografía primaria (ECA) se realizó durante el período de tiempo hasta el año 2010 que no estaba cubierto por la literatura secundaria. Los principales resultados fueron la muerte, morbilidad cardiovascular / mortalidad, estancia hospitalaria, insuficiencia renal terminal, la calidad de vida, y los eventos adversos. Cambio de la presión arterial se definió como parámetro sustituto.
RESULTADOS: Cuatro diferentes revisiones sistemáticas y ensayos controlados dos cumplieron con los criterios de inclusión. Sólo una revisión informó datos limitados sobre resultados relevantes al paciente. Durante un período de intervención de hasta 12 meses, la PAS media se redujo en 3.6 hasta 8.0 mm Hg en todos los exámenes. Para el período de la intervención misma, una ventaja estadísticamente significativa con respecto a la reducción media de la PAD entre 1,9 y 2,8 mmHg se encontró en tres exámenes. La cuarta publicación reportó una reducción no significativa (reducción de la presión arterial diastólica de 4,7 mmHg). Ninguno de los ECA identificados en la actualización de la literatura primaria de búsqueda informaron los datos sobre resultados relevantes al paciente. Sin embargo, ambos ensayos clínicos aleatorios mostraron mejoras en la presión arterial con la reducción de la sal.
CONCLUSIÓN: Una de las ventajas de una dieta reducida en sal en pacientes con presión arterial alta no se ha demostrado en relación con resultados relevantes al paciente sobre la base de revisiones sistemáticas y ensayos controlados publicados hasta el año 2010. Los resultados indican una disminución de la presión arterial efecto a través de la ingesta de sal reducida en los pacientes hipertensos.
Background/Objectives: Lifestyle interventions such as dietary changes have been proposed to control the cardiometabolic risk factors and thus prevent cardiovascular (CV) disease (CVD). We performed an umbrella review to investigate whether different dietary patterns affect CV risk in individuals with at least one cardiometabolic risk factor (hypertension, dyslipidemia, obesity, diabetes, metabolic syndrome) but not established CVD. Methods: We systematically searched the PubMed and Scopus databases (up to August 2024) for the systematic reviews and meta-analyses of randomized controlled trials (RCTs). Articles should be written in English and refer to a specific dietary pattern (such as Mediterranean diet, etc.). The population studied referred to adults with at least one cardiovascular (CV) risk factor. Results: From 4512 records identified, we finally included 25 meta-analyses with a total of 329 associations. Strong evidence for a benefit was found for LCD with reductions in BW [MD: −4.79 (95% CI −5.85, −3.72) kg, p ≤ 0.001], SBP [MD: −6.38 (95% CI −7.84, −4.93) mmHg, p ≤ 0.001], TG [
WMD:
−5.81 (95% CI −7.96, −3.66) mg/dL, p ≤ 0.001], and fasting plasma insulin [MD: −15.35 (95% CI −19.58, −11.12) pmol/L, p ≤ 0.001], as well as for low-GI diet for the reduction of BW [
SMD:
−0.66 (95% CI −0.90, −0.43) kg, p ≤ 0.001]. Conclusions: Across many dietary patterns, LCD showed strong or highly suggestive evidence for a benefit on SBP, BW reduction, and lipid profile improvement. Secondarily, low-GI, DASH, and Portfolio and Nordic diets suggested beneficial effects on controlling CV risk.
Síntesis amplia»Revisión panorámica de revisiones sistemáticas
