Dietary patterns associated with obesity outcomes in adults: an umbrella review of systematic reviews

Objective: The aim of this umbrella review was to summarise the evidence from existing systematic reviews on the association between different dietary patterns (DP) and overweight or obesity outcomes in adults. Design: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and searched the MEDLINE, EMBASE, CINAHL, Cochrane, Scopus, and Web of Science for systematic reviews reporting on DP and weight gain or overweight/obesity outcomes. Result: We identified 16 systematic reviews with 143 unique studies published between 2001 and 2019. Overall quality scores ranged from 4 to 10. Six reviews in 2/11 cohort and 6/19 cross-sectional studies reported (statistically significant) decreased OR for obesity (range: 0 center dot 53 to 0 center dot 73 and 0 center dot 35 to 0 center dot 88, respectively) associated with the Mediterranean diet. Five reviews in 5/15 cohort and 10/45 cross-sectional studies reported an inverse association between diet quality and weight gain or BMI (beta range: -1 center dot 3 to -0 center dot 09). Two reviews in 1/3 cohort and 1/2 cross-sectional studies reported a decreased risk of obesity (OR = 0 center dot 76) and weight gain (OR = 0 center dot 26), respectively, with fruit and vegetable intake. Five reviews of mixed DP in 3/40 cross-sectional studies reported an increased prevalence of obesity (OR = 1 center dot 19) or abdominal obesity (OR range: 1 center dot 07 to 1 center dot 27) with the Korean diet pattern. Conclusions: Our umbrella review confirms the hypothesis that Mediterranean-type DP reduce the risk of obesity in adults. Although population-specific evidence of effective interventions is needed, characteristics of Mediterranean-type DP are important considerations for national obesity prevention strategies.

Automated summary

The umbrella review showed that the Mediterranean-type diet can reduce the risk of obesity in adults, while the Korean diet pattern may increase obesity prevalence. Diet quality is inversely related to weight gain or BMI, and increased intake of fruits and vegetables can help reduce obesity risk.