PMID- 33693499
OWN - NLM
STAT- MEDLINE
DCOM- 20210628
LR  - 20230214
IS  - 1938-3207 (Electronic)
IS  - 0002-9165 (Linking)
VI  - 113
IP  - 6
DP  - 2021 Jun 1
TI  - Higher intake of microbiota-accessible carbohydrates and improved cardiometabolic 
      risk factors: a meta-analysis and umbrella review of dietary management in 
      patients with type 2 diabetes.
PG  - 1515-1530
LID - 10.1093/ajcn/nqaa435 [doi]
AB  - BACKGROUND: Microbiota-accessible carbohydrates (MACs) are critical substrates 
      for intestinal microbes; the subsequent production of SCFAs may have some 
      potential benefits for patients with type 2 diabetes mellitus (T2DM). OBJECTIVES: 
      We conducted a meta-analysis of randomized controlled trials (RCTs) to assess the 
      effects of higher compared with lower MAC intakes on cardiovascular risk factors 
      in T2DM patients and performed an umbrella review of RCTs to evaluate the 
      evidence quality concerning existing dietary T2DM interventions. METHODS: 
      Publications were identified by searching MEDLINE, EMBASE, and CINAHL. In the 
      meta-analysis, random-effects models were used to calculate pooled estimates, and 
      sensitivity analyses, meta-regression, subgroup analyses, and Egger's test were 
      performed. For the umbrella review, we summarized pooled estimates, 95% CIs, 
      heterogeneity, and publication bias. The Grading of Recommendations Assessment, 
      Development and Evaluation (GRADE) and modified NutriGrade were used to assess 
      the quality of evidence in the meta-analysis and umbrella review, respectively. 
      RESULTS: Forty-five RCTs with 1995 participants were included in the 
      meta-analysis. High MAC intake significantly reduced glycated hemoglobin (HbA1c) 
      (weighted mean difference [WMD] -0.436% [-0.556, -0.315]), fasting glucose (WMD 
      -0.835 mmol/L [-1.048, -0.622]), total cholesterol (WMD -0.293 mmol/L [-0.397, 
      -0.190]), triglycerides (WMD -0.118 mmol/L [-0.308, -0.058]), BMI (WMD -0.476 
      [-0.641, -0.312]), and systolic blood pressure (WMD -3.066 mmHg [-5.653, 
      -0.478]), with a moderate-to-high quality of evidence, compared with low intake. 
      Region, dose, and MAC type were key variables. The umbrella review of all dietary 
      interventions for cardiovascular risk factors in patients with T2DM included 26 
      meta-analyses with 158 pooled estimates. The evidence quality of MACs, dietary 
      fiber, high-protein diet, omega-3 (n-3), viscous fiber, vitamin D, and vitamin E 
      intake was moderate to high. CONCLUSIONS: When compared with lower intake, 
      increased MAC intake improved glycemic control, blood lipid, body weight, and 
      inflammatory markers for people with T2DM. This trial was registered at PROSPERO 
      (https://www.crd.york.ac.uk/PROSPERO/#recordDetails) as CRD42019120531.
CI  - (c) The Author(s) 2021. Published by Oxford University Press on behalf of the 
      American Society for Nutrition.
FAU - Xu, Bocheng
AU  - Xu B
AD  - College of Animal Sciences, Zhejiang University, Hangzhou, China.
FAU - Fu, Jie
AU  - Fu J
AD  - College of Animal Sciences, Zhejiang University, Hangzhou, China.
FAU - Qiao, Yanxiang
AU  - Qiao Y
AD  - Institute of Metabolic Diseases, the 5th Affiliated Hospital of Shenzhen 
      University Health Science Center, Shenzhen, Guangdong, China.
FAU - Cao, Jinping
AU  - Cao J
AD  - College of Animal Sciences, Zhejiang University, Hangzhou, China.
FAU - Deehan, Edward C
AU  - Deehan EC
AD  - Department of Agricultural, Food & Nutritional Science, University of Alberta, 
      Edmonton, Canada.
FAU - Li, Zhi
AU  - Li Z
AD  - College of Life Sciences, Hebei Normal University, Shijiazhuang, China.
FAU - Jin, Mingliang
AU  - Jin M
AD  - College of Animal Sciences, Zhejiang University, Hangzhou, China.
FAU - Wang, Xinxia
AU  - Wang X
AD  - College of Animal Sciences, Zhejiang University, Hangzhou, China.
FAU - Wang, Yizhen
AU  - Wang Y
AD  - College of Animal Sciences, Zhejiang University, Hangzhou, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PL  - United States
TA  - Am J Clin Nutr
JT  - The American journal of clinical nutrition
JID - 0376027
RN  - 0 (Dietary Carbohydrates)
SB  - IM
MH  - Diabetes Mellitus, Type 2/*diet therapy
MH  - Dietary Carbohydrates/*metabolism
MH  - Gastrointestinal Microbiome/*physiology
MH  - Humans
MH  - Risk Factors
OTO - NOTNLM
OT  - dietary interventions
OT  - dietary management
OT  - dietary microbiota-accessible carbohydrates
OT  - meta-analysis
OT  - type 2 diabetes mellitus
OT  - umbrella review
EDAT- 2021/03/12 06:00
MHDA- 2021/06/29 06:00
CRDT- 2021/03/11 06:44
PHST- 2020/07/21 00:00 [received]
PHST- 2020/12/17 00:00 [accepted]
PHST- 2021/03/12 06:00 [pubmed]
PHST- 2021/06/29 06:00 [medline]
PHST- 2021/03/11 06:44 [entrez]
AID - S0002-9165(22)00730-4 [pii]
AID - 10.1093/ajcn/nqaa435 [doi]
PST - ppublish
SO  - Am J Clin Nutr. 2021 Jun 1;113(6):1515-1530. doi: 10.1093/ajcn/nqaa435.