Fruit and vegetable intake and bones: A systematic review and meta-analysis

Autor: Lígia Araújo Martini, Melissa Orlandin Premaor, Fabio V. Comim, Juliana Ebling Brondani, Liziane Maahs Flores
Rok vydání: 2019
Předmět:
Critical Care and Emergency Medicine
Physiology
Osteoporosis
Cochrane Library
law.invention
Cohort Studies
Fractures
Bone
Mathematical and Statistical Techniques
0302 clinical medicine
Randomized controlled trial
law
Vegetables
Medicine and Health Sciences
030212 general & internal medicine
Musculoskeletal System
Trauma Medicine
education.field_of_study
Multidisciplinary
FRATURAS
Incidence
Statistics
Eukaryota
Metaanalysis
Research Assessment
Plants
Systematic review
Bone Fracture
Research Design
Meta-analysis
Physical Sciences
Medicine
Bone Remodeling
Anatomy
Traumatic Injury
Research Article
Cohort study
medicine.medical_specialty
Systematic Reviews
Science
Population
030209 endocrinology & metabolism
Research and Analysis Methods
Pelvis
03 medical and health sciences
Internal medicine
medicine
Humans
Bone Resorption
Statistical Methods
education
Hip
business.industry
Organisms
Biology and Life Sciences
Feeding Behavior
Bone fracture
medicine.disease
Fruit
Physiological Processes
business
Mathematics
Zdroj: PLoS ONE
Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual)
Universidade de São Paulo (USP)
instacron:USP
PLoS ONE, Vol 14, Iss 5, p e0217223 (2019)
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0217223
Popis: BackgroundAlthough intake of fruits and vegetables seemed to have a protective effect on bone metabolism, its effect on fractures remains uncertain.MethodsA systematic review of randomized controlled trials (RCTs) and cohort studies (PROSPERO: CRD42016041462) was performed. RCTs and cohort studies that evaluated the combined intake of fruits and vegetables in men and women aged over 50 years were included. We considered fractures as a primary outcome measure. Changes in bone markers were considered as secondary outcomes. The search strategy included the following descriptors: fruit, vegetables, vegetable products, bone and bones, bone fractures, postmenopausal osteoporosis, and osteoporosis. PubMed, Embase, and Cochrane Library were the databases used. The appraisal of the studies was performed by two independent reviewers, and discussed and agreed upon by both examiners. The data extracted from the RCTs and cohort studies were summarized separately. The risks of fractures were combined across studies using random models. Bone resorption marker (CTx) was summarized with standardized mean differences. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) method was used to evaluate the strength of recommendations.ResultsOf the 1,192 studies screened, 13 articles were included in the systematic review and 10 were included in the pooled analysis (6 cohort studies and 4 RCTs). The six cohort studies included in the meta-analysis included a population of 225,062. The pooled hazard ratio (HR) (95% confidence interval (CI)) of the hip in five studies was 0.92 (0.87, 0.98). Its heterogeneity was moderate (I2 = 55.7%, p = 0.060), GRADE (⊕⊕⊕O). Two cohort studies evaluated the risk of any fracture; the HR was 0.90 (95% CI: 0.86-0.96), with aheterogeneity of 24.9% (p = 0.249, GRADE (⊕⊕⊕O)). There was no association between the bone resorption marker CTx and 3 months of fruit and vegetable intake evaluated by four RCTs, GRADE (⊕⊕O O).ConclusionThere was an association between the increase of at least one serving of fruits and vegetables per day and decreases in the risk of fractures. The level of evidence for this association is moderate.
Databáze: OpenAIRE
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