Are Reproducible Dietary Patterns Consistently Associated With Disease Outcomes or Their Drivers in Italy? A Systematic Review

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition Pub Date : 2025-02-27 DOI:10.1016/j.advnut.2025.100397

Rachele Bianco , Monica Ferraroni , Michela C Speciani , Maria Parpinel , Valeria Edefonti

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引用次数: 0

Abstract

The strength, direction, and trend of associations between specific diseases and reproducible a posteriori dietary patterns (DPs) based on principal component analysis (PCA) or exploratory factor analysis (EFA) have rarely been investigated across populations. We conducted a systematic review of PCA/EFA-based DPs identified in Italy to explore 2 methodological issues: 1) cross-study reproducibility of Italian DPs; 2) consistency of associations between reproducible DPs and the same/similar disease outcomes/DP drivers/correlates. The systematic review process and findings on DP cross-study reproducibility were published separately. This paper focuses on associations, summarizing the data in figures and tables, with post-hoc criteria for similarity among target variables, statistical methods, and adjustment for confounding. Predefined rules of inference were used to evaluate selected Hill’s causal criteria (consistency, strength, and dose–response effects) and draw valid scientific conclusions on the association between PCA/EFA-based DPs and similar/the same target variables. Fifty-two articles, primarily on EFA-based DPs derived from food frequency questionnaires, were included. Regression models were used to explore the relationships between DPs and disease outcomes/DP drivers, aligning with original research questions, study designs, and literature on confounding. When considering similar target variables, 9 groups of reproducible DPs showed >50% statistically significant associations in the same direction across 1–3 groups of target variables, such as socioeconomic characteristics, incidence of chronic diseases, overall/cause-specific mortality, cardiovascular disease risk factors, pregnancy/breastfeeding-related and elderly-related outcomes. Groups targeting dairies/sweets and vegetable sources of fats showed >50% nonsignificant findings across all similar target variables. Overall, 54% of findings were nonsignificant. When considering the same target variable, the median number of DPs per group was equal to 2 (interquartile range: 2–2.5). Together with population comparability issues, this prevented us from reliably performing any meta-analyses. At this stage, valid scientific conclusions cannot be drawn to inform Italian nutritional recommendations.

This study was registered at PROSPERO as registration number CRD42022341037.

查看原文本刊更多论文

在意大利，可重复的饮食模式是否始终与疾病结局或其驱动因素相关？系统回顾。

背景：基于主成分分析（PCA）或探索性因子分析（EFA）的特定疾病与可重复的后天饮食模式（DPs）之间关联的强度、方向和趋势很少在人群中进行调查。方法：我们对意大利确定的基于PCA/ efa的DPs进行了系统回顾，以探讨两个方法学问题：1。意大利DPs的交叉研究再现性；2. 可重复DP与相同/相似疾病结局/DP驱动因素/相关因素之间关联的一致性。系统评价过程和DP交叉研究可重复性的结果分别发表。本文的重点是关联，以图表和表格的形式总结数据，以及目标变量之间的相似性、统计方法和混淆调整的事后标准。使用预定义的推理规则来评估选定的Hill因果标准（一致性、强度和剂量反应效应），并就基于PCA/ efa的DPs与相似/相同目标变量之间的关联得出有效的科学结论。结果：纳入了52篇文章，主要是基于食物频率问卷的基于efa的DPs。回归模型用于探索DP与疾病结局/DP驱动因素之间的关系，并与原始研究问题、研究设计和有关混杂的文献保持一致。当考虑相似的目标变量时，9组可重复DPs在1-3组目标变量（如社会经济特征、慢性病发病率、总体/原因特异性死亡率、心血管危险因素、妊娠/母乳喂养相关和老年相关结局）中显示出50 - 50%的相同方向的统计学显著相关性。针对乳制品/糖果和蔬菜脂肪来源的研究小组在所有类似的目标变量中显示了50%的非显著性发现。总体而言，54%的研究结果不显著。当考虑相同的目标变量时，每组DPs的中位数等于2 （IQR: 2-2.5）。加上人口可比性问题，这阻碍了可靠地进行任何荟萃分析。在这个阶段，无法得出有效的科学结论来指导意大利的营养建议。本综述在PROSPERO注册，编号为CRD42022341037。意义声明（2句话，真正新颖）：基于意大利的方法学项目，从精心设计的系统评价中收集的证据被评估了PCA/EFA的事后饮食模式的可重复性以及与疾病结局、DP驱动因素/相关因素的关联。利用统计学和营养学知识创建可繁殖的DPs组。采用预先定义的推理规则（多数规则标准和关联一致性的荟萃分析的可行性，关联强度的选择截断值，剂量-反应效应趋势的评估）的Hill标准的选择与纳入研究设计的局限性和使用的统计方法（包括混淆控制）一起进行评估，以得出关于意大利DPs的有效科学结论。如果得出因果结论，可能有助于为意大利饮食指南的下一个版本提供信息。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in Nutrition 医学-营养学

CiteScore

17.40

自引率

2.20%

发文量

117

审稿时长

56 days

期刊介绍： Advances in Nutrition (AN/Adv Nutr) publishes focused reviews on pivotal findings and recent research across all domains relevant to nutritional scientists and biomedical researchers. This encompasses nutrition-related research spanning biochemical, molecular, and genetic studies using experimental animal models, domestic animals, and human subjects. The journal also emphasizes clinical nutrition, epidemiology and public health, and nutrition education. Review articles concentrate on recent progress rather than broad historical developments. In addition to review articles, AN includes Perspectives, Letters to the Editor, and supplements. Supplement proposals require pre-approval by the editor before submission. The journal features reports and position papers from the American Society for Nutrition, summaries of major government and foundation reports, and Nutrient Information briefs providing crucial details about dietary requirements, food sources, deficiencies, and other essential nutrient information. All submissions with scientific content undergo peer review by the Editors or their designees prior to acceptance for publication.