Visceral fat (VF) is a key contributor to metabolic disorders, including type 2 diabetes and cardiovascular diseases. Predominantly plant-based diets (PPBDs) have been linked to improved body composition and metabolic health. This systematic review and meta-analysis (SRMA) evaluated the impact of PPBDs on VF.
A systematic search of PubMed, EMBASE, Scopus, Web of Science and Cochrane Library (up to November 2024) identified 13 studies (10 cross-sectional, 2 randomized controlled trials [RCTs], 1 non-randomized intervention) with a total of 4000 participants reporting VF outcomes. Risk of bias was assessed using RoB 2.0, ROBINS-I and JBI tools. Meta-analyses used random-effects models, with heterogeneity and publication bias assessed via statistical tests and Doi plots.
RCTs indicated a trend toward VF reduction in those following a PPBD (pooled mean difference: −177.99 cm³; 95% CI: −475.83 to 119.85). Cross-sectional studies showed significantly lower VF with high adherence to the Mediterranean diet (SMD: −0.45; 95% CI: −0.73 to −0.17; I² = 70%) and modest reductions with vegetarian diets (SMD: −0.24; 95% CI: −0.47 to −0.02; I² = 0%). Sensitivity analyses confirmed the robustness of findings. Certainty of evidence was rated very low.
PPBDs appear to be associated with lower VF and improved metabolic health, though the certainty of evidence remains very low. Further, well-powered RCTs are needed to confirm these findings.
PROSPERO; ID: CRD42024617129. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024617129.