Unos voća i povrća i kosti: sistematski pregled i meta-analiza.
PloS one
Sažetak istraživanja
Pozadina Iako se činilo da unos voća i povrća ima zaštitni efekat na metabolizam kostiju, njegov efekat na frakture ostaje neizvestan.
Metode Izvršen je sistematski pregled randomiziranih kontroliranih studija (RCT) i kohortnih studija (PROSPERO: CRD42016041462). Uključene su RCT i kohortne studije koje su procjenjivale kombinovani unos voća i povrća kod muškaraca i žena starijih od 50 godina. Prijelome smo smatrali primarnom mjerom ishoda. Promjene koštanih markera smatrane su sekundarnim ishodom. Strategija pretraživanja uključivala je sljedeće deskriptore: voće, povrće, proizvodi od povrća, kosti i kosti, frakture kostiju, postmenopauzalna osteoporoza i osteoporoza. Korištene su baze podataka PubMed, Embase i Cochrane Library. Ocjenu studija izvršila su dva nezavisna recenzenta, a oba ispitivača su je razgovarala i složila. Podaci izvučeni iz RCT i kohortnih studija sumirani su odvojeno. Rizici od prijeloma kombinirani su kroz studije korištenjem slučajnih modela. Marker resorpcije kosti (CTx) je sumiran sa standardizovanim srednjim razlikama. Za ocjenu jačine preporuka korištena je metoda ocjenjivanja, razvoja i evaluacije preporuka (GRADE).
Rezultati Od 1.192 pregledane studije, 13 članaka je uključeno u sistematski pregled, a 10 je uključeno u zbirnu analizu (6 kohortnih studija i 4 RCT). Šest kohortnih studija uključenih u metaanalizu uključivalo je populaciju od 225.062. Ukupni omjer opasnosti (HR) (95% interval pouzdanosti (CI)) kuka u pet studija bio je 0,92 (0,87, 0,98). Njena heterogenost je bila umjerena (I2 = 55,7%, p = 0,060), GRADE (⊕⊕⊕O). Dvije kohortne studije procijenile su rizik od bilo kakvog prijeloma; HR je bio 0,90 (95% CI: 0,86-0,96), sa aheterogenošću od 24,9% (p = 0,249, GRADE (⊕⊕⊕O)). Nije bilo povezanosti između markera resorpcije kostiju CTx i 3 mjeseca unosa voća i povrća procijenjenog u četiri RCT-a, GRADE (⊕⊕O O).
Zaključak Postojala je povezanost između povećanja najmanje jedne porcije voća i povrća dnevno i smanjenja rizika od prijeloma. Nivo dokaza za ovu povezanost je umjeren.
Prikaži originalni naslov i sažetak na engleskom
Fruit and vegetable intake and bones: A systematic review and meta-analysis.
Background Although intake of fruits and vegetables seemed to have a protective effect on bone metabolism, its effect on fractures remains uncertain.
Methods A 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.
Results Of 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).
Conclusion There 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.
Izvorni podaci
- DOI
- 10.1371/journal.pone.0217223
- PMID
- 31150426
- PMCID
- PMC6544223
- Provjereno
- 2026-07-26
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