What is the relationship between adherence to dietary guidelines or recommendations or specific dietary patterns, assessed using an index or score, and measures of body weight or obesity?
ConclusionThere is moderate evidence that, in adults, increased adherence to dietary patterns scoring high in fruits, vegetables, whole grains, legumes, unsaturated oils and fish; low in total meat, saturated fat, cholesterol, sugar-sweetened foods and drinks, and sodium; and moderate in dairy products and alcohol is associated with more favorable outcomes related to body weight or risk of obesity, with some reports of variation based on gender, race or body weight status.
GradeII - Moderate
- Two major categories of dietary pattern scores were identified in the literature:
- Studies that examined exposure based on a Mediterranean dietary pattern
- Studies that examined exposure based on dietary guidelines recommendations.
- In adults, adherence to a Mediterranean diet score or a dietary guidelines-related score is associated with decreased risk of obesity, with some reported variation based on gender or body weight status
- This protective association in adults is further supported by consistent evidence indicating that an increased Mediterranean diet score or dietary guidelines-related score is associated with decreased body weight, BMI, waist circumference or percent body fat, with some variation based on gender and race.
Given the combined evidence from this systematic review, several research recommendations can be advanced.
- Most striking is the need for consensus on a single index or score that is applicable across populations for a diversity of outcomes. If it is not feasible that one index can adequately assess the diversity of populations related to dietary patterns, research should be conducted to determine the best method by which components are chosen, grouped and scored and whether or not the research tool is population-based or independent of the population, so that there is uniformity across scores.
- The studies included in this review were focused on total scores rather than component scores and their association with health outcomes. To strengthen the analysis of component scores, the interaction terms across components need to be assessed in order to maintain a dietary patterns approach.
- For prospective cohort studies, diet intake should be measured at multiple time points with assessment of dietary changes over the time as they relate to health outcomes.
What is the evidence that supports this conclusion? For more information, click on the Evidence Summary link below.
Search Plan and Results
What were the search parameters and selection criteria used to identify literature to answer this question? For more information, click on the Search Plan and Results link below.