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Heiner Boeing - One of the best experts on this subject based on the ideXlab platform.

  • associations of Food Groups and cardiometabolic and inflammatory biomarkers does the meal matter
    British Journal of Nutrition, 2019
    Co-Authors: Carolina Schwedhelm, Lukas Schwingshackl, Heiner Boeing, George O Agogo, Emily Sonestedt, Sven Knuppel
    Abstract:

    Increased attention has been paid to circadian patterns and how predisposition to metabolic disorders can be affected by meal timing. Currently, it is not clear which role can be attributed to the Foods selected at meals. On a cross-sectional sub-cohort study (815 adults) within the European Prospective Investigation into Cancer and Nutrition-Potsdam study, we investigated whether the same Foods (vegetables, fruits, refined grains, whole grains, red and processed meats) eaten at different meals (breakfast, lunch or dinner) show different associations with biomarkers of cardiometabolic risk. Meal-specific usual intakes were calculated from multiple 24-h dietary recalls. Multivariable-adjusted linear regression models showed that intake of vegetables at breakfast was associated with lower LDL-cholesterol (-0·37 mmol/l per 50 g; 95 % CI -0·61, -0·12) and vegetables at dinner was associated with higher HDL-cholesterol (0·05 mmol/l per 50 g; 95 % CI 0, 0·10). Fruit intake at breakfast was associated with lower glycated Hb (HbA1c) (-0·06 % per 50 g; 95 % CI -0·10, -0·01) and fruits at dinner with lower C-reactive protein (CRP) (-0·21 mg/l per 50 g; 95 % CI -0·42, -0·01). Red and processed meat intake at breakfast was associated with higher HbA1c (0·25 % per 50 g; 95 % CI 0·05, 0·46) and CRP (0·76 mg/l per 50 g; 95 % CI 0·15, 1·36). Our results suggest that by preferring fruits and vegetables and avoiding red and processed meats at specific meals (i.e. breakfast and dinner), cardiometabolic profiles and ultimately chronic disease risk could be improved. Lunch seemed to be a less important meal in terms of Food-biomarker associations.

  • intake of 12 Food Groups and disability adjusted life years from coronary heart disease stroke type 2 diabetes and colorectal cancer in 16 european countries
    European Journal of Epidemiology, 2019
    Co-Authors: Lukas Schwingshackl, Carolina Schwedhelm, Sven Knuppel, Khalid Iqbal, Heiner Boeing, Georg F Hoffmann, Stefaan De Henauw, Nathalie Michels, Brecht Devleesschauwer
    Abstract:

    Our aim was to estimate and rank 12 Food Groups according to disability-adjusted life years (DALYs) from coronary heart disease (CHD), stroke, type 2 diabetes (T2D), and colorectal cancer (CRC) in 16 European countries. De novo published non-linear dose–response meta-analyses of prospective studies (based on 297 primary reports), and Food consumption data from the European Food Safety Authority Comprehensive European Food Consumption Database in Exposure Assessment, and DALY estimates from the Institute for Health Metrics and Evaluation were used. By implementing disease-specific counterfactual scenarios of theoretical minimum risk exposure level (TMRELs), the proportion of DALYs attributed to 12 Food Groups was estimated. In addition, a novel modelling approach was developed to obtain a single (optimized) TMREL across diseases. Four scenarios were analysed (A: disease-specific TMRELs/all Food-disease associations; B: disease-specific TMRELs/only significant Food-disease associations; C: single TMREL/all Food-disease associations; D: single TMREL/only significant Food-disease associations). Suboptimal Food intake was associated with the following proportions of DALYs; Scenario A (highest-estimate) and D (lowest-estimate): CHD (A: 67%, D: 52%), stroke (A: 49%, D: 30%), T2D (A: 57%, D: 51%), and CRC (A: 54%, D: 40%). Whole grains (10%) had the highest impact on DALYs, followed by nuts (7.1%), processed meat (6.4%), fruit (4.4%) and fish and legumes (4.2%) when combining all scenarios. The contribution to total DALYs of all Food Groups combined in the different scenarios ranged from 41–52% in Austria to 51–69% in the Czech-Republic. These findings could have important implications for planning future Food-based dietary guidelines as a public health nutrition strategy.

  • Food Groups and risk of overweight obesity and weight gain a systematic review and dose response meta analysis of prospective studies
    Advances in Nutrition, 2019
    Co-Authors: Sabrina Schlesinger, Carolina Schwedhelm, Georg Hoffmann, Angela Bechthold, Heiner Boeing, Manuela Neuenschwander, Lukas Schwingshackl
    Abstract:

    This meta-analysis summarizes the evidence of a prospective association between the intake of Foods [whole grains, refined grains, vegetables, fruit, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages (SSBs)] and risk of general overweight/obesity, abdominal obesity, and weight gain. PubMed and Web of Science were searched for prospective observational studies until August 2018. Summary RRs and 95% CIs were estimated from 43 reports for the highest compared with the lowest intake categories, as well as for linear and nonlinear relations focusing on each outcome separately: overweight/obesity, abdominal obesity, and weight gain. The quality of evidence was evaluated with use of the NutriGrade tool. In the dose-response meta-analysis, inverse associations were found for whole-grain (RRoverweight/obesity: 0.93; 95% CI: 0.89, 0.96), fruit (RRoverweight/obesity: 0.93; 95% CI: 0.86, 1.00; RRweight gain: 0.91; 95% CI: 0.86, 0.97), nut (RRabdominal obesity: 0.42; 95% CI: 0.31, 0.57), legume (RRoverweight/obesity: 0.88; 95% CI: 0.84, 0.93), and fish (RRabdominal obesity: 0.83; 95% CI: 0.71, 0.97) consumption and positive associations were found for refined grains (RRoverweight/obesity: 1.05; 95% CI: 1.00, 1.10), red meat (RRabdominal obesity: 1.10; 95% CI: 1.04, 1.16; RRweight gain: 1.14; 95% CI: 1.03, 1.26), and SSBs (RRoverweight/obesity: 1.05; 95% CI: 1.00, 1.11; RRabdominal obesity: 1.12; 95% CI: 1.04, 1.20). The dose-response meta-analytical findings provided very low to low quality of evidence that certain Food Groups have an impact on different measurements of adiposity risk. To improve the quality of evidence, better-designed observational studies, inclusion of intervention trials, and use of novel statistical methods (e.g., substitution analyses or network meta-analyses) are needed.

  • Food Groups and intermediate disease markers: a systematic review and network meta-analysis of randomized trials
    The American journal of clinical nutrition, 2018
    Co-Authors: Lukas Schwingshackl, Carolina Schwedhelm, Georg Hoffmann, Khalid Iqbal, Heiner Boeing
    Abstract:

    Background In previous meta-analyses of prospective observational studies, we investigated the association between Food Groups and risk of chronic disease. Objective The aim of the present network meta-analysis (NMA) was to assess the effects of these Food Groups on intermediate-disease markers across randomized intervention trials. Design Literature searches were performed until January 2018. The following inclusion criteria were defined a priori: 1) randomized trial (≥4 wk duration) comparing ≥2 of the following Food Groups: refined grains, whole grains, nuts, legumes, fruits and vegetables, eggs, dairy, fish, red meat, and sugar-sweetened beverages (SSBs); 2) LDL cholesterol and triacylglycerol (TG) were defined as primary outcomes; total cholesterol, HDL cholesterol, fasting glucose, glycated hemoglobin, homeostasis model assessment insulin resistance, systolic and diastolic blood pressure, and C-reactive protein were defined as secondary outcomes. For each outcome, a random NMA was performed, and for the ranking, the surface under the cumulative ranking curves (SUCRA) was determined. Results A total of 66 randomized trials (86 reports) comparing 10 Food Groups and enrolling 3595 participants was identified. Nuts were ranked as the best Food group at reducing LDL cholesterol (SUCRA: 93%), followed by legumes (85%) and whole grains (70%). For reducing TG, fish (97%) was ranked best, followed by nuts (78%) and red meat (72%). However, these findings are limited by the low quality of the evidence. When combining all 10 outcomes, the highest SUCRA values were found for nuts (66%), legumes (62%), and whole grains (62%), whereas SSBs performed worst (29%). Conclusion The present NMA provides evidence that increased intake of nuts, legumes, and whole grains is more effective at improving metabolic health than other Food Groups. For the credibility of diet-disease relations, high-quality randomized trials focusing on well-established intermediate-disease markers could play an important role. This systematic review was registered at PROSPERO (www.crd.york.ac.uk/PROSPERO) as CRD42018086753.

  • Food Groups and risk of hypertension a systematic review and dose response meta analysis of prospective studies
    Advances in Nutrition, 2017
    Co-Authors: Lukas Schwingshackl, Sabrina Schlesinger, Carolina Schwedhelm, Sven Knuppel, Khalid Iqbal, Angela Bechthold, Georg F Hoffmann, Violetta Andriolo, Heiner Boeing
    Abstract:

    The aim of this systematic review and meta-analysis was to summarize the evidence on the relation of the intakes of 12 major Food Groups, including whole grains, refined grains, vegetables, fruits, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages (SSBs) with the risk of hypertension. PubMed, Scopus, and Web of Science were searched systematically until June 2017 for prospective studies having quantitatively investigated the above-mentioned Foods. We conducted meta-analysis on the highest compared with the lowest intake categories and linear and nonlinear dose-response meta-analyses to analyze the association. Summary RRs and 95% CIs were estimated by using a random-effects model. Overall, 28 reports were included in the meta-analysis. An inverse association for the risk of hypertension was observed for 30 g whole grains/d (RR: 0.92; 95% CI: 0.87, 0.98), 100 g fruits/d (RR: 0.97; 95% CI: 0.96, 0.99), 28 g nuts/d (RR: 0.70; 95% CI: 0.45, 1.08), and 200 g dairy/d (RR: 0.95; 95% CI: 0.94, 0.97), whereas a positive association for 100 g red meat/d (RR: 1.14; 95% CI: 1.02, 1.28), 50 g processed meat/d (RR: 1.12; 95% CI: 1.00, 1.26), and 250 mL SSB/d (RR: 1.07; 95% CI: 1.04, 1.10) was seen in the linear dose-response meta-analysis. Indication for nonlinear relations of the intakes of whole grains, fruits, fish, and processed meats with the risk of hypertension was detected. In summary, this comprehensive dose-response meta-analysis of 28 reports identified optimal intakes of whole grains, fruits, nuts, legumes, dairy, red and processed meats, and SSBs related to the risk of hypertension. These findings need to be seen under the light of very-low to low quality of meta-evidence. However, the findings support the current dietary guidelines in the prevention of hypertension.

Lukas Schwingshackl - One of the best experts on this subject based on the ideXlab platform.

  • associations of Food Groups and cardiometabolic and inflammatory biomarkers does the meal matter
    British Journal of Nutrition, 2019
    Co-Authors: Carolina Schwedhelm, Lukas Schwingshackl, Heiner Boeing, George O Agogo, Emily Sonestedt, Sven Knuppel
    Abstract:

    Increased attention has been paid to circadian patterns and how predisposition to metabolic disorders can be affected by meal timing. Currently, it is not clear which role can be attributed to the Foods selected at meals. On a cross-sectional sub-cohort study (815 adults) within the European Prospective Investigation into Cancer and Nutrition-Potsdam study, we investigated whether the same Foods (vegetables, fruits, refined grains, whole grains, red and processed meats) eaten at different meals (breakfast, lunch or dinner) show different associations with biomarkers of cardiometabolic risk. Meal-specific usual intakes were calculated from multiple 24-h dietary recalls. Multivariable-adjusted linear regression models showed that intake of vegetables at breakfast was associated with lower LDL-cholesterol (-0·37 mmol/l per 50 g; 95 % CI -0·61, -0·12) and vegetables at dinner was associated with higher HDL-cholesterol (0·05 mmol/l per 50 g; 95 % CI 0, 0·10). Fruit intake at breakfast was associated with lower glycated Hb (HbA1c) (-0·06 % per 50 g; 95 % CI -0·10, -0·01) and fruits at dinner with lower C-reactive protein (CRP) (-0·21 mg/l per 50 g; 95 % CI -0·42, -0·01). Red and processed meat intake at breakfast was associated with higher HbA1c (0·25 % per 50 g; 95 % CI 0·05, 0·46) and CRP (0·76 mg/l per 50 g; 95 % CI 0·15, 1·36). Our results suggest that by preferring fruits and vegetables and avoiding red and processed meats at specific meals (i.e. breakfast and dinner), cardiometabolic profiles and ultimately chronic disease risk could be improved. Lunch seemed to be a less important meal in terms of Food-biomarker associations.

  • intake of 12 Food Groups and disability adjusted life years from coronary heart disease stroke type 2 diabetes and colorectal cancer in 16 european countries
    European Journal of Epidemiology, 2019
    Co-Authors: Lukas Schwingshackl, Carolina Schwedhelm, Sven Knuppel, Khalid Iqbal, Heiner Boeing, Georg F Hoffmann, Stefaan De Henauw, Nathalie Michels, Brecht Devleesschauwer
    Abstract:

    Our aim was to estimate and rank 12 Food Groups according to disability-adjusted life years (DALYs) from coronary heart disease (CHD), stroke, type 2 diabetes (T2D), and colorectal cancer (CRC) in 16 European countries. De novo published non-linear dose–response meta-analyses of prospective studies (based on 297 primary reports), and Food consumption data from the European Food Safety Authority Comprehensive European Food Consumption Database in Exposure Assessment, and DALY estimates from the Institute for Health Metrics and Evaluation were used. By implementing disease-specific counterfactual scenarios of theoretical minimum risk exposure level (TMRELs), the proportion of DALYs attributed to 12 Food Groups was estimated. In addition, a novel modelling approach was developed to obtain a single (optimized) TMREL across diseases. Four scenarios were analysed (A: disease-specific TMRELs/all Food-disease associations; B: disease-specific TMRELs/only significant Food-disease associations; C: single TMREL/all Food-disease associations; D: single TMREL/only significant Food-disease associations). Suboptimal Food intake was associated with the following proportions of DALYs; Scenario A (highest-estimate) and D (lowest-estimate): CHD (A: 67%, D: 52%), stroke (A: 49%, D: 30%), T2D (A: 57%, D: 51%), and CRC (A: 54%, D: 40%). Whole grains (10%) had the highest impact on DALYs, followed by nuts (7.1%), processed meat (6.4%), fruit (4.4%) and fish and legumes (4.2%) when combining all scenarios. The contribution to total DALYs of all Food Groups combined in the different scenarios ranged from 41–52% in Austria to 51–69% in the Czech-Republic. These findings could have important implications for planning future Food-based dietary guidelines as a public health nutrition strategy.

  • Food Groups and risk of overweight obesity and weight gain a systematic review and dose response meta analysis of prospective studies
    Advances in Nutrition, 2019
    Co-Authors: Sabrina Schlesinger, Carolina Schwedhelm, Georg Hoffmann, Angela Bechthold, Heiner Boeing, Manuela Neuenschwander, Lukas Schwingshackl
    Abstract:

    This meta-analysis summarizes the evidence of a prospective association between the intake of Foods [whole grains, refined grains, vegetables, fruit, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages (SSBs)] and risk of general overweight/obesity, abdominal obesity, and weight gain. PubMed and Web of Science were searched for prospective observational studies until August 2018. Summary RRs and 95% CIs were estimated from 43 reports for the highest compared with the lowest intake categories, as well as for linear and nonlinear relations focusing on each outcome separately: overweight/obesity, abdominal obesity, and weight gain. The quality of evidence was evaluated with use of the NutriGrade tool. In the dose-response meta-analysis, inverse associations were found for whole-grain (RRoverweight/obesity: 0.93; 95% CI: 0.89, 0.96), fruit (RRoverweight/obesity: 0.93; 95% CI: 0.86, 1.00; RRweight gain: 0.91; 95% CI: 0.86, 0.97), nut (RRabdominal obesity: 0.42; 95% CI: 0.31, 0.57), legume (RRoverweight/obesity: 0.88; 95% CI: 0.84, 0.93), and fish (RRabdominal obesity: 0.83; 95% CI: 0.71, 0.97) consumption and positive associations were found for refined grains (RRoverweight/obesity: 1.05; 95% CI: 1.00, 1.10), red meat (RRabdominal obesity: 1.10; 95% CI: 1.04, 1.16; RRweight gain: 1.14; 95% CI: 1.03, 1.26), and SSBs (RRoverweight/obesity: 1.05; 95% CI: 1.00, 1.11; RRabdominal obesity: 1.12; 95% CI: 1.04, 1.20). The dose-response meta-analytical findings provided very low to low quality of evidence that certain Food Groups have an impact on different measurements of adiposity risk. To improve the quality of evidence, better-designed observational studies, inclusion of intervention trials, and use of novel statistical methods (e.g., substitution analyses or network meta-analyses) are needed.

  • Food Groups and intermediate disease markers: a systematic review and network meta-analysis of randomized trials
    The American journal of clinical nutrition, 2018
    Co-Authors: Lukas Schwingshackl, Carolina Schwedhelm, Georg Hoffmann, Khalid Iqbal, Heiner Boeing
    Abstract:

    Background In previous meta-analyses of prospective observational studies, we investigated the association between Food Groups and risk of chronic disease. Objective The aim of the present network meta-analysis (NMA) was to assess the effects of these Food Groups on intermediate-disease markers across randomized intervention trials. Design Literature searches were performed until January 2018. The following inclusion criteria were defined a priori: 1) randomized trial (≥4 wk duration) comparing ≥2 of the following Food Groups: refined grains, whole grains, nuts, legumes, fruits and vegetables, eggs, dairy, fish, red meat, and sugar-sweetened beverages (SSBs); 2) LDL cholesterol and triacylglycerol (TG) were defined as primary outcomes; total cholesterol, HDL cholesterol, fasting glucose, glycated hemoglobin, homeostasis model assessment insulin resistance, systolic and diastolic blood pressure, and C-reactive protein were defined as secondary outcomes. For each outcome, a random NMA was performed, and for the ranking, the surface under the cumulative ranking curves (SUCRA) was determined. Results A total of 66 randomized trials (86 reports) comparing 10 Food Groups and enrolling 3595 participants was identified. Nuts were ranked as the best Food group at reducing LDL cholesterol (SUCRA: 93%), followed by legumes (85%) and whole grains (70%). For reducing TG, fish (97%) was ranked best, followed by nuts (78%) and red meat (72%). However, these findings are limited by the low quality of the evidence. When combining all 10 outcomes, the highest SUCRA values were found for nuts (66%), legumes (62%), and whole grains (62%), whereas SSBs performed worst (29%). Conclusion The present NMA provides evidence that increased intake of nuts, legumes, and whole grains is more effective at improving metabolic health than other Food Groups. For the credibility of diet-disease relations, high-quality randomized trials focusing on well-established intermediate-disease markers could play an important role. This systematic review was registered at PROSPERO (www.crd.york.ac.uk/PROSPERO) as CRD42018086753.

  • Food Groups and risk of colorectal cancer
    International Journal of Cancer, 2018
    Co-Authors: Lukas Schwingshackl, Carolina Schwedhelm, Sven Knuppel, Khalid Iqbal, Angela Bechthold, Georg F Hoffmann, Anne Laurre Preterre, Stefaan De Henauw, Nathalie Michels, Brecht Devleesschauwer
    Abstract:

    The aim of this systematic review and meta-analysis was to summarize the evidence on the relationship between intake of 12 major Food Groups, including whole grains, refined grains, vegetables, fruit, nuts, legumes, eggs, dairy, fish, red meat, processed meat and sugar-sweetened beverages with risk of colorectal cancer (CRC). We conducted a systematic search in PubMed and Embase for prospective studies investigating the association between these 12 Food Groups and risk of CRC until April 2017. Summary risk ratios (RRs) and 95% confidence intervals (95% CI) were estimated using a random effects model for high vs. low intake categories, as well as for linear and nonlinear relationships. An inverse association was observed for whole grains (RR30g/d : 0.95, 95% CI 0.93, 0.97; n = 9 studies), vegetables (RR100g/d : 0.97, 95% CI 0.96, 0.98; n = 15), fruit (RR100g/d : 0.97, 95% CI 0.95, 0.99; n = 16) and dairy (RR200g/d : 0.93, 95% CI 0.91, 0.94; n = 15), while a positive association for red meat (RR100g/d : 1.12, 95% CI 1.06, 1.19; n = 21) and processed meat (RR50g/d : 1.17, 95% CI 1.10, 1.23; n = 16), was seen in the linear dose-response meta-analysis. Some evidence for nonlinear relationships was observed between vegetables, fruit and dairy and risk of colorectal cancer. Findings of this meta-analysis showed that a diet characterized by high intake of whole grains, vegetables, fruit and dairy products and low amounts of red meat and processed meat was associated with lower risk of CRC.

Carolina Schwedhelm - One of the best experts on this subject based on the ideXlab platform.

  • associations of Food Groups and cardiometabolic and inflammatory biomarkers does the meal matter
    British Journal of Nutrition, 2019
    Co-Authors: Carolina Schwedhelm, Lukas Schwingshackl, Heiner Boeing, George O Agogo, Emily Sonestedt, Sven Knuppel
    Abstract:

    Increased attention has been paid to circadian patterns and how predisposition to metabolic disorders can be affected by meal timing. Currently, it is not clear which role can be attributed to the Foods selected at meals. On a cross-sectional sub-cohort study (815 adults) within the European Prospective Investigation into Cancer and Nutrition-Potsdam study, we investigated whether the same Foods (vegetables, fruits, refined grains, whole grains, red and processed meats) eaten at different meals (breakfast, lunch or dinner) show different associations with biomarkers of cardiometabolic risk. Meal-specific usual intakes were calculated from multiple 24-h dietary recalls. Multivariable-adjusted linear regression models showed that intake of vegetables at breakfast was associated with lower LDL-cholesterol (-0·37 mmol/l per 50 g; 95 % CI -0·61, -0·12) and vegetables at dinner was associated with higher HDL-cholesterol (0·05 mmol/l per 50 g; 95 % CI 0, 0·10). Fruit intake at breakfast was associated with lower glycated Hb (HbA1c) (-0·06 % per 50 g; 95 % CI -0·10, -0·01) and fruits at dinner with lower C-reactive protein (CRP) (-0·21 mg/l per 50 g; 95 % CI -0·42, -0·01). Red and processed meat intake at breakfast was associated with higher HbA1c (0·25 % per 50 g; 95 % CI 0·05, 0·46) and CRP (0·76 mg/l per 50 g; 95 % CI 0·15, 1·36). Our results suggest that by preferring fruits and vegetables and avoiding red and processed meats at specific meals (i.e. breakfast and dinner), cardiometabolic profiles and ultimately chronic disease risk could be improved. Lunch seemed to be a less important meal in terms of Food-biomarker associations.

  • intake of 12 Food Groups and disability adjusted life years from coronary heart disease stroke type 2 diabetes and colorectal cancer in 16 european countries
    European Journal of Epidemiology, 2019
    Co-Authors: Lukas Schwingshackl, Carolina Schwedhelm, Sven Knuppel, Khalid Iqbal, Heiner Boeing, Georg F Hoffmann, Stefaan De Henauw, Nathalie Michels, Brecht Devleesschauwer
    Abstract:

    Our aim was to estimate and rank 12 Food Groups according to disability-adjusted life years (DALYs) from coronary heart disease (CHD), stroke, type 2 diabetes (T2D), and colorectal cancer (CRC) in 16 European countries. De novo published non-linear dose–response meta-analyses of prospective studies (based on 297 primary reports), and Food consumption data from the European Food Safety Authority Comprehensive European Food Consumption Database in Exposure Assessment, and DALY estimates from the Institute for Health Metrics and Evaluation were used. By implementing disease-specific counterfactual scenarios of theoretical minimum risk exposure level (TMRELs), the proportion of DALYs attributed to 12 Food Groups was estimated. In addition, a novel modelling approach was developed to obtain a single (optimized) TMREL across diseases. Four scenarios were analysed (A: disease-specific TMRELs/all Food-disease associations; B: disease-specific TMRELs/only significant Food-disease associations; C: single TMREL/all Food-disease associations; D: single TMREL/only significant Food-disease associations). Suboptimal Food intake was associated with the following proportions of DALYs; Scenario A (highest-estimate) and D (lowest-estimate): CHD (A: 67%, D: 52%), stroke (A: 49%, D: 30%), T2D (A: 57%, D: 51%), and CRC (A: 54%, D: 40%). Whole grains (10%) had the highest impact on DALYs, followed by nuts (7.1%), processed meat (6.4%), fruit (4.4%) and fish and legumes (4.2%) when combining all scenarios. The contribution to total DALYs of all Food Groups combined in the different scenarios ranged from 41–52% in Austria to 51–69% in the Czech-Republic. These findings could have important implications for planning future Food-based dietary guidelines as a public health nutrition strategy.

  • Food Groups and risk of overweight obesity and weight gain a systematic review and dose response meta analysis of prospective studies
    Advances in Nutrition, 2019
    Co-Authors: Sabrina Schlesinger, Carolina Schwedhelm, Georg Hoffmann, Angela Bechthold, Heiner Boeing, Manuela Neuenschwander, Lukas Schwingshackl
    Abstract:

    This meta-analysis summarizes the evidence of a prospective association between the intake of Foods [whole grains, refined grains, vegetables, fruit, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages (SSBs)] and risk of general overweight/obesity, abdominal obesity, and weight gain. PubMed and Web of Science were searched for prospective observational studies until August 2018. Summary RRs and 95% CIs were estimated from 43 reports for the highest compared with the lowest intake categories, as well as for linear and nonlinear relations focusing on each outcome separately: overweight/obesity, abdominal obesity, and weight gain. The quality of evidence was evaluated with use of the NutriGrade tool. In the dose-response meta-analysis, inverse associations were found for whole-grain (RRoverweight/obesity: 0.93; 95% CI: 0.89, 0.96), fruit (RRoverweight/obesity: 0.93; 95% CI: 0.86, 1.00; RRweight gain: 0.91; 95% CI: 0.86, 0.97), nut (RRabdominal obesity: 0.42; 95% CI: 0.31, 0.57), legume (RRoverweight/obesity: 0.88; 95% CI: 0.84, 0.93), and fish (RRabdominal obesity: 0.83; 95% CI: 0.71, 0.97) consumption and positive associations were found for refined grains (RRoverweight/obesity: 1.05; 95% CI: 1.00, 1.10), red meat (RRabdominal obesity: 1.10; 95% CI: 1.04, 1.16; RRweight gain: 1.14; 95% CI: 1.03, 1.26), and SSBs (RRoverweight/obesity: 1.05; 95% CI: 1.00, 1.11; RRabdominal obesity: 1.12; 95% CI: 1.04, 1.20). The dose-response meta-analytical findings provided very low to low quality of evidence that certain Food Groups have an impact on different measurements of adiposity risk. To improve the quality of evidence, better-designed observational studies, inclusion of intervention trials, and use of novel statistical methods (e.g., substitution analyses or network meta-analyses) are needed.

  • Food Groups and intermediate disease markers: a systematic review and network meta-analysis of randomized trials
    The American journal of clinical nutrition, 2018
    Co-Authors: Lukas Schwingshackl, Carolina Schwedhelm, Georg Hoffmann, Khalid Iqbal, Heiner Boeing
    Abstract:

    Background In previous meta-analyses of prospective observational studies, we investigated the association between Food Groups and risk of chronic disease. Objective The aim of the present network meta-analysis (NMA) was to assess the effects of these Food Groups on intermediate-disease markers across randomized intervention trials. Design Literature searches were performed until January 2018. The following inclusion criteria were defined a priori: 1) randomized trial (≥4 wk duration) comparing ≥2 of the following Food Groups: refined grains, whole grains, nuts, legumes, fruits and vegetables, eggs, dairy, fish, red meat, and sugar-sweetened beverages (SSBs); 2) LDL cholesterol and triacylglycerol (TG) were defined as primary outcomes; total cholesterol, HDL cholesterol, fasting glucose, glycated hemoglobin, homeostasis model assessment insulin resistance, systolic and diastolic blood pressure, and C-reactive protein were defined as secondary outcomes. For each outcome, a random NMA was performed, and for the ranking, the surface under the cumulative ranking curves (SUCRA) was determined. Results A total of 66 randomized trials (86 reports) comparing 10 Food Groups and enrolling 3595 participants was identified. Nuts were ranked as the best Food group at reducing LDL cholesterol (SUCRA: 93%), followed by legumes (85%) and whole grains (70%). For reducing TG, fish (97%) was ranked best, followed by nuts (78%) and red meat (72%). However, these findings are limited by the low quality of the evidence. When combining all 10 outcomes, the highest SUCRA values were found for nuts (66%), legumes (62%), and whole grains (62%), whereas SSBs performed worst (29%). Conclusion The present NMA provides evidence that increased intake of nuts, legumes, and whole grains is more effective at improving metabolic health than other Food Groups. For the credibility of diet-disease relations, high-quality randomized trials focusing on well-established intermediate-disease markers could play an important role. This systematic review was registered at PROSPERO (www.crd.york.ac.uk/PROSPERO) as CRD42018086753.

  • Food Groups and risk of colorectal cancer
    International Journal of Cancer, 2018
    Co-Authors: Lukas Schwingshackl, Carolina Schwedhelm, Sven Knuppel, Khalid Iqbal, Angela Bechthold, Georg F Hoffmann, Anne Laurre Preterre, Stefaan De Henauw, Nathalie Michels, Brecht Devleesschauwer
    Abstract:

    The aim of this systematic review and meta-analysis was to summarize the evidence on the relationship between intake of 12 major Food Groups, including whole grains, refined grains, vegetables, fruit, nuts, legumes, eggs, dairy, fish, red meat, processed meat and sugar-sweetened beverages with risk of colorectal cancer (CRC). We conducted a systematic search in PubMed and Embase for prospective studies investigating the association between these 12 Food Groups and risk of CRC until April 2017. Summary risk ratios (RRs) and 95% confidence intervals (95% CI) were estimated using a random effects model for high vs. low intake categories, as well as for linear and nonlinear relationships. An inverse association was observed for whole grains (RR30g/d : 0.95, 95% CI 0.93, 0.97; n = 9 studies), vegetables (RR100g/d : 0.97, 95% CI 0.96, 0.98; n = 15), fruit (RR100g/d : 0.97, 95% CI 0.95, 0.99; n = 16) and dairy (RR200g/d : 0.93, 95% CI 0.91, 0.94; n = 15), while a positive association for red meat (RR100g/d : 1.12, 95% CI 1.06, 1.19; n = 21) and processed meat (RR50g/d : 1.17, 95% CI 1.10, 1.23; n = 16), was seen in the linear dose-response meta-analysis. Some evidence for nonlinear relationships was observed between vegetables, fruit and dairy and risk of colorectal cancer. Findings of this meta-analysis showed that a diet characterized by high intake of whole grains, vegetables, fruit and dairy products and low amounts of red meat and processed meat was associated with lower risk of CRC.

Carlo La Vecchia - One of the best experts on this subject based on the ideXlab platform.

  • consumption of fruit vegetables and other Food Groups and the risk of nasopharyngeal carcinoma
    Cancer Causes & Control, 2013
    Co-Authors: Jerry Polesel, Silvia Franceschi, Eva Negri, Luigi Barzan, Maurizio Montella, Antonella Zucchetto, Diego Serraino, Emanuela Vaccher, Werner Garavello, Carlo La Vecchia
    Abstract:

    The role of dietary habits in the etiology of nasopharyngeal carcinoma (NPC) has been extensively investigated in high-incidence areas, but evidence is scanty in low-incidence populations. This study aimed to investigate the relationship between NPC risk and a wide range of Food Groups in the Italian population. We conducted a hospital-based case–control study in Italy on 198, histologically confirmed, NPC cases of Caucasian ethnicity, aged 18–76 years. Controls were 594 Caucasian cancer-free patients admitted to general hospitals for acute conditions. Odds ratios (ORs) and the corresponding confidence intervals (CIs) were estimated through logistic regression, adjusting for socio-demographic characteristics, tobacco smoking, alcohol drinking, and energy intake. Elevated vegetable consumption was inversely related to NPC risk (OR for highest vs. lower quartile = 0.51; 95 % CI 0.29–0.90). The association was particularly strong for yellow- or red-pigmented vegetables (OR = 0.31; 95 % CI 0.18–0.54), and this effect was stronger among never smokers (OR = 0.18; 95 % CI 0.06–0.55) than among ever smokers (OR = 0.37; 95 % CI 0.19–0.71). Increased NPC risk emerged for elevated eggs consumption (OR = 2.50; 95 % CI 1.44–4.32; p-trend <0.01). No significant associations emerged between NPC risk and consumption of cereals, meat, fish, dairy products, and sweets. The study findings show that, also in low-risk populations, vegetable consumption is a protective factor against NPC. The stronger effect for yellow- or red-pigmented vegetables is in agreement with the inverse association reported for carotenoids intake.

  • Food Groups and renal cell carcinoma a case control study from italy
    International Journal of Cancer, 2007
    Co-Authors: Francesca Bravi, Silvia Franceschi, Carlo La Vecchia, Renato Talamini, Eva Negri, Maurizio Montella, Cristina Bosetti, Lorenza Scotti, Valerio Ramazzotti
    Abstract:

    Although nutrition and diet have been related to renal cell carcinoma (RCC), the role of specific Foods or nutrients on this cancer is still controversial. We evaluated the relation between a wide range of Foods and the risk of RCC in an Italian case-control study including 767 patients (494 men and 273 women) younger than 79 years with incident, histologically confirmed RCC, and 1,534 controls (988 men and 546 women) admitted to the same hospitals as cases for a wide spectrum of acute, non-neoplastic conditions, not related to long term diet modifications. A validated and reproducible Food frequency questionnaire, including 78 Foods and beverages, plus a separate section on alcohol drinking, was used to assess patients' dietary habits 2 years before diagnosis or hospital admission. Multivariate odds ratios (OR) were obtained after allowance for energy intake and other major confounding factors. A significant direct trend in risk was found for bread (OR = 1.94 for the highest versus the lowest intake quintile), and a modest excess of risk was observed for pasta and rice (OR = 1.29), and milk and yoghurt (OR = 1.27). Poultry (OR = 0.74), processed meat (OR = 0.64) and vegetables (OR = 0.65) were inversely associated with RCC risk. No relation was found for coffee and tea, soups, eggs, red meat, fish, cheese, pulses, potatoes, fruits, desserts and sugars. The results of this study provide further indications on dietary correlates of RCC, and in particular indicate that a diet rich in refined cereals and poor in vegetables may have an unfavorable role on RCC.

  • Food Groups and risk of prostate cancer in italy
    International Journal of Cancer, 2004
    Co-Authors: Cristina Bosetti, Silvia Franceschi, Carlo La Vecchia, Renato Talamini, Eva Negri, Ettore Conti, Maurizio Montella, Stefania Micelotta, Luigino Dal Maso
    Abstract:

    Although several studies have been conducted, the relation between diet and prostate cancer remains unclear. The role of a wide range of Foods on the risk of prostate cancer has thus been analyzed in a case-control study conducted in Italy between 1991 and 2002. Cases were 1,294 patients below age 75 years with incident, histologically confirmed carcinoma of the prostate; controls were 1,451 subjects below age 75 years admitted to the same hospitals as cases for a wide spectrum of acute, non-neoplastic conditions. Multivariate odds ratios (ORs) were obtained after allowance for major potential confounding factors, including calorie intake. Among the 19 Food Groups considered, 4 showed some significant association with prostate cancer risk. A significant trend of increasing risk with more frequent consumption was found for milk and dairy products (OR = 1.2 for highest vs. lowest quintile, p = 0.03) as well as bread (OR = 1.4, p = 0.01), whereas inverse associations were observed for soups (OR = 0.8, p = 0.02) and cooked vegetables (OR = 0.7, p = 0.01). This uniquely large study on prostate cancer and diet in a southern European population confirms that no strong association exists between any specific Foods and prostate cancer, apart from an increased risk for milk and dairy products and a possible protective effect of vegetables.

  • Food Groups and laryngeal cancer risk a case control study from italy and switzerland
    International Journal of Cancer, 2002
    Co-Authors: Cristina Bosetti, Carlo La Vecchia, F. Levi, Renato Talamini, Eva Negri, Luigino Dal Maso, Silvia Franceschi
    Abstract:

    Besides tobacco and alcohol, diet has been thought to be associated with laryngeal cancer risk. We thus analyzed the role of various Food Groups, as well as specific seasoning fats, in a case-control study conducted in Northern Italy and the Swiss Canton of Vaud from 1992 to 2000. Our study included 527 incident, histologically confirmed cases and 1,297 frequency-matched controls, selected among patients admitted to the same hospitals as cases for acute, nonneoplastic conditions, unrelated to smoking, alcohol consumption and long-term modifications of diet. The subjects' usual diet was investigated through a validated Food frequency questionnaire, including 78 Foods and beverages. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using unconditional multiple logistic regression models. After adjustment for major confounding factors, a significant trend of increasing risk was observed for eggs (OR = 1.7 for the highest compared to the lowest quintile), red meat (OR = 3.1), processed meat (OR = 1.7), fish (OR = 1.6) and sugars (OR = 1.6). Significant inverse associations were observed for pulses (OR = 0.7), raw vegetables (OR = 0.2), cooked vegetables (OR = 0.3), citrus fruit (OR = 0.6) and other fruit (OR = 0.5). In regard to seasoning fats, a significant reduction of cancer risk was observed for olive oil (OR = 0.4) and specific seed oils (OR = 0.6), while mixed seed oils were directly associated with laryngeal cancer risk (OR = 2.2). Our study suggests that increasing vegetables and fruit, decreasing meat consumption and perhaps substituting olive oil or specific seed oils for other types of seasoning lipids might help reduce laryngeal cancer risk.

  • Food Groups oils and butter and cancer of the oral cavity and pharynx
    British Journal of Cancer, 1999
    Co-Authors: Silvia Franceschi, A Favero, E Conti, Renato Talamini, Roberto Volpe, Eva Negri, Luigi Barzan, Carlo La Vecchia
    Abstract:

    To elucidate the role of dietary habits, a study was carried out in 1992–1997 in the province of Pordenone in Northeastern Italy, and those of Rome and Latina in central Italy. Cases were 512 men and 86 women with cancer of the oral cavity and pharynx (lip, salivary glands and nasopharynx excluded) and controls were 1008 men and 483 women who had been admitted to local hospitals for a broad range of acute non-neoplastic conditions. The validated dietary section of the questionnaire included 78 Foods or recipes and ten questions on fat intake patterns. After allowance for education, smoking, alcohol and total energy intake, significant trends of increasing risk with increasing intake emerged for soups, eggs, processed meats, cakes and desserts, and butter. Risk was approximately halved in the highest compared to the lowest intake quintile for coffee and tea, white bread, poultry, fish, raw and cooked vegetables, citrus fruit, and olive oil. The inverse association with oils, especially olive oil, was only slightly attenuated by allowance for vegetable intake. Thus, frequent consumption of vegetables, citrus fruit, fish and vegetable oils were the major features of a low-risk diet for cancer of the oral cavity and pharynx. © 1999 Cancer Research Campaign

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  • intake of 12 Food Groups and disability adjusted life years from coronary heart disease stroke type 2 diabetes and colorectal cancer in 16 european countries
    European Journal of Epidemiology, 2019
    Co-Authors: Lukas Schwingshackl, Carolina Schwedhelm, Sven Knuppel, Khalid Iqbal, Heiner Boeing, Georg F Hoffmann, Stefaan De Henauw, Nathalie Michels, Brecht Devleesschauwer
    Abstract:

    Our aim was to estimate and rank 12 Food Groups according to disability-adjusted life years (DALYs) from coronary heart disease (CHD), stroke, type 2 diabetes (T2D), and colorectal cancer (CRC) in 16 European countries. De novo published non-linear dose–response meta-analyses of prospective studies (based on 297 primary reports), and Food consumption data from the European Food Safety Authority Comprehensive European Food Consumption Database in Exposure Assessment, and DALY estimates from the Institute for Health Metrics and Evaluation were used. By implementing disease-specific counterfactual scenarios of theoretical minimum risk exposure level (TMRELs), the proportion of DALYs attributed to 12 Food Groups was estimated. In addition, a novel modelling approach was developed to obtain a single (optimized) TMREL across diseases. Four scenarios were analysed (A: disease-specific TMRELs/all Food-disease associations; B: disease-specific TMRELs/only significant Food-disease associations; C: single TMREL/all Food-disease associations; D: single TMREL/only significant Food-disease associations). Suboptimal Food intake was associated with the following proportions of DALYs; Scenario A (highest-estimate) and D (lowest-estimate): CHD (A: 67%, D: 52%), stroke (A: 49%, D: 30%), T2D (A: 57%, D: 51%), and CRC (A: 54%, D: 40%). Whole grains (10%) had the highest impact on DALYs, followed by nuts (7.1%), processed meat (6.4%), fruit (4.4%) and fish and legumes (4.2%) when combining all scenarios. The contribution to total DALYs of all Food Groups combined in the different scenarios ranged from 41–52% in Austria to 51–69% in the Czech-Republic. These findings could have important implications for planning future Food-based dietary guidelines as a public health nutrition strategy.

  • Food Groups and intermediate disease markers: a systematic review and network meta-analysis of randomized trials
    The American journal of clinical nutrition, 2018
    Co-Authors: Lukas Schwingshackl, Carolina Schwedhelm, Georg Hoffmann, Khalid Iqbal, Heiner Boeing
    Abstract:

    Background In previous meta-analyses of prospective observational studies, we investigated the association between Food Groups and risk of chronic disease. Objective The aim of the present network meta-analysis (NMA) was to assess the effects of these Food Groups on intermediate-disease markers across randomized intervention trials. Design Literature searches were performed until January 2018. The following inclusion criteria were defined a priori: 1) randomized trial (≥4 wk duration) comparing ≥2 of the following Food Groups: refined grains, whole grains, nuts, legumes, fruits and vegetables, eggs, dairy, fish, red meat, and sugar-sweetened beverages (SSBs); 2) LDL cholesterol and triacylglycerol (TG) were defined as primary outcomes; total cholesterol, HDL cholesterol, fasting glucose, glycated hemoglobin, homeostasis model assessment insulin resistance, systolic and diastolic blood pressure, and C-reactive protein were defined as secondary outcomes. For each outcome, a random NMA was performed, and for the ranking, the surface under the cumulative ranking curves (SUCRA) was determined. Results A total of 66 randomized trials (86 reports) comparing 10 Food Groups and enrolling 3595 participants was identified. Nuts were ranked as the best Food group at reducing LDL cholesterol (SUCRA: 93%), followed by legumes (85%) and whole grains (70%). For reducing TG, fish (97%) was ranked best, followed by nuts (78%) and red meat (72%). However, these findings are limited by the low quality of the evidence. When combining all 10 outcomes, the highest SUCRA values were found for nuts (66%), legumes (62%), and whole grains (62%), whereas SSBs performed worst (29%). Conclusion The present NMA provides evidence that increased intake of nuts, legumes, and whole grains is more effective at improving metabolic health than other Food Groups. For the credibility of diet-disease relations, high-quality randomized trials focusing on well-established intermediate-disease markers could play an important role. This systematic review was registered at PROSPERO (www.crd.york.ac.uk/PROSPERO) as CRD42018086753.

  • Food Groups and risk of colorectal cancer
    International Journal of Cancer, 2018
    Co-Authors: Lukas Schwingshackl, Carolina Schwedhelm, Sven Knuppel, Khalid Iqbal, Angela Bechthold, Georg F Hoffmann, Anne Laurre Preterre, Stefaan De Henauw, Nathalie Michels, Brecht Devleesschauwer
    Abstract:

    The aim of this systematic review and meta-analysis was to summarize the evidence on the relationship between intake of 12 major Food Groups, including whole grains, refined grains, vegetables, fruit, nuts, legumes, eggs, dairy, fish, red meat, processed meat and sugar-sweetened beverages with risk of colorectal cancer (CRC). We conducted a systematic search in PubMed and Embase for prospective studies investigating the association between these 12 Food Groups and risk of CRC until April 2017. Summary risk ratios (RRs) and 95% confidence intervals (95% CI) were estimated using a random effects model for high vs. low intake categories, as well as for linear and nonlinear relationships. An inverse association was observed for whole grains (RR30g/d : 0.95, 95% CI 0.93, 0.97; n = 9 studies), vegetables (RR100g/d : 0.97, 95% CI 0.96, 0.98; n = 15), fruit (RR100g/d : 0.97, 95% CI 0.95, 0.99; n = 16) and dairy (RR200g/d : 0.93, 95% CI 0.91, 0.94; n = 15), while a positive association for red meat (RR100g/d : 1.12, 95% CI 1.06, 1.19; n = 21) and processed meat (RR50g/d : 1.17, 95% CI 1.10, 1.23; n = 16), was seen in the linear dose-response meta-analysis. Some evidence for nonlinear relationships was observed between vegetables, fruit and dairy and risk of colorectal cancer. Findings of this meta-analysis showed that a diet characterized by high intake of whole grains, vegetables, fruit and dairy products and low amounts of red meat and processed meat was associated with lower risk of CRC.

  • Food Groups and risk of hypertension a systematic review and dose response meta analysis of prospective studies
    Advances in Nutrition, 2017
    Co-Authors: Lukas Schwingshackl, Sabrina Schlesinger, Carolina Schwedhelm, Sven Knuppel, Khalid Iqbal, Angela Bechthold, Georg F Hoffmann, Violetta Andriolo, Heiner Boeing
    Abstract:

    The aim of this systematic review and meta-analysis was to summarize the evidence on the relation of the intakes of 12 major Food Groups, including whole grains, refined grains, vegetables, fruits, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages (SSBs) with the risk of hypertension. PubMed, Scopus, and Web of Science were searched systematically until June 2017 for prospective studies having quantitatively investigated the above-mentioned Foods. We conducted meta-analysis on the highest compared with the lowest intake categories and linear and nonlinear dose-response meta-analyses to analyze the association. Summary RRs and 95% CIs were estimated by using a random-effects model. Overall, 28 reports were included in the meta-analysis. An inverse association for the risk of hypertension was observed for 30 g whole grains/d (RR: 0.92; 95% CI: 0.87, 0.98), 100 g fruits/d (RR: 0.97; 95% CI: 0.96, 0.99), 28 g nuts/d (RR: 0.70; 95% CI: 0.45, 1.08), and 200 g dairy/d (RR: 0.95; 95% CI: 0.94, 0.97), whereas a positive association for 100 g red meat/d (RR: 1.14; 95% CI: 1.02, 1.28), 50 g processed meat/d (RR: 1.12; 95% CI: 1.00, 1.26), and 250 mL SSB/d (RR: 1.07; 95% CI: 1.04, 1.10) was seen in the linear dose-response meta-analysis. Indication for nonlinear relations of the intakes of whole grains, fruits, fish, and processed meats with the risk of hypertension was detected. In summary, this comprehensive dose-response meta-analysis of 28 reports identified optimal intakes of whole grains, fruits, nuts, legumes, dairy, red and processed meats, and SSBs related to the risk of hypertension. These findings need to be seen under the light of very-low to low quality of meta-evidence. However, the findings support the current dietary guidelines in the prevention of hypertension.

  • Food Groups and risk of all cause mortality a systematic review and meta analysis of prospective studies
    The American Journal of Clinical Nutrition, 2017
    Co-Authors: Lukas Schwingshackl, Sabrina Schlesinger, Carolina Schwedhelm, Georg Hoffmann, Annamaria Lampousi, Sven Knuppel, Khalid Iqbal, Angela Bechthold, Heiner Boeing
    Abstract:

    Background: Suboptimal diet is one of the most important factors in preventing early death and disability worldwide.Objective: The aim of this meta-analysis was to synthesize the knowledge about the relation between intake of 12 major Food Groups, including whole grains, refined grains, vegetables, fruits, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages, with risk of all-cause mortality.Design: We conducted a systematic search in PubMed, Embase, and Google Scholar for prospective studies investigating the association between these 12 Food Groups and risk of all-cause mortality. Summary RRs and 95% CIs were estimated with the use of a random effects model for high-intake compared with low-intake categories, as well as for linear and nonlinear relations. Moreover, the risk reduction potential of Foods was calculated by multiplying the RR by optimal intake values (serving category with the strongest association) for risk-reducing Foods or risk-increasing Foods, respectively.Results: With increasing intake (for each daily serving) of whole grains (RR: 0.92; 95% CI: 0.89, 0.95), vegetables (RR: 0.96; 95% CI: 0.95, 0.98), fruits (RR: 0.94; 95% CI: 0.92, 0.97), nuts (RR: 0.76; 95% CI: 0.69, 0.84), and fish (RR: 0.93; 95% CI: 0.88, 0.98), the risk of all-cause mortality decreased; higher intake of red meat (RR: 1.10; 95% CI: 1.04, 1.18) and processed meat (RR: 1.23; 95% CI: 1.12, 1.36) was associated with an increased risk of all-cause mortality in a linear dose-response meta-analysis. A clear indication of nonlinearity was seen for the relations between vegetables, fruits, nuts, and dairy and all-cause mortality. Optimal consumption of risk-decreasing Foods results in a 56% reduction of all-cause mortality, whereas consumption of risk-increasing Foods is associated with a 2-fold increased risk of all-cause mortality.Conclusion: Selecting specific optimal intakes of the investigated Food Groups can lead to a considerable change in the risk of premature death.