Dietary outcomes of community-based cardiovascular disease preventive interventions: a systematic review and meta-analysis

Abstract

Objective: We aimed to synthesize available evidence on the effects of community-based interventions in improving various dietary outcome measures. Design: Systematic review and meta-analysis Setting: We searched databases including Medline, EMBASE, PSYCINFO, CINAHL, and the Cochrane registry for studies reported between January 2000 and June 2022. The methodological quality of the included studies was evaluated using the Cochrane risk of bias tools for each study type. For some of the outcomes, we pooled the effect size using a random-effects meta-analysis. Participants: A total of 51 studies, 33 randomized and 18 non-randomized, involving 100 746 participants were included. Results: Overall, 37 studies found a statistically significant difference in at least one dietary outcome measure favoring the intervention group, whereas 14 studies found no statistically significant difference. Our meta-analyses indicated that, compared to controls, interventions were effective in decreasing daily energy intake (MJ/day) (MD: -0.25; 95% CI: -0.37, -0.14), fat % of energy (MD: -1.01; 95% CI: -1.76, -0.25), and saturated fat % of energy (MD: -1.54; 95% CI: -2.01, -1.07). Furthermore, the interventions were effective in improving fiber intake (g/day) (MD: 1.08; 95% CI: 0.39, 1.77). Effective interventions use various strategies including tailored individual lifestyle coaching, health education, health promotion activities, community engagement activities and/or structural changes. Conclusion: This review shows the potential of improving dietary patterns through communitybased CVD preventive interventions. Thus, development and implementation of context-specific preventive interventions could help to minimize dietary risk factors, which in turn decrease morbidity and mortality due to CVDs and other non-communicable diseases.