Abstract:
OBJECTIVE:To investigate the relation between total fat intake and body weight in adults and children. DESIGN:Systematic review and meta-analysis of randomised controlled trials and cohort studies. DATA SOURCES:Medline, Embase, CINAHL, and the Cochrane Central Register of Controlled Trials to June 2010. INCLUSION CRITERIA:Randomised controlled trials and cohort studies of adults or children that compared lower versus usual total fat intake and assessed the effects on measures of body fatness (body weight, body mass index, or waist circumference) after at least six months (randomised controlled trials) or one year (in cohorts). Randomised controlled trials with any intention to reduce weight in participants or confounded by additional medical or lifestyle interventions were excluded. DATA EXTRACTION:Data were extracted and validity was assessed independently and in duplicate. Random effects meta-analyses, subgroups, sensitivity analyses, and metaregression were done. RESULTS:33 randomised controlled trials (73,589 participants) and 10 cohort studies were included, all from developed countries. Meta-analysis of data from the trials suggested that diets lower in total fat were associated with lower relative body weight (by 1.6 kg, 95% confidence interval -2.0 to -1.2 kg, I(2)=75%, 57,735 participants). Lower weight gain in the low fat arm compared with the control arm was consistent across trials, but the size of the effect varied. Metaregression suggested that greater reduction in total fat intake and lower baseline fat intake were associated with greater relative weight loss, explaining most of the heterogeneity. The significant effect of a low fat diet on weight was not lost in sensitivity analyses (including removing trials that expended greater time and attention on low fat groups). Lower total fat intake also led to lower body mass index (-0.51 kg/m(2), 95% confidence interval -0.76 to -0.26, nine trials, I(2)=77%) and waist circumference (by 0.3 cm, 95% confidence interval -0.58 to -0.02, 15,671 women, one trial). There was no suggestion of negative effects on other cardiovascular risk factors (lipid levels or blood pressure). GRADE assessment suggested high quality evidence for the relation between total fat intake and body weight in adults. Only one randomised controlled trial and three cohort studies were found in children and young people, but these confirmed a positive relation between total fat intake and weight gain. CONCLUSIONS:There is high quality, consistent evidence that reduction of total fat intake has been achieved in large numbers of both healthy and at risk trial participants over many years. Lower total fat intake leads to small but statistically significant and clinically meaningful, sustained reductions in body weight in adults in studies with baseline fat intakes of 28-43% of energy intake and durations from six months to over eight years. Evidence supports a similar effect in children and young people.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Hooper L,Abdelhamid A,Moore HJ,Douthwaite W,Skeaff CM,Summerbell CDdoi
10.1136/bmj.e7666subject
Has Abstractpub_date
2012-12-06 00:00:00pages
e7666eissn
0959-8138issn
1756-1833journal_volume
345pub_type
杂志文章,meta分析,评审abstract:OBJECTIVE:To investigate the relations of maternal diet and smoking during pregnancy to placental and birth weights at term. DESIGN:Prospective cohort study. SETTING:District general hospital in the south of England. PARTICIPANTS:693 pregnant nulliparous white women with singleton pregnancies who were selected from ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.319.7206.339
更新日期:1999-08-07 00:00:00
abstract:OBJECTIVE:To assess the effectiveness of an antenatal service using community based breastfeeding peer support workers on initiation of breast feeding. DESIGN:Cluster randomised controlled trial. SETTING:Community antenatal clinics in one primary care trust in a multiethnic, deprived population. PARTICIPANTS:66 ante...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.b131
更新日期:2009-01-30 00:00:00
abstract:OBJECTIVE:To cost the relation between socioeconomic status and various measures of primary care workload and assess the adequacy of current "deprivation" payments in relation to actual costings for patients living in qualifying areas. DESIGN:Retrospective data on primary care were collected over a 4.5 year period fro...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.314.7073.38
更新日期:1997-01-04 00:00:00
abstract:OBJECTIVES:To determine the accuracy of diagnoses of schizophrenia and non-affective psychosis entered by general practitioners on a computer system. To compare recording of clinical events on computer with written records. DESIGN:Examination of case notes of all patients with a computer diagnosis of psychosis. Search...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.307.6895.32
更新日期:1993-07-03 00:00:00
abstract:OBJECTIVE:To review the evidence base from randomised controlled trials of combined cardiac resynchronisation therapy and implantable cardioverter defibrillator therapy in left ventricular impairment and symptomatic heart failure. DESIGN:Bayesian network meta-analysis. DATA SOURCES:Medline, Embase, and Cochrane datab...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.39343.511389.BE
更新日期:2007-11-03 00:00:00
abstract:OBJECTIVES:To examine the risk of atrial fibrillation in relation to the whole spectrum of thyroid function in a large cohort of patients. DESIGN:Population based cohort study of general practice patients identified by linkage of nationwide registries at the individual level. SETTING:Primary care patients in the city...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.e7895
更新日期:2012-11-27 00:00:00
abstract:OBJECTIVE:To identify the attitudes of general practitioners towards the use of thermometers in general practice. DESIGN:Postal questionnaire survey. SETTING:All general practitioners in the catchment area of Frimley Park Hospital, Surrey. SUBJECTS:145 general practitioners. MAIN OUTCOME MEASURES:Answers to questio...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.304.6832.961
更新日期:1992-04-11 00:00:00
abstract:OBJECTIVE:To compare the effect on prevalence of diarrhoea and mortality of household based treatment of drinking water with flocculant-disinfectant, sodium hypochlorite, and standard practices in areas with turbid water source in Africa. DESIGN:Cluster randomised controlled trial over 20 weeks. SETTING:Family compou...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.38512.618681.E0
更新日期:2005-09-03 00:00:00
abstract:OBJECTIVE: To evaluate the effectiveness of antenatal corticosteroids given at ≥34 weeks' gestation. DESIGN: Systematic review with meta-analysis. DATA SOURCES: Electronic databases were searched from their inception to February 2016. ELIGIBILITY CRITERIA FOR STUDY SELECTION: Randomized clinical trials comparing ant...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.i5044
更新日期:2016-10-12 00:00:00
abstract:OBJECTIVE:To investigate the effect of overweight on premature mortality and work disability in young and middle aged Finns. DESIGN:Prospective cohort study based on data collected in the multiphasic health examinations by the Social Insurance Institution of Finland from 1966 to 1972 and follow up until 1982. SETTING...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.301.6756.835
更新日期:1990-10-13 00:00:00
abstract::Currently, clinicians have to make decisions about how to manage pulmonary embolism on the basis of imperfect tests and assessment of odds. Management protocols that inevitably result in large numbers of patients being referred for angiography are unhelpful. Management decisions based on assessment of odds and investi...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.314.7078.425
更新日期:1997-02-08 00:00:00
abstract:OBJECTIVE:To investigate differences between hospitals in clinical management of patients admitted with fractured hip and to relate these to mortality at 90 days. DESIGN:A prospective audit of process and outcome of care based on interviews with patients, abstraction from records with standard proforma, and follow up ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.310.6984.904
更新日期:1995-04-08 00:00:00
abstract::A random sample of 133 elderly patients who had an unplanned readmission to a district general hospital within 28 days of discharge from hospital was studied and compared with a matched control sample of patients who were not readmitted. The total group was drawn from all specialties in the hospital, and by interviewi...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.297.6651.784
更新日期:1988-09-24 00:00:00
abstract:OBJECTIVE:To measure the prevalence of breast feeding and to examine the value of using information collected on Guthrie cards (used for detecting inherited metabolic disease and hypothyroidism when newborn infants are 7 days old) to calculate this prevalence. DESIGN:Analysis, by geographical area and maternity unit, ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.308.6932.824
更新日期:1994-03-26 00:00:00
abstract:OBJECTIVE:To compare the implications of four widely used cholesterol screening and treatment guidelines by applying them to a population in the United Kingdom. DESIGN:Guidelines were applied to population based data from a cross sectional study of cardiovascular disease and risk factors. SETTING:Newcastle upon Tyne,...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.317.7166.1125
更新日期:1998-10-24 00:00:00
abstract:OBJECTIVE:To determine whether maternal smoking during pregnancy causes impairment in growth after birth. DESIGN:Longitudinal study. SETTING:Six medical university centres of six towns of north, central, and south Italy. SUBJECTS:12,987 babies (10,238 born from non-smoking mothers, 2276 from mothers smoking one to n...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.310.6982.768
更新日期:1995-03-25 00:00:00
abstract:OBJECTIVE:To obtain data on sexual contact between doctors and their patients. DESIGN:Anonymous questionnaire with 17 items sent to all working gynaecologists (n = 595) and all ear, nose, and throat specialists (n = 380) in the Netherlands. RESULTS:Response rate was 74%; a total 64 doctors gave a reason for not compl...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.304.6841.1531
更新日期:1992-06-13 00:00:00
abstract:OBJECTIVE:To investigate whether work related stress, measured and defined as job strain, is associated with the overall risk of cancer and the risk of colorectal, lung, breast, or prostate cancers. DESIGN:Meta-analysis of pooled prospective individual participant data from 12 European cohort studies including 116,056...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.f165
更新日期:2013-02-07 00:00:00
abstract:OBJECTIVE:To examine the association between accidental dural puncture and long term headache and related symptoms. DESIGN:Postal questionnaire survey to elucidate new symptoms occurring after childbirth, and linking of these to data in obstetric and anaesthetic case notes. Women were surveyed between 13 months and ni...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.306.6882.883
更新日期:1993-04-03 00:00:00
abstract:OBJECTIVE:To characterise the percentage of available outcome data being presented in reports of randomised clinical trials with continuous outcome measures, thereby determining the potential for incomplete reporting bias. DESIGN:Descriptive cross sectional study. DATA SOURCES:A random sample of 200 randomised trials...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.e8486
更新日期:2012-12-18 00:00:00
abstract::When oxygen concentrators became available on form FP10 in 1985 the Department of Health and Social Security issued clear guidelines for their prescription for long term treatment. Reassessment of those patients prescribed a concentrator in one district showed that 29 out of 61 patients did not fulfil these criteria. ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.297.6655.1030
更新日期:1988-10-22 00:00:00
abstract:OBJECTIVE:To assess the efficacy of high serum cholesterol concentration, raised blood pressure, and smoking as predictors of coronary heart disease. DESIGN:Prospective cohort study of middle aged men conducted over 25 years. SETTING:Finish components of an ongoing international study (seven countries study). PARTIC...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.299.6691.81
更新日期:1989-07-08 00:00:00
abstract:OBJECTIVES:To investigate the association between contemporary combined hormonal contraceptives (including progestogen types in combined preparations and all progestogen-only products) and overall and specific types of ovarian cancer. DESIGN:Prospective, nationwide cohort study. SETTING:Denmark, 1995-2014. PARTICIPA...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.k3609
更新日期:2018-09-26 00:00:00
abstract:OBJECTIVES:To quantify the relative contribution of premorbid and episode specific factors in determining the long term persistence of disabling symptoms of low back pain. DESIGN:Prospective cohort study. SETTING:Two general practices in the south Manchester area. PARTICIPANTS:180 patients, who previously participat...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.318.7199.1662
更新日期:1999-06-19 00:00:00
abstract:OBJECTIVE:To establish the extent to which systematic reviews and meta-analyses of individual participant data (IPD) are being used to inform the recommendations included in published clinical guidelines. DESIGN:Descriptive study. SETTING:Database maintained by the Cochrane IPD Meta-analysis Methods Group, supplement...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.h1088
更新日期:2015-03-06 00:00:00
abstract:OBJECTIVE:To determine the relation between mothers' self reported drinking habits before, during, and after pregnancy and infants' mental and motor development at 18 months of age. DESIGN:Follow up study of all singleton live births born to primigravidas living in Dundee and booked into antenatal clinics from 1 May 1...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章
doi:10.1136/bmj.303.6793.22
更新日期:1991-07-06 00:00:00
abstract::Many clinicians remain unsure of the relevance of measuring quality of life to their clinical practice. In health economics quality of life measures have become the standard means of assessing the results of health care interventions and, more controversially, the means of prioritising funding; but they have many othe...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.305.6861.1074
更新日期:1992-10-31 00:00:00
abstract:OBJECTIVE:To examine the effectiveness of day hospital attendance in prolonging independent living for elderly people. DESIGN:Systematic review of 12 controlled clinical trials (available by January 1997) comparing day hospital care with comprehensive care (five trials), domiciliary care (four trials), or no comprehen...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.318.7187.837
更新日期:1999-03-27 00:00:00
abstract:OBJECTIVES:To investigate potential determinants of severe hypoglycaemia, including baseline characteristics, in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial and the association of severe hypoglycaemia with levels of glycated haemoglobin (haemoglobin A(1C)) achieved during therapy. DESIGN:Post ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.b5444
更新日期:2010-01-08 00:00:00
abstract:OBJECTIVE:To determine the prevalence of diabetes in relation to birth weight in Pima Indians. DESIGN:Follow up study of infants born during 1940-72 who had undergone a glucose tolerance test at ages 20-39 years. SETTING:Gila River Indian community, Arizona. SUBJECTS:1179 American Indians. MAIN OUTCOME MEASURE:Prev...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.308.6934.942
更新日期:1994-04-09 00:00:00