Effect of oat supplementation interventions on cardiovascular disease risk markers: a systematic review and meta-analysis of randomized controlled trials.

Erand Llanaj, Gordana M Dejanovic, Ezra Valido, Arjola Bano, Magda Gamba, Lum Kastrati, Beatrice Minder, Stevan Stojic, Trudy Voortman, Pedro Marques-Vidal, Jivko Stoyanov, Brandon Metzger, Marija Glisic, Hua Kern, Taulant Muka

Journal: European journal of nutrition 2022;61(4):1749-1778

PMID: 34977959

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Plain Language Summary

Cardiovascular disease (CVD) is one of the leading causes of mortality among adults. Changes in diet can have a beneficial effect on the prevention and management of CVD. Studies have shown that increasing intake of wholegrains, particularly those containing oat components, reduces CVD risk markers including blood cholesterol, blood glucose and body mass index (BMI). The purpose of this systematic review was to look at the effects of oat supplementation interventions (OSI) on CVD risk markers among adults, accounting for different dietary backgrounds or control arms. 74 RCTs were included (4937 subjects). Supplementing the diet with oat cereals improves CVD risk markers in healthy adults and those with mild metabolic disturbances. In particular serum total and LDL cholesterol, BMI and waist circumference. The beneficial effects on total cholesterol and LDL-Cholesterol were independent of the dietary background. The role of OSIs on blood pressure, glucose homeostasis or other markers, could not be established.

Abstract

PURPOSE

Oat supplementation interventions (OSIs) may have a beneficial effect on cardiovascular disease (CVD) risk. However, dietary background can modulate such effect. This systematic review assesses the effects of OSIs on CVD risk markers among adults, accounting for different dietary backgrounds or control arms.

METHODS

We included randomized clinical trials (RCTs) that assessed the effect of oat, oat beta-glucan-rich extracts or avenanthramides on CVD risk markers.

RESULTS

Seventy-four RCTs, including 4937 predominantly hypercholesterolemic, obese subjects, with mild metabolic disturbances, were included in the systematic review. Of these, 59 RCTs contributed to the meta-analyses. Subjects receiving an OSI, compared to control arms without oats, had improved levels of total cholesterol (TC) [weighted mean difference and (95% CI) - 0.42 mmol/L, (- 0.61; - 0.22)], LDL cholesterol [- 0.29 mmol/L, (- 0.37; - 0.20)], glucose [- 0.25 nmol/L, (- 0.36; - 0.14)], body mass index [- 0.13 kg/m, (- 0.26; - 0.01)], weight [- 0.94 kg, (- 1.84: - 0.05)], and waist circumference [- 1.06 cm, (- 1.85; - 0.27)]. RCTs on inflammation and/or oxidative stress markers were scarce and with inconsistent findings. RCTs comparing an OSI to heterogeneous interventions (e.g., wheat, eggs, rice, etc.), showed lowered levels of glycated haemoglobin, diastolic blood pressure, HDL cholesterol and apolipoprotein B. The majority of included RCTs (81.1%) had some concerns for risk of bias.

CONCLUSION

Dietary OSIs resulted in lowered levels of blood lipids and improvements in anthropometric parameters among participants with predominantly mild metabolic disturbances, regardless of dietary background or control. Further high-quality trials are warranted to establish the role of OSIs on blood pressure, glucose homeostasis and inflammation markers.

Address: Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.; MTA-DE Public Health Research Group, Hungarian Academy of Sciences and University of Debrecen, Debrecen, Hungary.; Department of Ophthalmology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.; Swiss Paraplegic Research, Nottwil, Switzerland.; Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.; Department of Cardiology, University Hospital of Bern, University of Bern, Bern, Switzerland.; Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.; Graduate School for Health Sciences, University of Bern, Bern, Switzerland.; Faculty of Medicine, University of Prishtina "Hasan Prishtina", Prishtina, Kosovo.; Public Health and Primary Care Library, University Library of Bern, University of Bern, Bern, Switzerland.; Department of Epidemiology, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands.; Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands.; Department of Medicine, Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland.; University of Lausanne, Lausanne, Switzerland.; Swiss Paraplegic Research, Nottwil, Switzerland.; Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.; Standard Process Nutrition Innovation Centre, Kannapolis, USA.; Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland. [email protected].

DOI: 10.1007/s00394-021-02763-1

Patient Centred Factor

Mediators: Cardiovascular disease

Clinical Imbalances

Immune and inflammation Gastro-intestinal

Laboratory Testing

Blood

Modifiable Lifestyle Factors

Diet

Nutrition Evidence Keywords

BMI Body mass index Waist circumference Blood pressure

Bioactive Substances

LDL cholesterol HDL cholesterol Glycosylated haemoglobin

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https://dx.doi.org/10.1007/s00394-021-02763-1

MeSH Terms: Adult, Avena, Biomarkers, Cardiovascular Diseases, Cholesterol, Dietary Supplements, Glucose, Humans, Inflammation, Randomized Controlled Trials as Topic