Abstract
Background: Overweight and obesity are associated with low levels of high-density lipoprotein (HDL). The occurrence of cardiovascular disease is strongly predicted by HDL. Increased HDL reduces the risk of cardiovascular disease and stroke. Increased fruit and vegetable consumption (FVC) has been proposed to increase HDL in overweight and obesity; however, research outcomes are inconclusive on the effects of FVC on HDL in this population.
Objective: The purpose of this study was to examine the effect of weight loss FVC interventions on HDL in overweight or obese individuals.
Methods: We conducted a meta-analysis using a random-effects model to analyze the results of 6 primary studies. Secondarily, we conducted moderator analyses to explore the effects based on participants, methods, intervention, and source characteristics.
Results: We found a small standardized mean difference of FVC on HDL (d = 0.18; 95% confidence interval, 0.06-0.29; z = 3.04, P < .01), minimal heterogeneity (Q = 6.10, P = .30, I2 = 18.05%), and possible publication bias. Moderator analyses indicated that masking of data collectors (Z = 3.73, P = .05) and intention-to-treat analysis (Z = 3.73, P = .05) significantly moderated the overall summary effect. Given that only 1 research team reported masking and intention to treat, these results should be interpreted with caution.
Conclusions: There was a small increase in HDL across studies (d = 0.18) in overweight and obese individuals. The effect size may be limited because of the small number of studies included in this meta-analysis. Nonetheless, obese and overweight individuals should be encouraged to increase their FVC to improve HDL and lower cardiovascular risk factors.