ImportanceClear guidelines on the health effects of dairy food are important given the high prevalence of obesity, cardiovascular disease and diabetes, and increasing global consumption of dairy food.ObjectiveTo evaluate the effects of increased dairy food on cardio metabolic risk factors.Data SourcesSearches were performed until April 2013 using MEDLINE, Science Direct, Google,Embase, the Cochrane Central Register of Controlled Trials, reference lists of articles, and proceedings of major meetings.Study SelectionRandomized controlled studies with healthy adults randomized to increased dairy food for more than one month without additional interventions.Data Extraction and SynthesisA standard list was used to extract descriptive, methodological and key variables from all eligible studies. If data was not included in the published report corresponding authors were contacted.Results20 studies with 1677 participants with a median duration of dietary change of 26 (IQR 10-39) weeks and mean increase in dairy food intake of 3.6 (SD 0.92) serves/day were included.There was an increase in weight with low (+0.82, 0.35 to 1.28 kg, p<0.001) and whole fat dairy food (+0.41, 0.04 to 0.79kg, p=0.03), but no significant change in waist circumference (-0.07 , -1.24 to 1.10 cm) ; HOMA –IR (-0.94 , -1.93 to 0.04 units); fasting glucose (+1.32 , 0.19 to 2.45 mg/dl) ; LDL-c (1.85 ,-2.89 to 6.60 mg/dl); HDL-c (-0.19 , -2.10 to 1.71 mg/dl); systolic BP (-0.4, -1.6 to 0.8 mmHg); diastolic BP (-0.4 , -1.7 to 0.8 mmHg) or CRP (-1.07 , -2.54 to 0.39 mg/L). Changes in other cardio-metabolic risk factors were similar for low and whole fat dairy interventions.LimitationsMost clinical trials were small and of modest quality. .ConclusionIncreasing whole fat and low fat dairy food consumption increases weight but has minor effects on other cardio-metabolic risk factors.Trial Registration ACTRNAustralian New Zealand Clinical Trials Registry ACTRN12613000401752, http://www.anzctr.org.au Ethics Approval NumberNTX/10/11/115

BackgroundThere is increasing evidence that plant based diets are associated with lower cardiovascular risk.ObjectiveTo evaluate effects of a vegan compared to an omnivorous diet on cardio-metabolic risk factors.MethodsMeta-analysis of observational studies published between 1960 and June 2018 that reported one or more cardio-metabolic risk factors in vegans and controls eating an omnivorous diet were undertaken. Macro-nutrient intake and cardio-metabolic risk factors were compared by dietary pattern. The Newcastle Ottawa Scale (NOS) was used to assess the quality of each study. The inverse-variance method was used to pool mean differences. Statistical analyses were performed using RevMan software version 5•2 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen.Results40 studies with 12 619 vegans and 179 630 omnivores were included. From food frequency questionnaires in 28 studies, vegans compared to omnivores consumed less energy (-11%, 95% confidence interval -14 to -8) and less saturated fat (- 51%, CI -57 to -45). Compared to controls vegans had a lower body mass index (-1.72 kg/m2, CI -2.30 to -1.16), waist circumference (-2.35 cm, CI -3.93 to -0.76), low density lipoprotein cholesterol (-0.49 mmol/L CI -0.62 to -0.36), triglycerides (-0.14 mmol/L, CI -0.24 to -0.05), fasting blood glucose (-0.23 mmol/, CI -0.35 to -0.10), and systolic (-2.56 mmHg, CI -4.66 to -0.45) and diastolic blood pressure (-1.33 mmHg, CI -2.67 to -0.02), p<0.0001 for all. Results were consistent for studies with < and ≥ 50 vegans, and published before and after 2010. However in several large studies from Taiwan a vegan diet was not associated with favourable cardio-metabolic risk factors compared to the control diets.ConclusionIn most countries a vegan diet is associated with a more favourable cardio- metabolic profile compared to an omnivorous diet.

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Background Mobile health technologies have the potential to improve the reach and delivery of interventions for promoting long-term secondary prevention of coronary heart disease. Objective This study aims to determine the effectiveness of an SMS text messaging intervention (Text4HeartII) for improving adherence to medication and lifestyle changes over and above usual care in people with coronary heart disease at 24 and 52 weeks. Methods A two-arm, parallel, randomized controlled trial was conducted in New Zealand. Participants with a recent acute coronary syndrome were randomized to receive usual cardiac services alone (control, n=153) or a 24-week SMS text message program for supporting self-management plus usual cardiac services (n=153). The primary outcome was adherence to medication at 24 weeks, defined as a medication possession ratio of 80% or more for aspirin, statin, and antihypertensive therapy. Secondary outcomes included medication possession ratio at 52 weeks, self-reported medication adherence, adherence to healthy lifestyle behaviors, and health-related quality of life at 24 and 52 weeks. Results Participants were predominantly male (113/306, 80.3%) and European New Zealanders (210/306, 68.6%), with a mean age of 61 years (SD 11 years). Groups were comparable at baseline. National hospitalization and pharmacy dispensing records were available for all participants; 92% (282/306, 92.1%) of participants completed a 24-week questionnaire and 95.1% (291/306) of participants completed a 52-week questionnaire. Adherence with 3 medication classes were lower in the intervention group than in the control group (87/153, 56.8% vs 105/153, 68.6%, odds ratio 0.60, 95% CI 0.38-0.96; P=.03) and 52 weeks (104/153, 67.9% vs 83/153, 54.2%; odds ratio 0.56, 95% CI 0.35-0.89; P=.01). Self-reported medication adherence scores showed the same trend at 52 weeks (mean difference 0.3; 95% CI 0.01-0.59; P=.04). Moreover, self-reported adherence to health-related behaviors was similar between groups. Conclusions Text4HeartII did not improve dispensed medication or adherence to a favorable lifestyle over and above usual care. This finding contrasts with previous studies and highlights that the benefits of text interventions may depend on the context in which they are used. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12616000422426; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=370398. International Registered Report Identifier (IRRID) RR2-10.1186/s13063-018-2468-z

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