1. Dietary habits / Consumption of fat |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
-0.71 [-2.15, 0.73] |
Very low |
It may result in a slight decrease in fat consumption |
1 |
89 |
-0.71 [-2.15, 0.73] |
Low |
0.0 |
NA [NA, NA] |
NA |
2. Physical activity |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
0.67 [-0.14, 1.48] |
Very low |
It may increase physical activity |
1 |
49 |
0.67 [-0.14, 1.48] |
Low |
0.0 |
NA [NA, NA] |
NA |
3. Weight (management) / Waist size |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
-2.0 [-4.61, 0.61] |
Low |
It may result in little to no difference in waist size (cm) |
1 |
276 |
-2.0 [-4.61, 0.61] |
Low |
0.0 |
NA [NA, NA] |
NA |
4. Dietary habits |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
0.59 [-0.1, 1.29] |
Very low |
It may result in a slight improvement in dietary habits |
1 |
49 |
0.59 [-0.1, 1.29] |
Low |
0.0 |
N/A |
NA |
5. Quality of life / Psychological distress |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
0.15 [-0.63, 0.93] |
Very low |
It may result in little to no difference in psychological distress but the evidence is very uncertain |
1 |
49 |
0.15 [-0.63, 0.93] |
Low |
0.0 |
NA [NA, NA] |
NA |
6. Lipid profile / LDL-Cholesterol |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
18.56 [13.09, 24.04] |
Moderate |
It likely results in little to no difference in LDL levels (mg/dL) |
1 |
276 |
18.56 [13.09, 24.04] |
Moderate |
0.0 |
NA [NA, NA] |
NA |
7. Lipid profile / HDL-Cholesterol (mmol) |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
-7.35 [-11.44, -3.25] |
Very low |
It may increase HDL levels (mmol/L) but the evidence is very uncertain |
1 |
276 |
-7.35 [-11.44, -3.25] |
Moderate |
0.0 |
NA [NA, NA] |
NA |
8. Weight (management) / Weight (Kgs/lbs) |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
-3.67 [-11.47, 4.12] |
Very low |
It may result in little to no difference in weight (kgs) but the evidence is very uncertain |
1 |
89 |
-3.67 [-11.47, 4.12] |
Low |
0.0 |
NA [NA, NA] |
NA |
9. Lipid profile / Triglycerides |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
-0.25 [-0.81, 0.31] |
Moderate |
It likely results in little to no difference in triglycerides (mmol/L) |
1 |
276 |
-0.25 [-0.81, 0.31] |
Moderate |
0.0 |
NA [NA, NA] |
NA |
10. Lipid profile / Total cholesterol |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
6.96 [-5.71, 19.63] |
Moderate |
It likely results in little to no difference on total cholesterol (mg/dL) |
1 |
276 |
6.96 [-5.71, 19.63] |
Moderate |
0.0 |
NA [NA, NA] |
NA |
11. Blood-pressure / Diastolic pressure |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
-2.5 [-6.19, 1.19] |
Very low |
It may decrease diastolic blood pressure(mmHg) but the evidence is very uncertain |
1 |
276 |
-2.5 [-6.19, 1.19] |
Low |
0.0 |
NA [NA, NA] |
NA |
12. Blood-pressure / Systolic pressure |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
-5.0 [-11.39, 1.39] |
Very low |
It may decrease systolic blood pressure levels (mmHg) but the evidence is very uncertain |
1 |
276 |
-5.0 [-11.39, 1.39] |
Low |
0.0 |
NA [NA, NA] |
NA |
13. Weight (management) / BMI - Body Mass Index |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
-1.88 [-2.89, -0.88] |
Very low |
It may result in little to no difference in body mass index (kg/m²) but the evidence is very uncertain |
2 |
325 |
-1.88 [-2.89, -0.88] |
Very low |
0.0 |
NA [NA, NA] |
NA |
14. HbA1C / Glycated hemoglobin (HbA1c) |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
-0.41 [-0.87, 0.04] |
Very Low |
It may result in little to no difference in HbA1C levels (%) but the evidence is very uncertain |
3 |
427 |
-0.41 [-0.87, 0.04] |
Low |
0.0 |
NA [NA, NA] |
NA |
Footnotes per outcome:
1) a) Number of studies included in the network: 14 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=53); Number of comparison(s) informing the indirect estimate: 0 comparison(s) The range of follow up was from 2 to 24 months for the studies included in the whole network. The range of follow-up was 6 months in the studies directly comparing the self-management intervention versus usual care; b) We rated down the certainty of evidence due to very serious risk of bias very serious imprecision 2) a) We rated down the certainty of evidence due to very serious risk of bias and serious imprecision; b) Number of studies included in the network: 64 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=26); Number of comparison(s) informing the indirect estimate: 0 comparison(s). The range of follow up was from 1 to 24 months for the studies included in the whole network. The range of follow-up was 3 months in the studies directly comparing the self-management intervention versus usual care. 3) a) Number of studies included in the network: 81 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=138); Number of comparison(s) informing the indirect estimate: 0 comparison(s). The range of follow up was from 1 to 36 months for the studies included in the whole network. The range of follow-up was 6 months in the studies directly comparing the self-management intervention versus usual care.; b) We rated down the certainty of evidence due to very serious risk of bias and very serious risk of bias 4) a) Number of studies included in the network: 30 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=26); Number of comparison(s) informing the indirect estimate: 0 comparison(s). The range of follow up was from 1 to 24 months for the studies included in the whole network. The range of follow-up was 3 months in the studies directly comparing the self-management intervention versus usual care.; b) We rated down the certainty of evidence due to very serious risk of bias and serious imprecision 5) a) We rated down the certainty of evidence due to very serious risk of bias and very serious imprecision; b) Number of studies included in the network: 44 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=26); Number of comparison(s) informing the indirect estimate: 0 comparison(s).The range of follow up was from 2 to 24 months for the studies included in the whole network. The range of follow-up was 3 months in the studies directly comparing the self-management intervention versus usual care. 6) a) We rated down the certainty of evidence due to serious risk of bias; b) Number of studies included in the network: 171 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=138); Number of comparison(s) informing the indirect estimate: 0 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 6 months in the studies directly comparing the self-management intervention versus usual care. 7) a) We rated down the certainty of evidence due to serious risk of bias and very serious imprecision; b) Number of studies included in the network: 162 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=138); Number of comparison(s) informing the indirect estimate: 0 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 6 months in the studies directly comparing the self-management intervention versus usual care. 8) a) Number of studies included in the network: 145 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=53); Number of comparison(s) informing the indirect estimate: 0 comparison(s). The range of follow up was from 1 to 51 months for the studies included in the whole network. The range of follow-up was 6 months in the studies directly comparing the self-management intervention versus usual care.; b) We rated down the certainty of evidence due to very serious risk of bias and serious imprecision 9) a) Number of studies included in the network: 171 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=138); Number of comparison(s) informing the indirect estimate: 0 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 6 months in the studies directly comparing the self-management intervention versus usual care.; b) We rated down the certainty of evidence due to serious risk of bias 10) a) Number of studies included in the network: 176 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=138); Number of comparison(s) informing the indirect estimate: 0 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 6 months in the studies directly comparing the self-management intervention versus usual care.; b) We rated down the certainty of evidence due to serious risk of bias 11) a) Number of studies included in the network: 211 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=138); Number of comparison(s) informing the indirect estimate: 0 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 6 months in the studies directly comparing the self-management intervention versus usual care.; b) We rated down the certainty of evidence due to very serious risk of bias and serious imprecision 12) a) We rated down the certainty of evidence due to serious imprecision and very serious risk of bias; b) Number of studies included in the network: 233 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=138); Number of comparison(s) informing the indirect estimate: 0 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 6 months in the studies directly comparing the self-management intervention versus usual care. 13) a) We rated down the certainty of evidence due to very serious risk of bias, serious inconsistency and serious imprecision; b) Number of studies included in the network: 231 RCTs; Number of studies directly comparing the intervention with usual care: 2 RCT(s) (N=164); Number of comparison(s) informing the indirect estimate: 0 comparison(s).The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 3-6 months in the studies directly comparing the self-management intervention versus usual care. 14) a) We rated down the certainty of evidence due to serious imprecision, serious risk of bias and serious inconsistency; b) Number of studies included in the network: 463 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=213); Number of comparison(s) informing the indirect estimate: 0 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 3-6 months in the studies directly comparing the self-management intervention versus usual care.
References of studies informing direct evidence:
1) Sorkin-2014 2) Whittemore-2004 3) Fan-2016 4) Whittemore-2004 5) Whittemore-2004 6) Ali-2012 7) Fan-2016 8) Sorkin-2014 9) Fan-2016 10) Fan-2016 11) Fan-2016 12) Fan-2016 13) Fan-2016, Whittemore-2004 14) Fan-2016, Keogh-2011, Whittemore-2004
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