The Relationship between Vegetable Intake and Weight Outcomes: A Systematic Review of Cohort Studies

The relationship between vegetable consumption and measures of adiposity was assessed in cohort studies. Seven databases were searched from inception until October 2018. The quality of individual studies was assessed using the Joanna Briggs Institute Critical Appraisal of Cohort Studies tool. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was applied to determine the quality of the body of evidence. Ten studies were included. Six measured change in vegetable intake over time. Two showed that increasing vegetable consumption resulted in weight loss of 0.09-0.1 kg over four years (p < 0.001). Increased vegetable intake was also associated with a reduced risk of weight gain and overweight or obesity (Odds ratios (ORs) ranged from 0.18 to 0.88) in other studies. Four studies measured vegetable intake at the baseline only. One showed that intakes > 4 servings/day reduced the risk of weight gain (OR 0.27 (95% confidence interval (CI) 0.08-0.99) and another found an inverse association with waist circumference in women (0.36 cm per vegetable serving/day). This review provides moderate quality evidence for an inverse association between vegetable intake and weight-related outcomes in adults. When these findings are coupled with no apparent harm from vegetable consumption, the evidence-base can be used with acceptable confidence to guide practice and policy.