TABLE 4.
Pooled change in cardiometabolic outcomes as a result of healthy produce prescription programs1
| Percent change | Absolute change | Certainty of evidence (GRADE) | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Outcome | Studies (n) | Reference | Participants (n) | Estimate (95% CI) | P 2 | I2 (%) | Estimate (95% CI) | P 2 | I2 (%) | |
| Fruit and vegetable intake, servings/d3 | 5 | (37, 40–43) | 1039 | 22 (12, 32) | <0.001 | 97 | 0.79 (0.23, 1.35) | 0.004 | 96 | LOW4,5 ⊕⊕⊝⊝ |
| Fruit intake, servings/d | 3 | (38, 40, 42) | 257 | 39 (12, 67) | 0.005 | 90 | 0.59 (0.32, 0.87) | <0.001 | 59 | MODERATE6 ⊕⊕⊕⊝ |
| Vegetable intake, serving/d | 2 | (40, 42) | 178 | 29 (–8, 65) | 0.124 | 98 | 0.53 (–0.04, 1.10) | 0.068 | 87 | VERY LOW7,8,9 ⊕⊝⊝⊝ |
| SBP, mmHg | 4 | (26, 37, 38, 41) | 328 | –1.8 (–5.9, 2.3) | 0.383 | 86 | –2.39 (–7.77, 2.99) | 0.383 | 85 | VERY LOW10,11,12 ⊕⊝⊝⊝ |
| DBP, mmHg | 4 | (26, 37, 38, 41) | 328 | 0.0 (–1.2, 1.3) | 0.966 | 15 | 0.02 (–0.95, 0.99) | 0.964 | 13 | LOW10,12 ⊕⊕⊝⊝ |
| HbA1c, % | 5 | (26, 34, 38, 43, 44) | 1064 | –8.6 (–16.9, –0.35) | 0.041 | 99 | –0.81 (–1.56, –0.06) | 0.035 | 92 | VERY LOW10,13,14⊕⊝⊝⊝ |
| LDL, mM | 2 | (37, 38) | 214 | –1.1 (–12.4, 10.3) | 0.855 | 58 | –0.03 (–0.33, 0.27) | 0.856 | 50 | LOW15,16⊕⊕⊝⊝ |
| HDL, mM | 2 | (37, 38) | 214 | 2.9 (–4.9, 10.8) | 0.468 | 0 | 0.04 (–0.06, 0.14) | 0.463 | 0 | LOW15,16⊕⊕⊝⊝ |
| TG, mM | 2 | (37, 38) | 214 | 22.5 (–44.2, 89.2) | 0.509 | 52 | 0.23 (–0.44, 0.90) | 0.502 | 49 | LOW15,16⊕⊕⊝⊝ |
| BMI, kg/m2 | 3 | (27, 41, 44) | 215 | –1.6 (–2.8, –0.3) | 0.013 | 27 | –0.61 (–1.06, –0.16) | 0.008 | 6.4 | LOW17,18 ⊕⊕⊝⊝ |
DBP, diastolic blood pressure; GRADE, Grades of Recommendation, Assessment, Development, and Evaluation Working Group; HbA1c, glycated hemoglobin; RCT, randomized controlled trial; SBP, systolic blood pressure; TG, triglycerides.
P value of Z-test for significance of pooled change and 95% CI.
Where possible, fruit and vegetable intake (in servings/d) reported separately within a study was converted to combined fruit and vegetable intake by methods described previously (83) and meta-analyzed using the method described in the footnote of Table 3.
Downgraded by 1 for risk of bias: ≥4 studies non-RCTs; ≥3 studies with >10% loss to follow-up (risk of selection bias and attrition bias).
Downgraded by 1 for inconsistency: significant unexplained heterogeneity.
Downgraded by 1 for risk of bias: ≥2 studies non-RCTs; ≥1 study with >10% loss to follow-up (risk of selection and attrition bias).
Downgraded by 1 for risk of bias: ≥2 studies non-RCTs; 1 study with >10% loss to follow-up (risk of selection bias and attrition bias).
Downgraded by 1 for inconsistency: significant unexplained heterogeneity.
Downgraded by 1 for imprecision: does not meet optimal information size criterion.
Downgraded by 1 for risk of bias: ≥2 studies non-RCTs; ≥2 studies with >10% loss to follow-up (risk of selection bias and attrition bias).
Downgraded by 1 for inconsistency: significant unexplained heterogeneity.
Downgraded by 1 for imprecision: does not meet optimal information size criterion.
Downgraded by 1 for inconsistency: significant unexplained heterogeneity.
Downgraded by 1 for imprecision: does not meet optimal information size criterion.
Downgraded by 1 for risk of bias: ≥1 study with >10% loss to follow-up (risk of attrition bias).
Downgraded by 1 for imprecision: does not meet optimal information size criterion.
Downgraded by 1 for risk of bias: ≥2 studies non-RCTs (risk of selection bias).
Downgraded by 1 for imprecision: does not meet optimal information size criterion.