TABLE 2.
Analysis of qualitative concordance of the 49 included diet–disease outcomes1
| Qualitative concordance | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Study (reference) | Intervention/exposure category | Outcome category | Summary measure | Direction of effect (RCTs) | Significance (RCTs) | Direction of association: CS dietary intake | Significance (CSs) | Direction of association: CS biomarkers | Significance (CSs) | RCTs vs. CSs: dietary intake | RCTs vs. CSs: biomarker | CS biomarker vs. CS dietary intake | Overall |
| Abdelhamid et al. 2018 (40) + Chowdhury et al. 2014 (47) | Omega-3 | Cardiovascular disease | RR | Decreasing | Not sign | Decreasing | Sign | Decreasing | Not sign | Not concordant | Not concordant | Not concordant | Not concordant |
| Abdelhamid et al. 2018 (40) + Chowdhury et al. 2014 (47) | Omega-3 | Cardiovascular mortality | RR | Decreasing | Not sign | Decreasing | Not sign | Decreasing | Sign | Not concordant | Not concordant | Not concordant | Not concordant |
| Abdelhamid et al. 2018 (40) + Pan et al. 2012 (48) | α-Linolenic acid | Cardiovascular disease | RR | Decreasing | Not sign | Decreasing | Not sign | Decreasing | Not sign | Concordant | Not concordant | Not concordant | Not concordant |
| Adler et al. 2014 (41) + Aburto et al. 2013 (49) | Low sodium | All-cause mortality | RR | Decreasing | Not sign | Decreasing | Not sign | Decreasing | Not sign | Not concordant | Concordant | Not concordant | Not concordant |
| Adler et al. 2014 (41) + Aburto et al. 2013 (49) | Low sodium | Cardiovascular disease | RR | Decreasing | Not sign | Decreasing | Not sign | Decreasing | Not sign | Not concordant | Not concordant | Not concordant | Not concordant |
| Adler et al. 2014 (41) + Aburto et al. 2013 (49) | Low sodium | Cardiovascular mortality | RR | Decreasing | Not sign | Decreasing | Not sign | Decreasing | Not sign | Not concordant | Not concordant | Not concordant | Not concordant |
| Bjelakovic et al. 2012 (42) + Aune et al. 2018 (50) | Vitamin C | All-cause mortality | RR | Increasing | Not sign | Decreasing | Sign | Decreasing | Sign | Not concordant | Not concordant | Concordant | Not concordant |
| Bjelakovic et al. 2012 (42) + Aune et al. 2018 (50) | Vitamin E | All-cause mortality | RR | Increasing | Not sign | Decreasing | Not sign | Decreasing | Not sign | Concordant | Not concordant | Not concordant | Not concordant |
| Bjelakovic et al. 2012 (42) + Aune et al. 2018 (50) | β-Carotene | All-cause mortality | RR | Increasing | Not sign | Decreasing | Sign | Decreasing | Sign | Not concordant | Not concordant | Concordant | Not concordant |
| Bjelakovic et al. 2014 (46) + Hossain et al. 2019 (51) | Vitamin D | Breast cancer | RR | Decreasing | Not sign | Decreasing | Not sign | Increasing | Not sign | Concordant | Not concordant | Not concordant | Not concordant |
| Bjelakovic et al. 2014 (46) + Touvier et al. 2011 (52) | Vitamin D | Colorectal cancer | RR | Increasing | Not sign | Decreasing | Sign | Decreasing | Sign | Not concordant | Not concordant | Concordant | Not concordant |
| Bjelakovic et al. 2014 (46) + Zhang et al. 2015 (53) | Vitamin D | Lung cancer | RR | Decreasing | Not sign | Decreasing | Not sign | Decreasing | Sign | Not concordant | Not concordant | Not concordant | Not concordant |
| Brown et al. 2019 (14) + Wu et al. 2012 (54) | Omega-3 | Type 2 diabetes | RR | Same effect | Not sign | Increasing | Not sign | Decreasing | Not sign | Concordant | Concordant | Concordant | Concordant |
| Brown et al. 2019 (14) + Wu et al. 2012 (54) | α-Linolenic acid | Type 2 diabetes | RR | Decreasing | Not sign | Decreasing | Not sign | Decreasing | Not sign | Not concordant | Not concordant | Not concordant | Not concordant |
| Chowdhury et al. 2012 (12) + Chowdhury et al. 2012 (12) | Omega-3 | Stroke | RR | Increasing | Not sign | Decreasing | Not sign | Increasing | Not sign | Concordant | Concordant | Concordant | Concordant |
| Druesne-Pecollo et al. 2010 (15) + Aune et al. 2012 (55) | β-Carotene | Breast cancer | RR | Decreasing | Not sign | Decreasing | Sign | Decreasing | Not sign | Not concordant | Not concordant | Not concordant | Not concordant |
| Druesne-Pecollo et al. 2010 (15) + Aune et al. 2018 (50) | β-Carotene | Cancer | RR | Increasing | Not sign | Decreasing | Not sign | Decreasing | Sign | Concordant | Not concordant | Not concordant | Not concordant |
| Hanson et al. 2020 (16) + Alexander et al. 2015 (56) | Omega-3 | Prostate cancer | RR | Increasing | Not sign | Same effect | Not sign | Increasing | Not sign | Concordant | Not concordant | Concordant | Not concordant |
| Hanson et al. 2020 (16) + Cao et al. 2016 (57) | Omega-6 | Breast cancer | RR | Same effect | Not sign | Increasing | Not sign | Decreasing | Not sign | Not concordant | Not concordant | Not concordant | Not concordant |
| Hanson et al. 2020 (16) + Cao et al. 2016 (57) | PUFA | Breast cancer | RR | Increasing | Not sign | Increasing | Not sign | Decreasing | Not sign | Not concordant | Not concordant | Not concordant | Not concordant |
| Hanson et al. 2020 (16) + Fu et al. 2015 (58) | α-Linolenic acid | Prostate cancer | RR | Increasing | Not sign | Decreasing | Not sign | Same effect | Not sign | Not concordant | Not concordant | Concordant | Not concordant |
| Hanson et al. 2020 (16) + Zheng et al. 2013 (59) | Omega-3 | Breast cancer | RR | Increasing | Not sign | Decreasing | Sign | Decreasing | Not sign | Not concordant | Not concordant | Not concordant | Not concordant |
| Hooper et al. 2018 (43) + Chowdhury et al. 2014 (47) | Omega-6 | Cardiovascular disease | RR | Decreasing | Not sign | Decreasing | Not sign | Decreasing | Not sign | Concordant | Concordant | Concordant | Concordant |
| Hooper et al. 2018 (43) + Li et al. 2020 (26) | Omega-6 | All-cause mortality | RR | Same effect | Not sign | Decreasing | Sign | Decreasing | Sign | Not concordant | Not concordant | Concordant | Not concordant |
| Hooper et al. 2018 (43) + Li et al. 2020 (26) | Omega-6 | Cardiovascular mortality | RR | Increasing | Not sign | Decreasing | Sign | Decreasing | Sign | Not concordant | Not concordant | Concordant | Not concordant |
| Jenkins et al. 2018 (18) + Aune et al. 2018 (50) | Vitamin C | Cardiovascular disease | RR | Decreasing | Not sign | Decreasing | Sign | Decreasing | Sign | Not concordant | Not concordant | Concordant | Not concordant |
| Jenkins et al. 2018 (18) + Aune et al. 2018 (50) | Vitamin C | Cardiovascular mortality | RR | Increasing | Not sign | Decreasing | Sign | Decreasing | Sign | Not concordant | Not concordant | Concordant | Not concordant |
| Jenkins et al. 2018 (18) + Aune et al. 2018 (50) | Vitamin C | Stroke | RR | Decreasing | Not sign | Decreasing | Sign | Decreasing | Sign | Not concordant | Not concordant | Concordant | Not concordant |
| Jenkins et al. 2018 (18) + Aune et al. 2018 (50) | Vitamin E | Cardiovascular disease | RR | Decreasing | Not sign | Decreasing | Not sign | Decreasing | Not sign | Not concordant | Not concordant | Not concordant | Not concordant |
| Jenkins et al. 2018 (18) + Aune et al. 2018 (50) | Vitamin E | Cardiovascular mortality | RR | Decreasing | Not sign | Same effect | Not sign | Decreasing | Not sign | Concordant | Concordant | Concordant | Concordant |
| Jenkins et al. 2018 (18) + Aune et al. 2018 (50) | Vitamin E | Stroke | RR | Decreasing | Not sign | Decreasing | Not sign | Decreasing | Sign | Not concordant | Not concordant | Not concordant | Not concordant |
| Jenkins et al. 2018 (18) + Aune et al. 2018 (50) | β-Carotene | Cardiovascular disease | RR | Increasing | Not sign | Decreasing | Not sign | Decreasing | Sign | Concordant | Not concordant | Not concordant | Not concordant |
| Jenkins et al. 2018 (18) + Aune et al. 2018 (50) | β-Carotene | Coronary heart disease | RR | Increasing | Not sign | Decreasing | Sign | Decreasing | Sign | Not concordant | Not concordant | Concordant | Not concordant |
| Jenkins et al. 2018 (18) + Aune et al. 2018 (50) | β-Carotene | Stroke | RR | Increasing | Not sign | Decreasing | Sign | Decreasing | Not sign | Not concordant | Not concordant | Not concordant | Not concordant |
| Jenkins et al. 2018 (18) + Hunnicutt et al. 2014 (60) | Iron | Cardiovascular mortality | RR | Decreasing | Not sign | Decreasing | Not sign | Same effect | Not sign | Not concordant | Not concordant | Not concordant | Not concordant |
| Jenkins et al. 2018 (18) + Hunnicutt et al. 2014 (60) | Iron | Myocardial infarction | RR | Decreasing | Not sign | Decreasing | Not sign | Increasing | Sign | Not concordant | Not concordant | Not concordant | Not concordant |
| Khan et al. 2019 (17) + Chen et al. 2016 (61) | Omega-3 | All-cause mortality | RR | Decreasing | Not sign | Decreasing | Sign | Decreasing | Sign | Not concordant | Not concordant | Concordant | Not concordant |
| Moazzen et al. 2018 (19) + Moazzen et al. 2018 (19) | Folate | Colorectal cancer | RR | Increasing | Not sign | Decreasing | Not sign | Decreasing | Sign | Not concordant | Not concordant | Not concordant | Not concordant |
| Park et al. 2017 (20) + Wu et al. 2020 (62) | Vitamin A/carotenoids | Bladder cancer | RR | Decreasing | Not sign | Increasing | Not sign | Decreasing | Not sign | Not concordant | Not concordant | Not concordant | Not concordant |
| Rees et al. 2013 (45) + Jayedi et al. 2018 (63) | Selenium | All-cause mortality | RR | Decreasing | Not sign | Decreasing | Sign | Decreasing | Sign | Not concordant | Not concordant | Concordant | Not concordant |
| Rutjes et al. 2018 (44) + Doets et al. 2013 (64) | B-vitamins | Dementia/MCI | RR | Increasing | Not sign | Decreasing | Not sign | Same effect | Not sign | Not concordant | Not concordant | Concordant | Not concordant |
| Schwingshackl et al. 2017 (22) + Aune et al. 2018 (50) | Vitamin C | Cancer | RR | Decreasing | Not sign | Decreasing | Sign | Decreasing | Sign | Not concordant | Not concordant | Concordant | Not concordant |
| Schwingshackl et al. 2017 (22) + Aune et al. 2018 (50) | Vitamin E | Cancer | RR | Increasing | Not sign | Increasing | Not sign | Decreasing | Sign | Concordant | Not concordant | Not concordant | Not concordant |
| van Die et al. 2014 (21) + Applegate et al. 2018 (25) | Isoflavones | Prostate cancer | RR | Decreasing | Sign | Decreasing | Sign | Decreasing | Not sign | Concordant | Not concordant | Not concordant | Not concordant |
| Vinceti 2018 (39) + Vinceti 2018 (39) | Selenium | Cancer mortality | RR | Decreasing | Not sign | Decreasing | Not sign | Decreasing | Not sign | Not concordant | Not concordant | Not concordant | Not concordant |
| Vinceti et al. 2018 (39) + Vinceti et al. 2018 (39) | Selenium | Lung cancer | RR | Increasing | Not sign | Increasing | Not sign | Decreasing | Not sign | Not concordant | Not concordant | Not concordant | Not concordant |
| Vinceti et al. 2018 (39) + Vinceti et al. 2018 (39) | Selenium | Prostate cancer | RR | Decreasing | Not sign | Decreasing | Not sign | Decreasing | Sign | Not concordant | Not concordant | Not concordant | Not concordant |
| Vollset et al. 2013 (23) + Wang et al. 2014 (65) | Folate | Prostate cancer | RR | Increasing | Not sign | Increasing | Not sign | Increasing | Sign | Not concordant | Not concordant | Not concordant | Not concordant |
| Zhao et al. 2017 (24) + Zhao et al. 2017 (24) | Iron | Gestational diabetes | RR | Decreasing | Not sign | Increasing | Not sign | Increasing | Sign | Not concordant | Not concordant | Not concordant | Not concordant |
1CS, cohort study; MCI, mild cognitive impairment; RCT, randomized controlled trial; RR, risk ratio; sign, significant.