ArticleEClinicalMedicine2024
Association between substituting macronutrients and all-cause mortality: a network meta-analysis of prospective observational studies.
Article in EClinicalMedicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Dietary Patterns and Cardiovascular Diseases in Individuals with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Prospective Observational Studies.Advances in nutrition (Bethesda, Md.) · 2026Pooled it
- Adherence to Mediterranean Diet and Risk of Type 2 Diabetes: An Updated Systematic Review and Dose-Response Meta-analysis.Advances in nutrition (Bethesda, Md.) · 2025Pooled it
- Cardiometabolic trade-offs of carbohydrate- and fat-focused diets: a network meta-analysis of randomised clinical trials.European journal of nutrition · 2026Article
- Association of Dietary Animal and Plant Protein Composition with All-Cause Mortality: 24-Year Population-Based Cohort Study.Nutrients · 2026Article
- A nutrient-wide analysis of the associations of dietary nutrients with all-cause and disease-specific mortality.BMC public health · 2026Article
- Synergistic Effects of a Pro-Inflammatory-High-Fat Composite Dietary Pattern on Gut-Liver Injury and the Therapeutic Potential ofNutrients · 2026Article
- Isocaloric substitution with beef and mutton and metabolically unhealthy obesity among adults in Ordos, Inner Mongolia: a cross-sectional analysis.Frontiers in nutrition · 2026Article
- Optimal Intake of Animal-Source Foods: A Scoping Review to Inform a New WHO Guideline.Advances in nutrition (Bethesda, Md.) · 2025Article
- Current Evidence on Optimal Intake of Animal-Source Foods and Health Status.Advances in nutrition (Bethesda, Md.) · 2025Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Suboptimal diet quality is a key risk factor for premature death. Assuming relatively stable energy intake among individuals, changes in nutrient intakes occur by exchanging different nutrients. Therefore we aimed to examine the association of isocaloric substitution of dietary (macro)nutrients with all-cause mortality using network meta-analysis (NMA). Methods: For this systematic review and NMA of prospective observational studies MEDLINE, Embase, and Scopus were searched from inception to February 13th, 2024. Eligible studies reported substitution analyses for quantity and/or quality of macronutrients, including carbohydrates, proteins, and fatty acids on all-cause mortality. Random-effects NMA were used in order to evaluate the pooled hazard ratios (HR) and 95% confidence intervals (CI) of substituting each included nutrient with another. We assessed risk of bias with the ROBINS-E tool, and the certainty of evidence (CoE) using the Grading of Recommendations Assessment, Development and Evaluations (GRADE) approach. This study is registered with PROSPERO (CRD42023450706). Findings: Thirty-nine studies with 1,737,644 participants, 395,491 deaths, 297 direct comparisons, and seven nutrient-specific networks were included. Moderate CoE was found for an association with lower mortality risk when replacing 5% of energy intake from carbohydrates with polyunsaturated fatty acids (PUFA; HR: 0.90; 95%CI: 0.84, 0.95), n-6 PUFA (0.85; 0.77, 0.94), n-3 PUFA (0.72; 0.59, 0.86), and plant monounsaturated fatty acids (MUFA; 0.90; 0.85, 0.95), and when replacing 5% of energy from saturated fatty acids (SFA) and trans-fatty acids (TFA), with PUFA, MUFA, and plant-MUFA (HR Interpretation: Our results provide practical knowledge for public health professionals and can inform upcoming dietary guidelines. The beneficial association of increasing PUFA (both n-3 and n-6) and (plant-) MUFA intake while reducing carbohydrates, SFA and TFA, along with replacing animal protein and animal-MUFA with plant-based sources of protein and fat (MUFA) on the all-cause mortality risk, underscores the importance of plant-based dietary recommendations. Funding: None.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.