• Laura Chiavaroli, Kendall Cyril W C CWC Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada. , Catherine R Braunstein, Blanco Mejia Sonia S Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada. , Lawrence A Leiter, Jenkins David J A DJA Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada. , and John L Sievenpiper.
• Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.
• BMJ Open. 2018 Apr 2; 8 (3): e019438.

ObjectiveCarbohydrate staples such as pasta have been implicated in the obesity epidemic. It is unclear whether pasta contributes to weight gain or like other low-glycaemic index (GI) foods contributes to weight loss. We synthesised the evidence of the effect of pasta on measures of adiposity.DesignSystematic review and meta-analysis using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.Data SourcesMEDLINE, Embase, CINAHL and the Cochrane Library were searched through 7 February 2017.Eligibility Criteria For Selecting StudiesWe included randomised controlled trials ≥3 weeks assessing the effect of pasta alone or in the context of low-GI dietary patterns on measures of global (body weight, body mass index (BMI), body fat) and regional (waist circumference (WC), waist-to-hip ratio (WHR), sagittal abdominal diameter (SAD)) adiposity in adults.Data Extraction And SynthesisTwo independent reviewers extracted data and assessed risk of bias. Data were pooled using the generic inverse-variance method and expressed as mean differences (MDs) with 95% CIs. Heterogeneity was assessed (Cochran Q statistic) and quantified (I2 statistic). GRADE assessed the certainty of the evidence.ResultsWe identified no trial comparisons of the effect of pasta alone and 32 trial comparisons (n=2448 participants) of the effect of pasta in the context of low-GI dietary patterns. Pasta in the context of low-GI dietary patterns significantly reduced body weight (MD=-0.63 kg; 95% CI -0.84 to -0.42 kg) and BMI (MD=-0.26 kg/m2; 95% CI -0.36 to -0.16 kg/m2) compared with higher-GI dietary patterns. There was no effect on other measures of adiposity. The certainty of the evidence was graded as moderate for body weight, BMI, WHR and SAD and low for WC and body fat.ConclusionsPasta in the context of low-GI dietary patterns does not adversely affect adiposity and even reduces body weight and BMI compared with higher-GI dietary patterns. Future trials should assess the effect of pasta in the context of other 'healthy' dietary patterns.Trial Registration NumberNCT02961088; Results.© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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