Umbrella review data of colour-associated bioactive pigments found in fruit and vegetables, compared to placebo or low intakes, on human health outcomes relevant to public health

This dataset comprises data extracted from 86 publications included in an umbrella review which compared the effect of colour-associated bioactive pigments found in fruit and vegetables (carotenoids, flavonoids, betalains and chlorophyll) on human health outcomes relevant to public health.  Meta-analysed data from 83 systematic literature reviews were available for 17 different bioactive pigments spanning all colours of fruit and vegetables except green, with additional data from two randomised controlled trials and one cohort study for chlorophyll. This dataset represents 2,847 original research studies and data from over 37 million participants. There were 449 meta-analysed health outcomes extracted from the 83 systematic literature reviews. Extracted health outcomes were categorised according to pigment, comparator type, broad health outcome, study design, age group, source of pigment, risk of bias, and confidence in the estimated effect.  Data extracted were dose, intervention duration, sample size, number of original studies, effect estimate, 95% confidence intervals, I2 statistics, publication bias and p-value. Rigorous analysis, including estimations of a common effect size, stratification of the evidence, study level sensitivity analyses and reporting on heterogeneity and potential biases, may be carried out using these data, to further evaluate the effect of colour-associated bioactive pigments in fruit and vegetables on human health.

Methods
A systematic search strategy was implemented across four electronic databases on the 29th October 2021 [1]. The search aimed to identify systematic literature reviews of randomised controlled trials or cohort studies with meta-analyses which compared the effect of colour-associated bioactive pigments found in fruit and vegetables, compared to placebo or low intakes, on human health outcomes relevant to population health. Studies were required to report: (i) colour pigments consumed by humans through whole fruit or vegetables, extract or supplements derived from fruit or vegetables, and (ii) health-related outcomes relevant to population health including the prevention of disease and optimisation of disease risk factors, general wellbeing, function (cognitive function, physical function and exercise performance), growth and development in children, maternal and neonatal health. All identified records were screened for eligibility by two independent researchers. Studies which were considered eligible underwent data extraction by one researcher and checked for accuracy twice by a second investigator.  Study, participant and outcome data were extracted, including bioactive pigment name/colour, intervention and comparator conditions (type, duration and dose), number of meta-analysed studies/intervention groups, model, meta-analysed outcome, sample size (intervention/case, comparator/control, and total), effect size and statistical significance, risk of bias, heterogeneity, publication bias and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) quality rating (if reported) [2]. During data extraction, included studies were assessed for methodological quality using the Oxford University, Centre for Evidence-Based Medicine (CEBM) critical appraisal tool for systematic reviews, RCTs or prognostic studies [3].

Meta-analysed data from 83 systematic literature reviews was available for 17 different bioactive pigments spanning all colours of fruit and vegetables except green (i.e., chlorophyll), with additional data from two single randomised controlled trials and one cohort study available for chlorophyll. No data were found for betalains or its sub-classes; however, the betalains colours of red, violet, orange and yellow are represented by the included carotenoids and flavonoids. The 83 included systematic literature reviews measured and reported on 449 eligible meta-analysed health outcomes. Extracted health outcomes were grouped as cancer (reported by 192 meta-analyses), cardiovascular disease (135 meta-analyses), exercise (28 meta-analyses), mortality (27 meta-analyses), type 2 diabetes (24 meta-analyses), obesity (13 meta-analyses), bone health (9 meta-analyses), eye health (9 meta-analyses), the nervous system (5 meta-analyses), pregnancy health (4 meta-analyses), cognitive function (2 meta-analyses) and the respiratory system (1 meta-analysis).  Each single randomised controlled trial and cohort study for chlorophyll examined a unique health outcome: cancer (1 cohort study), cardiovascular disease (1 randomised controlled trial) and allergy (1 randomised controlled trial).

本数据集提取自一项伞形综述（umbrella review）纳入的86篇文献，该综述对比了果蔬中含有的与颜色相关的生物活性色素（类胡萝卜素（carotenoids）、黄酮类（flavonoids）、甜菜红素类（betalains）及叶绿素（chlorophyll））对与公共卫生相关的人类健康结局的影响。针对除绿色外的果蔬所有颜色类别，共纳入17种不同的生物活性色素，可获取来自83篇系统综述（systematic literature review）的荟萃分析数据；针对叶绿素，额外补充了2项随机对照试验（randomised controlled trial, RCT）及1项队列研究（cohort study）的数据。本数据集共计涵盖2847项原创研究，涉及超过3700万名研究参与者。从上述83篇系统综述中共提取得到449项经荟萃分析的健康结局数据。所提取的健康结局数据将按照色素类别、对照类型、大类健康结局、研究设计、年龄组、色素来源、偏倚风险及效应估计的置信度进行分类。提取的数据包括干预剂量、干预时长、样本量、原创研究数量、效应估计值、95%置信区间（95% confidence interval）、I²统计量（I2 statistics）、发表偏倚（publication bias）及P值（p-value）。利用本数据集可开展严谨的分析工作，包括计算合并效应量、进行证据分层、开展研究层面的敏感性分析，以及报告异质性与潜在偏倚情况，从而进一步评估果蔬中与颜色相关的生物活性色素对人类健康的影响。

研究方法
本研究于2021年10月29日针对4个电子数据库构建并实施了系统检索策略[1]。本次检索旨在筛选包含荟萃分析的系统综述，此类综述对比了果蔬中与颜色相关的生物活性色素（相较于安慰剂或低摄入量）对与人群健康相关的人类健康结局的影响。纳入研究需满足以下报告要求：(1) 人类通过完整果蔬、果蔬提取物或果蔬补充剂摄入的颜色类色素；(2) 与人群健康相关的健康结局，包括疾病预防、疾病危险因素优化控制、总体健康状况、功能状态（认知功能、躯体功能及运动表现）、儿童生长发育、孕产妇与新生儿健康。所有检出文献均由2名独立研究者进行纳入资格筛查。经筛查符合纳入标准的研究，由1名研究者进行数据提取，并由第二名研究者对数据准确性进行两次复核。提取的内容包括研究、参与者及结局相关数据，具体涵盖生物活性色素名称/颜色、干预与对照条件（类型、时长及剂量）、经荟萃分析的研究/干预组数量、分析模型、荟萃分析结局、样本量（干预组/病例组、对照组及总样本量）、效应量与统计学显著性、偏倚风险、异质性、发表偏倚，以及推荐分级、评估、制定与评价（Grading of Recommendations Assessment, Development and Evaluation, GRADE）质量评级（若有报告）[2]。在数据提取阶段，采用牛津大学循证医学中心（Centre for Evidence-Based Medicine, CEBM）针对系统综述、随机对照试验或预后研究的关键评价工具[3]，对纳入研究的方法学质量进行评估。

针对除绿色（即叶绿素）外的果蔬所有颜色类别，共纳入17种不同的生物活性色素，可获取来自83篇系统综述的荟萃分析数据；针对叶绿素，额外补充了2项单项随机对照试验及1项队列研究的数据。未检索到甜菜红素类及其亚类的相关数据，但甜菜红素类对应的红、紫、橙、黄颜色类别可由本研究纳入的类胡萝卜素与黄酮类色素代表。本次纳入的83篇系统综述共评估并报告了449项符合标准的经荟萃分析的健康结局。所提取的健康结局可归类为：癌症（192项荟萃分析报告）、心血管疾病（135项荟萃分析报告）、运动相关（28项荟萃分析报告）、死亡率（27项荟萃分析报告）、2型糖尿病（24项荟萃分析报告）、肥胖（13项荟萃分析报告）、骨骼健康（9项荟萃分析报告）、眼部健康（9项荟萃分析报告）、神经系统（5项荟萃分析报告）、妊娠健康（4项荟萃分析报告）、认知功能（2项荟萃分析报告）及呼吸系统（1项荟萃分析报告）。每项针对叶绿素的单项随机对照试验及队列研究均聚焦于单一健康结局：癌症（1项队列研究）、心血管疾病（1项随机对照试验）及过敏（1项随机对照试验）。