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INTRODUCTION: The Food Frequency Questionnaire is one of the most widely used tools for estimating nutritional intake in epidemiological studies. No study has been systematically performed to comprehensively explore Food Frequency Questionnaires designed, developed and validated specifically for the diabetic population (FFQs-DDV-DiaP). Therefore, a systematic review and meta-analysis will be carried out in order to identify and describe FFQs-DDV-DiaP; to examine their design, development, validity and reproducibility; as well as to estimate the overall degree of correlation and agreement; and to evaluate the factors that affect them. METHODS AND ANALYSIS: A systematic literature review will be performed in PubMed/MEDLINE, Scopus and Web of Science to find potentially relevant studies. Original studies related to the design, development, as well as the assessment of the validity and reproducibility of FFQs-DDV-DiaP; reported in English or Romance languages will be selected. Independent reviewers will select studies, extract relevant data and assess FFQs-DDV-DiaP quality. Data will be pooled using the generic inverse-variance method with random-effects models and expressed as correlation coefficients or mean differences with 95% CIs to examine the global validity and reproducibility of FFQs-DDV-DiaP. Heterogeneity will be evaluated by the Cochran Q-statistic and quantified by the I2 statistic. Stratified analyses and random-effects meta-regressions will be performed to explore heterogeneity and whether any covariate influences the effect sizes. Finally, publication bias will be assessed through the Begg's and Egger's tests. ETHICS AND DISSEMINATION: This systematic review and meta-analysis will not use confidential personal data. Therefore, the requirement of ethical approval or informed consent is not necessary. The results of this review will be disseminated only in peer-reviewed publications or at relevant scientific conferences. PROSPERO REGISTRATION NUMBER: CRD42021268575.

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Zinc could have a protective role against type 2 diabetes mellitus (T2DM). This systematic review and meta-analysis aimed to evaluate the association between dietary, supplementary, and total zinc intake, as well as serum/plasma and whole blood zinc concentration, and risk of T2DM. Observational studies, conducted on cases of incident diabetes or T2DM patients and healthy subjects that reported a measure of association between zinc exposure and T2DM, were selected. Random effects meta-analyses were applied to obtain combined results. Stratified meta-analyses and meta-regressions were executed to assess sources of heterogeneity, as well as the impact of covariates on the findings. From 12,136 publications, 16 studies were selected. The odds ratio (OR) for T2DM comparing the highest versus lowest zinc intake from diet was 0.87 (95% CI: 0.78-0.98). Nevertheless, no association between supplementary or total zinc intake from both diet and supplementation, and T2DM was observed. A direct relationship was found between serum/plasma zinc levels and T2DM (OR = 1.64, 95% CI: 1.25-2.14). A moderately high dietary zinc intake, in relation to the Dietary Reference Intake, could reduce by 13% the risk of T2DM, and up to 41% in rural areas. Conversely, elevated serum/plasma zinc concentration was associated with an increased risk of T2DM by 64%, suggesting disturbances in zinc homeostasis.

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INTRODUCTION: Cardiometabolic risk factors contribute to increase the incidence of some of the most widespread noncommunicable diseases today. The propensity to present an elevated cardiometabolic risk appears to especially affect non-Caucasians ethnic groups, such as the Native American Mapuche population. In addition, urbanization process has also a great impact on lifestyle and cardiometabolic profile. Therefore, a systematic review and meta-analysis will be conducted to summarize the relevant evidence regarding lifestyle and cardiometabolic profile in Mapuche population, and to assess the role of the ethnicity and the urbanization process on the lifestyle and cardiometabolic profile in Mapuche people with respect to European descendants. METHODS: A comprehensive search until 2019 will be performed using PubMed/MEDLINE, SciELO, Web of Science and Scopus. Observational studies, carried out in general population of Mapuche ethnicity living in rural and urban areas, with data of lifestyle and/or cardiometabolic profile, will be selected. A qualitative summary, as well as meta-analyzes when possible, will be done to present the information. Random effects meta-analyzes will be performed using the generic inverse variance method. Pooled effect size will be expressed as mean difference with 95% confidence intervals. Heterogeneity will be assessed using the Cochran Q-statistic and the I statistic. Stratified analyzes, meta-regressions, and sensitivity analyzes will be performed to evaluate potential sources of heterogeneity. In addition, random effects meta-regressions and stratified analyzes will also be used to examine the impact of covariates on the effect size estimated. Publication bias will be investigated using Egger and Begg test, and risk of bias will be assessed using the Research Triangle Institute Item Bank (RTI-IB). Finally, the quality of evidence will be evaluated through the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines. RESULTS: The results of meta-analyzes will provide important information about differences in lifestyle and cardiometabolic profile between Mapuche people and European descendants, as well as between Mapuche people living in urban and rural areas. CONCLUSION: This systematic review and meta-analysis will be helpful to obtain a more reliable understanding of lifestyle and cardiometabolic profile in Mapuche population compared to European descendants, and the impact of the transition from rural to urban areas in this ethnic group.

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