![]() The authors correctly advised that the results were not robust in view of the considerable influence of one RCT. A sensitivity analysis was carried out by reanalysing the data after excluding the largest RCT, which may have been more likely to detect a significant effect. It may have been more appropriate to limit the review to overweight populations who would be the target population for any weight-reducing intervention. Given the differences among the study populations (inclusion of athletes, students, healthy men and overweight patients), a meta-analysis may not have been appropriate. The data were combined in a meta-analysis and statistical heterogeneity was assessed. Some relevant information on the included studies was tabulated. Only double-blind RCTs were included and validity was assessed using established criteria. Two reviewers independently selected the studies, assessed validity and extracted the data this reduced the potential for bias and errors. Several relevant sources were searched, the search terms were stated, and attempts were made to locate unpublished studies. ![]() The inclusion criteria relating to the participants were not specified, and the participants in the included studies varied considerably. The review question was clear in terms of the study design, intervention and outcomes. None found any adverse effects with chromium picolinate. Three of the included RCTs assessed adverse effects. After excluding one RCT that accounted for 61% of the overall effect, the difference in percentage body fat between treatments was no longer statistically significant the WMD (262 patients) was 0.8% (95% CI: -1.7, 0.2). The meta-analysis showed that chromium picolinate significantly reduced the percentage body fat compared with placebo the WMD (416 patients) was 1.2% (95% CI: -1.7, -0.6). The meta-analysis showed no significant difference in lean body mass between chromium picolinate and placebo the WMD (416 patients) was 0.4 kg (95% CI: -0.1, 0.8). ![]() The sensitivity analyses suggested that the results were not robust: after excluding one RCT that accounted for 58% of the overall effect, the difference in weight change between chromium picolinate and placebo was no longer statistically significant WMD (335 patients) was 0.9 kg (95% CI: -2.0, 0.2). The funnel plot was asymmetrical, suggesting the possibility of publication bias. No significant statistical heterogeneity was found (P=1). The meta-analysis showed that chromium picolinate significantly reduced weight compared with placebo the WMD (489 patients) was 1.1 kg (95% CI: -1.8, -0.4). The validity scores ranged from 2 to 4 out of a maximum of 5 points. Only ten of these (601 patients randomised) provided sufficient data to be included in the meta-analyses. Seventeen RCTs (967 patients randomised) were included.
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