BMJ:饮食模式对肥胖人群体重降低和心血管风险因素的影响

2020-04-04 MedSci原创 MedSci原创

多数健康饮食模式均可在6个月的时间内,适度改善肥胖人群体重和心血管危险因素,但12个月时效果则不显著

近日研究人员考察了膳食营养模式对超重或肥胖成年人体重减轻和心血管危险因素改善的效果。
 
本次研究为系统综述及荟萃分析,收集截至2018年9月的相关资料,涉及超重(体重指数25-29)或肥胖(体重指数≥30)的成年人(年龄≥18岁)改变饮食模式的效果研究。研究的主要终点为6、12个月时,参与者体重、低密度脂蛋白(LDL)胆固醇、高密度脂蛋白(HDL)胆固醇、收缩压、舒张压、C反应蛋白变化。
 
121个符合条件的试验,总计21942名患者,考察了14种大众流行饮食法和3种对照干预饮食。与普通饮食相比,低碳水化合物和低脂肪饮食在6个月时对体重减轻(-4.63 vs -4.37 kg,,证据等级中度)和收缩压(-5.14 mm Hg vs -5.05 mm Hg,证据等级低)和舒张压(-3.21 vs -2.85 mm Hg,证据等级低)有效。适度的大量营养饮食导致体重减轻和血压降低。低碳水化合物(-1.01mg/dl,证据等级低)饮食对降低低密度脂蛋白胆固醇的作用小于低脂肪饮食(-7.08mg/dl,证据等级中度)和中等大量营养饮食(-5.22mg/dl,证据等级中度),但低碳水化合物饮食可增加高密度脂蛋白胆固醇水平(2.31 mg/dL,证据等级低),而低脂肪(-1.88 mg/dL,增加等级中度)和中等大量营养素(-0.89 mg/dL,增加等级中度)饮食模式则对高密度脂蛋白胆固醇无显著影响。在大众流行饮食中,那些与常规饮食相比, 6个月时对减肥和血压的影响最大的是Atkins(体重:-5.5公斤,收缩压-5.1毫米汞柱,舒张压-3.3毫米汞柱)、DASH(分别为-3.6公斤、-4.7毫米汞柱、-2.9毫米汞柱)和Zone(分别为-4.1公斤、-3.5毫米汞柱、-2.3毫米汞柱)。在6个月内,没有任何饮食能显著改善HDL胆固醇或C反应蛋白的水平。总的来说,在12个月时,所有饮食模式对体重减轻均有改善,而除地中海饮食外,所有干预措施对心血管危险因素的益处基本消失。
 
研究发现,多数健康饮食模式均可在6个月的时间内,适度改善肥胖人群体重和心血管危险因素,但12个月时效果则不显著。
 
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    2021-02-15 gaoxiaoe
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    2020-12-23 xjy13
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