JAHA:中山大学研究称:少吃主食可增加房颤风险

2019-08-09 岱西 中国循环杂志

少吃点主食等碳水化合物,是减肥人士流行的做法,殊不知长期这样减肥已埋下危及健康甚至生命的种子。

少吃点主食等碳水化合物,是减肥人士流行的做法,殊不知长期这样减肥已埋下危及健康甚至生命的种子。

近日中山大学附属第一医院庄晓东等对近14000人随访20余年的研究显示,主食、谷类以及水果等碳水化合物吃得少,会增加房颤发生风险。

房颤不仅仅让人感觉心悸、头晕,最糟糕的是会增加5倍的脑卒中风险。

这项研究中,碳水化合物吃得少不少,是根据每日供能占比计算的,其中少指的是每日供能占比低于44.8%,中等摄入指每日供能占比在44.8%~52.4%,吃得多为每日供能占比高于52.4%。

研究显示,碳水化合物吃得少的人,要比中等摄入者增加18%的房颤风险,比吃得多的人增加16%的风险。

研究还发现,不管用哪种蛋白或脂肪替代了少吃的碳水化合物,碳水化合物吃得少还是会增加房颤的发生风险。

为什么主食等碳水化合物吃得少,会增加得房颤的风险?庄晓东等认为原因有二:

一是低碳水化合物饮食者,蔬菜、水果和谷物吃得少,而这些食物具有减轻炎症的作用,而不吃或少吃无形中没有了这种“消炎”作用,使得房颤风险增加;

二是碳水化合物吃得少了,蛋白脂肪就相对吃得多了,而这类食物或会导致氧化应激,从而也增加了房颤风险。

“少吃碳水化合物的远期影响尚有争议,尤其是对心血管病的影响,我们的研究则提示,考虑到对心律失常的影响,靠少吃碳水化合物来减肥这种做法还是谨慎行之。”庄晓东指出。

庄晓东也指出,要想明确低碳水化合物饮食与房颤的因果关系,还需进一步随机对照研究来证实。

少吃主食等碳水化合物的危害,已有很多研究了,比如之前对ARIC研究1.5万人追踪25年的分析结果就表明,吃太少或吃太多主食等碳水化合物,都是不恰当的,都会让人减寿,而不多不少“正好”死亡风险最低。


注:以饮食中碳水化合物供能50%为参考水平;校正了年龄、性别、种族、总能力摄入、糖尿病、饮酒、吸烟、体力活动、收入水平和受教育程度

图1 ARIC队列研究饮食中碳水化合物供能占比(%)与全因死亡呈“U”曲线关系

这里的正好是指碳水化合物供能占比在50%~55%之间;“吃太多”是指占比>70%;“太少”指占比< 40%。

而我国膳食指南也建议,碳水化合物占每日供能的50%~65%。

庄晓东等进行的研究,数据也来自ARIC研究,其中纳入的13385例受试者基线时并无房颤,在中位随访22.4年期间,有1808人得了房颤。研究者对受试者进行了包括66种食物的膳食调查,同时评估了碳水化合物在每日供能的占比。碳水化合物每日供能平均占比约50%。

原始出处:Zhang S1,2, Zhuang X1,2, Lin X3, et al. Low-Carbohydrate Diets and Risk of Incident Atrial Fibrillation: A Prospective Cohort Study. J Am Heart Assoc. 2019 May 7;

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    2019-08-11 zhaohui6731
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    2019-08-10 qingfengqishi5

    学习了,学习了

    0

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    2019-08-10 thm112988

    0

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