Davidson M H, Hunninghake D, Maki K C, Kwiterovich P O, Kafonek S
Chicago Center for Clinical Research, IL 60610, USA.
Arch Intern Med. 1999 Jun 28;159(12):1331-8. doi: 10.1001/archinte.159.12.1331.
Patients with hypercholesterolemia are often counseled to limit or eliminate intake of red meats, despite evidence that lean red meats (LRMs) are not hypercholesterolemic in comparison with lean white meats (LWMs). The objective of this study was to evaluate the long-term effects on serum lipids of incorporating LRM (beef, veal, and pork) vs LWM (poultry and fish) into a National Cholesterol Education Program (NCEP) Step I diet in free-living individuals with hypercholesterolemia.
Subjects included 191 men and women with a serum low-density lipoprotein cholesterol level of 3.37 to 4.92 mmol/L (130-190 mg/dL) and triglyceride level less than 3.96 mmol/L (350 mg/dL). After a 4-week baseline phase, subjects were counseled to follow an NCEP Step I diet including 170 g (6 oz) of lean meat per day, 5 to 7 days per week. Based on random assignment, subjects were instructed to consume at least 80% of their meat in the form of LRM or LWM. Fasting serum lipid levels were assessed 4, 12, 20, 28, and 36 weeks after randomization.
After randomization, mean concentrations of total cholesterol (6.09 mmol/L [235.7 mg/dL] vs 6.08 mmol/L [235.2 mg/dL]) and low-density lipoprotein cholesterol (3.99 mmol/L [154.1 mg/dL] vs4.01 mmol/L [154.7 mg/dL]) were nearly identical in the LRM and LWM groups (1%-3% below baseline) during treatment. Mean triglyceride levels remained similar to baseline values and high-density lipoprotein cholesterol concentrations increased by approximately 2% in both groups.
The NCEP Step I diets containing primarily LRM or LWM produced similar reductions in low-density lipoprotein cholesterol and elevations in high-density lipoprotein cholesterol levels, which were maintained throughout 36 weeks of treatment.
尽管有证据表明,与瘦白肉(LWM)相比,瘦红肉(LRM)不会导致高胆固醇血症,但高胆固醇血症患者常被建议限制或避免摄入红肉。本研究的目的是评估在患有高胆固醇血症的自由生活个体中,将LRM(牛肉、小牛肉和猪肉)与LWM(家禽和鱼类)纳入国家胆固醇教育计划(NCEP)第一步饮食对血脂的长期影响。
研究对象包括191名男性和女性,其血清低密度脂蛋白胆固醇水平为3.37至4.92 mmol/L(130 - 190 mg/dL),甘油三酯水平低于3.96 mmol/L(350 mg/dL)。在为期4周的基线期后,建议受试者遵循NCEP第一步饮食,每周5至7天,每天摄入170克(6盎司)瘦肉。根据随机分配,受试者被指示至少80%的肉类摄入为LRM或LWM。在随机分组后的第4、12、20、28和36周评估空腹血脂水平。
随机分组后,在治疗期间,LRM组和LWM组的总胆固醇平均浓度(6.09 mmol/L [235.7 mg/dL] 对 6.08 mmol/L [235.2 mg/dL])和低密度脂蛋白胆固醇平均浓度(3.99 mmol/L [154.1 mg/dL] 对 4.01 mmol/L [154.7 mg/dL])几乎相同(比基线低1% - 3%)。两组的平均甘油三酯水平与基线值相似,高密度脂蛋白胆固醇浓度均升高约2%。
主要包含LRM或LWM的NCEP第一步饮食在降低低密度脂蛋白胆固醇和升高高密度脂蛋白胆固醇水平方面产生了相似的效果,且在36周的治疗过程中一直保持。