Shah Meena, Adams-Huet Beverley, Kavanaugh Arthur, Coyle Yvonne, Lipsky Peter
Division of Rheumatic Diseases, Department of Internal Medicine, University of Texas at Southwestern Medical Center, Dallas, Texas, USA.
J Rheumatol. 2004 Jan;31(1):71-5.
To evaluate the effect of a culturally sensitive cholesterol lowering dietary program on energy, protein, fiber, vitamin and mineral intake, diet quality, and hemoglobin levels in patients with systemic lupus erythematosus (SLE).
Seventeen patients with SLE were randomized to a Step II diet intervention group or a control group for 12 weeks. The diet intervention was made up of weekly group sessions during the first 6 weeks followed by telephone counseling every 2 weeks for the last 6 weeks. Food intake was assessed by 3-day food record at baseline, 6, and 12 weeks. Diet quality was assessed by expressing the nutrients as a percentage of the Dietary Reference Intakes of the US National Academy of Sciences, or as a percentage of the nutrient guidelines by the National Cholesterol Education Program, Adult Treatment Panel III. Between- and within-group changes in nutrient intakes were assessed by repeated measures ANOVA.
The changes in nutrient intakes were not significantly different between the groups for any of the nonfat nutrients except vitamin B12 (p = 0.05), which decreased in the diet group and increased in the control group. Within-group analysis showed a significant reduction (p = 0.0003 to 0.02) in the diet group in energy and sodium intake at 6 and 12 weeks and B12 intake at 12 weeks compared to the respective baseline values (28-32%, 37-41%, and 43%, respectively). Sodium intake decreased to 66-71% of the total sodium allowance (< 2400 mg per day) in the diet group. The intervention was successful in maintaining adequate intakes or even increasing intakes of most nutrients except B12, dietary fiber, folate, calcium, and iron, which were slightly higher or below 67% of the Dietary Reference Intakes or other dietary guidelines. Anemia, as assessed by hemoglobin levels, was present throughout the study and did not correlate with iron intake.
This culturally sensitive cholesterol reducing diet program was successful in decreasing sodium intake and maintaining adequate intakes of most nutrients except B12, dietary fiber, iron, calcium, and folate. Future intervention studies in patients with SLE need to pay special attention to these nutrients and the presence of anemia.
评估一项具有文化敏感性的降胆固醇饮食方案对系统性红斑狼疮（SLE）患者的能量、蛋白质、纤维、维生素和矿物质摄入量、饮食质量及血红蛋白水平的影响。
17例SLE患者被随机分为II期饮食干预组或对照组，为期12周。饮食干预在前6周包括每周一次的小组会议，后6周每2周进行一次电话咨询。在基线、第6周和第12周通过3天食物记录评估食物摄入量。饮食质量通过将营养素表示为美国国家科学院膳食参考摄入量的百分比，或国家胆固醇教育计划成人治疗小组III营养指南的百分比来评估。通过重复测量方差分析评估组间和组内营养素摄入量的变化。
除维生素B12外（p = 0.05），各非脂肪营养素组间摄入量变化无显著差异，维生素B12在饮食组中减少而在对照组中增加。组内分析显示，与各自基线值相比，饮食组在第6周和第12周的能量和钠摄入量以及第12周的维生素B12摄入量显著降低（p = 0.0003至0.02）（分别为28 - 32%、37 - 41%和43%）。饮食组的钠摄入量降至总钠摄入量（<2400毫克/天）的66 - 71%。该干预成功维持了除维生素B12、膳食纤维、叶酸、钙和铁之外的大多数营养素的充足摄入量，甚至增加了摄入量，这些营养素略高于或低于膳食参考摄入量或其他饮食指南的67%。通过血红蛋白水平评估的贫血在整个研究过程中都存在，且与铁摄入量无关。
这项具有文化敏感性的降胆固醇饮食方案成功降低了钠摄入量，并维持了除维生素B12、膳食纤维、铁、钙和叶酸之外的大多数营养素的充足摄入量。未来针对SLE患者的干预研究需要特别关注这些营养素以及贫血的存在。
