de Lorgeril Michel, Salen Patricia
Laboratoire Nutrition, Vieillissement et Maladies Cardiovasculaires (NVMCV), Université Joseph Fourier, Grenoble, France.
Public Health Nutr. 2006 Feb;9(1A):118-23. doi: 10.1079/phn2005933.
To discuss present knowledge about Mediterranean diet and cardiovascular diseases.
Review of existing literature.
Epidemiological studies as well as randomised dietary trials suggest that Mediterranean diet may be important in relation to the pathogenesis (and prevention) of CHD. For instance, a striking protective effect of an ALA-rich Mediterranean diet was reported in the Lyon Diet Heart Study with a 50 to 70% reduction of the risk of recurrence after 4 years of follow-up in CHD patients. According to our current knowledge, dietary ALA should represent about 0.6 to 1% of total daily energy or about 2 g per day in patients following a Mediterranean diet, whereas the average intake in linoleic acid should not exceed 7 g per day. Supplementation with very-long-chain omega-3 fatty acids (about 1 g per day) in patients following a Mediterranean type of diet was shown to decrease the risk of cardiac death by 30% and of sudden cardiac death by 45% in the GISSI trial.
In the context of a diet rich in oleic acid, poor in saturated fats and low in omega-6 fatty acids (a dietary pattern characterising the traditional Mediterranean diet), even small doses of omega-3 fatty acids (about 1 g EPA+DHA the form of fish oil capsules or 2 g alpha-linolenic acid in canola oil and margarine) might be very protective. These data underline the importance of the accompanying diet in any dietary strategy using fatty acid complements.
探讨目前关于地中海饮食与心血管疾病的知识。
对现有文献的综述。
流行病学研究以及随机饮食试验表明，地中海饮食可能对冠心病的发病机制（及预防）具有重要意义。例如，在里昂饮食心脏研究中报告了富含α-亚麻酸的地中海饮食具有显著的保护作用，冠心病患者在随访4年后复发风险降低了50%至70%。根据我们目前的知识，遵循地中海饮食的患者，膳食中的α-亚麻酸应占每日总能量的约0.6%至1%，即每天约2克，而亚油酸的平均摄入量不应超过每天7克。在GISSI试验中，遵循地中海式饮食的患者补充极长链ω-3脂肪酸（约每天1克）可使心脏性死亡风险降低30%，心脏性猝死风险降低45%。
在富含油酸、饱和脂肪含量低且ω-6脂肪酸含量低（传统地中海饮食的特征性饮食模式）的饮食背景下，即使是小剂量的ω-3脂肪酸（以鱼油胶囊形式摄入约1克二十碳五烯酸+二十二碳六烯酸或在菜籽油和人造黄油中摄入2克α-亚麻酸）也可能具有很强的保护作用。这些数据强调了在任何使用脂肪酸补充剂的饮食策略中，搭配饮食的重要性。
